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16 Cards in this Set
- Front
- Back
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Waht is the defn of CPP in adolescents
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2-3 mo of persistent painful vs. 3-6 months in adults
Provide reassurance, also you need no abandon the patient |
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What do you include on history?
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MSK
Bowel pain - IBS |
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What do you counsel about bowel?
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You need high fibre
water and avoid constipation soppy wet towel, not hard rocks |
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What investigations ?
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include CRP, ESR for underlying crohn's/inflammatory bowel
Bhcg |
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what is the first approach?
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NSAIDS and OCP for dysmenorrhea
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With primary dysmenorrhea what do you need to exclude first?
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You need to exclude uterine mullerian anomaly
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What is the most common obstructive anomaly?
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Imperforate hymen
1/1000 - 2000 females Usually become perforate in fetal life |
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transverse vaginal septum
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more common in middle and upper vagina
hematocolpos with menses |
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If it is pinkish and you think its an imperforate hymen what do you do?
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DON;t Resect it - it could be a transverse septum and if you don't do it right, it will scar down
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OHVIRA Syndrome
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obstructed hemivagina with associated renal anomaly
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What do you do if you find a vaginal septum
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There is 50% chance of increasing miscarriage risk
(true?) - if you have a miscarriage, then should take it out |
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is the arcuate uterus associated with any problems?
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No
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What should you do with a rudimentary horn with active endometrium?
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you should resect it.
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Which mullerian anomaly causes infertility?
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those with obstruction and back up which causes endometriosis
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When is the best time to screen for VWF?
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Should be on day 3 of menses
Low dose pill should NOT affect testing You can test again because the activity can vary |
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how do you use MPA to stop acute bleeding?
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MPA 20 mg TID x 5 days
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