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JL Reproduction and Sexual Health > Week 1 part 2 > Flashcards

Week 1 part 2 Flashcards

1
Q

What cells produce oestrogen?

A

Granulosa cells

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2
Q

In the follicular phase what does the increase in oestrogen cause?

A

Inhibition of FSH production causing atresia but not of dominant follicle

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3
Q

What occurs before ovulation?

A

Prior LH surge and dominant follicle ruptures to release oocyte

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4
Q

What happens 14 days post-ovulation?

A

Luteolysis

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5
Q

What uterine phase occurs over days 5 - 14?

A

Proliferative phase

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6
Q

What urterine phase occurs over days 14-28?

A

Secretory phase

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7
Q

What happens in uterine proliferative phase?

A

Oestrogen induced growth of endometrial glands and stroma

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8
Q

What phase of uterine cycle is this: Progesterone-induced glandular secretory activity
Decidualisation in late secretory phase
Endometrial apoptosis and subsequent menstruation

A

Luteal phase

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9
Q

In menstruation phase- what inhibits scar tissue formation?

A

Fibrinolysis

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10
Q

How much is lost in menstruation?

A

Less than 80 mls

No clots

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11
Q

How long is menstrual cycle

A

average 28 days

between 21 - 35 days cycle

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12
Q

Menorrhagia

A

Prolonged and increased menstrual flow

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13
Q

Metrorrhagia

A

Regular intermenstrual bleeding

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14
Q

Polymenorrhoea

A

Menses occuring at less than 21 day interval

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15
Q

Polymenorrhagia

A

Increased bleeding and frequent cycle

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16
Q

Menometrorrhagia

A

Prolonged menses and intermenstrual bleeding

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17
Q

Amenorrhoea

A

Absence of menstruation greater than 6 months

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18
Q

Oligomenorrhoea

A

Menses at intervals osf greater than 35 days

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19
Q

What is non-organic causes of menorrhagia (prolonged and increased menstrual flow) also known as?

A

Dysfunctional Uterine Bleeding

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20
Q

Name some local disorders causing organic menorrhagia?

A
  1. Fibroids
  2. Adenomyosis
  3. Endocervical or endometrial polyp
  4. Cervical eversion
  5. Endometrial hyperplasia
  6. Intrauterine contraceptive device
  7. PID
  8. Endometriosis
  9. Malignancy of cervix/uterus
  10. AV malformations
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21
Q

a benign tumour of muscular and fibrous tissues, typically developing in the wall of the womb.

A

Fibroids

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22
Q

a condition of the uterus (womb) where the cells that normally form a lining on the inside of the uterus, also grow in the muscle wall of the uterus.

A

Adenomyosis

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23
Q

the uterine lining grows outside the uterus –in the fallopian tubes, the ovaries or the tissue lining the pelvis (the peritoneum).

A

Endometriosis

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24
Q

a mass in the inner lining of the uterus. They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated). Pedunculatedpolypsare more common than sessile ones. They range in size from a few millimeters to several centimeters.

A

Endometrial polyp

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25
Q

In many women, cells from inside the cervical canal, known as glandular cells, are present on the outside surface of thecervix[1]. This used to be called cervical erosion and is now more commonly known as

A

Cervical eversion

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26
Q

s athickeningof the lining of the womb, caused by overgrowth of the cells that line the womb. It is not cancer. But in some women it can develop into womb cancer

A

Endometrial hyperplasia

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27
Q

Name four causes of organic menorrhagia in relation to endocrine?

A
  1. Hypo/hyperthyroidism
  2. Diabetes Mellitus
  3. Adrenal disease
  4. Prolactin disorders
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28
Q

3 Disorders of haemostasis causing organic menorrhagia?

A
  1. Von Willebrands disease
  2. ITP
  3. Factor II, V, VII and XII deficiency
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29
Q

Name four organic menorrhagia problems related to pregnancy?

A

Miscarriage
Ectopic pregnancy
Gestational trophoblastic disease - hydatidiform mole
post partum haemorrhage

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30
Q

What class are 85% of all dysfunctional uterine bleeding?

A

Anovulatory

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31
Q

What type of dysfunctional uterine bleeding is more common in obese women?

A

Anovulatory

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32
Q

What class of dysfunctional uterine bleeding is related to women aged 35-45, regular heavy periods, due to inadequate progesterone production by corpus luteum?

A

Ovulatory

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33
Q

How is DUB investigated?

A 
FBC
Cervical smear
TSH
Coagulation screen
Renal/liver tests
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34
Q

What imaging is done for investigating DUB?

A

Transvaginal ultrasound - endometrial thickness, presence of fibroids

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35
Q

Name another test used for investigating DUB?

A

Endometrial sampling - pipelle biopsies, hysteroscopic directed, dilatation and curettage

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36
Q

How is DUB managed non surgically?

A 
Progestogens
Combined oral contraceptive pill
Danazol
GnRH analogues
NSSAIDS
Anti-fibrinolytics
Capillary wall stabiliers
Progestogen relasing IUCD
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37
Q

What is the management of DUB sugically?

A

Endometrail resection/ablation (rollerball, thermal balloon)

Hysterectomy

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38
Q

What si the main concern between surgical management of DUB and medical?

A

Fertility lost in surgical

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39
Q

Name some differences between endometrial ablation and hysterectomy for DUB?

A

EA - daycase procedure, shorter, requries smear, combined HRT needed
H - major operation, longer, no smear required, oestrogen only HRT

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40
Q

What bacteria predominate in the healthy vagina and produce lacti acid and hydrogen peroxide?

A

Lactobacillus spp.

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41
Q

Name three other organisms found in the vagina healthy?

A

Strep viridans
Group B strep
Candida

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42
Q

Name 4 predisposing facotrs for candida infection?

A
  1. Recent antibiotic therapy
  2. High oestrogen levels (pregnancy)
  3. Poorly controlled diabetes
  4. Immunocomporomised patients
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43
Q

Intensly itchy white vaginal discharge?

A

Thrush

44
Q

How is thrush diagnosed?

A

Clinical diagnosis

High vaginal swab for culture

45
Q

Name a bacteria in the vagina that buds?

A

C. albicans

46
Q

Typical spotty rash on penis?

A

Candida balantis

47
Q

What organism plays a role in bacterial vaginosis?

A

Gardnerella vaginalis/mobiluncus sp.

48
Q

Thin, watery, fish smelling vaginal discharge?

A

Bacterial vaginosis

49
Q

How is BV diagnosed?

A

Clinical diagnosis

Raised vaginal pH > 4.5

50
Q

What cells are looked for from HVS in lab testing in BV?

A

Presence of clue cells

51
Q

What does Hay-Ison scoring system estimate in BV?

A

Proportions of clue cells to epithelial cells and lactobacilii

52
Q

How is BV treated?

A

Metronidazole orally

53
Q

Symptoms of UTI but may have lower abdo pain/back/perineal/penile and tender prostate?

A

Acute bacterial prostatitis

54
Q

Name a rare complication of UTI in men?

A

Acute bacyterial prostatitis

55
Q

How is acute bacterial prostatitis diagnosed?

A

Clinical signs + MSSU for C&S (+/- first pass urine for chlamydia/gonorrhoea)

56
Q

How is acute bacterial prostatitis treatd?

A

Ciprofloxacin for 28 days

Trimethoprim if high C .diff risk

57
Q

Commonest bacterial STI in UK?

A

cHLAMYDIA TRACHOMATIS

58
Q

Describe the chalmydia trachomatis bacteria?

A

Obligate intracellular bacteria wit hbiphasic life cycle - energy parasite

59
Q

Does chlamydia reproduce outside host cell?

A

No

60
Q

What test should not be done for chlamydia trachomatis?

A

Culture or gram stain - does not stain because no peptidoglycan in cel wall

61
Q

What serological group causes chlamydia trachoma (eye infeciton)?

A

Serovars A - C

62
Q

What serological group causes genital infection in chlamydia?

A

Serovars D-K

63
Q

What does serological group L1-L3 cause in chlamydia?

A

Lymphogranuloma venereum

64
Q

Treatment for chlamydia?

A

Azithromycin 1g oral dose

65
Q

STI that is gram negative dipplococcus?

A

Neisseria gonorrhoeae

66
Q

What does gonorrhoea look like on gram stain?

A

2 kidney beans facing each other - easily phagocytosed by polymorphs so often appear intracellularly

67
Q

Purulent discharge, a dripping tap?

A

Gonnorhoea

68
Q

How do you test for both chlamydia and gonorrhoea in one test?

A

Combined nucleic acid amplification tests (NAATS) or PCR - highly sensitive and specific tests

69
Q

Howis chalmydia nad gonnorhoea tested on male patients? for PCR/NAAT

A

First pass urine sample

70
Q

What swab is not used for culture of gonorrhoea?

A

High vaginal swab

71
Q

Will pcr and NAAT be positive even if organism have fied?

A

Yes - test takes hours not days

72
Q

What also has to be done other than PCR/NAAT for gonorrhoea?

A

5 weeks wait to do test of cure

73
Q

Treatment for gonorrhoea?

A

Ceftriaxone IM + oral azithromyicin

74
Q

What type of organism is treponema pallidum?

A

Spirochaete

75
Q

Does symphilis stain?

A

No

76
Q

Describe the primary stage of symphiis?

A

Chancre (painless ulcer) at site of infection - heals without treatment

77
Q

What occurs in secondary stage of symphilis?

A

Snail track mouth ulcers, generalised rahs and flue like symptoms

78
Q

When diagnosing symphilis what is done to look for spirochaetes in exudate from primary and secondary lesions?

A

Dark ground microscopy

79
Q

In sepcific test serology for syphilis can antibodys remain positive for life?

A

Yes

80
Q

What is non specific serology used for in syphilis?

A

To monitor response to treatment and test how active disease is

81
Q

Name two non specific serological tests for syphilis?

A

VDRL - Venereal Diseases Reserach Lab

RPR (rapid plasma reagin)

82
Q

Name 3 specific serological tests for syphilis?

A

TPPA (particle agglutination assay)
TPHA (haemagglutination assay)
IgM and IgG ELISA

83
Q

What is used as screenign test for syphilis?

A

IgG and IgM ELISA

84
Q

What two tests are specific for syphilis but remain positive for life, not useful in monitoring response to therapy?

A

TPPA

TPHA

85
Q

tREATMENT for Syphilis?

A

Injectable long actining penicillin

86
Q

Commonest viral STI?

A

Genital Warts

87
Q

What virus causes genital warts?

A

HPV

88
Q

Describe the genital wart causing virusl HPV?

A

Non-enveloped icosohedral virus containing double stranded DNA

89
Q

wHAT type of HPV cause genital warts?

A

6 and 11

90
Q

What type of HPV cause increased risk of cervical cancer?

A

16 and 18

91
Q

How are genital warts diagnosed?

A

Clinical

92
Q

Treatment of genital warts?

A

Cryotherapy, podophyllotoxin cream

93
Q

What vaccine is there for genital warts?

A

Quadrivalent vaccine given to 11-13 yo girls. Protects against 6,11, 16 and 18

94
Q

Lumps on vagina, whiter than surrounding skin with rough surface#?

A

Genital warts

95
Q

Describe herpes simplex virus?

A

Enveloped virus containing double stranded DNA

96
Q

Exquisitely painful multiple small vesicles, which are easily deroofed?

A

Genital herpes HSV

97
Q

wHERE does genital herpes virus migrate to and hide from the immune system at?

A

Sacral root ganglion

98
Q

How is genital herpes diagnosed?

A

Swab in virus transport medium of deroofed blister for PCR - highly sensitive and specific

99
Q

Treatment of HSV genital?

A

Aciclovir and pain relief

100
Q

Decribe the organism that infects in trchomonas vaginalis?

A

Single celled protozoal parasite

101
Q

How is trichomonas vaginalis transmitted?

A

Sexual contact

102
Q

Vaginal discharfe and irritation in females, urethritis in males?

A

Trichomonas vaginalis

103
Q

How is trichomonas vaginalis diagnosed?

A

High vaginal swab for microscopy

104
Q

How is trichomonas vaginalis treated?

A

Oral metronidazole

105
Q

How long do male pubic lice and female pubic lice liver for?

A

Males - 22 days

Females - 17 days

JL Reproduction and Sexual Health (18 decks)

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