Textbook notes Flashcards
Heavy menstrual bleeding
- what it is
- investigations 4
Menorrhagia-
think rage -> interferes with personal life.
- check Hb
- check coagulation and thyroid function
- transvaginal ultrasound
- endometrial biopsy
Intermenstrual bleeding
- causes 2
- investigations 3
- treatment 3
- anovulatory phase (either really young or near menopause)
- pevlic problems - polyps and adenomyosis, ovarian cysts
investigations:
- assess effect of loss of blood
- check Hb
- exclude malignancy
treatment:
IUS
COCP
surgery to remove polyps
what is primary and secondary ammenhorrea
primary: never had it by 16
secondary: when normal periods stop for 3 months or more
causes of physiological amenorrhoea -3
- pregnancy
- menopause
- lactation
causes of pathological amenorrhea - 5
- congenital (turners)
- Hypothalamus (decreased GnRH)
- Pituitary - hyperplasia making lactation
- Adrenal/thyroid -
- PCOS
post coital bleeding
- investigations - 2
- treatment - 2
investiatigations:
cervix examaintations
smear test
treatment:
progesterone IUS
Pill and NSAIDs
what is adenomyosis
- symptoms 4
- investigations 2
- treatment 2
when endometrium is in the myometrium symptoms: -none -pain -regular, heavy periods -large, tender uterus
investigations:
- ultrasound
- MRI
treatment:
- progesterone IUS
- pill and NSAIDS
fibroids
- what are they dependent on?
- symptoms 3
- complications 2
- investigations 1
- treatment 5
- benign tumours in myometrium
- depend on O and P
- symptoms
none
painful, heavy periods
dysuria
-complications
can grow, calcify, malignant
- investigations
ultrasound
- treatment tranexamic acid NSAID progesterones GnRH surgical
endometriosis
what is it dependent on?
- symptoms 4
- investigations 4
- treatment 6
dependent on oestrogen
can be 2nd to STI
- symptoms inflammation tender pelvis systemic infections none
- investigations ca125 serum levels transvaginal ultrasound MRI laproscopy biopsy
- treatment if no symptoms -> don't treat AB if infection NSAID combined pill POP GnRH surgical
intrauterine polyps
- what
- who
- symptoms 3
- investigations 1
- treatment 1
what:
small, benign tumours, when OE is high
who:
40-50
tamoxifen
- symptoms
nonr
menorrhagia
intermenstrual bleeding - investigations
ultrasound - treatment
re-section polyp
Endometrial cancer
2 types and features of both
RF - 5
1 = majority = OE sensitive 2 = not OE sensitive
RF:obestiy OE exposure diabetes late periods late menopause tamoxifen
endometrial cancer
- symptoms 3
- investigations 4
- treatment 2
- symptoms hyperplasia of endometrium post - menopausal bleeding tumours - investigations physical exam ca 125 ultrasound mri
- treatment
removal
radiotherapy
cervical cancer
- what kind of cell carcinoma
- symptoms 5
- investigations 3
- treatment 3
squamous cell carcinoma
- symptoms post coital bleeding smelly discharge IMB postmenopause bleeding uclers or mass visible
- investigations
biopsy
MRI
FBC - treatment
removal
hysterectomy
chemo-radiotherapy
PCOS
- symptoms - I know
- complications 1
- investigations 1
- treatment 3
complications - T 2 D investigations: diagnosis of exclusions bloods transvag
treatment:
diet
exercise
cocp
vulva disorders
2 names and characteristics
treatment for both is the same
- lichen planus
-papular rash, purple, pain
give steroid - lichen sclerosus
-loss of collagen, autoimmune, thyroid
give steroid
Prolapse
- causes 4
- symptoms 6
- investigations 3
- treatment 5
causes:
- NVD
- collagen deficit
- obesity
- constipation
symptoms:
- dragging feeling
- lump
- ulcerate and bleed
- discharge
- urinary frequency
- problems pooping
investigation:
- abdo exam
- speculum
- ultrasound
treatment:
- weight decrease
- stop smoking
- physio
- pessaries
- hysterectomy
urinary incontinence
- investigations 4
- treatment 7
investigations:
- speculum
- ask to cough and see if there is a leak
- abdo
- urine dip for infection
treatment:
- loose weight
- chronic cough treated
- reduce fluid intake
- pelvic floor muscle training
- vaginal cones
- duloxetine - SSRI
- surgery
Non - STI
bacterial vaginosis - presentation -treatment candidas - symptoms -treatment
bacterial vaginosis:
- presentation: grey-white discharge, fishy odour
treatment: metronidazole or clindamycin cream
candidas:
itching
treatment: imidazole or oral fluconazole
Chlamydia
symptoms 3
treatment 2
-Discharge
- IMB, post coital bleeding
- Can lead to infertility and chronic pelvic
pain
Treatment:
Azithromycin
Doxycycline
Gonorrhoea
symptoms 2
investigation 1
treatment 2
- Asymptomatic in women
- Can have discharge, urethritis, pelvic
infection
Investigations: swabs
Treatment:
Azithromycin and cefixime
Genital herpes
symptoms 4
treatment 2
- Primary infection
- Local lymphadenopathy
- Acute urinary retention
- Flu like illness
- Treat with Aciclovir, valaciclovir
Syphilis
- can it be transmitted to fetus?
- how is it diagnosed?
- how is it seen?
- Can be transmitted to fetus
- Diagnosed with positive serology
- Painless genital ulcers
Pelvic inflammatory disease what is it symptoms investigations treatment
what:
Infection in vagina and cervix
Usually chlamydia and gonorrhoea
symptoms: o Asymptomatic o Subfertility o Period problems o Bilateral lower abdomen pain o Abnormal vaginal bleeding and discharge o If severe: tachycardia, high fever
investigations:
swabs
treatment:
o Analgesia
o Doxy, metronidazole
