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Flashcards in Unit 2 Deck (115):
1

What ages do you need to have a cervical screening test

25-49 every 3 yrs
50-64 every 5 yrs

2

How often do you need to have breast cancer screenign

Every 3 yrs between the ages of 50-70

3

How do you take COCs

21 day pills
7 day break

4

How long to intra-uterine progesterone only systems last

5 yrs

5

How often do progesterone only implants last

3 yrs

6

How often do prog-only injections last

3 months

7

If you're sick within 2 hrs of taking the pill what do you do

Take another one straight away

8

What happens is you miss a coc- microgynon

less than 12 hrs ago-take it straight away- still covered
More than 12 hrs/missed more than 1 pill- tkae pill and check how many pills are left. if theres 7 or more use condoms for 7 days
If there less than 7 just finish this pack then start new one with no break and use condoms for 7 days

9

Whats the latest you can take a POP

3 hrs late or 12hrs for desogesterel

10

What are the 2 methods of emergency contraception

Intra-uterine device
Emergency Hormonal contraceptive

11

What is the main ingredient Levonelle
What dose do you take it at
When do you take it
How does it work

Leveorgestrel
1.5mg tab once stat
Within 3 days- max effectiveness within 12 hrs
Works by preventing ovulation and fertilization- prevent the surge in LH

12

How many days after unprotected sex can you take ella one

5 days

13

Whats the main ingredient in ellaOne

Ulipristal acetate

14

What happens in patient needs EC and is taking an inducer e.g. Carbamazepine

Give double the dose of Levenoelle (2 tabs)

15

What are the legal requirments of termination of pregnancy

2 drs need to certify there are good reasons for doing the abortion
Can do under 16s without parental consent if she can make an informed decision

16

What are the 2 tabs that you need to take to have an abortion

Mifepristone and Misoprostol

17

Explain the treatment for abortion within 7 weeks

Mifepristone 200mg orally - 24-48 hrs the misoprostol 400mcg

18

Less than 9 weeks

Mifiepristone 200mg orally then 24-48hs layer 800mcg of misoprostal either vaginally, buccal or sublingual

19

Between 7-9 weeks

Mifepristone 200mg, Misoprostal 800mcg, if abortion doesn't occur within 4 hrs give another misoprostal 400mcg

20

9-13 weeks

Mifepristone 200mg, 36-48rs give Misoprostal 800mcg vaginally, Misoprostal 400mcg every 3 hrs (max 4 further doses of misoprostal)

21

13-24 weeks

Mifespristone 200mg orally, 36-48hrs later misoprostal 800mcg vaginally.
misoprostal 400mcg (max 4 further doses 3hrs apart)
If abortion hasn't occurred give Mifepristone 200mg 3 hrs after last misoprostal

22

What is arthrotec and why do women have to be caredul with taking it

Diclofenac +misoprostal as a gastro protectant - cna cause miscarriages- BE CAREFUL

23

What is the importance of finasteride in women at child bearing age

If absorbed through the skin/ take Orally by a women whose pregnant with a male foetus can cause malformed genitals

24

What is the importance of Methotrexate in women at child bearing age

Birth defects, harms the unborn child due to malformations of the skull, face, heart or blood vessels or causes miscarriage

25

How many days treatment can you give of isotretinoin

28 days

26

How many days is the isotrtinoin Rx valid for

7 days

27

What is dysmenorrhea

Painful cramping in lower abdomen and radiates to thighs

28

At what age dysmenorrhea peak

late teens, early 20s

29

When are dysmenorrhea symptoms the worst

1st day

30

What is primary dysmenorrhea

No identifiable cause

31

What is secondary dysmenorrhea

Underlying pelvic pathology such as endometriosis, Fibroids, PID

32

Why are IUDs not recommended for dysmenorrhea

Inserting of device causes inflammation triggering the release of PGs

33

What symptoms are associated with the intense pain

N+V and migraine

34

What is the physiological reason for dysmenorrhoea

imbalance of uterine prostaglandins

35

1st line treatment for primary dysmenorrhea

NSAIds- ibuprofen, mefanamic acid or naproxen- inhibit PGs
or
hormonal contraception
or
TENS

36

When is hormonal contraception contraindicated in Dysmenorrhea

Obese, VTE, high BP

37

When do the onset of symptoms occur for primary Dys

6-12 months after first period

38

When is pain present in primary and secondary dysmenorrhea

primary- 1st day and few days before period
secondary- pain throughout the cycle

39

What is meorrhagia

Excessive menstrual blood loss over several cycles

40

What are the underlying causes of menorrhagia

hypothyroidsm, kidney/liver, coagulation disorders
pelvic patholgoies lile endometriois, PID and fibroids
Iatrogenic causes such as chemo or anticoagulant

41

What are the treatment options for menorrhagia

Levenorestrel-releasing intrauterine device
Tranexamic acid- NSAIDs
COC
oral norethisterone or long acting progesterone

42

What is endometriosis

endometrial tissue outside the uterine

43

How is endometriosis thought to happen

Retrograde menstruation
genetic predisposition, immune dysfuntion, metaplasia

44

Symptoms of endometriosis

Symptoms of dysmenorrhea
PG levels increase
Reduction in bone mass

45

Where does PID affect

Female upper genital tract-uterus, fallopian tubes and ovaries

46

Treatment of Endometriosis

Analgesia
COC + non-contraceptive progesterone (medroxyprogesterone) + POP

47

Symptoms of PID

Bilateral lower abdo pain
Bilateral abnormal abdo apin
Deep dyspareunia
abnormal vag bleeding
fever over 38

48

When do you have the highest risk of PID

Under 25, not using barrier contraception,
history of new sexual partner

49

What is menopause

12 months of amenorrhoea `

50

What happens in the phase before menopause to estrogen and inhibin

Ostrogen and inhibin levels decreased and reduced feedback to the pituitary results in rise in FSH and LH levels

51

What symptoms are caused by reduced oestrogen in menopause

Hot flushes +Night sweats
muscoskeletal (joint and muscle pain)
Effects on mood (low mood)
urogenital symptoms (vaginal dryness)
Sexual difficulties (low sexual desirE)
Osteoporosis
CHD-imbalance of lipid profile

52

How do you establish menopause

Low oestrogen and persistently high FSH and LH

53

Treatment of Menopause

HRT
Surgery
Ethinylestradiol
Tibolone
Raloxifene

54

What are the side effects of the HRT

Increases risk of breast cancer, cervical cancer, endometrial and ovarian cancer, venous thromboembolism, stroke and CHD

55

Side effects of Ethinylestradiol

Short term treatment for oestrogen deficiency

56

What symptoms does tibolone treat

treats vasomotor symptoms

57

SE of raloxifene

treats and prevents postmenopausal osteoporosis

58

What is the 1st line outpatient regimen for PID

IM ceftriaxone 500mg single dose
Doxycylcine 100 BD
Metronidazole 400mg BD for 14 days

59

2nd line outpatient regimen for PID

Oral ofloxacin 400mg BD orally and Metronidazole 400mg BD for 13 days

60

What are the main complications associated with PID

Tubal infertility, ectopic pregnancy and chronic pelvic pain

61

What is the usual cause of PID

STI

62

What are the symptoms of chamydia in women

Discharge, heavy periods, bleedings between periods, and pain

63

What are the symptoms of chamydia in

White, cloudy or watery discharge, swollen testicles, burning, pain on urinating,

64

How do women and men test themselves with chlamydia

women: swab
Males: urine sample or swab around urethra

65

Treatment for Chlamydia

Azithromycin one dose stat
or
Doxycyline BD for 7 days

66

Describe the symptoms of genital herpes

blisters around genitals, rectum, thighs and buttocks
Pain urinating
Stinging of genitals
Flu-like symptoms

67

Treatment of genital herpes

Antivirals like Acyclovir

68

Symptoms Genital Warts

Warms around genital area for both sexes

69

Can condoms treat you against genital warts

No because the condom doesn't cover all the area around e.g. thighs, testicles

70

Treatment of genital warts

use creams/lotions like podophyllotxin or physical removal

71

Symptoms of gonorrhoea

Thick and green/yellow discharge, bleeding between periods and pain on urination

72

How is HIV transmitted

Contaminated body fluids

73

Symptoms of HIV

Raised temp, sore throat, body rash, joint pain, swollen glands, weight loss

74

Treatment of HIV

Antivirals and Emergency HIV drugs like PEP medication

75

Symptoms of public lice

scratching causing itching and inflammation
Black powder in underwear
Blue spots on thighs and lower abdo

76

Treatment of public lice

Insecticides- topical wash

77

Symptoms of primary syphilis

1 or more painless ulcers/sores on penis opening, vagina or even the mouth

78

What is secondary syphilis

4-10 weeks after ulcers you develop a rash, have patchy hair loss, flu-like symptoms

79

Treatment of syphillis

3 Penicillin injection into buttocks or 28 day course of AB

80

What are the symptoms of trichomona vaginalis for women

Abnormal vag discharge, soreness, itchy, smell and pain

81

What are the symptoms of trichomona vaginalis in men

thin white discharge, soressness, pain on urination and ejaculation

82

What is the definition of infertile

Unable to conceive within a year

83

For women aged 35 and older, after how long is infertility diagnosed

pregnancy hasn't occurred within 6 months of trying

84

For women younger than 35, after how long is infertility diagnosed

1 yr of trying to get pregnant

85

What is primary infetility

Never conceived a child

86

What is secondary infertility

Had a child before but can't have another

87

What are the 3 types of treatment to restore fetility

Medical, surgical or assisted reproduction techniques

88

What are the 4 main causes of fertility

25%- unknown
25%- ovulatory disorders
20%- tubal damage
30%- abnormal sperm

89

How long of unprotected sexual intercourse is recommended before IVF should be tried

2 yrs

90

What are the 2 types of ovulatory problems

Infrequent ovulation- Oligoovulation
absence of ovulation-Anovulation

91

What is Oligozoospermia

Decreased number of sperm

92

What is Asthenozoospermia

Decreased sperm motility

93

What is teratozoospermia

Abnormal shaped sperm

94

What is primary spermatogenic failure

Failure to produce sperm

95

What is Hypogonadism

Low testosterone levels

96

What is retrograde ejaculation

Semen enters the bladder instead of out the penis

97

How is an erection caused

Vasorelaxation of the arteries and arterioles supplying the erectile tissue- increase in penile blood flow, increase in sinusoidal filling- compressing the venous, occluding venous outflow

98

Before a man is classed as a non-responder, which medication for Erectile dysfucntion should he have taken

8 doses of PDE-V at max strength with sexual stimulation

99

What is the max recommended cycling allowed for ED p/week

3 hrs

100

Which drugs work on the CYP1A2 receptors and what is happening to the clearance

Theophylline, clozapine, olanzapine, Caffeine
Decrease clearance

101

Which receptors does nicotine work on

CYP2A6
Increases clearance

102

Which drugs work on the CYP2D6 receptors and what happens to the clearance

Citalopram, fluoxetine, metoprolol and dextromethorpahn
Increase clearance

103

Which drugs
Clearance?
CYP2C9

Phenytoin and glyburide
Increases clearance

104

What is the normal length of pregnancy

37-42 weeks

105

What is pre term

less than 37 weeks

106

What is the neonatal period

up to 28 days

107

Why does Respiratory distress syndrome occur

Lack of pulmonary surfactant at birth- usually happens in preterm babies

108

What is first line for seizures in neonates

Phenobarbital

109

What is second and third line for seizures in babies

DAIZEPAM- can cause sedation
Phenytoin- not for long term and has narrow therapeutic index

110

What is colic

excessive and inconsolable crying in infant

111

When does GORD resolve by

2 months, latest 6 motnhs

112

What is croup

Inflammation of the trachea, bronchiole and the larynx- viral infection

113

What are the symptoms of croup

Seal-like barking cough
fever
cold symptoms

114

Treatment for croup

Self limiting- takes 48hrs
Refer to GP

115

Managment advice for croup

Increase fluid intake
Pctml and ibuprofen
Dexamethosone as a single dose