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YR 3 MED > OBS & GYNAE WK 2 > Flashcards

OBS & GYNAE WK 2 Flashcards

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1
Q

mechanism of action of contraception

A

suppressing FSH and LH by negative feedback
prevention of ovulation

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2
Q

LARC

A

Long acting reversible contraception
-IUD
-permanent methods

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3
Q

permanent contraception methods

A

tubal ligation - female
tie off tubes
vasectomy - male, no scalpel technique
early and late failure rate

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4
Q

LNG releasing IUD

A

Levonorgestrel-releasing
more effective than copper IUD
MIRENA
irregular spotting / bleeding is common

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5
Q

COPPER COILS VS COPPER IUD - PROS AND CONS

A

coils - hormonal
long lasting 3-10 yrs
very effective
quick

uncomfortable, pain
invasive
small risk of perforation

IUD
Can last up to 10 yrs
non-hormonal

heavier periods and longer

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6
Q

SDI

A

subdermal contraceptive implant
-delivery of a steroid progestin from polymer capsules or rods placed under the skin

most effective of all conceptive methods
lasts 3 yrs
progesterone only

bleeding

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7
Q

UK MEC criteria

A

4 categories
1 = no restriction for use, always useable
2 = broadly useable
3 = caution
4 = DO NOT use

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8
Q

combined hormonal contraception, what are the 3 types - CHC

A

pill
patch
ring
combined pill = take daily, then a break

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9
Q

what factors may affect effectiveness of CHC??

A

impaired absorption
increased metabolism

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10
Q

pros and the risks of CHC

Combined hormonal contraception

A

-reduction in ovarian and endometrial cancers
-beneficial effect on acne
-fewer functional ovarian cysts

-VENOUS THROMBOEMBOLISM
-ARTERIAL DISEASE, MI
-ADVERSE EFFECTS ON SOME CANCERS, breast and cervical cancer risk

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11
Q

POP

A

progestogen only pill
taken daily
eg. cerelle

inhibits ovulation
usually taken day 1-5

v small increased risk of breast cancer, so contraindicated in ppl w breast cancer

nausea, spots, bleeding, headache

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12
Q

depo provera / sayana press

A

injection into buttocks
or thigh, by professional, every 13 wks.
injection into thigh by yourself

weight gain
nausea
spots
stop depo after 50 yrs due to bone health

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13
Q

diaphragm

A

cup shaped w removal dome, made of silicon

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14
Q

emergency contraception - 3

A

levonorgestrel aka levonelle
72hrs after sex

ulipristal acitate aka ellaone
120hrs after sex

IUD - 5 days after

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15
Q

most common non-specific urethritis ?

A

chlamydia

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16
Q

cystitis vs urethritis vs dermatitis

A

c - bladder inflammation, wider symptoms (gut bacteria)
u - systemically well, dysuria and discharge (chlamydia, gonorrhoea)
d - rash, ulcers (candida)

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17
Q

investigations for urethritis

A

clinical exam
urethral swab for gram stain and microscopy
urethral swab for gonorrhoea culture
throat and rectal swabs for chlamydia and gonorrhoea NAAT (if they r having anal)
blood for syphilis and HIV

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18
Q

diagnosis of urethritis

A

> 5 polymorphs under microscope

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19
Q

gonococcal urethritis vs non-gonococcal urethritis

A

gonococcal - shorter incubation period, yellow/green, more urinary symptoms

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20
Q

chlamydia vs gonorrhoea

A

chlamydia - milky discharge, irregular bleeding, abdo pain, dysuria

gonorrhoea - more between younger ppl, men and men, greenish discharge

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21
Q

1st and 2nd line for gonorrhoea

A
  1. ceftriaxone usually
    or ciprofloxacin (only where antimicrobial sensitivities are known)
  2. cefixime
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22
Q

complications of gonorrhoea

A

tysonitis
bartholinitis
pretty rare

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23
Q

dyspareunia

A

pain associated with sexual intercourse

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24
Q

cervical excitation

A

cervical motion is tender on bimanual exam, sign of PID

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25
symptomatic sampling for vaginal discharge
cervical microscopy vaginal microscopy urinalysis VVS HVS amies swab
26
PID
lower abdo pain, discharge tenderness on bimanual vaginal exam under 25 not using barriers chlamydia most likely causing this use ceftriaxone, doxy
27
complications of Chlamydia Trachomatis
PID -> ectopic pregnancy conjunctivitis reactive arthritis
28
CT treatment
doxycycline or azithromycin if they can't take doxy
29
MG - mycoplasma genitalium
asymptomatic association w non-gonococcal urethritis and PID NAAT test high levels of macrolide resistance
30
bacterial vaginosis - why does this happen and what to use to treat it
white, frothy, milky discharge, smelly, fishy like cottage cheese pH increases as there is no lactobacillus (due to entry of semen, blood, or douching) use metronidazole topical clindamycin
31
what cells are present in bacterial vaginosis under microscopy
clue cells
32
candidiasis
Not sexually transmitted fungal infection white, clumpy discharge genital skin care advice any azole - eg. fluconazole
33
trichomonas - most common non viral STI IN WORLD TX
grey frothy discharge red smell itch strawberry cervix METRONIDAZOLE PARTNER NOTIFICATION
34
causes of genital ulceration
SEXUALLY TRANSMITTED herpes syphilis HIV monkeypox NOT SEXUALLY TRANSMITTED varicella zoster crohn's trauma (chemical) behcet's
35
genital herpes - caused by what?
HSV transmission - close contact thru mouth, anogenital tract pain, dysuria, discharge, flu, fatigue, erythema
36
primary vs recurrent herpes
primary - first time, few days incubation period recurrent - reactivation of latent virus, tingling, itching (prodrome)
37
mx of primary genital herpes simplex
swab lesion PCR FULL STI SCREEN aciclovir supportive
38
HSV 1 vs HSV 2
over 50% of genital herpes are type 1 type 2 is associated w less stigma than type 1
39
neonatal herpes
most dangerous when mother has it during 6 months before delivery
40
syphilis
chancre - painless ulcer usually incubation 10-90 days primary is usually on mouth primary -> secondary (whole body, swollen glands, fever, RASH) -> early latent -> late latent
41
secondary syphilis complications
meningitis hepatiis iritis uveitis pregnancy complications
42
syphilis ix and mx
swab lesion - PCR bloods antibodies - IgG and IgM, not very specific benzathene penicillin - IM
43
genital lumps causes
SEXUALLY TRANSMITTED warts scabies molluscum contagiosum monkeypox cyst NOT SEXUALLY TRANSMITTED folliculitis lichen planus skin tags cancer
44
genital warts transmission - complications
skin-to-skin contact, in areas most susceptible to trauma eg. vulva posterior NO LINK BETWEEN WARTS (HPV) AND HERPES (HSV) HPV will be cleared but HSV is lifelong COMPLICATION = intra-epithelial neoplasia
45
TX for genital warts
cryotherapy imiquimod
46
molluscum contagiosum
pearly white spots
47
HIV is what type of virus, and how many types??
RNA retrovirus HIV 1 and 2 HIV-1 group M -> global epidemic
48
HIV viral replication
v quick in early and late infection
49
mechanism of HIV
1. binding - receptors 2. fusion 3. reverse transcriptase 4. integration 5. transcription 6. translation 7. budding - new variant to infect other cells
50
what receptors are target site for HIV and what type of protein are they
CD4+ T cells glycoprotein
51
effect of HIV Infection on immune response??
REDUCED circulation of CD4+ cells reduced proliferation of CD4+ cells Reduced CD8+ cytotoxic T cell activation susceptible to fungal, viral infections and some cancers
52
how long does HIV take from exposure to establish itself as an infection
72 hrs
53
PCP
pneumocystis pneumonia dry cough, SOB <200 CD4+ cells interstitial infiltration
54
dx and tx of PCP
BAL immunofluorescence high dose co-trimoxazole
55
cerebral toxoplasmosis
from cats <150 CD4+ reactivation fo latent infection, multiple cerebral abscess headache, fever, seizures, raised ICP
56
CMV
CD4 <50 retinitis, colitis floaters, abdo pain
57
AIDS related cancers - Kaposi's sarcoma
HHV 8 Tx - anti retrovirals
58
non-hodgkins lymphoma
EBV
59
HIV - modes of transmission
sexual - 90% of cases parenteral transmission - injection drug use vertical transmission - mother to child
60
rapid HIV tests
POCT fingerpick blood specimen or saliva results within 20-30mins
61
PrEP
pre-exposure prophylaxis
62
prevention of vertical transmission
HAART during pregnancy c-section if detected viral load, safe if not for vaginal delivery exclusive formula feeding

YR 3 MED (23 decks)

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