Women’s Health

Question 1

How many days until progesterone pill is effective?

Answer 1

3 days

Question 2

What to do if you miss the POP?

Answer 2

If more than 3 hours late, take missed pill and use alternative contraception for 48 hours

Question 3

What levels of UKMEC can be given?

Answer 3

1 and 2

Question 4

What BMI is a contraindication to COCP?

Answer 4

Greater than 35

Question 5

What timeframe post partum can COCP be commenced in breastfeeding woman?

Answer 5

More than 6 weeks

Question 6

Treatment of dysfunctional uterine bleeding?

Answer 6

1. Nurofen
2. Mirena
3. Tranexamic acid 1g TDS first 3 days cycle
4. Oral progestins

Question 7

Causes of menorrhagia?

Answer 7

Adenomyosis
Fibroids (leionyomas) - most common
Endometrial hyperplasia
Malignancy
Coagulopathy
PCOS
Hypo/hyper thyroid

Question 8

Endometrial thickness cutoff for suspicion of endometrial cancer?

Answer 8

Premenopausal > 12mm
Perimenopausal > 4mm

Measure first half of cycle

Question 9

Progesterone only pill use in irregular cycles?

Answer 9

Same 12 days each calendar month

Question 10

What ages for cervical screening?

Answer 10

25-74

Question 11

When should you refer to specialist based on cervical screening results?

Answer 11

1. Any HSIL

2. HPV types 16 or 18 detected

Question 12

Things to know when choosing depot medroxyprogesterone?

Answer 12

1. Breakthrough bleeding
2. Can cause delay to fertility after cessation (up to 8 months)
3. Breast tenderness
4. Needs every 3 months
5. Takes 7 days, unless started on day 1-5 of cycle
6. Low BMD with long use

Question 13

First choice for treating UTI in pregnant woman?

Answer 13

Nitrofurantoin 100mg q6h for 5 days

Question 14

What age is primary amenorrhea?

Answer 14

15

Question 15

What age is it recommended to switch to alternative contraception when on Depo-provera?

Answer 15

50

Question 16

4 differentials for pv bleeding in early pregnancy?

Answer 16

Ectopic
Early pregnancy loss
Implantation of pregnancy
Polyps / infection

Question 17

What supplements are recommended in pregnancy?

Answer 17

Iodine 150 microg
Folic acid first 3 months 0.5mg
Unless BMI greater than 30 = 5mg

Question 18

When can tibilone be considered?

Answer 18

Tibolone 2.5mg daily

Post menopausal only (not Peri, as risk of breakthrough bleeding)

Question 19

Treatment for vaginal dryness?

Answer 19

1. Lubricating agent e.g. K Y
2. Low dose vaginal oestrogen e.g ovestin 1mg
3. Intravsginal pessary daily for 2 weeks then twice weekly

Question 20

Contraindications to HRT?

Answer 20

1. Oestrogen dependent cancer (breast, endometrial)
2. DVT
3. Undiagnosed abnormal vaginal bleeding
4. Acute ischaemic heart disease
5. Over 60

Question 21

What is cyclical combined HRT?

Answer 21

Estrogen continuous

Progestogen 10-14 days of cycle

Question 22

Benefits of MHT?

Answer 22

Reduce fractures
Reduced diabetes
Reduced colorectal cancer
Improved vasomotor sx

Question 23

Risks of MHT?

Answer 23

Breast cancer
Stroke / CAD
DVT
Gallbladder disease
Dementia
Urinary incontinence

Question 24

Name of cyclical combined tablets MHT brand?

Answer 24

Femoston 1/10

Question 25

Most effective SSRI and well

Tolerated for vasomotor symptoms of menopause?

Answer 25

Escitalopram 5mg, increase 2-4 weeks max 20mg

Question 26

Initial evaluation of ovulation status?

Answer 26

1. Progesterone day 21
2. Ultrasound day 5-9
3. Anti-mullerian hormone