Female Health

Question 1

Amenorrhoea - low LH/FSH?

Answer 1

Hypothalamic cause

Question 2

Amenorrhoea - raised serum prolactin?

Answer 2

Pituitary adenoma

Question 3

What hormone changes happen in menopause?

Answer 3

• Raised FSH/LH
• Lower oestrogen and progesterone

Question 4

What hormone changes in PCOS?

Answer 4

High LH and LH:FSH ratio
Also high testosterone, insulin and sometimes oestrogen

Question 5

Gold standard for PCOS? and what is seen?

Answer 5

Transvaginal ultrasound – string of pearls appearance
o ≥ 12 follicles
o ≥ 10cm3

Question 6

PID

Answer 6

• High vaginal swab
• Bloods: raised WCC and CRP

Question 7

Polyps

Answer 7

Hysteroscopy

Question 8

Ovarian cyst - what do you do and when?

Answer 8

• Don’t investigate if perimenopausal and/or only one cyst <5cm
• Do CA125 if menopausal, or >50 with early satiety, loss of appetite, abdominal pain, LUTS

Question 9

Ovarian torsion

Answer 9

• First-line = transvaginal ultrasound; whirlpool sign (free fluid in pelvis and oedema in the ovary)
• Definitive = laparoscopic surgery

Question 10

Endometriosis - pelvic pain, deep dyspareunia, dysmenorrhoea, infertility

Answer 10

• Examination: visible endometrial tissue, fixed cervix, tenderness
• Gold standard = laparoscopic surgery with biopsy
• (Can do pelvic ultrasound)

Question 11

Ectopic pregnancy

Answer 11

• Do a pregnancy test
• hCG bloods: slow rise
• Gold standard = transvaginal ultrasound

Question 12

Ovarian cancer

Answer 12

CA125

Question 13

Endometrial cancer

Answer 13

Gold standard = hysterectomy and biopsy