Flashcards in Gynea conditions Deck (25):
Who gets fibroids?
What is a fibriod?
What % are incidental findings?
What is red degeneration?
Fibroid torsion - lack of blood supply - necrosis
Treatment of fibroids?
Watch and wait
Surgery ......myomectomy, hysterectomy, endometrial ablation, uterine artery embolisation
IUS - for menorrhagia (or tranexamic acid or COCP)
What is adenomyosis?
Endometrial tissue in myometrium
Medical management- contraception
Surgical - hysterectomy
What symptoms might you get with endometriosis?
Painful viscera - bowel and urine
Dx- lap. Biopsy.
Lap plus ablation
Gold standard for fibroid removal?
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
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
7-14 weeks vacuum aspiration
13-24 weeks - dilation and evacuation (surgical forceps)
Wha are the types of miscarriage?
What are associated with recurrent miscarriage?
BV infection - 2nd trimester loss
Parental chromosomal abnormality
Where are the major of ectopic pregnancies located?
Rx- mexotrxate (don't get pregnant until 3 months after)
Surgical - laparoscopy - salpigectomy
What is lichen sclerosis?
Bruised purpuric signs -
Elastic tissue become collagen
Vulva becomes white flat and shiny
Rx- clobetasol propionate
When can a TOP happen post 24weeks?
Risk to mothers life
Permanent injury to mothers physical/mental health
Child would be severely handicapped
What is the treatment for genital warts (aka condylomata accumulate)?
Multiple non-keratinised - topical podophyllum
Solitary keratinised - cryotherapy
2nd line : imiquimond
What do you see a whirlpool sign in?
Or Bowel volvulus
What is the treatment for symptomatic cervical ectropium?
Silver nitrate or diathermy
What are this causes of a lobulated uterus?
Itching vuvla, white shiny appearance?
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
How might ovarian torsion present?
Unilateral pain and tender mass
How do you diagnose fibroids?
How can atrophic vaginitis present?
Vag bleeding, dyspareunia, urinary infection, stress incontinence or prolapse
No oestrogen - thinner, loss of structure