Female Reproductive Tract

Question 1

What is involved in basic gynaecological pathology?

Answer 1

Cervix
Uterus & endometrium
Ovaries
Pregnancy related disorders

Question 2

What are the common presenting complaints in gynaecology?

Answer 2

Vaginal bleeding
Pain
Discharge
Infertility

Question 3

What is involved in a cervical smear test?

Answer 3

View cervix and take samples

Question 4

How often are smear tests performed?

Answer 4

3 years age 25-49

5 years age 49-64

Question 5

What are the different types of human papilloma virus (HPV)?

Answer 5

Warts/verrucas (low risk)
Cervical cancer (high risk)

Question 6

How is HPV transmitted?

Answer 6

Sexual contact

Question 7

Are there any symptoms of HPV?

Answer 7

No

Question 8

HPV is thought to be the main cause of what?

Answer 8

CIN and therefore cervical cancer

Question 9

What happens if smears are abnormal?

Answer 9

Refer to colposcopy

Biopsies

Question 10

What does CIN stand for?

Answer 10

Cervical Intra-epithelial Neoplasia

Question 11

What are the risk factors of cervical cancer?

Answer 11

HPV

Smoking

Question 12

What are the symptoms of cervical cancer?

Answer 12

Abnormal discharge and bleeding

Question 13

What is cervical carcinoma?

Answer 13

Abnormal cells and invasion

Question 14

What do those with cervical carcinoma present with?

Answer 14

Inter menstrual or post coital bleeding

Question 15

How is cervical carcinoma treated?

Answer 15

Local excision or radical hysterectomy +/ chemo/radiotherpy

all depending on stage

Question 16

What are endocervical polyps?

Answer 16

Benign lesions

Question 17

What do those with endocervical polyps present with?

Answer 17

Irregular vaginal bleeding

Question 18

How can endocervical polyps be be treated?

Answer 18

Removal at hysteroscopy

Question 19

What is menorrhagia?

Answer 19

Heavy periods (>08ml)

Question 20

What are the causes of menorrhagia?

Answer 20

Dysfunctional uterine bleeding (DUB)
Fibroids
Endometriosis
Polyps

Question 21

How is menorrhagia treated?

Answer 21

Mirena coil
Mefanamic & transexamic acid
COCP
Depo
Endometrial ablation
Hysterectomy

Question 22

What are fibroids (leiomyomas)?

Answer 22

Benign tumours

Question 23

How do fibroids occur?

Answer 23

Arise from myometrium (uterine muscular wall)

Question 24

What are the symptoms of fibroids?

Answer 24

Heavy/painful periods
Pelvic pain
Distension

Question 25

What is endometriosis?

Answer 25

Endometrial tissue in the wrong location (outside the endometrium)

Question 26

How is endometritis and pelvic inflammatory disease transmitted?

Answer 26

Infections (usually STIs)

Question 27

What may someone with endometritis and pelvic inflammatory disease present with?

Answer 27

Abnormal discharge Pain (pelvic, periods, sex) Bleeding (can be asymptomatic)

Question 28

What is endometritis and pelvic inflammatory disease a major cause of?

Answer 28

Infertility

Question 29

What are the treatments for endometriosis?

Answer 29

COCP Mirena Zoladex Surgery

Question 30

Why is endometrial cancer often detected early?

Answer 30

It presents as post menopausal bleeding

Question 31

What are the risk factors of endometrial cancer?

Answer 31

Nulliparity, high BMI, HRT, late menopause

Question 32

How is endometrial cancer diagnosed?

Answer 32

Biopsy (pipelle or hysteroscopy)

Question 33

How is endometrial cancer treated?

Answer 33

TAH and BSO

Question 34

What are the risk factors of endometrial carcinoma?

Answer 34

Obesity | Oestrogen exposure

Question 35

What are follicular cysts?

Answer 35

Benign ovarian cysts >6cm Asymptomatic No treatment

Question 36

What are crystadenocas?

Answer 36

Very large fluid filled ovarian cysts

Question 37

What are benign mature teratomas?

Answer 37

Large ovarian cysts filled with solid substance

Question 38

How does polycystic ovaries present itself?

Answer 38

Irregular periods, no periods, infertility

Question 39

How is polycystic ovaries treated?

Answer 39

COCP Metformin Clomifene

Question 40

What are complications of polycystic ovaries?

Answer 40

Increased CV risk Increased T2DM risk Pregnancy problems

Question 41

Why does ovarian cancer have poorer prognosis then endometrial cancer?

Answer 41

Often asymptomatic | Present late when already spread

Question 42

What is a miscarriage?

Answer 42

Loss of pregnancy before 24 weeks

Question 43

What are the 4 classifications of miscarriage?

Answer 43

Threatened Inevitable Incomplete Missed

Question 44

What are the risk factors of miscarriage?

Answer 44

``` Age Multiple pregnancies Smoking Alcohol Connective tissue disroders Diabetes ```

Question 45

What are the 3 treatment options for miscarriage?

Answer 45

Conservative Medical (misoprostol) Surgical (vacuum)

Question 46

What are the risk factors of exotic pregnancy?

Answer 46

``` Pelvic inflammatory disease (PID) Coil IVF Previous ectopic Pelvic surgery Fertility treatments Smoking ```

Question 47

How does an ectopic pregnancy present?

Answer 47

Pain and unilateral low abdominal pain

Question 48

How are ectopic pregnancies tested for?

Answer 48

Raised beta-HCG levels on blood testing

Question 49

How are ectopic pregnancies treated?

Answer 49

Surgically