Reproductive Flashcards
What drugs are used to treat endometriosis?
GnRH agonist.
What drugs are used to treat precocious puberty?
GnRH agonist.
How would you manage a patient with a menstrual disorder?
Pharmacological - gonadotropin, progesterone, COCP/HRT.
Surgical depending on condition.
How would you manage a patient with erectile dysfunction?
Viagra.
Therapy for psychological causes.
Surgery eg pump insertion.
How would you manage a couple as a GP struggling to get pregnant?
Male - advise stop smoking, reduce alcohol intake, reduce stress levels, healthy diet.
Female - advise stop smoking, reduce alcohol intake, reduce stress levels, loose weight, regular sexual intercourse.
Refer to fertility clinic if not conceived after 1 year. Early referral for women >36years or know cause of infertility/family history.
What fertility treatment can be recommended by a specialist clinic?
Medical - eg clomiphene, GnRH agonist/antagonist, and gonadotrophins.
Surgical - eg laparoscopy for ablation of endometriosis, and varicocele repair.
Assisted reproduction techniques - eg articulate insemination, and IVF.
What drugs would you give to reduce the risk of respiratory distress syndrome if pre-term delivery is unavoidable?
Glucocorticoid treatment of the mother.
How can labour be induced?
Membrane rupture (stimulated release of prostaglandins).
Artificial prostaglandins.
Synthetic oxytocin.
Anti-progesterone agents.
What drugs are used to treat Chlamydia trachomatis and rectal chlamydia?
1st line - doxycycline or azithromycin.
2nd line - erythromycin or ofloxacin.
Rectal chlamydia - doxycycline.
What drugs are used to treat Neisseria gonorrhoeae?
IM ceftriaxone plus oral azithromycin.
If allergic to penicillin give spectinomycin.
What drugs are used to treat syphilis (early, late and neuro)?
Early syphilis - benzathine penicillin G single dose IM.
Late latent, CVS or gummatous - Ben Pen G 3 doses.
Neurosyphilis - IM procaine penicillin plus probenecid for 14 days.
What drugs are used to treat herpes simplex viruses 1 and 2?
Aciclovir, valciclovir, or famciclovir.
Suppressive treatment for recurrent HSV.
What drug is used to treat trichomonas vaginalis?
Metronidazole.
What drug is used to treat scabies?
Permethrin.
What drug is used to treat pubic lice?
Malathion.
How would you manage a patient with anogenital warts?
No treatment as up to 70% spontaneously resolve within 1 year.
Topical application eg podophyllotoxin.
Physical ablation eg excision.
What drug is used to treat bacterial vaginosis?
Metronidazole.
What drugs are used to treat volvovaginal candidiasis?
Topical and oral azoles.
How would you manage a patient with pelvic inflammatory disease?
Antibiotics for 14 days (beware sepsis) - outpatient IM ceftriaxone, PO doxycycline, PO metronidazole. Inpatient (severe disease) give same IV, then discharge with PO doxycycline and PO metronidazole.
Surgical management - laparoscopy/laparotomy if no response to therapy, clinically severe disease or presence of tube-ovarian abscess.
Symptom management - analgesia and rest.
Contact tracing.
How would you manage a patient with pelvic organ prolapse?
Non-surgical - use of pessaries (ring, shelf and gelhorn).
Surgical - laparoscopic, vaginal or abdominal eg anterior repair, paravaginal repair etc.
How would you manage a patient with urinary incontinence?
Pelvic floor exercises.
Surgery eg sling operations, and culposuspension.
Bulking agents.
How would you manage a patient going through the menopause?
Non-hormonal treatments - dressing in light layers, avoid caffeine, alcohol, spicy foods, lifestyle changes eg increase exercise, reducing dietary fat intake. Antidepressants.
Hormonal - HRT in a pill , vaginally or transdermally.
How would you manage a patient with CIN?
CIN I - follow-up or cryotherapy.
CIN II and III - superficial excision (cone, large loop excision of the transformation zone).
How would you manage a patient with cervical carcinoma (invasive and microinvasive)?
Microinvasive - cervical cone excision.
Invasive - hysterectomy, lymph node dissection and if advanced chemotherapy and radiotherapy.
What are the two types of oral contraceptive pill?
COCP - oestrogen and progestin.
POP - progestin only.
What drug is used to induce ovulation?
Weak oestrogen which blocks receptors - clomiphene.
What drug is used to reduce the risk of breast cancer?
Weak oestrogen that clocks receptors - tamoxifen.
What drug is used for medical termination of pregnancy and induction of labour?
Anti-progestin - mifepristone.
What drug can be used to treat advanced prostate cancer?
Anti-androgen progesterone derivative - cyproterone.
What drug is used to reduce the risk of invasive breast cancer in post menopausal women with osteoporosis?
Selective oestrogen receptor modulators (SERMs) - raloxifene.
What are the treatment options for a male patient needing testosterone replacement therapy?
Implants - testosterone.
IM - enenthate, proprionate.
Oral - undecanoate, mesterolone.
What drug is used to prevent hair loss, male pattern baldness and benign prostatic hyperplasia in male patients?
Androgen replacement therapy - finasteride.
