Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Conditions + definitions > Repro wk 4 > Flashcards

Repro wk 4 Flashcards

(95 cards)

Start Studying
1
Q

What is the important gynae history of an adolescent?

A

Age of menarche
Cycle
Pain

Sexual (absence of parents) - activity/contraception
Abuse

Weight loss/gain
Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do you investigate primary ammenorrhoea?

A

If normal secondary secondary characteristics for age - 16

If absent secondary sexual characteristics - age 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What investigations should be done before gynae referral?

A

FSH, LH, PRL, TSH, testosterone/oestrogen
Pelvic USG
Progesterone withdrawal bleed - pregnancy vs not enough oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you induce puverty?

A

Gradual build up with oestrogen
Check its effect on breast development

Add progesterone once maximum height potenital is reached
Once on at least 20mg of oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause secondary amenorrhoea?

A

Weight
PCOS
Pregnancy
Fluctuating LH/oestrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause bleeding disorders in the young?

A

Anovulation (najority - normal up to 2-4 years post menarche)
Sexual abuse/trauma
Pregnancy complications
PLatlet defects/other blood disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you treat menorrhagia?

A 
Reassure + talk to girl directly
Progesterone only pill/combined
Mefenamic acid
Tranexamic acid
Mirena
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the possible adverse outcomes with ovarian cysts?

A

They can turn gangrenous
Tort
Or rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of ovarian cysts?

A

Subacute history
Usually tender on one side of pelvis or behind uterus
May feel mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is prolapse?

A

50% of parous

Only 10-20% seek medical help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How many women have prolapse?

A

A protrusion of an organ/structure beyond its normal anatomical confines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the three layers of the pelvic floor?

A

Endopelvic fascia
Pelvic diaphragm
Urogenital diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the endopelvic fascia?

A

Network of fibro-muscular connective tissue

Fibromuscular allows it to stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is pelvic diaphragm?

A

Layer of striated muscle with fascial coverings

Consists of levator ani + coccygeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the urogenital diaphragm?

A

Superficial + deep transverse perinela muscles with fascial coverings
Normally weakest part

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the parts of the endopelvic fascia?

A

Uterosacral/cardinal complex
Pubocervical fascia
Rectovaginal fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does the uterosacral c/cardinal complex extend to/from?

A

Medially from uterus, cervix
Laternal vaginal fornices
Pubocervical/rectovaginal fascia

Laterally to sacrum + fascial overlying piriformis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you palapate the uterosacral complex?

A

Down traction on cervix

See if there is any side-side movement of cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does the uterosacral complex tend to break?

A

Medially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the pubocervical fascia?

A

A trapezoid fibromuscular tissue
Which provides the main support of the anterior vaginal wall
Often leads to bladder prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What structures are found on the central surface of the pubocervical fascia?

A

Base of cardinal ligmanets (where it merges)

Cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are found at the lateral boundaries of the pubocervical fascia?

A

Arcus tendineis fascia pelvis (a white line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is found at the distal boundary of the pubocervical fascia?

A

Urogenital diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where does the pubocervical fascia tend to break?

A

At lateral attachments

Or immediately in front of cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the rectovaginal fascia?
Fibro-muscular elastic tissue | Holds rectum in place and leads to rectal prolapse
26
What does the rectovaginal fascia fuse with centrally?
Mereges with base of cardinal/uterosacral ligaments and perineum
27
What does the rectovaginal fascia fuse with laterally?
Fuses with fascia over levator ani
28
What is the attachment of the rectovaginal fascia distally?
Perineal body
29
Where does the rectovaginal fascia tend to brreak?
Centrally
30
How many levels of endopelvi support are there?
3 levels
31
What are the risk factors for pelvic organ prolapse?
``` Forceps delivery Large baby Prolonged second stage of labour Child birth in general Advancing age Obesity Previous pelvic floor surgery Other - syndromes, hormonal, constipation, heavy lifting ```
32
What is a safe answer for all pelvic floor disorders?
Forceps delivery
33
What types of exercise can cause pelvic prolapse?
High impact aerobics | Weight lifting
34
What are the typical vaginal pelvic organ prolpase symptoms?
``` Sensation of buldge/protrusion "heaviness" Seeing or feeling buldge/protrusion Pressure Difficulty inserting tampons Splinting ```
35
What investigations are there for prolapse?
No investigations to diagnose | MRI/USS - levator ani thickness, fascial defects
36
How do you prevent vaginal prolapse?
Avoid constipation Effective management of chronic chest pathology Smaller family size Pelvic floor exercises Improvements in antenatal/intrapartum care
37
What are management options of vaginal prolapse?
Pessaries | Surgery
38
What are the aims of pelvic floor surgery?
Relieve symptoms Restore/maintain bowel/bladder function Maintain capacity for vaginal sexual function Tailorto individual needs
39
What is the benefit of giving methadone via mouth?
Do not get any of the IV side effects
40
Is methadone safe in pregnancy?
No direct harm, like most opiates However, if mother stops taking care of self - not eating etc or abuse (as common in opiate drug users) then foetus may be harmed
41
Why is cocain dangerous in pregnancy?
High chance of miscarriage Causes vasoconstriction of vessels Sometimes in heart
42
How should you care for a neonate with a mother on methadrone?
Monitor and house in neonate unit for 5 days | Risk of epileptic fits or death from withdrawl
43
How does the umbilical cord look in uterine death?
Dark red
44
What can cause excess coils in the cord? What is the normal amount?
Exzcessive movement | Normal is 1 coild every 5-6 cm
45
What can cause placenta abruption?
Hypertension Trauma Cocaine
46
What is the mecahnism behind pre-eclampsia?
Trophoblast problem Either too many or too active Tropohoblasts break down smooth muscle around placenta implantation site to prevent vasoconstriction
47
What is the 5yr (average) survival rate of ovarian cancer after 5yrs?
30%
48
Who is likely to get ovarian cancer?
Mostly over 30 years Some genetic cases (5-10%) Incessant ovulation (no contraception, no pregnancy) Breast feeding/OCP protective
49
What are the symptoms of ovarian cancer?
``` Often vague Indegestion/poor appetiite Altered bowel habit Bloating/discomfort Weight gain Pelvic mass - often asymptomatic and large at presentation ```
50
How do you diagnose ovarian cancer?
USS abdo + pelvis CT to stage Ca 125 biochem test
51
What is the Ca 125 test?
A glycoprotein antigen Caused by inflamation as well as Malignancy (ovarian, colon/pancreas, breast) Also in benign conditions - menstration, endometriosis Liver disease
52
What are the normal levels of Ca 125?
0-30/35
53
How do you calculate risk of ovarian cancer?
U x M x Ca125 U being US features, 1 = 1 multiple = 3 M = menopausal, pre = 1, post = 3
54
What are the US features that contribute to the risk score?
``` Multi-locular lesion Solida reas Bilateral Ascites Intra-abdominal ```
55
How do you treat ovarian cancer?
Surgery (gold standard) | Chemo after has best survival, although sometimes before to reduce
56
What are the cure rates of the sages of ovarian cancer?
1: 85% 2: 47% 3: 15% 4: 10%
57
What is the chemo regime for ovarian cacner?
First line being platinum + taxane within 8 wks of surgery Cure unlikely Average response being 2 yrs
58
How do you manage recurrance of ovarian cancer?
Chemo, possibly surgery | If unable to tolerate - tamoxifen or palliation
59
How thick should the endometrium be in a post menopausal woman?
Less than 4mm
60
How do you investigate post menopausal bleeding?
Trans-vaginal USS | Endometrial biopsy
61
How is a hysteroscopy carried out?
Either as out-patient with local anaesthesia | In-patient with general anaesthesia
62
How do you stage endometiral cancer?
Surgical/pathological | MRI
63
What is type 1 endometrial cancer?
Endometrioid adenocarcinoma Caused by unopposed oestrogen Characterised by hyperplasia with atypia precurosr By far most common
64
What is type 2 endometrial cancer?
Uterine serous + clear cell carcinoma Has higher grade + more aggressive so worse prognosis Generally in older women Has serous intraepithelial carcinoma precurose
65
How do you treat endometrial cancer?
Early stages - surgery High risk - chemo Advanced - radio Surgery preferred if possible With progesterone for palliation
66
What is the difference between a total ans subtotal hysteroectomy?
Total includes uterus and cervix | Subtotal only uterus
67
What are the risk factors for endometrial cancer?
``` Post menopausal High circulating oestrogen >obesity >unopposed oestrogen therapy >PCOS >early menarch/late menopause Atypical endometrail hyperplasia ```
68
What are the symptoms of endometrial cancer?
Abnomrla vaginal bleeding | Post menopausal bleesing
69
What can cause post-menopausal bleeding?
``` HRT Atrophic chance (vaginitis) Polyps cervical/endometrial Endometrial cancer Other cancer ```
70
What is the 5yr survival for endometrial cancer?
78% for all stages 95% stage 1 14 stage 4
71
What is the average age for menopause?
51
72
When is premature menopause?
40 years or less
73
Why does menopause happen?
Due to ovarian insufficnency - not enough viable eggs left Means that follicle no longer develops to form oestrogen As a result, oestradiol falls FSH rises Results in oestridol from peripheral conversion of androgens in fat
74
What are the symptoms of menopause?
``` Vasomotor symptoms "flush" Vaginal dryness/soreness Low libido Muscle/joint aches Mood changes silent - Osteoporosis ```
75
What are the modes of treatment for menopause?
HRT either: local systemic
76
What are the local treatments for menopause?
Vaginal oestrogen pessary | Vaginal cream
77
What are the systemic treatment options for menopause?
Transdermal - reduced risk of VTE as avoids first pass Oral Either oestrogen only if no uterus Progesterone if still has uterus - can be oral
78
What are the contraindications to HRT?
Current hormone dependant cancer (breast/ endometrium) Current active liver disease Uninvestigated abnormal bleeding Seek advice if previous VTE/blood disorders Seek advice if previous breast cancer or BRCA carrier
79
When do you give cyclical vs non-cyclical HRT?
Cyclical (14 days just oestrogen, 14 days with progesterone) - if still ovarian function (perimenopausal) Still bleeds Continuous if no ovarian function Bleed free after 3 months
80
What are the risks of HRT?
``` Breast cancer on combined (dependant on BMI) >Returns to normal after 5 yrs off HRT Ovarian cancer VTE (if oral) CVA (oral) (if after 60) ```
81
What are the benefits of HRT?
Vasomotor flushes get better Treats local genital symptoms Helps prevent osteoporosis
82
What is secondary amenorrhoea?
Has had periods, none for last 6 months
83
What are the causes of secondary amenorrhoea?
``` Pregnancy/breast feeding Contraception Polycystic ovaries Early menopause Thyroid disease/cushings Significant illness Raised prolactin Hypotholamic (stress/weight change (only need 10% weight change) Andorgen secreting tumour ```
84
How do you investigate secondary amenorrhoea?
Check androgen features (hirsutism etc) /virilisation Check pregnancy Bloods - FSH, LH, oestrogdiol/testosterone Thyroid function Pelvic ultrasound
85
How do you treat secondary amenorrhoea?
Treat specific cause Assume fertile and give contraception unless after 2yrs post menopause Check for Fragile X syndrome
86
How does PCO present?
Oligo/amenorrhoea Androgenic symptoms Anovulatory infertility Does not cause weight gain or pain
87
How do you manage PCO?
Weight loss/exercise Anti-androgen Endometrial protection (progestogens)
88
How do you manage an ovarian cyst?
Do not touch as may kill eggs | Reassure + USS
89
What is vulvovaginitis?
Inflammation of the vulva and vagina | Most common condition in young girls (yrs 2-7 most common)
90
What causes vulvovaginitis?
Most commonly bacteria
91
What is labial agglutination?
Adhesion of labia minor in midline Encourages urine retention + vaginal secretions Can lead to vulvovaginitis
92
How do you manage labial aggluation?
If symptomatic - improved hygiene may be all that is needed Treat only if chronic vulvoaginitis or difficulty urinating Topical oestrogen Lubrication of labial with bland ointment
93
Who is likely to get vaginal discharge?
Mucoid discharge common in infants 2 weeks after birth due to maternal oestrogen Prepubertal girls experiencing increased oestrogen
94
What can cause pathological vaginal discharge?
Infections by organisms Haemolytic streptococcal vaginitis Monial vaginitis Foreign body
95
How do you manage vaginal discharge?
``` Conservatively: Culture to identify organism Urinalysis to rule out cystitis Review hygiene Check for pin worms If persistent, review under anesthesia for foreign body ```

Conditions + definitions (68 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions