Repro wk 6 Flashcards

(29 cards)

1
Q

What is FGM?

A

All procedures that involve partial or total removal of external female genitalia
Or other injury to female genital organs for cultural or non-medical reasons

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2
Q

How many types of FGM are there?

A

4

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3
Q

What is type 1 FGM?

A

Clitoridectomy (partial/total removal of clitoris)

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4
Q

What is type 2 FGM?

A

Excision
Parital/total removal of clitoris and labia minor
+/- removal of labia majora

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5
Q

What is type 3 FGM?

A

Infibulation - narrowing of vaginal opening through creation of covering seal
Seal formed by cutting + re-positioning inner/outer labia
+/- removal of clitoris

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6
Q

What is type 4 FGM?

A

All other harmful procedures to female genitalia for non-medical purposes

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7
Q

What is de-infeibulation?

A

Surgical procedure to opening up the closed vagina of FGM type 3?

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8
Q

What are the complications fo FGM?

A
Severe pain/shock
Infection
Injury to adjacent tissues
Sprains, disolcations, broken bones/injuries from being restrained
Immediate fatal haemorrhaging
Infection by blood bourne virus
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9
Q

What are the long term complications of FGM?

A
Urine retention
Difficulties with menstration
Uterine, vaginal, pelvic infections
Cysts /neuromas
INcreased risk of fistula
On-going impact of trauma/PTSD
Sexual dysfunction
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10
Q

What are the psychological effects of FGM?

A
PTSD
Anxiety
Depression
Fear of intimacy
Loss of trust
Unresolved anger
NIghtmares
Flashbacks
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11
Q

What increases the risk of FGM?

A
Mother has FGM
Siblings/cousins undergone FGM
MOther/father request reinfibulation
Parents express views valuing practice
Girl withdrawn from teaching classes on personal/social/health education
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12
Q

What are the types of breast cancer?

A
In situ carcinoma
Invasive carcinoma
>Ductal
>Lobular
>Tubular
>Cribriform
>Medullary
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13
Q

When are women screened for breast cancer?

A

Aged 50-70 every 3 years

Through GP practice

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14
Q

What is looked for in breast screening?

A
Lump/thickening in breast (often painles)
Discharge/bleeding from nipple
Change in size/contours of breast
Change in colour or appearance of areola
Redness or pitting of skin
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15
Q

What tests are used to diagnose breast cancer?

A

Clinical exam
Mammography
Ultrasound
FNA cytology

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16
Q

What is sentinel lymph node biopsy?

A

Checking the first lymph nodes to recieve lymph from breast tumour
If negative then rest of the nodes in the basin will aslo be negative

17
Q

How do you treat breast cancer?

A

Resection (mastectomy/just affected tissue)
Micromets treatment
>Hormone therapy - oestrogen if receptors present
>Chmo
>Targetted therapy (HER2 - trastuzumab)

18
Q

What are the risk factors for vulva intra-epithelial neoplasia?

A

Smoking
Previous related malignancy
Immunosuppression
Other genital intra-epithelial neoplasia

19
Q

Who gets lower genital tract intra-epithelial neoplasia?

A

Decreasing age of presentation
Younger women with multi-focal with HPV +
Older women unifocal with HPV -

20
Q

What is the presentation of VIN?

A
Raised papular or plaques lesions
Erosions, nodules, warty 
Keratotic roughened appearance
Sharp border
Differentiated VIN tends to be unifocal ulcer or plaque
Discoloration
21
Q

How do you diagnose VIN?

22
Q

How do you manage VIN?

A
Prevent cancer
Eliminate symptoms
Preserve sexual function 
Preserve body image
Surveilence
Surgery
Laser ablation
Topical treatments
23
Q

What topical treatments can be used in VIN?

A

Imiquimod
Photodynamic therpay
5FU, alpha-interferon, cidofivir

24
Q

What are the types of vulva cancer?

A

Mostly SCC (caused by:)
>VIN
>Lichen sclerosus

Also BCC

25
What is the presentation of vulval cancer?
pain itch bleeding lump/ulcer Mostly over 60 Younger women with VIN
26
What is groin node dissection?
Inguinal and upper femoral nodes Separate node incisions Staging and remove nodal disease Associated with significant morbidity >Wound infection >Lymphocysts >Nerve damage
27
What are the risk factors for urinary incontinence?
``` Age Parity Menopause Smoking Medical problems Raised Intra abdo pressure Pelvic floor trauma Denervation Connective tissue disease Surgery ```
28
What examinations should you do with complaint of urinary incontinence?
``` General Abdominal Neurological Gyanae Pelvic floor ```
29
How do you manage stress urinary incontinence?
PT - pelvic floor training Surgery (Tension-free vaginal tape ) Pharmacological - duloxetine