Chapter 7- Genito-urinary System

Question 1

Is duloxetine licensed for treatment of moderate to severe stress incontinence in women?

Answer 1

Yes

Question 2

What can be used for drug treatment in over 5years if alarm treatment not suitable for nocturnal enuresis

Answer 2

Oral or sublingual desmopressin

Question 3

Common side effects of antimuscarinics

Answer 3

Constipation 
Dilation of pupils 
Dry mouth 
Photophobia 
Reduced secretions 
Bradycardia then tachycardia 
Urinary retention 
Urinary urgency 
Confusion

Question 4

Dose adjustments for fesoterodine for urinary frequency

Answer 4

Max 4mg daily with concurrent use of potent inhibitors of CYP3A4

Question 5

Most common cause of urinary retention in men

Answer 5

Benign prostatic hyperplasia

Question 6

MHRA warning with finasteride

Answer 6

Reports of depression and in rare cases suicidal thoughts in Ned taking finasteride for male pattern hair loss

Question 7

Handling and storage info with finasteride

Answer 7

Women of childbearing potential should avoid handling crushed or broken tablets of finasteride

Question 8

What can be used for the alkalinisation of urine

Answer 8

Potassium citrate

Sodium bicarbonate

Question 9

Oestrogen containing contraceptives should ideally be stopped how long before major elective surgery and can be substituted with what?

Answer 9

4 weeks

Progesterone only

Question 10

MOA of progesterone only contraceptives

Answer 10

Alter cervical mucus to prevent sperm penetration and may inhibit ovulation in some women

Question 11

Emergency hormonal contraceptive options and licensing on duration

Answer 11

Levonorgestrel (72hours - can be given 72-96 hours but unlicensed
Ulipristal (120hrs (5days))

Question 12

Alternative method for emergency contraception other than hormonal?

Answer 12

Insertion of intra-uterine device inserted up to 120 hrs (5days) after UPS

Question 13

The effectiveness of contraceptives can be decreased by drugs that induce hepatic enzyme activity - true or false?

Answer 13

True

Question 14

Options of contraception not affected by enzyme inducers

Answer 14

parenteral progesterone only:
Medoxyprogesterone
Norethisterone
Intra-uterine devices

Question 15

What to do with contraception if on a short course (2 months or less) of an enzyme inducing drug

Answer 15

Continue contraception but use barrier method for duration of treatment and four weeks after

Question 16

Why is ulipristal not recommended in patients with severe asthma taking oral corticosteroids?

Answer 16

Due to the antiglucocorticoid effect of ulipristal

Question 17

The most effective IUDs have how much copper in?

Answer 17

380mm^2

Question 18

MHRA advice with copper IUD

Answer 18

1 in every 1000 insertions cause uterine perforation symptoms:

• severe pelvic pain
• increased bleeding
• sudden changes in period
• pain during intercourse
• unable to feel the threads

Question 19

List 4 phosphodiesterase type 5 inhibitors used for erectile dysfunction

Answer 19

Avanafil
Sildenadil
Tadalafil
Vardenafil

Question 20

Tamsulosin can be given OTC under what conditions

Answer 20

• 45-75 year old male
• have BPH
• give 2 week supply initially, if benefit can give a further 4 weeks but they need to see GP
• if no benefit after two weeks, stop taking and see GP

Question 21

Bladder infections you can give aqueous chlorhexidine but it’s not effective against what

Answer 21

Pseudomonas

Question 22

Drospirenone is a progesterone used in COC- it’s a derivative of what and therefore what do you need to be cautious of?

Answer 22

Spironolactone

Potassium

Question 23

COC increase the risk of what?

Answer 23

Breast cancer
Cervical cancer
VTE

Question 24

COC decrease the risk of what

Answer 24

Ovarian cancer

Endometrial cancer