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Blurting > Reproductive and Sexual Health > Flashcards

Reproductive and Sexual Health Flashcards

1
Q

Investigation to confirm menopause

A

LH and FSH

2 seperate occasions

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2
Q

Management Principles for menopause

A

Stress management
HRT
Manage menorrhagia

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3
Q

Delivery of HRT: cyclical progesterone

A

Oestrogen always
Progesterone last 14 days of cycle
IF still menstruating

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4
Q

Presentation of menopause (4)

A

Hot flushes
Oligomenorrhoea/Menorrhagia
Insomnia
Mood swings

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5
Q

What is adenomyosis

A

Endometrium in the myometrium

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6
Q

Presentation of adenomyosis (2)

A

Dysmenorrhoea

Menorrhagia

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7
Q

Causes of endometritis (4)

A

Neisseria
Chlamydia
TB
IUD

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8
Q

Association of chronic endometritis

A

PID

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9
Q

Presentation of endometritis

A

Abnormal bleeding

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10
Q

Management of endometritis/PID (2)

A

Analgesia - NSAIDs
Empirical antibiotics
- If IUD associated removal of IUD is encouraged

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11
Q

What is the growth stimulus for fibroids?

A

Oestrogen-dependent benign tumour

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12
Q

What is a polyp?

Association?

A

Endometrial overgrowth

Menopause

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13
Q

Presentation of polyp

A

Abnormal bleeding

Abnormal discharge

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14
Q

Types of epithelial ovarian tumours

A

Serous
Mucinous
Endometriod
Clear Cell

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15
Q

What is seen in serous ovarian tumours

A

Psammoma bodies

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16
Q

What is the origin of most cases of serous ovarian tumour?

A

Tubal

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17
Q

Association of mucinous ovarian tumour

A

Pseudomyxoma peritoni

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18
Q

Associations of endometriod and clear cell ovarian tumour

A

Endometriosis

Lynch Syndrome

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19
Q

Risk factors for ovarian tumour

A

Nulliparity

Increasing age

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20
Q

Types of sex cord and stromal tumours

A

Fibroma
Theca cell (sertoli and leydig cell tumours)
Granulosa cell

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21
Q

Types of germ cell tumour

A

Yolk sac
Teratoma
Choriocarcinoma
Dysgerminoma

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22
Q

Presentation of theca cell tumour

A

Increased production of androgens

= hirsutism

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23
Q

What is seen in granulosa cell tumours

A

Call-exner bodies

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24
Q

Hormonal feature of granulosa cell tumours

A

Production of oestrogen

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25
Q

Associations of fibroma

A

Meig’s syndrome

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26
Q

Requirement for something to be a teratoma

A

Must contain all three embryological layers

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27
Q

Ix findings in teratoma

A

May see calcifications on KUB

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28
Q

What is seen in yolk sac tumour

A

Schiller-duval bodies

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29
Q

Similar to dysgerminoma =

A

Testicular seminoma

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30
Q

Androgen Insensitivity Syndrome
Genotype and phenotype
Genetics

A

46XY but external genitalia NOT male

X-linked recessive disorder

31
Q

Pathophysiology of androgen insensitivity

A

Mullerian inhibition doesnt occur = female

Androgen induction of wolffian ducts doesnt occur = not male

32
Q

Presentation of androgen insensitivity

A

Primary amenorrhoea
Short vagina
Lack of pubic hair

33
Q

Causes of obstructive male infertility (3)

A

CF
Vasectomy
Infection

34
Q

Investigation in obstructive male infertility

A

Normal

LH, FSH, testosterone

35
Q

Presentation of obstructive male infertility

A

Normal 2y sexual characteristics

Absence of vas deferens

36
Q

Causes of non-obstructive male infertility (6)

A 
Mumps 
Iatrogenic
Klinefelters 
Kallmans 
Anorexia 
Tumours
37
Q

Presentation of non-obstructive male infertility

A

Reduced 2y sexual characteristics
Vas deferens present
Low testicular volume

38
Q

Ix of non-obstructive male infertility

A

High LH and FSH
Low testosterone
(In Kallmans = hypogonadotrophic hypogonadism - low LH and FSH)

39
Q

Risk factor for SSC of cervix

A

HPV (types 16 and 18)

40
Q

Risk factors for adenocarcinoma of cervix

A

Associated with higher SE

Smoking

41
Q

Presentation of SSC of cervix

A

Post-coital bleeding

42
Q

Staging of SSC of cervix

A

S1 - confined to the cervix
S2 - local spread
S3 - pelvic and lymphatic spread
S4 - distant spread

43
Q

Pathology of adenocarcinoma of cervix

A

Proliferation of glandular epithelium

44
Q

Where does CIN occur

A

Transformation zone of the cervix

45
Q

Associations with CIN

A

Usually as a result of HPV infection

Can lead to invasive SSC

46
Q

Presentation of chlamydia (4)

A

Discharge
Post-coital bleeding
Cervicitis
PID

47
Q

Management of syphillis

A

IM Benzylpenicillin

48
Q

Investigation pathway for syphillis

A

Dark brown microscopy
1. Combined IgM and IgG
+VE - do IgM ELISA
-VE - no further testing

49
Q

Presentation of syphillis

Early and later

A

Chancre

Papular rash

50
Q

Types of chlamydia that commonly cause infection

A

Serotypes D-K

51
Q

Investigation of chlamydia

A

First pass urine or high vaginal swab

Combined NAATs

52
Q

Pathophysiology of thromboembolic disease and pregnancy

A

Pregnancy is pro-thrombotic

Production of a large amount of clotting factors

53
Q

Management options of thromboembolic disease in pregnancy

A

Warfarin

Heparin

54
Q

Warfarin and pregnancy

A

Avoid weeks 6-12
Stop 6 weeks before the birth
Safe for breast feeding

55
Q

Heparin and pregnancy

A

Can be given as prophylaxis

Stop 24 hours before birth

56
Q

High risk of thromboembolic events prophylaxis

A

Give heparin for 6 weeks post-natally

57
Q

TOP limit

Scottish limit for procecdure

A

23 + 6 weeks

Only go up to 18 + 6 in scotland

58
Q

HSA1

A

Used for TOP
Requires 2 doctors to be in agreement
Usually done under section C

59
Q

HSA2

A

Used for TOP

Emergency situation - cannot object

60
Q

Limits for types of TOP

A

Medical - 18+6

Surgical 12

61
Q

Classification of medical TOP

A

Early - up to 9 weeks

Late - 9-12 weeks

62
Q

Type of surgical TOP

A

Vacuum - 6-12 weeks
Manual vacuum - up to 9 weeks
Surgical evacuation - 13-24 weeks NOT in Scotland

63
Q

Medical termination regime

A

Oral mifepristone 200mg

24-48 hours later vaginal or oral prostaglandin

64
Q

Prophylaxis given in termination

A

Metronidazole

65
Q

Types of Monozygous twins

A

MCDA
MCMA
Conjoined

66
Q

Types of dizygous twins

A

DCDA

67
Q

What type of twin pregnancy is the highest risk?

A

Monozygous

68
Q

Split of DCDA twins

A

Day 1-3

69
Q

Split of MCDA

A

Day 4-8

70
Q

Split of MCMA

A

Day 8-13

71
Q

Conjoined twins split

A

Day 15+

72
Q

Presentation of twin pregnancy

A

Exaggerated symptoms
Large for dates
Multiple foetal poles

73
Q

Delivery for DCDA twins

A

37-38 weeks

74
Q

Delivery for MCDA

A

36 weeks

Blurting (6 decks)

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