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GP > GP - sexual & reproductive health > Flashcards

GP - sexual & reproductive health Flashcards

1
Q

What are the 3 main components of breast milk?

A

colostrum > protein, 3 days post birth
foremilk
hindmilk - energy

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2
Q

Name 3 common causes of vaginal discharge

A 
candida/thrush 
bacteria vaginosis 
trichomonas
chlamydia
gonorrhoea
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3
Q

How does hormonal contraception work?

A

combined (pills, patch, vaginal ring) - prevents ovulation, thickens cervical mucus, thins womb lining
Progesterone (pill, implant, injection, coil) - thickens cervical mucus, thins womb lining

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4
Q

How do you treat gonorrhoea and chlamydia?

A

Chlamydia - arithromycin 1g, single dose

Gonorrhoea - IM ceftriaxone

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5
Q

What is the difference between the Fraser and Gillick competency?

A

Fraser - seeing if doctor can offer contraception
Gillick -states that a person under 16 can consent to their own medical treatment without the need for parental permission

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6
Q

What does the child need to understand to comply with Gillick competency?

A 
the purpose of the treatment 
the pros and cons 
the risks 
the chances of success 
the availability of other options
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7
Q

What are the 5 criteria for Fraser competency?

A
  1. They have sufficient maturity and intelligence to understand the nature and implications of proposed treatment
  2. they cannot be persuaded to tell their parents
  3. They are likley to continue having sex with or without contraception
  4. their physical or mental health will suffer if they do not get treatment
  5. it is in their best interests
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8
Q

What are three types of combined contraceptive? How do they work?

A

COCP, vaginal ring, patch

They prevent ovulation, thicken cervical mucus and thin lining of womb

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9
Q

What are the contraindications of combined oral contraceptives?

A

migraine with aura, venous thromboembolism, hypertension, BMI>35, aged >35, active breast cancer, IHD, stroke, smoking

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10
Q

What cancers do COCP increase and decrease the risk of?

A

Increase risk of breast cancer

Protective of ovarian, endometrial, colon

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11
Q

What is the criteria to decide whether an individual can have contraception?

A

UKMEC (medical eligibility criteria)

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12
Q

What are the advantages of COCP?

A

regular and predictable cycle, helps acnie, decreased risk of PID due to thickened mucus, some people like having periods, 12 hour window, can improve heavy or painful periods

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13
Q

Name 4 progesterone-only contraceptives

How do they work?

A

Pill, implant, mirena coil, depo-provera injection

They suppress LH and FSH, inhibit ovulation (sometimes), thicken cervical mucus, thin endometrium

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14
Q

What are the SE and benefits of the injection?

A

SE - increased appetite, slow return to fertiliy, changes insulin requirements
Benefits - can help PMS and aid painful periods

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15
Q

What is nexplanon? What additional information do you need to give them?

A

It is etonogestrel - the implant

They need to use condoms for 1 week

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16
Q

What are the indications of the mirena coil?

A

Contraception
Menorrhagia
Endometriosis
Endometrial protection with HRT

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17
Q

What are the advantages of progesterone only contraception?

A

No estrogenic SE, few contraindications, fewer interactions

18
Q

What are the disadvantages of the implant?

A

It’s a minor operation
It can cause irregular bleeding
it is affected by liver enzyme inducers

19
Q

What are classic oestrogenic SE?

A

breast tenderness, nausea, headaches, vaginal discharge

20
Q

What are classic progestogenic SE?

A

acne, hirturism, mood-swings, breakthrough bleeding, amenorrhoea

21
Q

What are some disadvantages of progesterone only pills?

A

Shorter window of effectiveness, increased risk of ectopic due to slow ovum transport, distrupted mestrual pattern, can develop ovarian cysts, less effective than COCP

22
Q

What are the most common SE of the Evra patch?

A

Skin irriation

23
Q

Disadvantages of COCP?

A

does not protect against STI, decreased efficacy if taken imperfectly, decreased efficacy with D&V, affected by liver enzymes and inhibitors

24
Q

How does copper coil work?

A

toxic to sperm and egg

Trigger foreign body reaction in uterus so prevents implantation

25
Q

What are some negatives of the copper coil?

A

heavy irregular spotty bleeding, PID (first 20 days), ectopic, perforation, expulsion

26
Q

How long after UPSI can copper coil be inserted? Why does it work?

A

5 days - prevents implantation by irritating uterine wall

27
Q

How long after UPSI can levonelle/levonorgestrel be taken? How does it work?

A

72 hours - inhibits ovulation, decreases viability of ovum, decreases sperm number

28
Q

How long after UPSI can acetate/ellaOne by taken? How does it work?

A

120 hours - inhibits ovulation, decreases viability of ovum, decreases sperm numbers

29
Q

What are the advantages and disadvantages of emergency contracpetive pills?

A

Adv - can be easily found, can be repeated in same cycle

Dis - N&V, intermenstrual bleeding

30
Q

What causes bacterial vaginosis?

A

increased lactobacilli, increased pH

31
Q

What is it?

White, itching, lots, odour, pain

A

Bacterial vaginosis

STI

32
Q

What is it?

White, cottage cheese texture, thick, itching, rash

A

Yeast infection, thrush, candidasis

33
Q

What is it?

Clear, increased volume

A

ectropian, physical exercise, sexual arousal, ovulation, hormonal contraception, stress, pregnancy

34
Q

What is it?

brown

A

ovulation, advanced cervical cancer, polyp, menstruating, fistula, endometrial cancer, period, miscarriage, normal spotting

35
Q

What is it?

Brown, odour

A

pregnancy, miscarriage, normal

36
Q

What is it?

Yellow/green, thick, bad smelling, pain, itching

A

trichomoniasis

37
Q

What is it?

Yellow

A

Chlamydia, gonnorhea

38
Q

What is it?

Green

A

infection

39
Q

What is it?

Heavy and odour

A

PID, retained foreign body

40
Q

How do you treat PID?

A

ofloxacine + metronidazole (oral)

IM cefrixone + doxycyline + metronidazole

41
Q

How do you treat syphilis?

A

benzathine benzylpenicillin

erythromycine/doxycycline

42
Q

How do you treat bacterial vaginosis?

A

oral/topical metronidazole

GP (11 decks)

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