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MRCOG Part 2 > General Gynaecology including Chronic Pelvic Pain GT41 > Flashcards

General Gynaecology including Chronic Pelvic Pain GT41 Flashcards

1
Q

What is the prevalence of fibroids in women of reproductive age?

A

20-40%

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2
Q

When should pharmaceutical treatment for fibroids be considered?

A

When fibroids are under 3cm and not distorting the cavity and symptomatic

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3
Q

What is the prevalence of chronic pelvic pain in women of reproductive age?

A

15-25% (1 in 6)

Similar to asthma and migraine!

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4
Q

What is the rate of negative laparoscopy for chronic pelvic pain?

A

35%

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5
Q

What is the rate of finding endometriosis and adhesions at laparoscopy when conducted for chronic pelvic pain?

A

33% and 24% respectively

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6
Q

What is the incidence of adnexal pathology detected for the first time in pregnancy?

A

0.5%

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7
Q

In how many cases do simple cysts of <= 5cm regress spontaneously in pregnancy?

A

90-100%

No need to rescan unless other indication

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8
Q

What is the size cut off for conservative management of dermoid cysts in pregnancy?

A

6cm

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9
Q

When would aspiration of ovarian cyst in pregnancy be considered?

A

Simple unilocular with no solid elements
>10cm
Causing pain
Increasing risk of fetal malpresentation or obstructed labour due to its position

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10
Q

What is the Caesarean section rate following UAE?

A

2/3

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11
Q

What is the preterm delivery rate following UAE?

A

20%

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12
Q

What is the risk of recurrent molar pregnancy (1 or 2 previous)?

A

1 in 55 for 1 previous

1 in 10 for 2 previous

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13
Q

What follow up is required in suspected benign premenopausal cysts <50mm?

A

No follow up

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14
Q

What follow up is required in suspected benign premenopausal cysts 50 - 70 mm?

A

Yearly ultrasound follow up

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15
Q

What follow up is required in suspected benign premenopausal cysts >70 mm?

A

Consider MRI or surgical intervention (difficulty in visualising whole cyst at USS)

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16
Q

What is the incidence of psychosexual disorders in women attending gynae clinic?

A

20-30%

17
Q

What are the chances of needing reintervention following endometrial ablation aged 40?

A

20%

18
Q

What are the chances of needing reintervention following UAE for uterine fibroids?

A

8-9%

19
Q

Why should pre-operative treatment with GnRH analogues be considered for fibroids?

A
  • See demonstrative reduction in fibroid size
  • Slight improvement in haematological indices
  • Possible reduction in intraoperative blood loss and op time
  • May be able to use laparoscopic approach instead
20
Q

In which patients should Selective Progesterone Receptor Modulators be used with caution?

A
  • Severe asthma requiring PO steroids
  • Hepatic dysfunction
  • Hereditary problems of galactose intolerance
  • Lapp lactase deficiency
  • Glucose-galactose malabsorption
21
Q

What is the definition of chronic pelvic pain?

A

Intermittent or constant pain in the lower abdomen or pelvis of a woman lasting at least 6 months duration

22
Q

What % of women referred to gynae cinic for pain had symptoms suggestive of IBS?

A

50%

23
Q

What is the incidence of nerve entrapment persisting for >5/52 after 1 Pfannenstiel incision?

A

3.7%

24
Q

When should a Ca125 be performed in women presenting with chronic pelvic pain?

A

If has symptoms of bloating, early satiety, urinary urgency or frequency; especially new IBS symptoms in >50yo

25
Q

What is the pre-treatment before a diagnostic laparoscopy for chronic pelvic pain?

A

Therapeutic hormonal treatment for 3-6 months

26
Q

What is LUNA?

A

Laparoscopic uterosacral nerve ablation

Not useful in treatment of chronic pelvic pain

27
Q

What are the Rome III criteria for IBS?

A
  • Continuous/recurrent abdo pain/discomfort on >=3/7 a month in the last 3/12, with the onset >=6/12 ago + 2:
  • Improvement with defecation
  • Onset associated with a change in the frequency of stool
  • Onset associated with a chage in the form of stool
28
Q

What are the ‘red flag’ symptoms when taking a history for chronic pelvic pain.?

A
  • Bleeding PR
  • New bowel symptoms >50yo
  • New pain after monepause
  • Pelvic mass
  • Suicide ideation
  • Excessive weight loss
  • Irregular bleeding >40yo
  • PCB

MRCOG Part 2 (97 decks)

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