paediatric and adult gyn

Question 1

what is Gillick competence ?

Answer 1

children under 16 can consent if they have sufficient understanding and intelligence to fully understand what is involved in a proposed treatment etc

Question 2

what is Fraser guidelines ?

Answer 2

doctors can give contraceptive advice and treatment to a girl under 16 if ;
advice understood
cannot be persuaded to inform parents
likely to continue having sex
mental health at risk
in best interest

Question 3

how does vulvovaginitis present ?

Answer 3

3-7
yellow-green offensive discharge
vaginal soreness and itching
red flush

Question 4

what causes vulvovaginitis ?

Answer 4

poor perineal hygiene
lack of oestrogen
chemical irritation

Question 5

how do you treat menorrhagia ?

Answer 5

progesterone only pill
tranexamic acid
COCP
mirena coil

Question 6

what causes pain in periods and how do you stop it ?

Answer 6

higher levels of prostaglandins

anti-prostaglandin drugs - mefenamic acid

Question 7

how do you induce puberty ?

Answer 7

gradual build up with oestrogen

add progesterone once maximum height reached

Question 8

what can cause secondary amenorrhoea ?

Answer 8

weight
PCOS
pregnancy
fluctuating LH/oestrogens

Question 9

how is polycystic ovary syndrome diagnosed ?

Answer 9

2/3 of;
oligo or anovulation
clinical or biochemical signs of hyperandrogenism
polycystic ovaries on USS

Question 10

how do pelvic cysts present ?

Answer 10

subacute history
usually tender to one side of pelvis or behind
may feel mass

Question 11

is mucoid discharge usual in infants ?

Answer 11

yes, common in infants up to 2 weeks after birth, result from maternal oestrogen

Question 12

what are rare cases/rare causes of common conditions in gynae ?

Answer 12

absent uterus - malaria agenesis
undeveloped breasts - turners
heavy periods - thyroid disorder
congenital adrenal hyperplasia - mineralocorticoid deficiency
childhood cancer survivors - amenorrhoea