Female Reproductive Tract

Question 1

Human Papilloma Virus

Answer 1

Transmitted by sexual contact
Risk increases with increase of sexual partners
No symptoms
Main cause of CIN and cervical cancer

Many different types
Low risk types, wart verruca’s
High risk types, cervical cancer
HPV vaccination ages 12-13

Question 2

Cervical Intra-epithelial Neoplasia

Answer 2

3 stages under microscope

Question 3

Cervical cancer

Answer 3

Risk factors
-HPV, smoking, non attendance to screening
Symptoms
-Abnormal discharge and bleeding
-later stages cervix can look abnormal

Question 4

What is cervical cancer

Answer 4

Abnormal cells and invasion stroma

Can present with inter-menstrual or post-coital bleeding

Question 5

Treatment of cervical cancer

Answer 5

depends of stage of diagnosis
local excision or radical hysterectomy
chemo

Question 6

Endocervical polyps

Answer 6

Not cancerous
Benign lesions
Present with spotting
Can remove at hysteroscopy

Question 7

Menorrhagia

Answer 7

Heavy periods >80ml blood loss
Causes:
50% dub, unknown
Fibroids, endometriosis, polps various things

Treament:
Coil 
COCP 
Depo
Endometrial ablation 
Hysterectomy 
Mefanamic and transamic drugs

Question 8

Fibroids (Leiomyomas)

Answer 8

Common benign tumours
Arise from myometrium (uterine muscle wall)
Present heavy painful periods, pelvic pain or distension
Treatment depends on symptoms and wishes for pregnancy

Question 9

Endometriosis and Pelvic inflammatory disease

Answer 9

Caused by infections, usually sexual transmitted

Abnormal discharge, pain or bleeding

Can be asymptomatic

Major cause of infertility

Question 10

Endometriosis

Answer 10

tissue in wrong location

benign condition

Question 11

Treatment of Endometriosis

Answer 11

COCP
Mirena coil
Zoladex
Surgery

Question 12

Endometrial Cancer

Answer 12

Cancer of the lining of the uterus

Presents as post menopausal bleeding

Question 13

Risk factors of endometrial cancer

Answer 13

Nulliparity - no children
high bmi
hrt 
late menopause
oesrogen exposure

usually diagnosed on biopsy - pipelle or hysteroscopy
treatment total hysterectomy

Question 14

Follicular cysts

Answer 14

Benign, very common
less than 6cm
asymptomatic

Question 15

Polycystic ovarian syndrome

Answer 15

Multiple cysts in the ovary
Common cause of infertility

Treatment
COCP
Metformin
Clomifene

Complications
Increased CV risk
Increased risk of T2DM
Increased problems in pregnancy

Question 16

Ovarian cyst

Answer 16

Can be benign or malignant

If cyst is large, needs to be removed

Question 17

Teratoma - dermoid cyst

Answer 17

hair 
teeth 
bone 
thyroid 
GI tract
skin

Question 18

Ovarian cancer

Answer 18

presents late already spread

asymptomatic

Question 19

Pregnancy related diseases

Answer 19

Miscarriage

Question 20

Miscarriage

Answer 20

Los before 224 weeks
15% of pregnancies
Usually first trimester

Risk factors
increasing age, multiple pregnancies, smoking, alcohol, connective tissue disorders in mothers, diabetes
Presented with bleeding

Treatment
Conservative - nature
Misoprostol - induce false birth
Surgical usually by vacuum suction under GA

Question 21

Ectopic Pregnancy

Answer 21

Pregnancy that occurs somewhere else, usually in tubes
Abdominal pelvic pain
Emergency is rupture

Risk Factors
PID
Coil
IVF 
Previous ectopic 
Pelvic surgery