Women's Health Flashcards

12.5% Gynaecology covers a broad spectrum of women's health care, and involves all principles of adult health as above. Obstetrics also embodies these principles with the addition of the understanding of the basic sciences as they apply to reproduction and the effects of pathobiology and pathophysiology on the reproductive process (pregnancy, labour, birth and the post-natal period).

1
Q

Gestational Diabetes Diagnosis

A

Fasting plasma glucose of ≥5.1 mmol/L
or
OGTT at 1 hour ≥10.0
or
OGTT at 2 hours 8.5–11.0

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2
Q

Cervical cancer screening

A

2 years after first sexual intercourse or 25–74 years.

HPV test

Negative Result: Every five years.

Positive NON 16-18: Repeat in 12 month. Again positive: Colposcopy.

Positive 16-18: Colposcopy.

Low grade: Repeat in 12 month. Again positive: Colposcopy.

High grade: Colposcopy

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3
Q

Breast cancer: Risk factors

A

Risk factors:
- increasing age (>40 years)
- living in a Western population
- pre-existing benign breast lumps
- alcohol intake >2 SDs/day
- use of menopause hormonal therapy (MHT) (combined estrogen and progestogen) >5 years
- personal history of breast cancer
- family history in a first-degree relative (raises risk about threefold)
- known genetic mutations BRCA1 or BRCA2
- nulliparity
- late menopause (after 53)
- obesity
- childless until after 30 years of age
- early menarche
- ionising radiation exposure
- Ashkenazi Jewish ancestry
- Breast cancer in a male relative

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4
Q

Breast cancer: Screening Low risk

A

Low risk: Family member diagnosed at 50 years or over.

Screening: mammograms
every two years for women aged 50–74 years

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5
Q

Breast cancer: Screening Moderate risk

A

Moderate risk:

One 1st degree diagnosed before 50 years
or
Two 1st degree in the same family side at any age
or
Two 2nd degree in the same family side diagnosed before 50 years.

Sreening: Annual mammogram for women age 40 years

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6
Q

Breast cancer: Screening High risk

A

High risk:

Member of the family in prencence of BRCA 1-2.

or

Two 1st or 2nd degree on the same family side diagnosed with BC or ovarian Ca PLUS:

*Aditional relatives with BC or OC.
*BC diagnosed before 40 years.
*Bilateral BC.
*Breast & Ovarian Ca in the same woman.
*BC in a male relative.
*Ashkenazi jewish ancestry.

or

One 1st or 2nd degree with BC < 45 PLUS One 1st or 2nd degree with sarcoma < 45

Screening:

Annual mammogram for women age 40 years

Referal to a cancer clinic for risk assessment, possible genetic testing and management plan.

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7
Q

Uterine prolapse

A

weakening of the uterosacral ligament

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8
Q

OCP’s and ovarian cancer

A

OCP’s have no relation to developing ovarian cancer. Some sources have even labelled it as a protective factor

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9
Q

risk factors for the development of urinary incontinence

A
  • Obesity (stress)
    – Prenatal urinary incontinence (detrusor)
    – Constipation (stress)
    – Instrumental delivery
    -Third and fourth-degree tears
    -Baby with a birth weight of more than 4.0 kg (detrusor)
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10
Q

Progesterone increases the risk of

A

DVT

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11
Q

Post menopause is defined as

A

permanent end of menstruation and fertility, defined as occurring 12 months after the last
menstrual period

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12
Q

Most likely cause of post-menopausal bleeding

A

vaginitis due to oestrogen deficiency

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13
Q

Age of onset for ovarian cancer

A

50

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14
Q

HPV can cause what type of cancers

A

– Cancer of cervix.
– Cancer of oro-pharyngeal cavity.
– Squamous cell carcinoma of anus, penis and vagina.
– Cancer of the uterus

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15
Q

Cervical carcinoma risk factors

A

-All women who are or ever have been sexually active.
-Early age at first sexual intercourse.
- after 35
- prolonged use of OCP ( > 5 years)
- immunosuppression
- multiparity (>5)
- persistent HPV infection
-Multiple sexual partners.
-Genital warts virus infection.
-Cigarette smoking

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16
Q

Irregular bleeding while on OCP risks

A

– Smoking
– Chronic malabsorption syndrome
– Severe nausea, vomiting and diarrhoea.
– Hepatic enzyme-inducing drugs
(anti-epileptics, anti-tuberculosis and drugs
used to treat HIV. Modafinil is a drug used in patients with a history of narcolepsy can also interfere with contraceptive pills efficacy due to enhanced liver metabolism)

17
Q

Conservative methods to manage urinary incontinence

A

-Lose weight by 5% or more
-Reduce caffeine intake
-Modify fluid intake-according to hydration status.
-Pelvic floor muscle training
-Treat constipation to avoid straining.
-Treatment of respiratory conditions leading to a chronic cough

18
Q

Investigation of choice for the diagnosis of endometriosis

A

Diagnostic laparoscopy with histopathology

19
Q

What criteria of women that do not need cervical screening?

A

Women who have never engaged in sexual intercourse

20
Q

Approach to PMS

A

1st line: Conservative treatment for 3 menstrual cycles (yoga)
2nd line: COCP, SSRI
3rd: GNRH antagonists due tenderness (danazol) careful because this drug can induce menopause, main complaint of fluid retention spironolactone, main complaint of dysmenorrhoea (mefenamic acid)

BEST method: endometrial ablation, hysterectomy?

21
Q

Oral contraceptive pills increase the incidence of which cancer

A

cervical cancer

22
Q

Stein- Leventhal syndrome is also known as

A

PCOS

23
Q

Ovulation inducing drugs

A

Clomiphene

24
Q

Ovarian cyst: premenopausal cyst less than 5cm and asymptomatic

A

reassure