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15 Cards in this Set
- Front
- Back
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A 28 yr old woman presents with PV discharge that smells. It sometimes hurts when she pees. What is the differential? How would you make the diagnosis? |
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A woman comes with urge incontinence. Whate investigations could be done? What is the management>? |
Investigate withMSU, bladder diary, Urodynamics Bladder retraining followed by Oxybutinin(may cause anti-cholinergic SEs) |
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Moderate Dyskaryosis? |
Colposcopy |
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What are risk factors for developing breast or endometrial or ovarian cancer? |
General RFs BRCA 1 + 2 Never used OCP Age Family History Long oestrogen exposure Breast Only: High social class, increased breast density Endometrial only: Tamoxifen |
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Endometriosis? |
Presence of endometrial tissue outside the womb, causing painful heavy periods and dyspareunia. The uterus is usually fixed and retroverted and there is a palpable pelvic mass. Diagnosis is made by US and Laparoscopy. Management is: COCP, NSAIDs Surgery if there is suspected severe disease. Pulse of GnRH if fertility is required, or IVF. |
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What are the risk factors for Cervical Cancer? |
HPV infection Increased number of sexual partners Smokers OCP
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What causes Chorioamnitis and how does it present? What is the management? |
Infection after PROM, usually E coli, Strep and Entero faecalis. Abdominal pain, tenderness and a maternal fever. Do not do a Vaginal Exam, Child should be delivered immediately and given antibiotics. |
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What are contraindications for the COCP? |
CVS: clots, AF, Sickle cell Migraine: with aura, severe Liver: cirrhosis, viral hepatitis, abnormal LFTs Other: HUS, mole |
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What are the best investigations for tubal patency? |
Laparoscopy and dye is the gold standard as the tubes can be visualised and a firm diagnosis made. Hysterosalpingogram is best to avoid the somplications of surgery, but 1/3 diagnoses of abnormalities are incorrect, and patients will need laparoscopy in any case. |
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What is the appropriate management of fibroids? |
Fertility is desired
Fertility not desired
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What is the management of menorrhagia and dysmenorrhoea? |
NSAIDs Tranexamic Acid COCP
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What effects do oestrogen and progesterone have on the endometrium? |
Oestrogen is secreted soon after the menses to cause proliferation of the gland cells and stroma, causing production of a thin mucus lining. Progesterone levels rise in luteal phase after ovulation, causing preparing the endometrium to receive the fertilised egg, but increaseing cervical and vaginal secretions. |
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What would a hormone profile show in PCOS? |
LH : FSH ratio would be 2:1 or 3:1 Prolactin high testorerone high |
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What are the options for Termination of Pregnancy? |
Early Medical Abortion (before 9 weeks) Mifespristone and then PGE2. Vacuum Aspiration (7 - 15 weeks) - under GA or LA Late Medical Abortion (9 - 20 weeks) is Mifepristone and PGE2 as well. Surgical Dilation and Evacuation (15 weeks onwards) - Under general anaesthetic the cervix needs to be stretched before the uterus is evacuated. Late abortion may be two part surgical operation or a PGE2 induced labour. Appropriate counselling and support is needed for the patient. |
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How does Anal cancer present? What are risk factors? How is it diagnosed? What is the treatment? |
Bleeding and pain usually Analtrauma, haemmorhoids, MSM, HPV. Diagnosed by biopsy and surgically excised. |
