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Flashcards in clinical gynaecology Deck (17):
1

describe cervical screening

PAP smear
- effective screening test for cervical cancer

2

what does clinical gynecology include

the female genital tract
- discomfort/disease
- prevention of disease
- reproduction/contraception

3

when a patient comes in with gynecological symptoms what is the next step?

- take a proper history
- do a gynecological examination
- order further investigations

4

describe gynecologic history taking

presenting complaint
- onset, duration, course, severity
- lifestyle impact

specific complaint related history
- cervical smear
- sexual health
- obstetric history
- menstrual bleeding

5

questions to ask when a patient comes in with heavy menstrual bleeding

- last menstrual period
- cycle regularity
- flow
- inter-menstrual bleeding
-postcoital bleeding
- medications

6

describe gynecological examination

- general & abdominal examination (breast >40yrs)
- pelvic exam e.g. speculum & bimanual

7

describe gynaecological investigations

- urine
- cervical smear
- vaginal swabs
- biopsy (pipelle)
- ultrasound
- blood test

8

what are structural causes of heavy menstrual bleeding

P= Polyps
A= adenomyosis
L = leiomyoma
M = malignancy & hyperplasia

9

what are the non-structural causes of heavy bleeding

C = coagulopathy
O = ovulatory dysfunction
E = endometrial
I = iatrogenic
N = not yet classified

10

define uterine fibroids and the symptoms present

benign leiomyomata arising from the uterine myometrium

- no pain
- pelvic discomfort
- abnormal uterine bleeding

11

treatment of uterine fibroids

conservative

medical
- NSAIDS during menstrual bleeding
- GnRH analogues
- mirena if fibroids are small and not submucosal

invasive
- Myomectomy
- hysterectomy
- uterine artery embolism

12

treatment for heavy menstrual bleeding

initially:
- progesterones (high dose / 10 days)
- tranexamic acid

followed by:
- oral contraceptive (depending on Aage and BMI)
- progesterone

13

describe tranexamic acid

anti-fibrinolytic that prevents plasminogen activation

14

what are surgical procedures for heavy menstrual bleeding

endometrial ablation (balloon method)

hysterectomy

15

types of incontinence

- overflow
- stress
- urge

(common in overweight women)

16

describe endometriosis and how it is diagnosed

- a disease characterized by functional extra-uterine endometrium

- diagnosed by laparoscopy

17

treatment for endometriosis

- explanation and multidisciplinary approach
- pain managment
- hormonal supression of endometrial cells
- (mirena)
- surgical e.g. laparoscpoic excision