Gynae Flashcards
(34 cards)
Most common cause of post menopausal bleeding
Vaginal atrophy
Can still co-exist with endometrial cancer though and should be referred urgently to secondary care
How long should a woman wait to start regular hormonal contraception after taking ulipristal acetate (emergency contraception)
5 days
When can the IUS be inserted after birth
Up to 48hrs after delivery or after 4 weeks
What is the COCP protective against
Ovarian and endometrial cancer
How long should a woman wait to start regular hormonal contraception after having taken levonorgestrel (emergency contraception)
Immediately
What form of contraception should someone with a gastric sleeve / bypass / duodenal switch have
No oral contraception inc emergency due to lack of efficacy
When is levonorgestrel given as oppose to ulipristal
Levonorgestrel must be taken within 72hrs of UPSI
Which contraception has a proven association with weight gain
Depo provera
Mode of action of contraceptive implant
Inhibition of ovulation
What should be done with regard to the COCP and surgery
Stop the pill 4 weeks before surgery and restart 2 weeks after
Management of atypical endometrial hyperplasia in post menopausal women
Total hysterectomy with bilateral salpingo-oophorectomy
Most appropriate due to risk of malignant progression
What is endometrial hyperplasia associated with
- taking oestrogen unopposed by progesterone
- obesity
- late menopause
- early menarche
- > 35
- current smoker
- nulliparity
- tamoxifen
Presentation of a suspected threatened miscarriage
Painless per vaginal bleeding and a closed cervical os
Investigations for suspected PCOS
Pelvic ultrasound
FSH, LH, prolactin, TSH
Testosterone
Sex hormone binding globulin
Investigations for suspected PCOS
Pelvic ultrasound
FSH, LH, prolactin, TSH
Testosterone
Sex hormone binding globulin
What serum bHCG level indicates ectopic pregnancy
> 1500
Diagnostic findings of a miscarriage on TV US
A crown rump length greater than 7mm with no cardiac activity
When is surgical management indicated over medical in an ectopic pregnancy
If there is a foetal heartbeat present
When can expectant management of an ectopic pregnancy be indicated
- An upruptured embryo
- <35mm in size
- No heartbeat
- Asymptomatic
- B-hCG <1000
What is first line treatment of hyperemesis gravidarum
Antihistamines eg promethazine
Most common site of ectopic pregnancy
Ampulla
Drug of choice in medical management of ectopic
Methotrexate
Imaging of choice in suspected ectopic pregnancy
Transvaginal US
Diagnostic triad for hyperemesis gravidarum
5% pre pregnancy weight loss
Dehydration
Electrolyte imbalance
