Flashcards in Reproductive conditions Deck (40):
What is the causative agent of gonorrhoea? How is it classified?
Neisseria gonorrhoea, gram -ve bacilli
What percentage of males and females with gonorrhoea are symptomatic?
90% males, 50% females
What are the male symptoms of gonorrhoea?
urethral discharge (mucupurulent - remember Ugandan man?)
What are the female symptom of gonorrhoea?
change in vaginal discharge, mucupurlent
What are the investigations for gonorrhoea?
NAAT, of urine for men endocervical / VV swab for women
What is the management of gonorrhoea?
ceftriaxone 500mg IM stat, azithromycin 1g PO stat
What must be done after treatment gonorrhoea?
test of cure
What is the classification of organism causing chlamydia?
Gram -ve bacilli
What percentage of makes an females are symptomatic for chlamydia?
Men - 50%, women 30%
What are the male and female features of chlamydia?
Male - urthethritis, urethral discharge, urinary symptoms, epydidimo orchitis
female - discharge, dysuria, abdo pain, fever FRIABLE COBBLESTONE CERVIX, mucupurlent endocervical discharge
Investigations for chlamydia
NAAT - VV for women, first catch urine for men
Doxycycline 100mg BD 7/7, (not in pregnancy) or azithromycin 1g stat
What are the complications of chlamyda in pregnancy?
Classify the causative agent of syphillis
treponemes (think of Swiss Dan and his treponemes)
What are the symptoms of primary syphillis
painless ulcer, lymphadenopathy
What are the symptoms of secondary syphillis
night time headaches, malaise, fever, aches, rash
What are the symptoms of tertiary syphillis?
neurological - dementia, menigovascular involvement,
CVD - aortitis, aortic regurg
what are the investigations for syphillis?
VDRL, FTA ABS, EIA (treponemal enzyme immunoassay) IgM
What is the management of syphillis?
1st line - benzylpenicillin IM stat, 2d line - azithromycin 2g PO STAT
What is the epidemiology of breastfibroadenoma? What are the RF?
Common in young women, driven by oestrogen, so RF = cocp, hrt
What is a breast lobule, what is a breast duct?
Lobule - end part (like alveoli) duct - tubey part (like bronchioles)
What is the definition of a fibroadenoma?
benign mass in lobules composed of fibrous and epithelial tissues, grow to 2-3cm
Features breast fibroadenoma
Firm, non tender, highly mobile
What investigations are needed for fibroadenoma?
hx/ex, USS, refer to breast doc,
Management needed for fibroadenoma
Careful watching, relief of syx - bras, analgesia
What are the types of breast cancer? Which are most common?
ductal, lobular, invasive, in situ
most arise from epithelium of lobules / ducts
what is Paget's disease of breast?
Ca that infiltrates nipple / epithelium
What is inflammatory breast ca?
rapidly growing, painful mass,
Risk factors for breast ca?
*driven by oestrogen* so COCP, HRT, nullips, early period, late menopause
Clinical features breast Ca
painless lump, nipple inversion, nipple discharge
most common sites of mets for breast ca
brain, bone, lung, liver
What is the triple assessment? what other inv are needed for breast ca?
mammography +US >35, <35 - US
biopsy / fine needle incision
also needed - sentinal node biopsy, CT for mets
2 week wait rules for breast cancer
>30 and unexplained breast lump
>50 with discharge, retraction
Management of breast ca
wide local excision - always need radiotherapy
endocrine if er +ve or pr -ve
chemotherapy (if young)
inflammation of breast, non-infectious / infectious in origin
define breast abscess
localised collection of pus
causative organisms in peurperal breast abscess, or non peurperal breast abscess
peurperal - staph aureus, strep
non peuperal - mixed flora
Features of breast abscess
most frequently - areolar / periareolar
oedema, tenderness, erythema
investigations breast abscess
USS, Fine needle asp / drainage