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JG Year 2 > 204 Gynea - HMB > Flashcards

204 Gynea - HMB Flashcards

1
Q

What is primary dysmenorrhoea?

A

Not associated with an organic cause

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2
Q

What is secondary dysmenorrhoea?

A

There is an organic cause

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3
Q

What is adenomyosis?

A

Ectopic endometrial tissue in myometrium

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4
Q

What are the symptoms fibroids?

A 
Mainly - HMB 
Associated symptoms:
Painful sex
Increased urinary frequency and urgency
Can cause miscarriages and pre term labour
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5
Q

What is the medical treatment for fibroids?

3 listed

A

GnRH analogues
Mirena
Esmya

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6
Q

How does esmya help with the treatment of fibroids?

A

Block progesterone receptors, inhibit cel prolif and stimulate apoptosis
Selectively blocks progesterone activity at pituitary

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7
Q

Which tumour markers should be requested when dealing with HMB? (3 listed)

A

CA19-9 - Ovarian and pancreatic ca
Ca125 Ovarian Ca
CEA - Colon and breast Ca

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8
Q

What is the criteria for endometrial biopsy?

A

Women over 40 and younger women who have failed to respond to treatment

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9
Q

What are the 2 surgical options for HMB?

A

Endometrial ablation

Hysterectomy (90% long term satisfaction)

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10
Q

What are the surgical options for treatment of fibroids?

3 listed

A

Myomectomy
Hysterectomy
Uterine artery embolisation

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11
Q

What are the complications of fibroids?

4 listed

A

Degeneration- hyaline change/calcification
Torsion
Infection with pyometra
Malignancy - leiomyosarcoma

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12
Q

Which antifibrinolytic is used in the treatment of HMB?

When should it be taken?

A

Tranexamic acid - take only during menstruation. Decreases by 50%

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13
Q

Which NSAID can be used in conjunction with tranexamic acid to treat HMB?

A

Mefenamic acid

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14
Q

When should oral progestogens be used in the treatment of HMB?

A

It shouldn’t be used - it can be used to regulate bleeding

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15
Q

What is another name for levonorgestrel?

A

Mirena coil

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16
Q

Which medical treatment decreased HMB by 90%?

A

Mirena coil

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17
Q

What are leuprorelin acetate and triptorelin examples of?

A

GnRH antagonists- i.e. downregulate the release of LH and FSH which inhibits the release of oestrogen from ovary

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18
Q

What is the typical P/C of endometrial cancer?

A

Post menopausal bleeding

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19
Q

What is the commonest cause of post menopausal bleeding?

A

Atrophic vaginitis

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20
Q

What is the treatment of atrophic vaginitis?

A

Topical oestrogen

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21
Q

What surgical treatment should be considered in the management of endometrial cancer?

A

TAH +/- RTx = if there is more than 50% of the myometrium involved

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22
Q

What are the 3 different types of HRT?

A
  1. E2 only for hysterectomised women
  2. Sequential - E2 daily + prog for 14 days of month
  3. Continuous - E2 and prog daily
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23
Q

What is the most important indicator of subfertility?

A

Woman’s age

24
Q

What is the contents of seminal plasma?

A

Glucose
Fructose
PGs
Proteins

25
Q

What is Sheehans syndrome?

A

Hypopituitarism caused by ischemic necrosis due to blood loss and hypovolemic shock during and after childbirth. Can cause subfertility

26
Q

What is Kallman’s syndrome?

A

Genetic condition - failure of onset of puberty - one cause of subfertility

27
Q

What is the assisted conception technique for mild sperm dysfunction when a couple is trying to conceive?

A

IUI

28
Q

What is the assisted conception technique of choice for severe tubular damage?

A

IVF - have to remove the damaged tube prior to IVF as risk of toxins affecting the pregnancy

29
Q

What is a threatened miscarriage?

A

Bleeding but cervical os still closed - 25% go on to miscarry

30
Q

What is a molar pregnancy?

A

Non viable fertilised egg implants into the endometrium

31
Q

What is a complete molar pregnancy?

A

diploid/paternal origin

32
Q

What is the level of beta-hCG in an non-pregnant woman?

A

<5 UI/mL

33
Q

What is ovarian hypersensitivity syndrome?

A

Risk of ovarian induction - massive ovarian cysts, ascites, pleural and pericardial effusions, Hypovolaemia.

34
Q

What are the risks to the offspring in ovarian induction?

A

Premature birth, Epigenetic disorders

35
Q

What is asthenospermia?

A

Normal morphology but lack motility

36
Q

What is teratozoospermia?

A

Abnormally high number of abnormal forms

37
Q

What is oligozoospermia?

A

Decreased sperm count

38
Q

What are the signs and symptoms of a molar pregnancy?

A

PV spotting, uterus large for gestational age

39
Q

What are the maternal causes of molar pregnancy? (7 listed)

A 
Müllerian duct abnormalities
Obesity
Alcohol
Smokers
Systemic disease
DM
Thyroid dysfunction
40
Q

What are the complications of a molar pregnancy?

4 listed

A

Infection or haemorrage of retained PoC
Uterine perforation at time of ERCP
Ashermans syndrome
Cervical incompetence

41
Q

What is Ashermans syndrome?

A

Adhesions / fibrosis of endometrium out curettage or retained PoC

42
Q

When was the abortion act commissioned?

A

1967

43
Q

What are the 4 methods of therapeutic abortion?

A

Suction curettage + prostaglandin pessary to dilate cervix
Antoprogestogen tabs + prostaglandin tabs
Dilation of cervix and evacuation of uterine contents
Prostaglandin induction +/- oxytocin infusion

44
Q

How many weeks into pregnancy can a suction curettage be performed to complete a therapeutic abortion?

A

12-14 weeks

45
Q

Up to how many weeks into pregnancy can antiprogestogen tabs be given for a therapeutic abortion?

A

Up to 9 weeks

46
Q

What is percentage of ectopic pregnancies are tubular (usually in ampulla)?

A

98%

47
Q

How is an ectopic pregnancy confirmed?

A

Nil seen on USS of abdomen with a βhCG of >1500

48
Q

What is the treatment of an acutely-presenting ectopic pregnancy?

A

Surgical laparoscopy and salpingectomy of affected tube as long as the other is healthy

49
Q

What is the risk when an ovarian cyst reaches >5cm in size?

A

Torsion

50
Q

What are the typical S&S of an ectopic pregnancy?

4 listed

A

Amenorrhea for 4-6 weeks
Pain
Scanty brown discharge PV
Empty uterus on USS

51
Q

What are the types of benign ovarian cysts?

2 listed

A

Serous/ mucinous cystadenoma

Endometrioma ( chocolate cyst)

52
Q

What are the 2 types of malignant ovarian cysts?

A

Cystadenocarcinoma

Gonadoblastoma

53
Q

What produces beta-hCG?

A

Embryo and later the syncitiotrophoblast

54
Q

What type of drug is mifepristone and when is it used?

A

Competitive progesterone receptor antagonist. It causes decidual degeneration of the endometrium and cervical softening/dilation in a therapeutic abortion

55
Q

What type of drug is misoprostol and when is it used?

A

Synthetic prostaglandin-E2 analogue which causes contractions and softens the cervix in a therapeutic abortion

56
Q

What is an adnexal mass?

A

A mass associated with the uterine appendages

57
Q

What are fibroids?

A

Benign tumour of SM of the uterus

JG Year 2 (28 decks)

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