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31 Cards in this Set
- Front
- Back
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What are the indications for the use of POP ? |
Avoid ostrogenic side effects CI for estrogens: Previous history of VTE Smokers >35 years Hypertension DM Lactating mothers > 40 years |
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What are the problems associated with the use of POP ? |
It has to be taken every day at the same time Irregular menstrual cycles Not as effective Small percentage develop amenorrhoea |
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What is the pearl index ? |
It is a way to express the efficacy of a contraceptive method and is calculated as follows: Total accidental pregnancies x 12 x 100 _________________________________________ Total months of exposure This will reflect how many pregnancies will occur in 100 sexually active women in one year. |
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What are the risk factors for endometrial Ca ? |
Obesity (peripheral estrogen production and anovulation) Nulliparous infertile (unopposed) Family History Delayed menopause Exogenous estrogen Endogenous estrogen Medical Disorders |
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What is the management of early endometrial Ca ? |
TAH + BSO With or without Pelvic irradiation |
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What is the management of late endometrial CA ? |
Radical hysterectomy, pelvic node dissection, pelvic irradiation |
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What are the advantages over hormonal methods as emergency contraception when comparing it to a Copper T A380 IUCD ? |
It is more effective Can be used up to 5 days after unprotected intercourse (versus 3 days) Can be left in situ as future contraception No hormonal side effects (such as nausea and vomiting) |
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What are the absolute contra-indications to inserting an IUCD ? |
Shortened or distorted uterine cavity Pregnancy AUB of which the diagnoses is unkown Active genital tract infection Valve prosthesis or past attack of infective endocarditis |
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A patient presents with a white vaginal discharge and a history of vulvovaginal itch. What is the most likely causative organism ? |
Candida Albicans |
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A patient presents with a white vaginal discharge and a history of vulvovaginal itch. What are the predisposing factors to this condition ? |
Candida infection predisposing factors: Immunosuppression: DM HIV Superinfection due to antibiotic use Abnormal genital environment promoting infection: Tight fitting clothing |
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What are the microscopic signs of candida albicans ? |
Pseudohyphae Blastospores Yeast cells |
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Define: Hirsuitism |
Hirsuitism is the growth of terminal hair in amounts that is socially undesirable. Characteristically, follicles on the face, upper lip, breasts, lower abdomen and upper thighs are induced to grow in a male pattern. |
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Define: Virilisation |
The development of secondary male sexual characteristics in a woman. These may include severe hirsuitism associated with defeminisation, clitoromegaly, deepening of the voice and sometimes temporal balding. Muscle bulk increases and the body habitus is altered. |
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When would you refer a patient for colposcopy ? |
High grade squamous intraepithelial neoplasia two consecutive low grade squamous intraepthelial neoplasias (SIL) Clinically apparent lesion Follow-up after large loop excision of the transformation zone (LLETZ) |
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What are the best treatment options for a 26 year old G1P1 CIN III ? |
Local destructive therapy if she wants more children can be considered: LLETZ CO2 Laser If however her family is complete a vaginal or total abdominal hysterectomy can be considered. |
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What are the ultrasound findings characteristic of malignancy ? |
Papillary growths Thick cystic walls Irregular margins > 8cm in size Frequently bilateral Ascitic fluid present Fixed to surrounding tissues Areas of necrosis or haemorrhage |
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What biochemical marker is used for the diagnoses of ovarian Ca ? |
CA125 |
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Define: Krukenberg tumour |
A tumour of the ovary that has metastasized from a primary site, clasically the GIT |
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Define: Menopause |
Natural menopause is defined as the permanent cessation of menstruation, determined retrospectively after 12 consecutive months of amenorrhoea without any other pathological or physical cause |
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What is the average age of menopause ? |
51.4 years |
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How is menopause diagnosed ? |
History of 12 months of amenorrhoea Climacteric symptoms Hormonal changes |
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What are the major causes of vaginal bleeding in a child ? |
Infection (most importantly) Prolapse of the urethral mucosa, hymenal tags; warts Foreign material Sexual abuse or trauma Precocious menarche Rare tumours of the vagina and cervix Bleeding disorders |
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3 major hormonal changes during menopause ? |
Decreased estrogen Increased FSH Increased LH |
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List the causes of FSH and LH deficiency |
Hypopituitarism Hypogonadism Kallmann syndrome |
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What are the advantages of MVA over sharp curretage ? |
Minimal bleeding (decreased intraoperative bleeding) Decreased operation time Decreased pain Decreased risk of uterine perforation Decreased risk of long term endometrial damage |
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List the different methods of anaesthesia for MVA |
Short acting opiods and sedatives Intracervical block General anasethesia |
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What is the difference between condylomata lata and condylomata accuminata ? |
Lata is a sign of syphilis whereas accuminata is associated with HPV |
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List the conditions and organisms responsible for genital ulcers |
Syphilis - Treponema pallidum Chancroid - Haemophilus ducreyi Granuloma inguinale - Calymmobacterium granulomatis Herpes - HSV |
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Discuss follow-up care of a pessary ring |
Intial follow up after 2 weeks and then 3 monthly Remove it, clean it and then reinsert it Examine for signs of erosion and/or infection |
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List the different compartments and types of prolapses |
Anterior - Urethrocele, cystocele Middle - Uterine, vault Posterior - Rectocele, enterocele |
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What are the indications for a pessary ring ? |
Patient not suitable for surgery Patient does not want surgery Patient pregnant (surgery needs to be postponed) |
