Day before specialites

Question 1

APGAR- appearance

Answer 1

2= pink
1= blue extremities, pink body
0= blue

Question 2

APGAR- pulse

Answer 2

2= over 100
1= under 100
0= no pulse

Question 3

APGAR- resp effort

Answer 3

2= strong, crying
1= weak and irregular
0= none

Question 4

APGAR- grimace

Answer 4

2= cries on stimulation, coughs, sneezes
1= grimaces
0= none

Question 5

APGAR- tone (activity)

Answer 5

2= active movement
1= limb flexion
0= flaccid

Question 6

What is the pain relief needed for ventouse vs forceps

Answer 6

Ventouse none major needed
Forceps requires epidural or pudendal nerve block

Question 7

Time until…. in abdo hysterectomy
- discharge
- bed rest
- work
- sex

Answer 7

Discharge- 2-4 days
Bed rest- 4 days
Work- 2-4 if light duties, 4-6 weeks properly, 6-8 weeks if heavy lifting
Sex- 4-6 weeks

Question 8

Time until…. in c-section
- discharge
- work

Answer 8

Discharge- 1-2 days
Work- 6-8 weeks including exercise

Question 9

Time until…. in laparascopic hysterectomy
- discharge
- work

Answer 9

• discharge= 1-2 days
• work= 4-6 weeks

Question 10

Time until…. in diagnostic or sterilisation laparascopy
- discharge
- work

Answer 10

Discharge- 6 hours
Work- less than 1 week

Question 11

Time until…. in operative laparoscopy like cyst removal
- discharge
- work

Answer 11

Discharge- 6 hours same day
Work- 2-3 weeks

Question 12

Time until…. in vaginal hysterectomy
- discharge
- work

Answer 12

Discharge- 24-48 hours
Work- 4 weeks

Question 13

Time until…. in surgical miscarriage
- discharge
- work

Answer 13

discharge= same day
Work= 5-7 days

Question 14

Time until…. in endometrial ablation
- discharge
- work

Answer 14

Discharge= 2 hours- bit longer if GA
Work= week

Question 15

FIGO ovarian cancer staging

Answer 15

Stage I: Cancer is confined to one or both ovaries
- IA: Growth is limited to 1 ovary with no tumor on external surfaces
- IB: Growth is limited to both ovaries with no tumor on external surfaces
- IC: Tumor is either stage IA or IB, but with tumor on surface of one or both ovaries
Stage II: Cancer has spread to the uterus or other nearby organs
- IIA: Extension and/or metastases of cancer to the uterus and/or fallopian tubes
- IIB: Extension of the cancer to other pelvic tissues
- IIC: Tumor is at either stage IIA or IIB, but with tumor on surface of one or both ovaries
Stage III: Cancer has spread to the lymph nodes or abdominal lining
- IIIA: Tumor limited to the true pelvis
- IIIB: Metastasis of abdominal peritoneal surfaces ≤ 2 cm. in diameter
- IIIC: Peritoneal metastasis beyond the pelvis > 2 cm. in diameter
Stage IV: Cancer has spread to distant organs, such as the lungs or liver

Question 16

Pathway for ovarian cancer in secondary care

Answer 16

RMI over 250- MDT
CT abdo pelvis
Laparotomic surgery

Question 17

Management of ovarian cancer

Answer 17

Stage 1a and 1b= hysterectomy, BSO and infracolic omentectomy, samples of abdomen
1c= adjuvant chemo too
2 and above= fuck knows

Question 18

Management of endometrial cancer

Answer 18

Mainstay is total hysterectomy, bilateral salpingo-oophorectomy and lymphadenectomy 1A
1B and above give radiotherapy
If want to preserve fertility- in 1A can do progestin and surveying every 3-6 months

Question 19

Staging for endometrial cancer

Answer 19

Stage 1: The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.
- 1A: The cancer is found only in the endometrium or less than one-half of the myometrium.
- 1B: The tumor has spread to one-half or more of the myometrium.

Stage 2: The tumor has spread from the uterus to the cervical stroma but not to other parts of the body

• 3: The cancer has spread beyond the uterus, but it is still only in the pelvic area.
• 3A: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.
• 3B: The tumor has spread to the vagina or to the tissue immediately next to the uterus called the parametrium.
• 3C1: The cancer has spread to the regional pelvic lymph nodes
• 3C2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes

Stage 4: The cancer has metastasized to the rectum, bladder, and/or distant organs.
- 4A: The cancer has spread to the mucosa of the rectum or bladder.
- 4B: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs

Question 20

Management of cervical cancer

Answer 20

Stage 1- radical trachelectomy plus lymphadenectomy in A2, can do cone biopsy if wish to maintain fertility
Stage 2 and 3- chemo and radiation
Stage 4- radiation and chemo