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Flashcards in Gynea conditions Deck (25):
1

Who gets fibroids?

Black,
Older
Nulliparity

2

What is a fibriod?

Lieomyoma

3

What % are incidental findings?

50%

4

What is red degeneration?

Fibroid torsion - lack of blood supply - necrosis
Pain

5

Treatment of fibroids?

Watch and wait
Surgery ......myomectomy, hysterectomy, endometrial ablation, uterine artery embolisation

Medical
IUS - for menorrhagia (or tranexamic acid or COCP)

6

What is adenomyosis?

Endometrial tissue in myometrium

Medical management- contraception

Surgical - hysterectomy

7

What symptoms might you get with endometriosis?

Cyclical pain!
Painful viscera - bowel and urine
Extra bleeding
Deep dyspyrunia
Sub fertility
Chocolate cysts
(Rare- haemopneumothorax)

Dx- lap. Biopsy.
Lap plus ablation

8

Gold standard for fibroid removal?

Myomectomy

9

How would you diagnose someone with PCOS?

Rotterdam criteria: 2/3 must be present
- polycyctis ovaries (>12 follicles or volume >10cm on us)
- oligo- ovulation or anovulation
- clinical or biochemical signs of hyperadrogenism

10

How do you decide which type of TOP (termination) is used?

Gestation and woman's choice

<9 weeks - medical: mifepristone (orally) and misoprostol (orally 400mcg or if later pv/buccally 800mcg)

9-13 weeks - mifepristone (orally) and misoprostol 800mcg (vaginally) plus further misoprostol if needed

13-24 weeks - mifepristone (orally) and misoprostol 800mcg (pv) then 3hourly dose of misoprostol.

After 21+6 - fetocide - 3ml intracardiac potassium chloride

Surgical -
7-14 weeks vacuum aspiration
13-24 weeks - dilation and evacuation (surgical forceps)

11

Wha are the types of miscarriage?

Missed
Inevitable
Threatened
Incomplete

12

What are associated with recurrent miscarriage?

BV infection - 2nd trimester loss
Parental chromosomal abnormality
Underinvestment abnormalities
Antiphospolipid syndrome
Thrombophillia

13

Where are the major of ectopic pregnancies located?

Ampulla (tubes)
Isthmus
Ovary
Peritoneum

Rx- mexotrxate (don't get pregnant until 3 months after)
Surgical - laparoscopy - salpigectomy

14

What is lichen sclerosis?

Bruised purpuric signs -
Elastic tissue become collagen
Vulva becomes white flat and shiny

Rx- clobetasol propionate

15

When can a TOP happen post 24weeks?

Risk to mothers life
Permanent injury to mothers physical/mental health
Child would be severely handicapped

16

What is the treatment for genital warts (aka condylomata accumulate)?

Multiple non-keratinised - topical podophyllum

Solitary keratinised - cryotherapy

2nd line : imiquimond

17

What do you see a whirlpool sign in?

Ovarian torsion

Or Bowel volvulus

18

What is the treatment for symptomatic cervical ectropium?

Silver nitrate or diathermy

19

What are this causes of a lobulated uterus?

Fibroids, pregnancy

20

Itching vuvla, white shiny appearance?

Lichen sclerosis

21

What is goserelin and what's it used for?

GnRH analogue, used prior to fibriod surgery to shrink then

Not for >6m use due to demineralisation of bone

Fibriods worse when preg and on cocp

22

How might ovarian torsion present?

Unilateral pain and tender mass
N&V

23

How do you diagnose fibroids?

Transvaginal ultrasound

24

How can atrophic vaginitis present?

Vag bleeding, dyspareunia, urinary infection, stress incontinence or prolapse

No oestrogen - thinner, loss of structure

25

Most common cause of clear wet non itchy vaginal discharge?

Ectropium (extension of columnar zone which is secretory )