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GP Exams > Women's > Flashcards

Women's Flashcards

1
Q

Symptoms of ovarian cancer

A
  1. Abdominal bloating
  2. Increased abdominal girth
  3. Indigestion or early satiety
  4. Change in bowel habits, specifically constipation
  5. Urinary frequency, incontinence
  6. Abdominal or pelvic pain
  7. Dyspareunia
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2
Q

Potential causes of Ca-125 elevation

A
  1. Ovarian cancer
  2. False positive
  3. Benign ovarian neoplasm
  4. Uterine fibroids
  5. Hepatitis
  6. SLE / autoimmune disease
  7. Bowel ca
  8. Pancreatic ca
  9. Endometrial ca
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3
Q

Contraindication to oestrogen MHT therapy

A
  • hx hormone dependent cancer
  • active hormone dependent cancer
  • past hx thromboembolic disease is relative contraindication (transdermal oestrogen preferable)
  • cardiovascular / cerebrovascular disease is relative contraindication too
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4
Q

Dx criteria for PCOS

A

Rotterdam dx criteria (two of three required)
1. Oligo/anovulation

  1. Hyperandrogenism
    - biochemical (raised FAI or free testosterone)
    - clinical (hirsutism, acne)
  2. Polycystic ovaries on USS
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5
Q

Risk factors for breast ca

A
  • Family history of breast and ovarian cancer
  • Increasing age
  • Late childbearing (after the age of 30 years)
  • Nulliparity (no children)
  • Early menarche (<12 years of age)
  • Late menopause
  • Use of hormone replacement therapy (particularly combined therapy)
  • Ashkenazi Jewish ethnicity
  • Obesity (post-menopausal women)
  • Lifestyle factors (high alcohol consumption, high-fat diet)
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6
Q

DDx breast lump

A
  • Prominent fibroglandular tissue (normal breast tissue)
  • Cyst
  • Fibroadenoma
  • Abscess
  • Lipoma
  • Fat necrosis
  • Haematoma
  • Breast cancer
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7
Q

Hx questions to elicit if female factor underlying cause of infertility

A
  • symptoms of PCOS (hirsutism, acne, irregular menses)
  • symptoms to suggest endometriosis
  • symptoms of prolactinoma (galactorrhea, headache)
  • symptoms of hypothyroidism
  • symptoms to suggest PID
  • symptoms of uterine polyp
  • previous contraception use / depot provera
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8
Q

Causes of bleeding in first trimester

A
  • miscarriage
  • ectopic pregnancy
  • endometrial implantation
  • gestational trophoblastic disease
  • cervical lesions
  • vaginal lesions
  • uterine infection
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9
Q

Options for mx of miscarriage

A
  1. Expectant
  2. Medical
  3. Surgical
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10
Q

Causes of secondary dysmenorrhea

A
  • endometriosis
  • adenomyosis
  • fibroids
  • pelvic infection
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11
Q

Examination findings in someone with endometriosis

A
  • reduced uterine mobility
  • adnexal masses
  • uterosacral nodularity
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12
Q

Common causes of itchy vulvitis in postmenopausal woman

A
  1. Lichen sclerosus
  2. Psoriasis
  3. Dermatitis

(vaginal candidiasis very unlikely in this age group)

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13
Q

Tx for vaginal lichen sclerosis

A

Super potent corticosteroid

- Diprosone 0.05% in optimised vehicle

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14
Q

Mx troublesome bleeding with Implanon

A
  • COCP, taken continuously or cyclically for 3/12
  • 5/7 NSAID Mefenamic acid 500 mg BD to TDS
  • 5/7 Tranexamic acid 500mg BD
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15
Q

Post partum nipple pain - what physical examination is required

A
  • examination breasts and nipples - nipple trauma, breast lumps, swelling or erythema
  • temp
  • baby oromotor assessment - tongue mobility & palate
  • baby weight since birth
  • observation of a breastfeed with consent
  • neonatal examination
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16
Q

Primary amenorrhea causes

failure of menses to start by 16yrs

A
  1. Hypothalamic amenorrhea (exercise, low BMI)
  2. PCOS
  3. Imperforate hymen
  4. Congenital absence uterus / vagina
  5. Chromosomal anomalies
  6. Pituitary tumours
17
Q

Secondary amenorrhea

absence of menses for > 6 months in a woman who has established menstruation

A
  1. Hypothalamic amenorrhea (exercise, low BMI)
  2. PCOS
  3. Pregnancy
  4. Hyperprolactinaemia
  5. Premature ovarian insufficiency
  6. Medication (OCP, antipsychotics)
  7. Thyroid dysfunction
  8. Adrenal disorders (Cushing)
  9. Asherman syndrome
18
Q

How to prescribe MHT

- previous hysterectomy

A

Continuous oestrogen
- transdermal or oral preparation
(transdermal oestrogen has lower VTE risk)

19
Q

How to prescribe MHT

- perimenopausal

A

LMP < 12 months ago

  • cyclical MHT (reduce risk of breakthrough bleeding)
  • after 12 months of cyclical MHT, can switch to continuous

eg. Femoston

20
Q

How to prescribe MHT

- postmenopausal

A

LMP > 12 months ago
- continuous combined oestrogen / progesterone

eg. Angeliq

21
Q

Causes of heavy menstrual bleeding

A
  • uterine fibroids
  • endometrial / endocervical polyps
  • endometrial hyperplasia
  • adenomyosis
  • presence of an IUD
  • hypothyroidism
  • bleeding disorder eg. von Willebrand disease
  • PCOS
22
Q

Second and third trimester bleeding

A
  • bloody show with associated labour
  • early pregnancy loss (< 20 weeks)
  • placenta previa
  • placental abruption
  • uterine rupture
  • vasa previa (rare)
23
Q

RF for urinary incontinence

A
  • parity
  • vaginal deliveries of children
  • FMHx urinary incontinence
  • smoking hx
  • excessive caffeine intake
  • faecal incontinence
  • vaginal atrophy
  • recurrent UTI
  • recent weight gain
  • hx heavy lifting (occupational or exercise)
24
Q

3 invx for urinary incontinence

A
  1. Urine MCS
  2. Bladder diary
  3. Bladder emptying imaging / renal tract USS
25
Q

5 non-pharm mx options for urinary incontinence

A
  1. Limit fluid intake (8 cups / day)
  2. Minimise bladder irritants such as caffeine, alcohol
  3. Maintain healthy BMI
  4. Avoid heavy lifting
  5. Avoid constipation with high fibre diet
  6. Pelvic floor training
  7. Timed voids

GP Exams (15 decks)

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