Adolescent Gynae BW 3

Question 1

Menarche and initial cycles:

What role does nutrition have in menarche?

Answer 1

Question 2

What is HMB? Heavy menstrual bleeding?

Answer 2

Question 3

What impact does HMB have on individuals?

Answer 3

Question 4

What is AUB? Abnormal uterine bleeding

PALM

COIEN

Answer 4

Question 5

What are non structual causes of AUB? PALM COIEN:

Answer 5

Question 6

Periods (menstrual symptoms+ Signs)

Answer 6

Caused by increased PG

Question 7

What is retrograde menstruation?

What would you find (signs and symptoms)? What time of pain does this cause?

Answer 7

Question 8

Fixing periods problems:

Answer 8

1. NSAIS
2. TXA
3. Cyclic progestagens
4. OCP- Pill - easy once per day
5. Mirena IUS

Question 9

Contious OCP, Continous progestogens (not bleeding) - Different methods:

Answer 9

Question 10

RCH guidelines on skipping periods and good for patients:

Question 11

What are other benefits of OCP?

List 4 - 2 marks

Answer 11

Question 12

Preparing for periods in girls with disabilities:

What should be done and discussed?

Answer 12

Explaining what the period is

Chnages that occur

Age approriate manner

Show how to change and dispose

Being comfortable with the idea of bleeding- Not bad

Period products suitable for patient

Question 13

CAse 1: Read

Answer 13

• Education for child and parent
• teaching how to use pads correctly
• pain management? Heavy?
• Behaviourally difficult because shes in pain? (non verbal)
• Consider NSAIDs for symptoms
• Heat packs, rest
• COCP
• Depo-provera
• Period underwear
• LARC - mirena

Question 14

Practise points:

read: For previous case

Answer 14

Question 15

What is amenorrhoea?

Primary vs secondary?

Answer 15

Question 16

Causes of amenorrhoea: From head to toe:

ALWAYS do HCG first!

What investigations?

What are common causes of secondary amenorrhoea?

Answer 16

1) FBC, Prolactin levels, TFTs
2) PCOS, excsise (common secondary causes)

Question 17

History and examination for amenorrhoea: Outline assessment? What are you going to ask?

Physical examination: General appearance? height and weight? BP? Secondary characteritics? Thryroid/hirituism

Tanner stage?

Secondary characteritics?

Answer 17

Question 18

First line investigations for Amenorrhoea?

Answer 18

1. FSH, LH
2. Oestradiol
3. TSH -
4. Prolactin
5. Pelvic USS- check for no obstruction +uterus present

Question 19

Case 2:

Hx? Exam? Management?

Answer 19

Question 20

Common vulval conditions: Anatomy: Is described in clocklike fashion:

What is the hymen? What is an imperforate hymen?

Answer 20

Question 21

Different hymen anomalies:

Answer 21

Question 22

What is an imperforate hymen?

Answer 22

Question 23

What is vulvavaginitis?

What ages? What causes it?

Why does it occur?

Answer 23

Hypoesotrogenic state- allows inflammation to occur in vagina

Often posttoliet training, inadequate wiping, irratants

Question 24

What do you explain to parents about vulvavaginitis?

Treatment options? Explain to parent

Answer 24

Question 25

What if it continues? What should you do? What other things need to be considered? think derm conditions

Answer 25

Question 26

What is labial fusion? When does it occur? Why? Can be distressing to parents - What do you need to explain to parents? that it will go away through puberty

Answer 26

Question 27

Lichen scleorsus: What is it? What are signs and symptoms? Treatment?

Answer 27

Question 28

What are different types of ovarian cysts? What is a functional ovarian cyst? ( Management?

Answer 28

Question 29

What is a dermoid cysts? What years of life do they occur in? Treatment options? - (they are quite heavy- can cause twisting and tort on themselves) - they dont go away on their own

Answer 29

Question 30

Ovarian cancer in adolescents: Often germ cells: Need to add on what tumour markers? to look?

Answer 30

Question 31

Ovarian torsion: outline symptoms: Key features?

Answer 31