General gynae Flashcards
3 Benign itchy vulval skin conditions
-what they look like
- Lichen SCLEROSIS (itch + white thickened plaques on skin)
- Lichen SIMPLEX (itch + hyper/hypo pigmentation)
- Lichen PLANUS (pain/itch + flat purple papules)
Which vulval skin condition may be associated with vulval intra-epithelial neoplasia
Lichen sclerosis
Explain in histological terms what a cervical ectropion is
Cells normally found on the inside of the cervix (glandular) are present on the outside of the cervix (normally squamous epithelial)
Symptoms of cervical ectropion/ polyp
- heavy flow periods
- intermenstrual bleeding
- prolapse through cervix
Non-infective pathological causes of vaginal discharge
- Cervical polyps
- Vulval dermatitis
- Erosive lichen planus
- Cancer (cervix/ uterus/ ovary)
- Fistula
5 Non-infective pathological causes of vaginal discharge
- Cervical polyps
- Vulval dermatitis
- Erosive lichen planus
- Cancer (cervix/ uterus/ ovary)
- Fistula
5 Infective causes of vaginal discharge
- BV (most common)
- Candida
- Chlamydia
- Gonorrhoea
- Trichomonas vaginalis
Risk factors for bacterial vaginosis
- IUD
- Vaginal douching
- Sexually active
Type of discharge in BV
- Grey-watery discharge
* Strong fishy smell
Type of discharge in candida
- Thick white/ watery discharge (cottage-cheese like)
* Odourless
Type of discharge in trichomonas vaginalis
- Thick, yellow-green
* Strong fishy odour
What is the most common pelvic tumour
Fibroids
4 sites where fibroids are found.
Which is the most common?
- Intramural (most common)
- Submucosal (under lining)
- Subserosal (under perimetrium)
- Pedunculated (growing on a stalk)
Symptoms of fibroids
- Abnormal bleeding
- Abdo pain/ pressure
- Urinary urgency (from compression)
- Constipation (from compression)
4 pregnancy-related complications of fibroids
- Recurrent spontaneous abortion
- Premature contractions
- Abnormal foetal presentation
- Block cervix, making C section necessary
Bimanual palpation is normally enough to examine fibroids.
In what 4 cases would imaging also be necessary?
- New finding
- Increase in size
- Fibroids causing symptoms
- Exclude differentials eg ovarian masses
What 2 hormonal treatments may be given for fibroids
- GnRH agonists
- Exogenous progestins
(both would suppress oestrogen)
What is adenomyosis?
Symptoms?
Endometrium grows into myometrium
-Causes menstrual cramps, bloating before periods
Cellular origin of fibroids
Monoclonal
What is endometriosis
Presence and growth of tissue similar to endometrium outside the uterus
What is a chocolate cyst/ endometrioma
Growth of endometrial tissue within ovary
Appearance of chocolate cyst/ endometrioma on USS
Ground glass appearance (due to abnormal blood)
What gynae conditions respond to oestrogen?
When will they be biggest?
Larger during reproductive years
Smaller after menopause
- Fibroids
- Endometriosis
On laparoscopy to diagnose endometriosis, what are signs of
-active disease
Red vesicles
On laparoscopy to diagnose endometriosis, what are signs of
-less active disease
White scars (with surrounding abnormal blood vessels)
Black/ brown “powder burn” spots
On laparoscopy to diagnose endometriosis, what are signs of
-severe disease
Severe adhesions
Ovarian endometriomas
What imaging is used to see endometriomas
TV USS
What are follicular cysts
Persistently enlarged follicles
What are lutein cysts
Persistently enlarged corpus luteum
Complications of ovarian cysts
- Rupture
2. Torsion
Definition of menorrhagia
Heavy bleeding
> 80ml per period
