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NMR > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

What ages do you need to have a cervical screening test

A

25-49 every 3 yrs

50-64 every 5 yrs

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2
Q

How often do you need to have breast cancer screenign

A

Every 3 yrs between the ages of 50-70

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3
Q

How do you take COCs

A

21 day pills

7 day break

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4
Q

How long to intra-uterine progesterone only systems last

A

5 yrs

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5
Q

How often do progesterone only implants last

A

3 yrs

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6
Q

How often do prog-only injections last

A

3 months

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7
Q

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

A

Take another one straight away

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8
Q

What happens is you miss a coc- microgynon

A

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

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9
Q

Whats the latest you can take a POP

A

3 hrs late or 12hrs for desogesterel

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10
Q

What are the 2 methods of emergency contraception

A

Intra-uterine device

Emergency Hormonal contraceptive

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11
Q

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

A

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

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12
Q

How many days after unprotected sex can you take ella one

A

5 days

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13
Q

Whats the main ingredient in ellaOne

A

Ulipristal acetate

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14
Q

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

A

Give double the dose of Levenoelle (2 tabs)

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15
Q

What are the legal requirments of termination of pregnancy

A

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

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16
Q

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

A

Mifepristone and Misoprostol

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17
Q

Explain the treatment for abortion within 7 weeks

A

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

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18
Q

Less than 9 weeks

A

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

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19
Q

Between 7-9 weeks

A

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

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20
Q

9-13 weeks

A

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

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21
Q

13-24 weeks

A

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

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22
Q

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

A

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

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23
Q

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

A

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

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24
Q

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

A

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

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25
Q

How many days treatment can you give of isotretinoin

A

28 days

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26
Q

How many days is the isotrtinoin Rx valid for

A

7 days

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27
Q

What is dysmenorrhea

A

Painful cramping in lower abdomen and radiates to thighs

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28
Q

At what age dysmenorrhea peak

A

late teens, early 20s

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29
Q

When are dysmenorrhea symptoms the worst

A

1st day

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30
Q

What is primary dysmenorrhea

A

No identifiable cause

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31
Q

What is secondary dysmenorrhea

A

Underlying pelvic pathology such as endometriosis, Fibroids, PID

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32
Q

Why are IUDs not recommended for dysmenorrhea

A

Inserting of device causes inflammation triggering the release of PGs

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33
Q

What symptoms are associated with the intense pain

A

N+V and migraine

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34
Q

What is the physiological reason for dysmenorrhoea

A

imbalance of uterine prostaglandins

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35
Q

1st line treatment for primary dysmenorrhea

A 
NSAIds- ibuprofen, mefanamic acid or naproxen- inhibit PGs
or 
hormonal contraception 
or
TENS
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36
Q

When is hormonal contraception contraindicated in Dysmenorrhea

A

Obese, VTE, high BP

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37
Q

When do the onset of symptoms occur for primary Dys

A

6-12 months after first period

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38
Q

When is pain present in primary and secondary dysmenorrhea

A

primary- 1st day and few days before period

secondary- pain throughout the cycle

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39
Q

What is meorrhagia

A

Excessive menstrual blood loss over several cycles

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40
Q

What are the underlying causes of menorrhagia

A

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

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41
Q

What are the treatment options for menorrhagia

A

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

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42
Q

What is endometriosis

A

endometrial tissue outside the uterine

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43
Q

How is endometriosis thought to happen

A

Retrograde menstruation

genetic predisposition, immune dysfuntion, metaplasia

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44
Q

Symptoms of endometriosis

A

Symptoms of dysmenorrhea
PG levels increase
Reduction in bone mass

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45
Q

Where does PID affect

A

Female upper genital tract-uterus, fallopian tubes and ovaries

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46
Q

Treatment of Endometriosis

A

Analgesia

COC + non-contraceptive progesterone (medroxyprogesterone) + POP

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47
Q

Symptoms of PID

A 
Bilateral lower abdo pain
Bilateral abnormal abdo apin
Deep dyspareunia
abnormal vag bleeding
fever over 38
48
Q

When do you have the highest risk of PID

A

Under 25, not using barrier contraception,

history of new sexual partner

49
Q

What is menopause

A

12 months of amenorrhoea `

50
Q

What happens in the phase before menopause to estrogen and inhibin

A

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

51
Q

What symptoms are caused by reduced oestrogen in menopause

A 
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
Q

How do you establish menopause

A

Low oestrogen and persistently high FSH and LH

53
Q

Treatment of Menopause

A 
HRT
Surgery
Ethinylestradiol
Tibolone
Raloxifene
54
Q

What are the side effects of the HRT

A

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

55
Q

Side effects of Ethinylestradiol

A

Short term treatment for oestrogen deficiency

56
Q

What symptoms does tibolone treat

A

treats vasomotor symptoms

57
Q

SE of raloxifene

A

treats and prevents postmenopausal osteoporosis

58
Q

What is the 1st line outpatient regimen for PID

A

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

59
Q

2nd line outpatient regimen for PID

A

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

60
Q

What are the main complications associated with PID

A

Tubal infertility, ectopic pregnancy and chronic pelvic pain

61
Q

What is the usual cause of PID

A

STI

62
Q

What are the symptoms of chamydia in women

A

Discharge, heavy periods, bleedings between periods, and pain

63
Q

What are the symptoms of chamydia in

A

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

64
Q

How do women and men test themselves with chlamydia

A

women: swab
Males: urine sample or swab around urethra

65
Q

Treatment for Chlamydia

A

Azithromycin one dose stat
or
Doxycyline BD for 7 days

66
Q

Describe the symptoms of genital herpes

A

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

67
Q

Treatment of genital herpes

A

Antivirals like Acyclovir

68
Q

Symptoms Genital Warts

A

Warms around genital area for both sexes

69
Q

Can condoms treat you against genital warts

A

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

70
Q

Treatment of genital warts

A

use creams/lotions like podophyllotxin or physical removal

71
Q

Symptoms of gonorrhoea

A

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

72
Q

How is HIV transmitted

A

Contaminated body fluids

73
Q

Symptoms of HIV

A

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

74
Q

Treatment of HIV

A

Antivirals and Emergency HIV drugs like PEP medication

75
Q

Symptoms of public lice

A

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

76
Q

Treatment of public lice

A

Insecticides- topical wash

77
Q

Symptoms of primary syphilis

A

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

78
Q

What is secondary syphilis

A

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

79
Q

Treatment of syphillis

A

3 Penicillin injection into buttocks or 28 day course of AB

80
Q

What are the symptoms of trichomona vaginalis for women

A

Abnormal vag discharge, soreness, itchy, smell and pain

81
Q

What are the symptoms of trichomona vaginalis in men

A

thin white discharge, soressness, pain on urination and ejaculation

82
Q

What is the definition of infertile

A

Unable to conceive within a year

83
Q

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

A

pregnancy hasn’t occurred within 6 months of trying

84
Q

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

A

1 yr of trying to get pregnant

85
Q

What is primary infetility

A

Never conceived a child

86
Q

What is secondary infertility

A

Had a child before but can’t have another

87
Q

What are the 3 types of treatment to restore fetility

A

Medical, surgical or assisted reproduction techniques

88
Q

What are the 4 main causes of fertility

A

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

89
Q

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

A

2 yrs

90
Q

What are the 2 types of ovulatory problems

A

Infrequent ovulation- Oligoovulation

absence of ovulation-Anovulation

91
Q

What is Oligozoospermia

A

Decreased number of sperm

92
Q

What is Asthenozoospermia

A

Decreased sperm motility

93
Q

What is teratozoospermia

A

Abnormal shaped sperm

94
Q

What is primary spermatogenic failure

A

Failure to produce sperm

95
Q

What is Hypogonadism

A

Low testosterone levels

96
Q

What is retrograde ejaculation

A

Semen enters the bladder instead of out the penis

97
Q

How is an erection caused

A

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
Q

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

A

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

99
Q

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

A

3 hrs

100
Q

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

A

Theophylline, clozapine, olanzapine, Caffeine

Decrease clearance

101
Q

Which receptors does nicotine work on

A

CYP2A6

Increases clearance

102
Q

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

A

Citalopram, fluoxetine, metoprolol and dextromethorpahn

Increase clearance

103
Q

Which drugs
Clearance?
CYP2C9

A

Phenytoin and glyburide

Increases clearance

104
Q

What is the normal length of pregnancy

A

37-42 weeks

105
Q

What is pre term

A

less than 37 weeks

106
Q

What is the neonatal period

A

up to 28 days

107
Q

Why does Respiratory distress syndrome occur

A

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

108
Q

What is first line for seizures in neonates

A

Phenobarbital

109
Q

What is second and third line for seizures in babies

A

DAIZEPAM- can cause sedation

Phenytoin- not for long term and has narrow therapeutic index

110
Q

What is colic

A

excessive and inconsolable crying in infant

111
Q

When does GORD resolve by

A

2 months, latest 6 motnhs

112
Q

What is croup

A

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

113
Q

What are the symptoms of croup

A

Seal-like barking cough
fever
cold symptoms

114
Q

Treatment for croup

A

Self limiting- takes 48hrs

Refer to GP

115
Q

Managment advice for croup

A

Increase fluid intake
Pctml and ibuprofen
Dexamethosone as a single dose

NMR (3 decks)

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