Female Reproductive Tract Flashcards
What is involved in basic gynaecological pathology?
Cervix
Uterus & endometrium
Ovaries
Pregnancy related disorders
What are the common presenting complaints in gynaecology?
Vaginal bleeding
Pain
Discharge
Infertility
What is involved in a cervical smear test?
View cervix and take samples
How often are smear tests performed?
3 years age 25-49
5 years age 49-64
What are the different types of human papilloma virus (HPV)?
Warts/verrucas (low risk) Cervical cancer (high risk)
How is HPV transmitted?
Sexual contact
Are there any symptoms of HPV?
No
HPV is thought to be the main cause of what?
CIN and therefore cervical cancer
What happens if smears are abnormal?
Refer to colposcopy
Biopsies
What does CIN stand for?
Cervical Intra-epithelial Neoplasia
What are the risk factors of cervical cancer?
HPV
Smoking
What are the symptoms of cervical cancer?
Abnormal discharge and bleeding
What is cervical carcinoma?
Abnormal cells and invasion
What do those with cervical carcinoma present with?
Inter menstrual or post coital bleeding
How is cervical carcinoma treated?
Local excision or radical hysterectomy +/ chemo/radiotherpy
all depending on stage
What are endocervical polyps?
Benign lesions
What do those with endocervical polyps present with?
Irregular vaginal bleeding
How can endocervical polyps be be treated?
Removal at hysteroscopy
What is menorrhagia?
Heavy periods (>08ml)
What are the causes of menorrhagia?
Dysfunctional uterine bleeding (DUB)
Fibroids
Endometriosis
Polyps
How is menorrhagia treated?
Mirena coil Mefanamic & transexamic acid COCP Depo Endometrial ablation Hysterectomy
What are fibroids (leiomyomas)?
Benign tumours
How do fibroids occur?
Arise from myometrium (uterine muscular wall)
What are the symptoms of fibroids?
Heavy/painful periods
Pelvic pain
Distension
What is endometriosis?
Endometrial tissue in the wrong location (outside the endometrium)
How is endometritis and pelvic inflammatory disease transmitted?
Infections (usually STIs)
What may someone with endometritis and pelvic inflammatory disease present with?
Abnormal discharge
Pain (pelvic, periods, sex)
Bleeding
(can be asymptomatic)
What is endometritis and pelvic inflammatory disease a major cause of?
Infertility
What are the treatments for endometriosis?
COCP
Mirena
Zoladex
Surgery
Why is endometrial cancer often detected early?
It presents as post menopausal bleeding
What are the risk factors of endometrial cancer?
Nulliparity, high BMI, HRT, late menopause
How is endometrial cancer diagnosed?
Biopsy (pipelle or hysteroscopy)
How is endometrial cancer treated?
TAH and BSO
What are the risk factors of endometrial carcinoma?
Obesity
Oestrogen exposure
What are follicular cysts?
Benign ovarian cysts >6cm
Asymptomatic
No treatment
What are crystadenocas?
Very large fluid filled ovarian cysts
What are benign mature teratomas?
Large ovarian cysts filled with solid substance
How does polycystic ovaries present itself?
Irregular periods, no periods, infertility
How is polycystic ovaries treated?
COCP
Metformin
Clomifene
What are complications of polycystic ovaries?
Increased CV risk
Increased T2DM risk
Pregnancy problems
Why does ovarian cancer have poorer prognosis then endometrial cancer?
Often asymptomatic
Present late when already spread
What is a miscarriage?
Loss of pregnancy before 24 weeks
What are the 4 classifications of miscarriage?
Threatened
Inevitable
Incomplete
Missed
What are the risk factors of miscarriage?
Age Multiple pregnancies Smoking Alcohol Connective tissue disroders Diabetes
What are the 3 treatment options for miscarriage?
Conservative
Medical (misoprostol)
Surgical (vacuum)
What are the risk factors of exotic pregnancy?
Pelvic inflammatory disease (PID) Coil IVF Previous ectopic Pelvic surgery Fertility treatments Smoking
How does an ectopic pregnancy present?
Pain and unilateral low abdominal pain
How are ectopic pregnancies tested for?
Raised beta-HCG levels on blood testing
How are ectopic pregnancies treated?
Surgically
