questions Flashcards
investigations for heavy menstrual bleeding
FBC
transvaginal ultrasound scan if symptoms suggest structural or histological abnormality
management of heavy menstrual bleeding for patients who do not require contraception
mefenamic acid or tranexamic acid started on first day of period
management of heavy menstrual bleeding in patients requiring contraception
IUS- mirena
COCP
long-acting progestogens
causes of delayed puberty with short stature
turner’s syndrome
prader- willi syndrome
noonan’s syndrome
causes of delayed puberty with normal stature
PCOS
androgen insensitivity
kallman’s syndrome
klinefelter’s syndrome
what is fibroid degeneration
growth of fibroids outstrips their blood supply and undergo degeneration
presents: low grade fever, pain and vomiting
managed conservatively
what is asherman’s syndrome
adhesions form within the uterus following damage
- after pregnancy related dilatation and curettage procedure
- myomectomy
Presentation of asherman’s syndrome
secondary amenorrhoea
significantly lighter periods
dysmenorrhoea
infertility
history of damage to uterus
diagnosis of intrauterine adhesions
hysteroscopy- gold standard
hysterosalpingography
what is cervical ectropion
larger area of columnar epithelium present on the ectocervix due to elevated oestrogen levels
presentation of cervical ectropion
vaginal discharge
post-coital bleeding
management of cervical ectropion
ablative treatment- only for troublesome symptoms
what is a nabothian cyst
fluid filled cysts often seen on the surface of the cervix
up to 1cm in size
harmless
risk factors for prolapse
increasing age
multiparity
obesity
spina bifida
presentation of prolapse
sensation of pressure, heaviness
urinary symptoms: incontinence, frequency, urgency
presentation of bartholin’s cyst
tender unilateral fluid filled cyst between 1-4 cm
becomes abscess with infected: tender, hot, red
presentation of ovarian cysts
unilateral dull ache which may be intermittent or only during intercourse
large cysts may cause abdominal swelling or pressure effects on bladder
what is sheehan’s syndrome
rare complication of post-partum haemorrhage where the drop in circulating blood volume leads to AVN of the pituitary gland
only affects the anterior pituitary gland
presentation of sheehan’s syndrome
reduced lactation
amenorrhoea
adrenal insufficiency and adrenal crisis
hypothyroidism
management of sheehan’s syndrome
oestrogen and progesterone as HRT until menopause
hydrocortisone for adrenal insufficiency
levothyroxine
growth hormone
what is endometrial hyperplasia
abnormal proliferation of endometrium in excess of normal proliferation that occurs during menstrual cycle
may develop endometrial cancer
features of endometrial hyperplasia
abnormal vaginal bleeding: intermenstrual
management of endometrial hyperplasia
simple endometrial hyperplasia: high dose progesterone with repeat sampling in 3-4 months, LNG-IUS
atypia: hysterectomy
what is endometrial hyperplasia associated with
taking oestrogen unopposed
obesity
late menopause
early menarche
aged 35 over
current smoker
nulliparity
tamoxifen
