Bleeding Problems & General Gynaecology Flashcards
What is the average absorbency of period products?
Menstrual disks - 61ml
Tampons/cups/pads - 20-50ml
Period pants - 2ml
How does an endometrial polyp appear on TVUS?
Hyperechoic lesions with regular contours in the uterine cavity, surrounded by a thin hyperechoic halo
What is the risk of progression from endometrial hyperplasia without atypia to endometrial cancer if left untreated?
2%
When is a fibroid classed as subserosal?
Subserosal, and <50% intramural
When is a fibroid classed as intramural?
Subserosal but >/= 50% intramural, or 100% intramural (no distortion into activity)
When is a fibroid classed as submucosal?
Any distortion of the cavity, irrespective how much it is intramural
Which histologic subtype of endometrial cancer is likely to confer the best prognosis?
Endometrioid adenocarcinoma
Why is shoulder pain common after a laparoscopy?
The diaphragm and the skin over the shoulder are supplied by the same set of nerves that arise from the cervical plexus
What is the standard for semen volume?
> /= 1.5ml
What is the standard for semen pH?
> /= 7.2
What is the standard for semen concentration
> /= 15 million per ml
What is the standard for total sperm number
> /= 39 million per ejaculate
What is the standard for semen vitality?
> /=58% live sperm
What is the standard for sperm morphology?
> /=4%
What is the standard for sperm motility?
40% or more motile or 32% or more with progressive motility
If a semen analysis is abnormal, when should it be repeated?
In 3 months
If azoospermia, or severe oligozoospermia i.e. <5 million sperm/mL detected, repeat analysis ASAP
Should antisperm antibodies be screened for in a semen analysis?
No
What level of progesterone is suggestive of anovulation?
<16
What level of progesterone confirms ovulation HAS taken place?
> 30
How do fibroids appear on USS?
- Solid, round and well defined
- Hypoechoic and heterogenous
- Distortion of the outer uterine contour
- Calcifications appear hyperechoic
- Circumferential flow on colour doppler
- Acoustic shadowing (large fibroids)
What is the microscopic appearance of fibroids on histology?
- Spindle cells arranged in fascicles
- Cigar shaped nucleus
- Normal mitotic activity
- Well differentiated
- Abundant extracellular matrix
What are the most common types of female pelvis?
Gynaecoid (>50%)
Anthropoid (25%)
Android (20%)
Platypelloid (<5%)
Which type of pelvis is most accommodating for childbirth?
The gynaecoid pelvis. Rounded pelvic inlet and a wide subpubic arch of 80-90 degrees.
The android being the least accommodating
What is the lifetime risk of uterine cancer?
1 in 36
In any woman with postmenopausal bleeding, what is the risk of endometrial cancer?
5-10%
What are the two categories of uterine cancer?
Type 1 cancers are associated with unopposed oestrogen
Type 2 cancers are oestrogen independent and often related to genetic mutations
What is the most common histological form of endometrial cancer?
Endometrial endometrioid adenocarcinoma - 80% of endometrial Ca
What % of endometrial cancers occur in women <40?
1%