General Gynaecology

Question 1

Components of normal vaginal discharge?

Answer 1

Cervical mucous
Vaginal fluid - transudate from vaginal walls and secretions from skenes and batholians glands
Cells - stratified squamous epithelium from vagina and ectocervix and glandular epithelium from endocervical canal
Normal vaginal flora - lactobacilli

Question 2

Bacterial vaginosis aetiology?

Answer 2

Shift in vaginal flora from lactobacillus to more diverse bacterial species - facultative anaerobes
Production of volatile amines by the new bacterial flora
Rise in vaginal pH >4.5

Question 3

What are the predominant types of bacteria associated with BV?

Answer 3

Gardnerella vaginalis
Prevotella species
Porphyromonas species
Bacteroides species

Question 4

Amsels criteria

Answer 4

Homogenous thin grey-white discharge coating vaginal walls
Vaginal pH >4.5
Positive anime whiff test - 10% KOH
Clue cells - vaginal epithelial cells with adherent coccobacilli

Question 5

Benefits to HRT?

Answer 5

Gold standard treatment for vasomotor symptoms and vulvo-vaginal atrophy
Reduces osteoporosis related fractures 
Reduces colorectal cancer 
Cardiovascular protection 
Decreases risk of Alzheimer’s disease
Improves all cause mortality

Question 6

Risks of HRT?

Answer 6

Increased risk of breast cancer
Increased risk of ischemic stroke
Increased risk of VTE

Question 7

Viral components of Gardasil 9?

Efficacy?

Answer 7

Quadrivalent gardasil - 6,11,16,18
and 31, 33, 35, 45, 52, 58

Efficacy 97-100%