Adult and Child Gynae Flashcards
(25 cards)
Gillick competence
children under 16 consenting that they have sufficient understanding and intelligence to fully understand what is involved in a propose treatment, nature, effects and risks, chances of success etc
what are the fraser guidelines?
‘a doctor would proceed to give contraceptive and treatment to a girl under 16 provided he is satisfied on the following matters that’
physical changes during puberty are progressive and are called what?
‘tanner’ stages
what is precocious puberty?
early puberty (before age 8 in girls and 9 in boys)
what is delayed puberty?
boys have no signs of testicular development by age 14
girls have not developed breasts by age 13 or periods haven’t started by 15
what is vulvovaginitis?
persistant vulval irritation or vaginal discharge
the most common reason for the gynaecological referral or a prepubertal girl
how does vulvovaginitis present?
yellow greenish foul smelling discharge
vaginal exams in adolescents
should only be performed on consenting adolescents who are sexually active and only when it is to add value to the assessment
Menorrhagia
heavy bleeding effecting the quality of life
how do you induce puberty?
gradual build up of oestrogen
what could be causing secondary amenorrhoea?
pregnancy
PCOS
weight gain
fluctuating LH and oestrogen
what are the two different types of amenorrhoea?
primary (no period by the age of 16)
secondary (no period in 6 months despite having periods before then)
investigations for amenorrhoea:
FSH, LH, oestrogen etc
Pelvic USS
pregnancy test
what is dysmenorrhoea?
pain during menstruation
what is amenorrhoea?
no periods
causes of secondary amenorrhoea:
PCOS
weight
pregnancy
fluctuating LH, estrogens
what are the cardinal features of PCOS?
hyperandrogegism
polycystic ovary morphology
how do you diagnose polycystic ovaries?
USS TAS
ultrasound transvaginal sonography
how can you treat polycystic ovaries?
weight loss and lifestyle changes
combined oral contraceptive pill
how would you treat Menorrhagia?
gold standard
combined oral contraceptive
or mirena IUD, POP minipill
when are irregular periods normal?
in the first 2 years of menarche
how would you treat dysmenorhoea?
combined oral contraceptive pill
official name of the criteria that must be met when diagnosing PCOS
rotterdam criteria
what are the 3 things you must have 2 of to diagnose PCOS?
oligo or an-ovulation
polycystic ovaries on US or direct inspection
clinical or biochemical signs of hyperandrogegism
