Contraception, Infertility, PCOS, Menopause - Dr Usama BW3

Question 1

Contraception:

Answer 1

Question 2

Conception rate:

Answer 2

Question 3

Menstrual cycle:

Follicular development:

Pituatary and ovarian hormone levels

Endometrials cycle (thickness)

Answer 3

LH peaks causes Ovulation: - corpeus luteum

Question 4

Natural family planning:

Answer 4

Question 5

What is lactatioonal amenorrhoea?

Explain? Issues relying on it? How long does it owork?

Answer 5

Question 6

Condoms (males)

benefits? Risks?

Answer 6

Question 7

Female condoms: Risks benefits

Answer 7

fds

Question 8

COCP=

COCP? Vaginal ring?

What does the COCP actually do to stop someone getting pregnant-????

Answer 8

Suppreses LH surge mid cycle

THickens cervical mucus

Question 9

Pros vs Cons - COCP:

Answer 9

• Mode Of treatment for PMS
• Excessicve androgen - PCOS
• Cheap - effective
• missed pills - catch up
• still gets sti

Question 10

Contraindication to COCP

Answer 10

Question 11

Other uses of COCP

Answer 11

Menohaggia

acne

Hiritusims

Question 12

Managing side effects of COCP

Answer 12

Acne

Headaches

Nauseas (estrogen)

Lower libidio+ Mood changes - Use copper

Breakthrough bleeding

Question 13

How does the progesterone only pill work?

Advantages vs disadvantages

Answer 13

Question 14

LARC: Long acting reversible contraception

What are the major benefits?

What is Depo-provera? What is it? How often? How does it work?

Answer 14

Question 15

Depo-provera- Advantages/diasadvantages

Explain - Advantages vs disadvantages

What do you need to do with this? (DEXA scan) - M

Often used in patients with intelectual disability

Answer 15

Question 16

Implanon: Pros vs Cons:

How long does it last?

How does it work?

Answer 16

Question 17

Intrauterine contraceptive devices:

Mirena: Pros vs Cons

Better side effect profile:

Localised effect vs systemic: Can be used to menorrhagia, amenhorrhoea rates high.

Can be painful to insert:

Serious side effects? LIST

Answer 17

• Uterine perforation!!! (complication) (young and old- more common)
• Expulsion - Can occur in women with heavy periods
• Infection: Foriegn body- PID (discharge , pain fever)
• may causes pt increase Ovarian cysts

Question 18

Copper IUDS:

Pro vs vs cons

Answer 18

f

Question 19

Permanent Contraception:

Tubal ligation

Salpingectomy

Vasectomy

Pros vs Cons ???

Answer 19

• Usually added onto C section- (when pt has had enough kids)
• Surgical risk: Complications/ adhesions/infections/PID/Damage to bowel and bladder/anaesthetic risk
  *

Question 20

Tubal ligation

Provs vs Cons

Answer 20

Question 21

Bilateral salpingectomy:

Pros vs Cons

Answer 21

Question 22

Vasectomy:

Pros Vs Cons

Very safe easy

Answer 22

Question 23

What is the UK MEC criteria?

What does it do?

Explain

score 1-4

1 all good

4 - contraindicated

Answer 23

Question 24

Timing of initation:

Answer 24

Question 25

Late and missed pills: COCP: read up Explain? Timings? What do you tell them to do???

Answer 25

Question 26

Missed progesterone only pill-

Answer 26

Question 27

Emergency contraception: What do you need to? What do you need t couensel patient on?

Answer 27

Question 28

Levonogestre; - LNG EC (Progesterone based- same as mirena) Emergency copper IUD?

Answer 28

Question 29

Menopause: Define? Average age? Symptoms? when do they begin to occur? How long can it last? What are primary issues people complain about ?

Answer 29

* Urinary frequency * Vaginal dryness * Vaginal atrophy * Facial flushing * Mood swings changes

Question 30

Consequences of menopause? List 6 complications:

Answer 30

Question 31

Benefits of menopausal hormone therapy? What does it help prevent? What is it made up of? (only oestorgen) If she has uterus (needs progesterone + add mirena)

Answer 31

* Decreases CV risk * decreases thrombosis risk

Question 32

List most important risks associated with menopausal hormonal therapy:

Answer 32

* generally should be iniated before the age of 60 * Current safety * Using testosterone therapy

Question 33

Fertility: New lecture: types of infertility?

Answer 33

Question 34

What are causes of subfertility: female? Male?

Answer 34

Question 35

PCOS Clinical syndrome: Significant psychosocial issues:

Answer 35

Question 36

How is a diagnosis of PCOS made? Need 2/3 - Whats the classification called? What are the 3 criteria?

Answer 36

Question 37

Other causes of anoovulation? Hyperandrogenism?

Answer 37

Question 38

Hx examination of PCOS: Outline

Answer 38

Question 39

Investigations for PCOS: OUtline

Answer 39

Question 40

Management of PCOS: Principles? Lifestyles? BMI? Psychological (depression)

Answer 40

Question 41

Management: Metabolic and long term: Explain Key points: Insulin resistance/CVS health (yearly BP and lipid profile), Endometrial (cocp, low threshold)

Answer 41

* LAser/ hair removal- * COCP - Hiritusim

Question 42

Management: PCOS- fertilty- getting pregnant with PCOS:

Answer 42

* First line: No treatment until BMI \<35 * Letrzole - aromotase inhibitor- Highly effective (inducing ovulation -mimic LH surge) * Clomiphene- SERM

Question 43

What are other key points about management of PCOS:

Answer 43

CVS - manage CV risk Management - Of lipids/ BSL/ sugar resistance/ Use of metformin: