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7 Cards in this Set
- Front
- Back
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Polycystic Ovary Syndrome |
S - Multiple follicles causing oligo-menorrhoea and hyperandrogenism A - Unknown cause S - Hirsutism, acne, insulin resistance, amennorhoea P - I - Check Thyroid, blood glucose, prolactin, adrenal hyperplasia. T - Lifestyle; Metformin for DM, Clomifene for Infertility. |
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Endometriosis |
S - Dysmenorrhoea caused by endometrial tissue A - Genetic link but not certain of the cause. S - Chronic pelvic pain, dysmenorrhoea, dyspareunia, subfertility. P - Endometrial tissue outside the womb responds to oestrogen and is painful until period, may form a cyst in ovaries, adhesions elsewhere. I - FBC for anaemia, Laparoscopy is diagnositic and lesions can be removed. T - Analgesia for pain, COCP, IUS and progesterones regulate hormone production. Offer fertility help.
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Fibroids |
A - leiomyomata are tumours of the myometrum, mostly due to oestrogen, so size varies through the cycle. S - 50% asymptomatic, but may cause menorrhagia and infertility, or pressure on bladder or bowel causing dysuria or constipation. P - 1/1000 are malignant where fibroid outgrows its blood supply. Fibroids might get in the way in pregnancy leading to prolonged labour. E - Palpable mass in abdomen. I - Ultrasound and MRI show location: Sub serosal, intramural or submucosal. T - Treat if large and symptomatic - Tranexamic acid for bleeds, NSAIDs for pain. Hysterectomy or artery embolisation. |
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Pelvic Inflammatory Disease |
S - Pain and infertility due to infection. A - Young adults with multiple sex partners and likely chlamydia or gonorrhoea infection in the past. IUD insertion or BV are linked S - Lower abdo pain, fever, discharge, red cervix, dyspareunia, intermenstrual bleeding. E - Cervical excitation, fever, abdo tenderness. I - Endocervical swab for chlamydia and gonorrhoea
T - Swab + Antibiotics. IV ceftriaxone if severe, otherwise Doxycycline and Metronidazole. F - Abscess, infertility, Ectopic, Fitz hugh curtis pain. |
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Breast Cancer |
A - Common cancer affecting women from 25 to 55, witha national screening program. Strong family link. Increased oestrogen exposure increases the risk, early menarche late menopause, nulliparous, HRT, obese, smokers. Genetics: BRCA 1 and 2 increase risk to 70%. S - Painless breast mass : + discharge/ nipple changes, tethering, oedema. P - Adenocarcinomas mostly I - Triple assessment is Examination fo the lump, Fine needle aspiration and imaging by MRI or Ultrasound. In theatre, thhe sentinal node can be stained with radioactive blue ink and then removed. T - Surgery may be mastectomy and axillary nose sampling or clearance with radiotherapy or chemotherapy. Hormone treatment involves Tamoxifen, an aromatase inhibitor oor Herceptin.
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Infertility |
A - Previous surgery, irregular cycles, hirsutism, acne, adnexal abnormalities. S - No pregnancy despite trying. Investigate after 1 year, treat after two. P - Causes are hypothalamic, PCOS, idiopathic, Tubal, Age related or endometriosis. I - FSH, LH between day 2 and 5. Progesterone at day 21, Oestradiol, Testosterone, prolactin Semen analysis. TV US and hysteroslpingogram. T - All women need counselling. Hypothalamic - Menotrophin stimulates ovulation. PCOS - wt loss, clomiphene. Tubal - IVF Endometriosis - Clomiphene and Intrauterine insemination. Age related, give clomiphene
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Menopause |
A - Age around 50, S - amenorrhoea, irregular cycle, hot flushes, night sweats, mood changes, dry vagina. P - Ovarian failure due to absence of follicles, which reduces oestrogen and progesterone. I - Pregnancy test, FSH and LH are unreliable, best indicator is amenorrhoea. T - With Uterus - Continuous combined HRT then Cyclic if needed, with withdrawel bleed. Antidepressants, clonidine or gabapentin may be needed if symptoms persist. Without Uterus - Topical Oestrogen, Oral Oestrogen |
