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Flashcards in Reproductive conditions Deck (40):
1

What is the causative agent of gonorrhoea? How is it classified?

Neisseria gonorrhoea, gram -ve bacilli

2

What percentage of males and females with gonorrhoea are symptomatic?

90% males, 50% females

3

What are the male symptoms of gonorrhoea?

urethral discharge (mucupurulent - remember Ugandan man?)

4

What are the female symptom of gonorrhoea?

change in vaginal discharge, mucupurlent

5

What are the investigations for gonorrhoea?

NAAT, of urine for men endocervical / VV swab for women

6

What is the management of gonorrhoea?

ceftriaxone 500mg IM stat, azithromycin 1g PO stat

7

What must be done after treatment gonorrhoea?

test of cure

8

What is the classification of organism causing chlamydia?

Gram -ve bacilli

9

What percentage of makes an females are symptomatic for chlamydia?

Men - 50%, women 30%

10

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

11

Investigations for chlamydia

NAAT - VV for women, first catch urine for men

12

Management chlamydia

Doxycycline 100mg BD 7/7, (not in pregnancy) or azithromycin 1g stat

13

What are the complications of chlamyda in pregnancy?

premature, preterm

14

Classify the causative agent of syphillis

treponemes (think of Swiss Dan and his treponemes)

15

What are the symptoms of primary syphillis

painless ulcer, lymphadenopathy

16

What are the symptoms of secondary syphillis

night time headaches, malaise, fever, aches, rash

17

What are the symptoms of tertiary syphillis?

neurological - dementia, menigovascular involvement,

CVD - aortitis, aortic regurg

Gummata

18

what are the investigations for syphillis?

VDRL, FTA ABS, EIA (treponemal enzyme immunoassay) IgM

19

What is the management of syphillis?

1st line - benzylpenicillin IM stat, 2d line - azithromycin 2g PO STAT

20

What is the epidemiology of breastfibroadenoma? What are the RF?

Common in young women, driven by oestrogen, so RF = cocp, hrt

21

What is a breast lobule, what is a breast duct?

Lobule - end part (like alveoli) duct - tubey part (like bronchioles)

epithelium lined

22

What is the definition of a fibroadenoma?

benign mass in lobules composed of fibrous and epithelial tissues, grow to 2-3cm

23

Features breast fibroadenoma

Firm, non tender, highly mobile

24

What investigations are needed for fibroadenoma?

hx/ex, USS, refer to breast doc,

25

Management needed for fibroadenoma

Careful watching, relief of syx - bras, analgesia

26

What are the types of breast cancer? Which are most common?

ductal, lobular, invasive, in situ

most arise from epithelium of lobules / ducts

27

what is Paget's disease of breast?

Ca that infiltrates nipple / epithelium

28

What is inflammatory breast ca?

rapidly growing, painful mass,

29

Risk factors for breast ca?

*driven by oestrogen* so COCP, HRT, nullips, early period, late menopause

30

Clinical features breast Ca

painless lump, nipple inversion, nipple discharge

31

most common sites of mets for breast ca

brain, bone, lung, liver

BBLL

32

What is the triple assessment? what other inv are needed for breast ca?

hx/ex

mammography +US >35, <35 - US

biopsy / fine needle incision


also needed - sentinal node biopsy, CT for mets

33

2 week wait rules for breast cancer

>30 and unexplained breast lump

>50 with discharge, retraction

34

Management of breast ca

wide local excision - always need radiotherapy

mastectomy

endocrine if er +ve or pr -ve

radiotherapy

chemotherapy (if young)

35

define mastitis

inflammation of breast, non-infectious / infectious in origin

36

define breast abscess

localised collection of pus

37

causative organisms in peurperal breast abscess, or non peurperal breast abscess

peurperal - staph aureus, strep

non peuperal - mixed flora

38

Features of breast abscess

most frequently - areolar / periareolar

oedema, tenderness, erythema

39

investigations breast abscess

USS, Fine needle asp / drainage

40

management breast abscess

>3cm - refer to surgeons

<3cm - fine needle drainage

abx- naficillin / vanco / clinda