General Gynae 2

Question 1

What chromosomes in Turner’s syndrome?

Answer 1

45X

Question 2

Those with Turner’s syndrome are prone to: (x4)

Answer 2

diabetes
otitis media
coarctation of the aorta
renal malformations

Question 3

Name some physical features you might expect to see in a girl with Turner’s syndrome.

Answer 3

webbed neck
short stature
low set ears
increased carrying angle @ elbow

Question 4

Do girls with Turner’s syndrome have a normal vagina and womb?

Answer 4

yes

Question 5

Do girls with Turner’s syndrome have normal intelligence?

Answer 5

YES

Question 6

When is Turner’s syndrome often diagnosed?

Answer 6

age 13/14 when no puberty.

vagina and womb normal but ovaries don’t work properly

Question 7

What’s wrong with the ovaries in Turner’s syndrome?

Answer 7

dont make enough oestrogen
dont make enough eggs
present at age 13/14 with no puberty

Question 8

What treatments are required in Turner’s syndrome?

*think:
short stature
ovaries
complications.

Answer 8

• growth hormone therapy
• COCP (replace oestr + prog)
• monitoring for complications

Question 9

What can be done if a girl with Turner’s syndrome wants to get pregnant?

Answer 9

donor eggs

Question 10

growth hormone therapy

COCP

monitoring for complications

are treatments for…

Answer 10

Turner’s syndrome

Question 11

47 XXY. What’s this?

Answer 11

Klinefelter’s

Question 12

45X. What’s this?

Answer 12

Turner’s

Question 13

What is the chromosomal make up of a boy with androgen insensitivity syndrome?

Answer 13

normal - 46XY.

he’s just insensitive to androgens.

Question 14

What are chromosomes in Klinefelter’s?

Answer 14

47 XXY

Question 15

Genetically male but female/ambiguous external characteristics - tall, no body hair, with abdominal testes and a womb.

Answer 15

androgen insensitivity syndrome

46XY but can’t respond to androgens

Question 16

What treatments may be required in androgen insensitivity syndrome?

Answer 16

remove abdominal testes! (malig risk)

depends on what gender they identify as.

e. g. vaginal dilation / penis reconstruction
e. g. male breast reduction

Question 17

Why is it important to surgically remove abdominal testes in androgen insensitivity syndrome?

Answer 17

risk of malignancy

Question 18

Premature ovarian failure is defined as…

Answer 18

menopause <40

Question 19

Name 3 causes of premature ovarian failure

Answer 19

• genetic
• chemotherapy
• autoimmune

Question 20

Three investigation results which you’d expect to find in premature ovarian failure?

Answer 20

low oestrogen

high FSH/LH

Question 21

When testing FSH for premature ovarian failure, you need …

Answer 21

2 raised samples of FSH 4 wks apart

Question 22

35 yr old lady has low oestrogen, low AMH and high LH and high FSH (2 samples taken 4wks apart). What is likely diagnosis?

Answer 22

premature ovarian failure

Question 23

What is the treatment for premature ovarian failure?

Answer 23

HRT / COCP
DONOR EGGS
testosterone might increase libido

Question 24

36 yr old woman with premature ovarian failure is struggling with low libido. What might you prescribe?

Answer 24

testosterone gel

Question 25

Define FGM.

Answer 25

all procedures involving partial / total removal
of female external genitalia
for NON MEDICAL REASONS

Question 26

all procedures involving partial / total removal
of female external genitalia
for NON-MEDICAL REASONS

What’s this?

Answer 26

FGM

Question 27

Name the 4 types of FGM.

Answer 27

1. clitoridectomy
2. excision of labia
3. infibulation
4. all other

Question 28

What is infibulation in FGM?

Answer 28

narrowing introitus

Question 29

What might other forms of FGM involve?

Answer 29

cauterisation

Question 30

Name 4 obstetric complications of FGM.

Answer 30

fistula
tears
PPH
fear of childbirth

Question 31

What is the treatment for FGM? (ideally done before conception)

Answer 31

de-fibulation.

diathermy and suture edges
(ideally pre-conception)