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30 Cards in this Set
- Front
- Back
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What is the most common cell type of valva carcinoma?
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Sqaumous cell carcinoma
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Which HPV is associted with cervical cancer?
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HPV 16, 18 (30s)
(6 & 11 are associated with warts) |
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Where does the majority of cervical cancer arise from? What is the cell type?
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- Transformation zone
- Stratified squamous |
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What are the emergency contraceptions and time from sexual intercourse that they can be used?
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Levonell (72hr)
EllaOne (120hr) IUD (120hr after unprotected sex at any time in cycle or if multiple UPS then up to 5 days after the calculated earliest day of ovulation) |
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What are the contridictions of the emergency contriception pills?
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Liver inducing enzyme drugs. These women should have Cu-IUD or if refused double dose of Levonelle 3mg
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Action of Cu-IUD
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Primary affect on fertilizartion
- Direct toxicity on sperm & ova - Decreased sperm motility & survival Seconday effect on preventing implantation - Inflammation reaction of endometrium |
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Duration of use of Cu-IUD
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Banded device most common (>380 mm Cu) - 10yrs
Unbanded devices - 5 yrs |
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Mirena / LNG-IUS (Levonorgestrel releasing system). Lasts for? How it works?
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1) 5 yrs
2) Primary action hormonal -suppresses endometrium preventing implantation. - Makes cervicle mucus more impenetrable to sperm - Most women (>75%) will continue to ovulate since systemic levels of progestogen are rarely sufficient to affect the hypothalamic-pituitary-ovarian axis |
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Progestogen-only pills (POP) how do they work?
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- Causing hostile viscous cervical mucus preventing sperm penetration into the upper reproduction tract.
- Spectrum of effect on ovulatory function - Cerazette (desogestrel) is the first oestrogen free pill that consistenly inhibits ovulation in 97% of cycles |
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How to take the POP?
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Start at any time if no pregnanct. Immediate protection if started up to 5th day of menstrual cycle. Extra precaution 48hrs at any other time of cycle. Take continuouslt everyday (no pill free interval) at same time. If more than 3hrs have passed since usual time(traditional POP) or 12hr (desogestrel pill) then miss pill rules should follow
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Depo-provera method? Action
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1) Once every 12 weeks IM. Start day 1-5 (at other time at risk of cliniction 7 day extra protection)
2) Inhibition of ovulation. Action on endometrium & cervical mucus |
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Nexplanon action? How long last?
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- Ovulation suppression. Thickening of cervical mucus & inhibiying endometrial development
2) 3yrs |
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Action of Combined hormonal contraceptives?
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- Ovulation suppression
- Cerival mucus change to reduce sperm penetration - Reduction of receptivity of endometrium to blasocyst |
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Correct use of diaphragm
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Check condition of diaphragm for tears or holes before use
Apply two one inch strips of spermicide to each diaphragm surface Insert before intercourse Top up with spermicide if inserted more than 3 hours prior to SI Always check cervix is covered before SI Leave in situ for minimum of 6 hours after coitus May be worn for up to 30 hours at a time Leave device in situ and top up with spermicide if coitus is to be repeated Do not bath with device in situ – shower only Check before every use. Wash after use with warm water and mild soap. |
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Treatment: heavy menstral bleeding does not want contriception? (normal examinations etc)
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mefenamic acid 500 mg tds (particularly if there is dysmenorrhoea as well) or tranexamic acid 1 g tds. Both are started on the first day of the period
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Treatment: heavy menstral bleeding does wants contriception? (normal examinations etc)
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- intrauterine system (Mirena) should be considered first-line
- combined oral contraceptive pill -long-acting progestogens |
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Smear Management: Mild dyskaryosis
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repeat smear after 6 months and referral for colposcopy if changes persisted
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Smear Management: Moderate dyskaryosis
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Refer for colposcopy
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Smear Management: Severe dyskaryosis
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Refer for colposcopy
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Smear Management: Inadequate
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Repeat smear - if persistent (3 inadequate samples), assessment by colposcopy
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Management of PID?
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oral ofloxacin 400 mg twice daily plus oral metronidazole 400 mg twice daily for 14 days
In pts ceftriaxone 2 g IV daily plus IV doxycycline 100 mg twice daily,* followed by oral doxycycline 100 mg twice daily plus oral metronidazole 400 mg twice daily for a total of 14 days |
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Chlamydia management?
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doxycycline (7 day course) or azithromycin (single dose)
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Which type of cervical cancer is not detected on screeen?
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Cervical adenocarcinomas (15% of cases)
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England cervical screening program:
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25-49 years: 3-yearly screening
50-64 years: 5-yearly screening |
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What can be used as a short-term option to rapidly stop heavy menstrual bleeding
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Norethisterone 5 mg tds
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Is Ciprofloxacin contradicted in pregnancy?
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YES
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Are quinolones contradicted in pregnancy?
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Yes (all -floxacin)
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Medical management of infertility in PCOS?
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Clomifene is superior to metformin
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Management of bacteria vaginosis
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oral metronidazole for 5-7 days
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When should anti-D be given?
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anti-D at 28 + 34 weeks, after
or if any bleeding occurs |
