ASHERMAN: Causes

Acquired Anomaly
Secondary to Surgery
Hysterosalpingography confirms diagnosis
Endometrial damage/ Eugonadotropic
Repeated uterine trauma
Missed Menses
Adhesions
Normal estrogen and progesterone

CONTRACEPTIVES Side Effects-

CONTRACEPTIVES:

Cholestatic jaundice
Oedema (corneal)
Nasal congestion
Thyroid dysfunction
Raised BP
Acne/ Alopecia/ Anaemia
Cerebrovascular disease
Elevated blood sugar
Porphyria/ Pigmentation/ Pancreatitis
Thromboembolism
Intracranial hypertension
Vomiting (progesterone only)
Erythema nodosum/ Extrapyramidal effects
Sensitivity to light

Oral contraceptive complications: warning signs

ACHES:
Abdominal pain
Chest pain
Headache (severe)
Eye (blurred vision)
Sharp leg pain

IUD: side effects

PAINS:
Period that is late
Abdominal cramps
Increase in body temperature
Noticeable vaginal discharge
Spotting

Ovarian cancer: risk factors

“Blue FILM”:
Breast cancer
Family history
Infertility
Low parity
Mumps

Omental caking: likeliest cause

Omental CAking = Ovarian CA
• “Omental caking” is term for ascities, plus a fixed upper abdominal and pelvic mass. Almost
always signifies ovarian cancer.
Endometrial carcinoma: Risk factors
“ENDOMET”

Elderly
Nulliparity
Diabetes mellitus
Obesity
Menstrual irregularity
Estrogen therapy
hyperTension

Endometriosis: Symptoms
5 “D”s

Dysmenorrhoea
Disorders of menstruation
Dyspareunia
Dyschezia
Dull ache of abdomen

Pelvic Inflammatory Disease (PID): causes, effects

“PID CAN be EPIC”:
• Causes:
Chlamydia trachomatis
Actinomycetes
Neisseria gonorrhoeae
• Effects:
Ectopic
Pregnancy
Infertility
Chronic pain

Pelvic Inflammatory Disease (PID): complications

I FACE PID:
Infertility
Fitz-Hugh-Curitis syndrome
Abscesses
Chronic pelvic pain
Ectopic pregnancy
Peritonitis
Intestinal obstruction
Disseminated: sepsis, endocarditis, arthritis, meninigitis

Criteria of hospitalization in PID

GU PAP
GI symptoms
Uncertain diagnosis
Peritonitis
Abscess
Pregnancy

Secondary amenorrhea: causes

SOAP:
Stress
OCP
Anorexia
Pregnancy
Sexual response cycle
EXPLORE:
EXcitement
PLateau
Orgasmic
REsolution

Parity abbreviations (ie: G 3, P 2012)

“To Peace And Love”:
T: of Term pregnancies
P: of Premature births
A: of Abortions (spontaneous or elective)
L: of Live births
• Describes the outcomes of the total number of pregnancies (Gravida).

Dysfunctional uterine bleeding (DUB): 3 major causes

DUB:
Don’t ovulate (anovulation: 90% of cases)
Unusual corpus leuteum activity (prolonged or insufficient)
Birth control pills (since increases progesterone-estrogen ratio)

Causes of premenarchal bleeding:

FEST
F=Foreign body
E=Exogenous estrogen
S=sexual abuse
T=Tumors(ovarian,adrenal,pitutary,sarcoma botryods.)

Polycystic Ovarian Syndrome (PCOS): first line treatment

Treat PCOS with OCP’s (oral contraceptive pills).

Vaginal pH
Vagina has 4 labia and normal pH of vagina is about 4.

Bacterial vaginosis
Think: “Take a Whiff and get some Clue of Fishy odour!”

On Whiff test the vaginal discharge gives a Fishy (amine) odour

Clue cells are seen on microscopy

Menopause Wreaks
HAVOC
Hot flashes
Atrophy of the Vagina
Osteoporosis
Coronary artery disease

( absolute contraindication to hormone replacement therapy )

ABCD

A = Acute liver disease

B= undiagnosed vaginal (B)leeding

C=Cancer (breast/uterine)

D= DVT (thromboembolic disease )

prolapse etiology
all c ‘s
c-child birth trauma
c- congenital weakness-suporting tissue pelvic floor
c-chronic increase of abdominal pressure
c-chronic cough/constipation
c-climatrix-decrease ostrogens

Chronic Pelvic Pain

Think of LEAPING pain
Leiomyoma
Endometriosis
Endometritis
Adhesions
Adenomyosis
PID
Infections rather than PID
Neoplasia
Gastrointestinal

Acute Pelvic Pain

A ROPE
Appendicitis
Abscess
Abortion
Ruptured ovarian cyst
Ovarian torsion
PID (tubo-ovarian abscess)
Ectopic pregnancy

Risk factors for cervical dysplasia __

OSHA Ends Dirt, Garbage, and Chemicals
Oral contraceptives
Sex
HPV
Alcohol
Educaion—Poverty
DES (Diethylstilbestrol)
Genetics
Cigarettes

Metastasis of cervical cancer

RIB Eye Steak
Rectal
Intra-abdominal
Bladder
Endometrial

Causes of urinary incontinence—- This Urine Flow is So Outrageous

Total
Urge
Functional
Stress
Overflow

Reversible causes of urinary incontinence

DIAPPERS
Delirium
Infection
Atrophic Vaginitis
Pharmacologic causes
Psychiatric causes
Excessive Urine production
Restricted mobility
Stool impaction

Prolactin and oxytocin: Functions

PROlactin stimulates mammary glands to PROduce milk and
Oxytocin stimulates mammary glands to OOze milk.

Physiologic causes of Prolactinoma

7S
Sex
Stress
Sleep
Surgery
Suckling
Second half of the cycle

prolapse etiology
all c ‘s
c-child birth trauma
c- congenital weakness-suporting tissue pelvic floor
c-chronic increase of abdominal pressure
c-chronic cough/constipation
c-climatrix-decrease ostrogens