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AMK 2023 > Womens health > Flashcards

Womens health Flashcards

1
Q

Name a 2 medical or surgical causes that trigger menopause

A

hysterectomy and GnRH analogues

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2
Q

During menopause: what two hormone levels fall first

A

Oestrogen and progesterone

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3
Q

During menopause: what 2 hormone levels rise

A

FSH and LH

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4
Q

what contradictions are there for HRT

A

Current or past breast cancer, oestrogen sensitive cancer, undiagnosed vaginal bleeding or untreated endometrial hyperplasia

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5
Q

what causes are there for starting antibiotic treatment for mastitis and what is your choice?

A

systematically unwell, nipple fissure present, unresolved after 24hrs when milk is removed, or culture indicating infection. Treat with flucloxacillin 10-14 days.

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6
Q

PC in breastfeeding: pain while feeding 3 days after birth in both breasts. pain worse before feed. diagnosis and management?

A

Engorgment, hand expression

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7
Q

PC in breastfeeding: pain intermittent and present during feed, nipple blanch followed by cyanosis. diagnosis?

A

Reynaud’s disease of nipple

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8
Q

what is the treatment for nipple candidiasis

A

miconazole cream for mother and nystatin infusion for child

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9
Q

what are the most common types of carcinoma of the breast

A

ductal and lobular

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10
Q

What are the risk factors for breast cancer?

A

COC, no breastfeeding, PMHx of breast cancer, western diet, obesity, HRT, 1st degree FHx, nulliparous or child after 30, early menarche or late menopause, BRAC1+2

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11
Q

what are the 4 most common sites of breast cancer metastasis

A

liver, lung, bone, brain

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12
Q

what are the appropriate investigations for confirmed breast cancer?

A

oestrogen and progesterone receptor status, HER2 status, routine bloods including LFTs and CXR.

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13
Q

what type of breast lump has increased incidence in HRT

A

Fibroademoma

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14
Q

what type of breast lump can be recurrent and should settle spontaneously?

A

breast cyst

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15
Q

What is the name given to a benign warty lesion located behind the areola?

A

intraductal papilloma

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16
Q

what is done with patients with positive HPV screen but a normal cytology

A

repeat after 12 months

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17
Q

what is done with patients with positive HPV screen but a abnormal cytology

A

colposcopy

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18
Q

Chronic pelvic pain, secondary dysmenorrhoea, deep dyspareunia, sub fertility, urinary symptoms, painful bowel movements and tender modularity in posterior vaginal fornix are all features of what condition

A

Endometriosis

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19
Q

What is the gold standard in diagnosis endometriosis?

A

laparoscopy

20
Q

what is the primary management of endometriosis?

A

NSAIDS and/or paracetamol, COC pill or progestergens,

21
Q

17F with a BMI of 28, complaining of excessive bodily hair (hirsutism), Balding on the back of the head and deeper voice, acne and depression is what condition?

A

PCOS

22
Q

PCOS usually presents with what Physical signs

A

hirsutism, male pattern balding, obesity, dark colour in fat folds (acanothosis nigricans) and clitomegoly, increased muscle mass.

23
Q

what investigations are there for suspected PCOS

A

total testosterone (normal to raised), free testosterone (>5mmol), LH may be elevated compared to FSH, TFTs CAH, Cortisol, fasting glucose tolerance

24
Q

what are the 3 diagnostic criteria for PCOS which you need 2 of

A

polycystic ovaries, oligo-ovulation or annovulation, clinical or biochemical signs of hyperandrogenism

25
Q

what is characterised by preterm PROM and what are the typical causes?

A

amniotic sac breaks before 37wks, INFECTION, other factors include smoking, vaginal bleeding, previous preterm

26
Q

what 4 over the counter medications are big no-nos in pregnancy?

A

peptobismol, Decongestants like phenylephrine, cough and cold meds like guaifenesin, Pain meds like aspirin, ibuprofen, naproxen

27
Q

name 10 prescription meds not safe in pregnancy?

A

paroxetine, xanax or diazapan (valium), lithium, warfarin, methotrexate, doxycycline and tetracycline, valoproic acid, ACE inhibitors, Acne meds like isotretinoins

28
Q

What medication is given and for how long for risk management in high risk pregnancies for preeclampsia

A

75-150mg of aspirin daily for 12 weeks

29
Q

what are the two laboratory tests of diagnosing preeclampsia

A

Protein/creatinine ratio of >/30mg/mmol (first line)

albumin/creatinine ratio of >/ 8mg/mmol

30
Q

what what 2 medications can be given to treat preeclampsia where the bpm is higher than 135/85

A

labetalol or nifedipine

31
Q

how does IUS work

A

Hormal contraceptions (progesterone), prevents implant by increasing endometrial phagocytotic cells and decreasing sperm penetrance and migration

32
Q

how does IUD work

A

Copper coil, Cytotoxic inflammatory reaction in endometrium, inhibits sperm motility and prevents implant if fertilised.

33
Q

what are contraindications for IUD

A

Wilsons disease, cancer, current pregnancy (48hr to 4wks post partum), infection including PID, recent STD or septic abortion

34
Q

in HER2+ tutors what drug can be given

A

trastuzamab but not in heart disease

35
Q

In ER+ tumors what is given before/during menopause and then post menopause

A

tamoxifen in pre or peri, aromatase inhibitors like anastrozole for post

36
Q

in what cases do you change the dose of the emergency contraception levongestel

A

BMI >26

37
Q

how long is levongestel effective?

A

up to 72hrs

38
Q

how long is ulipristal effective?

A

up to 120hrs

39
Q

which emergency contraception can be used twice in the same cycle out of levongestel or ulipristal

A

BOTH lol

40
Q

what is the most effective form of emergency contraception

A

IUD

41
Q

How long after exposure is an IUD effective for emergency contraception?

A

5 days or after likely ovulation date

42
Q

what is the management for HMP or menorrhagia for patients who do not want contraception?

A

tramexamic acids or NSAIDS

43
Q

what is the management for HMP or menorrhagia for patients who do want contraception?

A

1st - IUS, 2nd - COC, 3rd - long acting progesterones

44
Q

what can be used as a short-term option to rapidly stop heavy menstrual bleeding?

A

Oral norethisterone

45
Q

glucose in her urine at her 28-week midwife appointment and so her fasting plasma glucose was measured. The result was 7.2mmol/L.

What is the next step in her management?

A

insulin should be commenced if fasting glucose level is >= 7 mmol/l insulin at the time of diagnosis

46
Q

what is the choice of antidepressant in breastfeeding women?

A

serataline

AMK 2023 (16 decks)

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