Week 1 part 2 Flashcards Preview

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Flashcards in Week 1 part 2 Deck (105):
1

What cells produce oestrogen?

Granulosa cells

2

In the follicular phase what does the increase in oestrogen cause?

Inhibition of FSH production causing atresia but not of dominant follicle

3

What occurs before ovulation?

Prior LH surge and dominant follicle ruptures to release oocyte

4

What happens 14 days post-ovulation?

Luteolysis

5

What uterine phase occurs over days 5 - 14?

Proliferative phase

6

What urterine phase occurs over days 14-28?

Secretory phase

7

What happens in uterine proliferative phase?

Oestrogen induced growth of endometrial glands and stroma

8

What phase of uterine cycle is this: Progesterone-induced glandular secretory activity
Decidualisation in late secretory phase
Endometrial apoptosis and subsequent menstruation

Luteal phase

9

In menstruation phase- what inhibits scar tissue formation?

Fibrinolysis

10

How much is lost in menstruation?

Less than 80 mls
No clots

11

How long is menstrual cycle

average 28 days
between 21 - 35 days cycle

12

Menorrhagia

Prolonged and increased menstrual flow

13

Metrorrhagia

Regular intermenstrual bleeding

14

Polymenorrhoea

Menses occuring at less than 21 day interval

15

Polymenorrhagia

Increased bleeding and frequent cycle

16

Menometrorrhagia

Prolonged menses and intermenstrual bleeding

17

Amenorrhoea

Absence of menstruation greater than 6 months

18

Oligomenorrhoea

Menses at intervals osf greater than 35 days

19

What is non-organic causes of menorrhagia (prolonged and increased menstrual flow) also known as?

Dysfunctional Uterine Bleeding

20

Name some local disorders causing organic menorrhagia?

1. Fibroids
2. Adenomyosis
3. Endocervical or endometrial polyp
4. Cervical eversion
5. Endometrial hyperplasia
6. Intrauterine contraceptive device
7. PID
8. Endometriosis
9. Malignancy of cervix/uterus
10. AV malformations

21

a benign tumour of muscular and fibrous tissues, typically developing in the wall of the womb.

Fibroids

22

a condition of the uterus (womb) where the cells that normally form a lining on the inside of the uterus, also grow in the muscle wall of the uterus.

Adenomyosis

23

the uterine lining grows outside the uterus – in the fallopian tubes, the ovaries or the tissue lining the pelvis (the peritoneum).

Endometriosis

24

a mass in the inner lining of the uterus. They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated). Pedunculated polyps are more common than sessile ones. They range in size from a few millimeters to several centimeters.

Endometrial polyp

25

In many women, cells from inside the cervical canal, known as glandular cells, are present on the outside surface of the cervix [1]. This used to be called cervical erosion and is now more commonly known as

Cervical eversion

26

s a thickening of the lining of the womb, caused by overgrowth of the cells that line the womb. It is not cancer. But in some women it can develop into womb cancer

Endometrial hyperplasia

27

Name four causes of organic menorrhagia in relation to endocrine?

1. Hypo/hyperthyroidism
2. Diabetes Mellitus
3. Adrenal disease
4. Prolactin disorders

28

3 Disorders of haemostasis causing organic menorrhagia?

1. Von Willebrands disease
2. ITP
3. Factor II, V, VII and XII deficiency

29

Name four organic menorrhagia problems related to pregnancy?

Miscarriage
Ectopic pregnancy
Gestational trophoblastic disease - hydatidiform mole
post partum haemorrhage

30

What class are 85% of all dysfunctional uterine bleeding?

Anovulatory

31

What type of dysfunctional uterine bleeding is more common in obese women?

Anovulatory

32

What class of dysfunctional uterine bleeding is related to women aged 35-45, regular heavy periods, due to inadequate progesterone production by corpus luteum?

Ovulatory

33

How is DUB investigated?

FBC
Cervical smear
TSH
Coagulation screen
Renal/liver tests

34

What imaging is done for investigating DUB?

Transvaginal ultrasound - endometrial thickness, presence of fibroids

35

Name another test used for investigating DUB?

Endometrial sampling - pipelle biopsies, hysteroscopic directed, dilatation and curettage

36

How is DUB managed non surgically?

Progestogens
Combined oral contraceptive pill
Danazol
GnRH analogues
NSSAIDS
Anti-fibrinolytics
Capillary wall stabiliers
Progestogen relasing IUCD

37

What is the management of DUB sugically?

Endometrail resection/ablation (rollerball, thermal balloon)
Hysterectomy

38

What si the main concern between surgical management of DUB and medical?

Fertility lost in surgical

39

Name some differences between endometrial ablation and hysterectomy for DUB?

EA - daycase procedure, shorter, requries smear, combined HRT needed
H - major operation, longer, no smear required, oestrogen only HRT

40

What bacteria predominate in the healthy vagina and produce lacti acid and hydrogen peroxide?

Lactobacillus spp.

41

Name three other organisms found in the vagina healthy?

Strep viridans
Group B strep
Candida

42

Name 4 predisposing facotrs for candida infection?

1. Recent antibiotic therapy
2. High oestrogen levels (pregnancy)
3. Poorly controlled diabetes
4. Immunocomporomised patients

43

Intensly itchy white vaginal discharge?

Thrush

44

How is thrush diagnosed?

Clinical diagnosis
High vaginal swab for culture

45

Name a bacteria in the vagina that buds?

C. albicans

46

Typical spotty rash on penis?

Candida balantis

47

What organism plays a role in bacterial vaginosis?

Gardnerella vaginalis/mobiluncus sp.

48

Thin, watery, fish smelling vaginal discharge?

Bacterial vaginosis

49

How is BV diagnosed?

Clinical diagnosis
Raised vaginal pH > 4.5

50

What cells are looked for from HVS in lab testing in BV?

Presence of clue cells

51

What does Hay-Ison scoring system estimate in BV?

Proportions of clue cells to epithelial cells and lactobacilii

52

How is BV treated?

Metronidazole orally

53

Symptoms of UTI but may have lower abdo pain/back/perineal/penile and tender prostate?

Acute bacterial prostatitis

54

Name a rare complication of UTI in men?

Acute bacyterial prostatitis

55

How is acute bacterial prostatitis diagnosed?

Clinical signs + MSSU for C&S (+/- first pass urine for chlamydia/gonorrhoea)

56

How is acute bacterial prostatitis treatd?

Ciprofloxacin for 28 days
Trimethoprim if high C .diff risk

57

Commonest bacterial STI in UK?

cHLAMYDIA TRACHOMATIS

58

Describe the chalmydia trachomatis bacteria?

Obligate intracellular bacteria wit hbiphasic life cycle - energy parasite

59

Does chlamydia reproduce outside host cell?

No

60

What test should not be done for chlamydia trachomatis?

Culture or gram stain - does not stain because no peptidoglycan in cel wall

61

What serological group causes chlamydia trachoma (eye infeciton)?

Serovars A - C

62

What serological group causes genital infection in chlamydia?

Serovars D-K

63

What does serological group L1-L3 cause in chlamydia?

Lymphogranuloma venereum

64

Treatment for chlamydia?

Azithromycin 1g oral dose

65

STI that is gram negative dipplococcus?

Neisseria gonorrhoeae

66

What does gonorrhoea look like on gram stain?

2 kidney beans facing each other - easily phagocytosed by polymorphs so often appear intracellularly

67

Purulent discharge, a dripping tap?

Gonnorhoea

68

How do you test for both chlamydia and gonorrhoea in one test?

Combined nucleic acid amplification tests (NAATS) or PCR - highly sensitive and specific tests

69

Howis chalmydia nad gonnorhoea tested on male patients? for PCR/NAAT

First pass urine sample

70

What swab is not used for culture of gonorrhoea?

High vaginal swab

71

Will pcr and NAAT be positive even if organism have fied?

Yes - test takes hours not days

72

What also has to be done other than PCR/NAAT for gonorrhoea?

5 weeks wait to do test of cure

73

Treatment for gonorrhoea?

Ceftriaxone IM + oral azithromyicin

74

What type of organism is treponema pallidum?

Spirochaete

75

Does symphilis stain?

No

76

Describe the primary stage of symphiis?

Chancre (painless ulcer) at site of infection - heals without treatment

77

What occurs in secondary stage of symphilis?

Snail track mouth ulcers, generalised rahs and flue like symptoms

78

When diagnosing symphilis what is done to look for spirochaetes in exudate from primary and secondary lesions?

Dark ground microscopy

79

In sepcific test serology for syphilis can antibodys remain positive for life?

Yes

80

What is non specific serology used for in syphilis?

To monitor response to treatment and test how active disease is

81

Name two non specific serological tests for syphilis?

VDRL - Venereal Diseases Reserach Lab
RPR (rapid plasma reagin)

82

Name 3 specific serological tests for syphilis?

TPPA (particle agglutination assay)
TPHA (haemagglutination assay)
IgM and IgG ELISA

83

What is used as screenign test for syphilis?

IgG and IgM ELISA

84

What two tests are specific for syphilis but remain positive for life, not useful in monitoring response to therapy?

TPPA
TPHA

85

tREATMENT for Syphilis?

Injectable long actining penicillin

86

Commonest viral STI?

Genital Warts

87

What virus causes genital warts?

HPV

88

Describe the genital wart causing virusl HPV?

Non-enveloped icosohedral virus containing double stranded DNA

89

wHAT type of HPV cause genital warts?

6 and 11

90

What type of HPV cause increased risk of cervical cancer?

16 and 18

91

How are genital warts diagnosed?

Clinical

92

Treatment of genital warts?

Cryotherapy, podophyllotoxin cream

93

What vaccine is there for genital warts?

Quadrivalent vaccine given to 11-13 yo girls. Protects against 6,11, 16 and 18

94

Lumps on vagina, whiter than surrounding skin with rough surface#?

Genital warts

95

Describe herpes simplex virus?

Enveloped virus containing double stranded DNA

96

Exquisitely painful multiple small vesicles, which are easily deroofed?

Genital herpes HSV

97

wHERE does genital herpes virus migrate to and hide from the immune system at?

Sacral root ganglion

98

How is genital herpes diagnosed?

Swab in virus transport medium of deroofed blister for PCR - highly sensitive and specific

99

Treatment of HSV genital?

Aciclovir and pain relief

100

Decribe the organism that infects in trchomonas vaginalis?

Single celled protozoal parasite

101

How is trichomonas vaginalis transmitted?

Sexual contact

102

Vaginal discharfe and irritation in females, urethritis in males?

Trichomonas vaginalis

103

How is trichomonas vaginalis diagnosed?

High vaginal swab for microscopy

104

How is trichomonas vaginalis treated?

Oral metronidazole

105

How long do male pubic lice and female pubic lice liver for?

Males - 22 days
Females - 17 days