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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
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

NMR (3 decks)

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