Adolescent Gynaecology Flashcards

1
Q

Define Gillick Competence?

A

Child <16yrs is able to give/withhold consent if the doctor feels she fully understands an intervention and it’s risks
It can be overridden by parents in some circumstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Fraser Competence?

A

Refers specficially to giving contraceptive advice/prescription:
- Mature enough to understand advice & implications of treatment
- Likely to continue/begin sex regardless of treatment
- Attempted to persuade to tell parents (or let you tell them)
- Health would suffer without treatment/advice
- In their best interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At what age do you investigate Primary Amenorrhoea as abnormal?

A

16 if normal 2* sex characteristics

14 if not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What tests can you do for 1* amenorrhoea?

A

FSH, LH, PRL, TSH, Test & oestrogen

Pelvic US

Progesterone withdrawal bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you induce puberty?

A

Gradually build up Oestrogen
Add progesterone once max height potential reached (and on atleast 20mg of oestrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes for 2* amenorrhoea in adolescents?

A
  • Weight (Anorexia)
  • PCOS
  • Pregnancy
  • Fluctuating LH/oestrogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What bleeding disorders are common in adolescence?

A

Amenorrhoea (common periodically for 1st 2 years)

Pregnancy

Coagulation disorders e.g. vWs

Leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you manage menorrhagia in adolescants?

A

Reassure
PoP
Tranexamic Acid
Mefenamic Acid
cOCP
Mirena (LNG-IUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who gets vulvovaginitis and why?

A

2-7yr olds

Often due to infection or labial agglutination (adhesion of labia minora in midline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you manage labial agglutination?

A
  • Hygiene
  • Lubrication
  • Topical Oestrogen
  • Surgical separation (rarely)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you manage infection in vulvovaginitis?

A
  • Culture (E. Coli, Proteus, Pseudomonas)
  • Urinalysis (rules out cystitis)
  • Hygiene
  • Perianal exam with tape for pinworms
  • Exam UA if persistant discharge to rule out foreign body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Also always remember to test teens for!

A

Chlamydia!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly