Part 8 Flashcards
what is used to screen for ovarian cancer?
Ca125 (CEA ay also be done to rule out bowel cancer)
Most common ovarian cancer?
most common in under 25s?
Serous (from epithelium)
Teratoma
Tx of ovarian cancer
Surgical removal + chemo
What maintains acidic environment in normal vaginal flora?
If there is an imbalance it may lead to?
Lactobaccilus
Bacterial Vaginosis (fishy, clue cells, metronidazole)
Prostatis treatment?
May be secondary to UTI
MSSU, 1st pass urine + PCR
Ciprofloxacin
Can’t see can’t pee can’t bend the knee
Reiter’s syndrome
PID with RUQ pain
Fitz Hugh Curtis Syndrome
gonorrhea on microscope
and TX?
Gram - ve diplococci (2 kidney beans)
IM Ceftriaxone
treatment of syphillis?
IM penicillin
HSV that cause genital Herpes?
Cold sores?
HSV2
HSV1
green frothy discharge + strawberry cervix
Tx
trichomonas vaginalis
Metronidazole
Contact tracing period for chlamydia
4 weeks (male urethral) 6 months (endocervix, anal, oral)
Contact tracing gonorrhea
2 weeks (male urethral) 3 months (endocervix, anal, oral)
Contraindications to COCP/ring/patch
Prevents ovulation + may cause VTE, PE, Stroke etc
Breastfeeding, migraine with aura, PMH of breast cancer, VTE, smoking >15/day, BMI >35 (UKMEC 4)
relationship between COCP and cancer
protective against Ovarian + endometrial cancer
Increased risk of breast + cervical cancer
How is COCP taken
up to day 5 of cycle
after day 5 requires 7 days additional contraception
miss 2 take 7 days additional contraception
what is POP
Progesterone only pill
It’s shit, has to be taken same time very day
thickens cervical mucus (not the best contraceptive)
What emergency contraception options are there?
Oral levonelle- up to 72 hours post UPSI
Oral ella one- up to 120 hours post UPSI
Copper IUD- up to 120 hours post UPSI (toxic to egg and sperm)
ALWAYS do a pregnancy test at 3 weeks
How does depo provera work?
12 weekly injections
inhibits ovulation, thickens mucous, thins endometrium
Weight gain, osteoperosis
started up to day 5 (beyond requires 1 week of contraception)
how long is IUD used and when is it given?
5 years
within 7 days of cycle, up to 5 days post-UPSI, <48 hrs or >4 weeks postpartum, immediately post TOP
how long is IUS used and what are the benefits?
5 years
affects implantation as it thins endometrium
Lighter, less frequent periods
What is the best contraception?
Implant (3 years)
Inhibits ovulation
Extra info for post vasectomy?
Sperm live in tubes for 8 weeks- use additional contraception for at least 8 weeks!
Post vasectomy semen analysis is required to exclude failure!
If sperm count is really low, what is a better treatment than IUI? + it’s indications?
ICSI (intracytoplasmic sperm injection)
- Severe male factor infertility
- Previous failed fertilisation with IVF
- Preimplantation genetic diagnosis (checking the genes or chromosomes of your embryos for a specific genetic condition.)
Indications for IVF
- Unexplained infertility (> 2 years durations)
- Pelvic disease (endometriosis, tubal disease, fibroids)
- Anovulatory infertility (after failed ovulation induction)
- Failed Intra-uterine insemination (after 6 cycles)
Main complications of ACT
Ectopic pregnancy (risk higher in IVF), surgical risks of oocyte retrieval/sperm aspiration, failed fertilisation (4%), miscarriage, failed treatment
undescended testes, resulting in lowered sperm count and increased risk of testicular cancer.
cryptochordism
