Gynae pass med Flashcards
(22 cards)
Beads-on-a-string’ sign refers
chronic salpingitis, with mural nodules appearing as ‘beads’ and the relatively-thin wall appearing as ‘string’.
fibroids appear like what on USS
Fibroids will often appear as hypoechoic masses.
Infertility in PCOS first line drug after weight loss
Clomifene
moa clomifene
Binds to estrogen receptors: Clomiphene binds to estrogen receptors in the brain.
Blocks estrogen: Clomiphene prevents estrogen from binding to the receptors.
Triggers the pituitary gland: The brain’s pituitary gland releases more follicle stimulating hormone (FSH) and luteinizing hormone (LH).
Stimulates ovarian follicles: The increased FSH and LH stimulates the growth of ovarian follicles and ovulation.
Ix and mX for menorrhagia
when do meds get started
FBC
TVUS
either mefenamic acid 500 mg tds (particularly if there is dysmenorrhoea as well) or tranexamic acid 1 g tds. Both are started on the first day of the period
IUS first line for contraception
what drug option is a good short-term option to rapidly stop heavy menstrual bleeding.
Norethisterone 5 mg tds
urinary incontinence
what ix and what to rule out
urinanalyis to rule out DM and UTI
vag exam
urodynamic studies
A complete hydatidiform mole occurs when
all of the genetic material comes from the father.
Incomplete hydatidiform mole occurs due
two sets of paternal chromosomes and one set of maternal chromosomes
what 3 features other than snowstorm appearance of mixed echogenecity will be shown when looking at a hydatidiform mole complete
vaginal bleeding
uterus size greater than expected for gestational age
abnormally high serum hCG
what is cervical excitation and what causes it
Cervical excitation, also known as cervical motion tenderness (CMT), is a sign of pelvic pathology that can be caused by a number of conditions, including:
Pelvic inflammatory disease (PID): A common cause of CMT
Ectopic pregnancy: Another common cause of CMT
Endometriosis: Can cause CMT
Ovarian torsion: Can cause CMT
Appendicitis: Can cause CMT
Perforated abdominal viscus: Can cause CMT
CMT is often detected during a bimanual pelvic exam, where two fingers are used to feel the pelvis. The pain associated with CMT is so intense that patients may reach up towards the ceiling, as if to grab a chandelier. This is why CMT is also known as the “chandelier sign”
An 18 year-old girl presents to the Emergency Department with sudden onset sharp, tearing pelvic pain associated with a small amount of vaginal bleeding. She also complains of shoulder tip pain. On examination she is hypotensive, tachycardic and has marked cervical excitation.
ectopic preg
The history of tearing pain and haemodynamic compromise in a women of child bearing years should prompt a diagnosis of ectopic pregnancy.
patient presents with signs of secondary amenorrhoea, having had regular menstrual cycles until recently. The most prevalent cause of secondary amenorrhoea is
pregnancy
The patient presents with signs of secondary amenorrhoea, having had regular menstrual cycles until recently. The most prevalent cause of secondary amenorrhoea is pregnancy; however, a negative beta-HCG test rules this out. The diminished gonadotrophin levels suggest that the secondary amenorrhoea has a
hypothalamic origin
explain hypothalamic dysfunction with ammenhroea
Gonadotrophins, which are secreted by the anterior pituitary gland in response to hypothalamic stimulation, promote follicular development and ovulation. These hormone levels decline when physiological conditions render the body unsuitable for pregnancy, such as in cases of anorexia nervosa. Conversely, elevated gonadotrophin levels would indicate ineffective ovulation by the ovaries, prompting an increased hormonal effort to stimulate follicular development and ovulation. In this case, hypothalamic amenorrhoea is the most probable cause given her elevated stress levels, suggesting her body may not support pregnancy effectively.
Uncontrolled hyperthyroidism can lead to amenorrhoea which is due to raised levels of
prolactin
POI gonadotrophins present how
high gonadotrophin levels due to decreased feedback inhibition from the ovaries
recurrent candida vag what do you need to rule out
DM
referral criteria for vomit in preg
Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics
Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics
A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection)
avoiding triggers have not worked to stop hyperemesis what can we do
give antihistmines orally
secon line - oral ondansetron - increased risk of cleft palate
oral metoclop- not used for more than 5 days
if admitted - normal saline with added potassium is used to rehydrate
how long after miscarriage should preg test be carried out
3 weeks
when should surgical mx of miscarriage be carried out
infection
increased risk of H
