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Yr 4 - PassMed Corrections > GOSH 2 > Flashcards

GOSH 2 Flashcards

1
Q

What is the 1st line investigation in post-menopausal bleeding?

A

TV US to look at endometrial thickness –> pipelle biopsy to sample endometrium (can be used to diagnose endometrial cancer in most cases).

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2
Q

What is the next investigation if a pipelle biopsy has been inconclusive when investigating endometrial cancer?

A

Hysteroscopy with biopsy

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3
Q

Mx of obstetric cholestasis?

A

Induction of labour at 37-38 weeks (due to increased risk of stillbirth)

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4
Q

Mx of Factor V Leiden in pregnancy?

A

LMWH antenatally + 6 weeks postpartum

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5
Q

What can be used in management of endometriosis if NSAIDs/COCP/progestogens have not been effective?

A

GnRH analogues (pseudo-menopause)

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6
Q

Define premature ovarian failure

A

The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40 years.

2x samples of FSH required

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7
Q

Give some causes of oligohydramnios

A

1) PROM

2) Potter sequence: bilateral renal agenesis + pulmonary hypoplasia

3) IUGR

4) Post-term gestation

5) Pre-eclampsia

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8
Q

In a very athletic woman, what causes 2ary amenorrhoea?

A

Hypothalamic hypogonadism

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9
Q

Is diabetes a high risk factor for pre-eclampsia?

A

Yes

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10
Q

Are women with autoimmune conditions such as SLE or antiphospholipid syndrome at high risk of pre-eclampsia?

A

Yes

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11
Q

What are some normal lab findings in pregnancy?

A

1) reduced urea

2) reduced creatinine

3) increased urinary protein loss

This is due to increased perfusion to the kidneys in pregnancy.

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12
Q

Is aspirin safe in breastfeeding?

A

No - risk of Reye’s

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13
Q

How long can a urine pregnancy test remain positive following termination?

A

Up to 4 weeks

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14
Q

Why is COCP contraindicated 21 days post partum?

A

Increased VTE risk

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15
Q

What is a history of sudden collapse occurring soon after a rupture of membranes suggestive of?

A

Amniotic fluid embolism

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16
Q

Next step if suspicion of ovarian cancer but there IS an abdominal or pelvic mass?

A

CA125 and US test can be bypassed and the patient directly referred to gynaecology

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17
Q

Mx of GBS colonisation in pregnancy?

A

Intrapartum IV benzylpenicillin

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18
Q

What is the gold standard investigation for mycoplasma genitalium?

A

NAATs

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19
Q

What are 3 key features of 3ary syphilis?

A

1) Neurosyphilis e.g. labile mood, confusion, delusions, seizures, judgement impairment

2) Aortic aneurysms

3) Gummatous lesions

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20
Q

What is Argyll-Robertson pupil? What is it found in?

A

A specific finding in neurosyphilis.

It is a CONSTRICTED pupil that accomodates when focusing on a neear objct but does not react to light.

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21
Q

What can increase the risk of genital wart recurrence?

A

Smoking

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22
Q

1st line management of uncomplicated Mycoplasma genitalium?

A

Doxycycline for 7 days

Followed by azithromycin for 2 days

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23
Q

Management of complicated Mycoplasma genitalium?

A

Moxifloxacin 400mg daily for 14 days

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24
Q

What is the protein on the surface of HIV that binds to CD4+?

A

gp120

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25
Q

What is PrEP a combination of?

A

2x NRTIs

Emtricitabine + tenofovir disoproxil

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26
Q

Which form of contraception can increase the risk of BV?

A

Copper IUD

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27
Q

What criteria can be used for the diagnosis of BV?

A

Amsel criteria

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28
Q

What makes up the Amsel criteria? (4)

A

1) Homogenous discharge on examination

2) Microscopy showing ‘clue cells’

3) Vaginal pH >4.5

4) Fishy odour on adding 10% potassium hydroxide to vaginal fluid

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29
Q

Describe the ‘whiff test’

A

Presence of an amine odour when POTASSIUM HYDROXIDE is added to vaginal fluid.

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30
Q

What does a positive Whiff test indicate?

A

BV

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31
Q

What are the main component of the healthy vaginal bacterial flora?

A

Lactobacilli

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32
Q

Which form of contraception may be PROTECTIVE against BV?

A

COCP

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33
Q

What criteria can be used to grade the appearance of vaginal flora?

A

Hay/Ison Criteria

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34
Q

What are the 4 gradings of the Hay/Ison Criteria?

A

Grade I (normal) –> Lactobacilli predominate

Grade II (intermediate) –> Mixed flora with some lactobacilli but Gardnerella or Mobiluncus also present

Grade III (BV) –> Predominantly Gardnerella and/or Mobiluncus. Few or absent lactobacilli.

Grave IV –> Gram-positive bacteria predominate

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35
Q

What does the Hay/Ison criteria take into account?

A

The microscopic appearance of gram-stained vaginal smear.

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36
Q

What 2 criteria can be used in the diagnosis of BV?

A

1) Hay/Ison criteria

2) Amsel criteria

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37
Q

How many of the Amsel criteria must be met to diagnose BV?

A

3/4

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38
Q

What are 3 possible investigations in BV?

A

1) Whiff test

2) Vaginal pH test (using swab & pH paper)

3) Charcoal vaginal swab

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39
Q

What is a key complication of BV?

A

At higher risk of acquiring and transmitting STIs.

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40
Q

What is the main complication of BV during pregnancy?

A

1st trimester miscarriage

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41
Q

How do lactobacili keep the vaginal pH low?

A

By producing lactic acid

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42
Q

What investigation can confirm the diagnosis of candidiasis?

A

Charcoal swab

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43
Q

Are routine investigations are not typically required for acute, uncomplicated vulvovaginal candidiasis cases?

A

No

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44
Q

Medical treatment is recommended for certain groups of individuals with BV.

What are these groups?

A

1) Anyone with symptoms

2) Any pregnant individuals (regardless of choice in continuation of pregnancy)

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45
Q

What defines recurrent vulvovaginal candidiasis?

A

≥4 episodes in 1 year

With at least 2 episodes confirmed by microscopy or culture when symptomatic.

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46
Q

What are ‘clue cells’?

A

Epithelial cells from cervix with bacteria stuck inside (typically Gardnerella vaginalis).

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47
Q

Key contraindication of oral antifungal tablets (e.g. fluconazole) for candidiasis?

A

pregnancy & breastfeeding

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48
Q

Increased levels of which hormone can increase the risk of candidiasis?

A

Oestrogen e.g. higher in pregnancy

Lower after menopause so risk is lower

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49
Q

When are antibiotics started in PID?

A

Empirically

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50
Q

Give 4 risk factors for candidiasis

A

1) Immunosuppression e.g. steroids, HIV

2) Higher oestrogen e.g. pregnancy

3) Poorly controlled diabetes

4) Broad spectrum Abx

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51
Q

What is Fitz-Hugh-Curtis Syndrome?

A

A complication of PID.

It is caused by inflammation and infection of the liver capsule (Glisson’s capsule), leading to adhesions between the liver and peritoneum. Bacteria may spread from the pelvis via the peritoneal cavity, lymphatic system or blood.

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52
Q

How long are symptoms present for in bladder pain syndrome (AKA interstitial cystitis)?

A

> 6 weeks

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53
Q

What organs of the pelvis are affected in PID?

A

Endometritis –> endometrium

Salpingitis –> fallopian tubes

Parametritis –> parametrium

Oophoritis –> ovaries

Peritonitis –> peritoneal membrane

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54
Q

Typical outpatient Abx regime in PID?

A

1) Single IM dose of ceftriazone

2) Oral doxycyline 14 days (to cover chlamydia & mycoplasma genitalium)

3) Oral metronidazole 14 days (to cover anaerobes e.g. Gardnerella)

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55
Q

What should you always look for signs of in PID?

A

SEPSIS

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56
Q

In which cases of PID require admission for IV Abx? (2)

A

1) Sepsis

2) Pregnancy

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57
Q

What can be seen during cytoscopy in interstitial nephritis (in approx 20% of patients)?

A

1) Hunner lesions –> red, inflamed patches of the bladder mucosa associated with small blood vessels

2) Granulations –> tiny haemorrhages on the bladder wall

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58
Q

What is hydrodistension?

Purpose of it in interstitial nephritis?

A

Filling the bladder with water, to high pressure, during cystoscopy (requires GA).

This can give a temporary (3-6 month) improvement in symptoms.

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59
Q

PID can less commonly be caused by non-STIs, such as what?

(3)

A

1) Gardnerella vaginalis

2) H. influenzae

3) E. coli

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60
Q

Complications of PID?

A

1) Sepsis

2) Abscess

3) Infertility

4) Increased risk of ectopic

5) Fitz-Hugh-Curtis syndrome

6) Chronic pelvic pain

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61
Q

In patients presenting with urinary incontinence, what is it important to rule out? (2)

A

1) UTI

2) Diabetes

Get urinalysis

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62
Q

What age prematurity does retinopathy of prematurity affect?

A

<32 weeks gestation

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63
Q

What steroid is used to educe the chance of RDS in PROM?

A

Dexamethasone

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64
Q

What investigations may be required in recurrent candidiasis?

A

1) check compliance with previous treatment

2) confirm diagnosis: high vaginal swab (charcoal) for microscopy and culture

3) blood glucose test/HbA1c to exclude diabetes

4) exclude differential diagnoses such as lichen sclerosus

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65
Q

Are progestogen-only methods of contraception safe to use alongside sequential HRT?

A

Yes

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66
Q

What is the classic triad of vasa praevia?

A

1) Rupture of membranes

2) Painless vaginal bleeding

3) Foetal bradycardia

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67
Q

Maternal risk in vasa praevia vs placenta praevia?

A

Vasa praevia - no major maternal risk

Placenta praevia - materanl risk

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68
Q

Typical features of hydatidiform mole?

A
  • May have bleeding in 1st or early 2nd trimester
  • Associated with exaggerated symptoms of pregnancy e.g. hyperemesis.
  • Uterus may be large for dates
  • Serum hCG is very high
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69
Q

What Bishop’s score indicates that the cervix is ripe, or ‘favourable’?

A

≥8

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70
Q

What intervention should be performed in a Bishop’s score ≥8?

A

No interventions required

There is a high chance of spontaneous labour.

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71
Q

What does a Bishop’s score <5 indicate?

A

Indicates that labour is unlikely to progress without induction.

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72
Q

What is the preferred method of induction in a Bishop’s score <5?

A

Vaginal prostaglandin E2

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73
Q

What is the preferred method of induction in a Bishop’s score >6?

A

Amniotomy & IV oxytocin infusion

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74
Q

Describe the Bishop’s score

A

Cervical position:
- posterior (0)
- intermediate (1)
- anterior (2)

Cervical dilation:
- <1cm (0)
- 1-2cm (1)
- 3-4cm (2)
- >5cm (3)

Cervical consistency:
- firm (0)
- intermediate (1)
- soft (2)

Cervical effacement:
- 0-30% (0)
- 40-50% (1)
- 60-70% (2)
- 80% (3)

Foetal station:
- -3 (0)
- -2 (1)
- -1, 0 (2)
- +1, +2 (3)

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75
Q

What is the 1st line management of N&V in pregnancy/hyperemesis gravidarum?

A

Antihistamines e.g. oral cyclizine or promethazine

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76
Q

What is the 2nd line management of N&V in pregnancy/hyperemesis gravidarum?

A

1) Oral ondansetron

2) Oral metoclopramide or domperidone

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77
Q

What is there an increased risk of with use of ondansetron during pregnancy?

A

Cleft lip/palate

78
Q

Why is metoclopramide not used for >5 days in pregnancy?

A

Can cause EPSEs

79
Q

Fibroids under what size can be treated with medical management?

A

<3cm

80
Q

When should post-term women be offered induction?

A

Women should be offered induction between 41-42 weeks of an uncomplicated pregnancy to avoid risks of prolonged pregnancy.

81
Q

Stepwise investigations in reduced foetal movements?

A

1) Handheld doppler

2) If no foetal heartbeat detected –> immediate US

3) If foetal heartbeat present –> CTG for at least 20 minutes

82
Q

To confirm ovulation, when should the serum progesterone level be taken?

A

7 days prior to expected next period

83
Q

What conditions are associated with a raised maternal AFP? (3)

A

1) Neural tube defects (meningocele, myelomeningocele and anencephaly)

2) Abdominal wall defects (omphalocele and gastroschisis)

3) Multiple pregnancy

84
Q

What conditions are associated with a decreased maternal AFP? (4)

A

1) Down’s syndrome

2) Maternal diabetes

3) Trisomy 18 (Edward’s)

4) Maternal diabetes mellitus

85
Q

How does materal diabetes affect AFP?

A

Reduced AFP

86
Q

Pregnant women with what BP are likely to be admitted and observed?

A

≥160/110 mmHg

87
Q

Define gestational HTN

A

HTN >20/52

88
Q

Define pre-eclampsia

A

Gestational HTN + proteinuria OR organ dysfunction

89
Q

Mx of eclampsia?

A

Magnesium sulphate IV bolus

Treat for 24h after last seizure or 24h after delivery (whichever is later)

90
Q

What can be given alongside Mg sulphate in eclampsia if it causes respiratory depression?

A

Calcium gluconate

91
Q

Define eclampsia

A

Pre-eclampsia + seizures

92
Q

Mx of HELLP syndrome?

A

Deliver the baby

93
Q

3 key risk factors for placental abruption?

A

1) Pre-eclampsia

2) Cocaine use

3) Multiparity

94
Q

Definitive mx of placental abruption?

A

Category 1 C-section

95
Q

Colour of blood in placental abruption vs placenta praevia?

A

Abruption - dark red and less of it visible (blood has to travel further)

Praevia - lighter red and more of it visible (blood has less far to travel)

96
Q

Define PPH

A

> 500ml blood loss

97
Q

What are the 4 causes of PPH?

A

1) Tone (80%) i.e. uterine atony

2) Tissue i.e. retention of placental tissue which prevents contractions

3) Trauma e.g. vaginal or cervical tears

4) Thrombin

98
Q

What are some risk factors for uterine atony causing PPH?

A

1) Overworked uterus: Age, BMI, multiple parity

2) Chorioamnionitis

3) Polyhydramnios

99
Q

Time period for 1ary PPH?

A

<24h after delivery

100
Q

Time period for 2ary PPH?

A

24h to 6 weeks after delivery

101
Q

Stepwise mx of PPH caused by uterine atony?

A

1st line –> bimanual compression (palpating and rubbing fundus to stimulate contractions) & catheterise

2nd line –> pharmacological: IV oxytocin, IV or IM ergometrine, IM carboprost, sublingual misoprostol

3rd line –> intrauterine balloon tamponade

102
Q

What is key preventative method of PPH?

A

Active mx of 3rd stage of labour –> IM oxytocin for vaginal and IM tranexamic for C-section

103
Q

In PPH, what position should women be placed in?

A

Left lateral position

104
Q

What are the 2 key risk factors for cord prolapse?

A

1) Artifical rupture of membranes (50% of cases happen after this)

2) Abnormal lie (breech, unstable)

105
Q

Why should there be minimal handling of cord in cord prolapse?

A

Due to risk of vasospasms

Keep the cord warm and moist

106
Q

Mx options in cord prolapse?

A

1) Left lateral position or on all fours

2) Minimal handling of cord, keep it warm and moist

3) Presenting part of foetus can be pushed back to avoid cord compression

4) Can fill bladder with 500ml normal saline

5) Tocolytics e.g. terbutaline (to reduce contractions)

6) Definitive mx: c-section

107
Q

What is the definitive mx of cord prolapse?

A

C-section

108
Q

Define shoulder dystocia

A

After delivery of the foetal head, the ANTERIOR shoulder of the foetus becomes impacted on the PUBIC SYMPHYSIS.

109
Q

2 key complications of shoulder dystocia?

A

1) Brachial plexus injury

2) 3rd/4th degree tear

110
Q

Some ffeatures of Erb’s palsy?

A

1) Forward rotated shoulder

2) Upper arm redness

3) Muscle atrophy and diminished arm length

4) Waiter tip deformity of wrist

5) Winged scapula

6) Horner’s: ptosis & miosis

111
Q

2 best SSRIs in breastfeeding?

A

Paroxetine & sertraline

112
Q

peak incidence of puerperal psychosis?

A

2-3 weeks post birth

113
Q

What tool is used for postnatal depression?

A

Edinburgh postnatal depression scale?

114
Q

Mx of puerperal psychosis?

A

Admit to mother & baby unit!

115
Q

Is the nexplanon implant affected by enzyme inducers?

A

Yes

116
Q

Most common type of ovarian cancer?

A

Serous cystadenocarcinoma

117
Q

What infection is implicated in the pathogenesis of Burkitt’s lymphoma?

A

EBV infection

118
Q

Microscopy findings in Burkitt’s lymphoma?

A

‘starry sky’ appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

119
Q

Management of lichen sclerosis?

A

Potent topical steroid e.g. dermovate

120
Q

What is the most common infective cause of diarrhoea in HIV patients?

A

Cryptosporidium

121
Q

What lobe does HSV encephalitis typically affect?

A

Temporal lobe (e.g. may have symptoms such as aphasia or rising feeling in stomach before seizure).

122
Q

What is the mainstay of treatment of Cryptosporidium diarrhoea?

A

Supportive

123
Q

Give some causes of erythema nodosum

(4)

A

1) TB

2) Sarcoidosis

3) IBD

4) Pregnancy

124
Q

1st line investigation in suspected ovarian cancer?

A

Ca125

125
Q

At what BMI should the standard dose of levonorgestrel (1.5mg) be doubled?

A

BMI >26 (or weight >70kg)

126
Q

1st line investigation to look for source of infection in discitis due to Staphylococcus?

A

Echocardiogram

127
Q

If not breastfeeding, how soon after birth can the COCP be prescribed?

A

3 weeks (due to increased VTE risk)

128
Q

Is the Depo-Provera injection affected by enzyme inducers?

A

No

129
Q

What is UKMEC for COCP for patients in wheelchair?

A

3

130
Q

Triad of features of disseminated gonococcal infection?

A

1) Dermatitis

2) Migratory polyarthritis

3) Tenosynovitis

131
Q

What endometrial thickness is a high negative predictive value for endometrial cancer in PMB?

A

<4mm

132
Q

What is a rare but recognised side effect of lamotrigine?

A

Steven Johnson syndrome –> look out for a rash

133
Q

Which contraceptive method (aside from coils) is not affected by enzyme inducers/inhibitors?

A

Depot injection

134
Q

How soon after surgery can the COCP be restarted?

A

2 weeks

135
Q

In early pregnancy, what type of ovarian cysts are common?

A

Corpus luteum cysts.

136
Q

What is required for diagnosis of premature ovarian insufficiency?

A

1) <40 y/o

2) 2x raised FSH levels taken 4 weeks apart

137
Q

What should all men presenting with ED have checked?

A

Morning testosterone

138
Q

What investigation may be done in cryptosporidium infection?

A

Modified Ziehl-Neelsen stain (acid-fast stain) of the stool –> will reveal characteristic RED cysts of Cryptosporidium.

139
Q

What score can be used to classify the severity of N&V in pregnancy?

A

The Pregnancy-Unique Quantification of Emesis (PUQE) score

140
Q

COCP containing what can be beneficial for PMS?

A

Drosperinone

141
Q

At what age should a woman with PMB be referred under the 2ww pathway?

A

≥55 y/o

142
Q

1st line investigation in PMB?

A

TV US to look at endometrial thickness

143
Q

What is next investigation in PMB if endometrial thickness is ≥4mm?

A

Hysteroscopy with endometrial biopsy

144
Q

What is next investigation in PMB if endometrial thickness is <4mm?

A

High negative predictive value

145
Q

What drug can lead to false negative results on the urea breath test?

A

Abx used to treat H. pylori e.g. amoxicillin

Recommended that patients haven’t taken Abx for 4 weeks prior to test.

146
Q

What triad is seen in PCOS?

A

1) Polycystic ovaries
2) Hyperandrogenism
3) Oligo/anovulation

Only 2/3 required to be present for a diagnosis.

147
Q

What criteria is used to diagnose PCOS?

A

Rotterdam criteria

148
Q

What is the most common symptom of PCOS?

A

Hirsutism

149
Q

How are insulin and androgens related?

A

Insulin promotes release of androgens from ovaries & adrenal glands.

Insulin also suppresses SHBG production by liver. SHBG usually binds to androgens and suppresses their function.

150
Q

Via what 3 mechanisms is there hyperandrogenism in PCOS?

A

1) Elevated LH levels

2) High insulin promoting release of androgens

3) High insulin suppressing SHBG production by liver

151
Q

Where is sex hormone binding globulin (SHBG) usually produced?

A

Liver

152
Q

What is impact of SHBG on androgens?

A

Normally binds to androgens and SUPPRESSES their function.

153
Q

What is the leading environmental contributor in PCOS?

A

Post-natal obesity

154
Q

What is the role of SHBG in women?

A

Serves to LIMIT exposure to both androgens and oestrogens.

Low SHBG levels in women have been associated with HYPERANDROGENISM and ENDOMETRIAL CANCER due to heightened exposure to androgens and estrogens, respectively.

155
Q

What are 4 key differentials for PCOS?

A

1) Congenital adrenal hyperplasia

2) Hypothyroidism

3) Cushing’s syndrome

4) Hyperprolactinaemia

156
Q

How will LH be affected in PCOS?

A

Raised

157
Q

Cause of cysts in PCOS?

A

Elevated baseline LH level –> lack of LH surge

158
Q

How may Cushing’s syndrome present similarly to PCOS?

A

Excess cortisol production, leading to many features similar to PCOS (e.g. weight gain, acne, hypertension, insulin resistance).

159
Q

How may CAH present similarly to PCOS?

A

Causes cortisol deficiency and may also lead to androgen excess, leading to a clinical picture indistinguishable from that of PCOS.

160
Q

How can hyperprolactinaemia present similarly to PCOS?

A

Amenorrhoea

161
Q

What 2 mechanisms can lead to excess androgen production in PCOS?

A

1) Elevated LH level

2) Insulin resistance & hyperinsulinaemia

162
Q

Gold standard investigation for visualising the ovaries?

A

TV US

163
Q

What is the screening test of choice for diabetes in patients with PCOS?

A

OGTT

164
Q

What glucose level implies an IMPAIRED fasting glucose?

A

6.1-6.9

165
Q

Women with PCOS that become pregnant require screening for what?

A

Gestational diabetes

166
Q

What is the initial step for improving fertility in PCOS?

A

Weight loss

167
Q

What endometrial thickness needs a referral to exclude endometrial hyperplasia or cancer in PCOS?

A

> 10mm

168
Q

Why can PCOS increase risk of endometrial cancer?

A

1) Women with PCOS do not ovulate (or ovulate infrequently),

2) Therefore do not produce sufficient progesterone due to no corpus luteum

3) They continue to produce oestrogen and do not experience regular menstruation.

4) Consequently, the endometrial lining continues to proliferate under the influence of oestrogen, without regular shedding during menstruation.

5) Endometrial hyperplasia and significant risk of endometrial cancer

169
Q

How will LH to FSH ratio be affected in PCOS?

A

Raised LH:FSH

170
Q

Diagnostic criteria for PCOS from pelvic US?

A

1) ≥12 follicles on one ovary on US

OR

2) Ovarian volume >10 cm3

171
Q

What can be used to treat facial hirsutism in PCOS?

A

Topical eflornithine

172
Q

What OGTT result implies an impaired glucose tolerance?

A

Plasma glucose at 2 hours of 7.8 – 11.1 mmol/l

173
Q

What is licensed for the treatment of hirsutism and acne in PCOS?

A

Co-cyprindiol (Dianette) –> COCP

174
Q

What guides the management of simple ovarian cysts?

A

their size

175
Q

How long is co-cyprindiol (Dianette) taken for in PCOS?

A

Only 3 months (due to VTE risk)

176
Q

Premenopausal women with a simple ovarian cyst less than what size do not need further investigations?

A

<5cm on US

177
Q

What tumour markers are required for women under 40 with a complex ovarian mass?

(3)

A

1) AFP
2) HCG
3) LDH

178
Q

What size ovarian masses typically cause ovarian torsion?

A

> 5cm

179
Q

Definitive diagnosis of ovarian torsion?

A

Laparoscopic surgery

180
Q

How are 5-7cm ovarian cysts managed?

A

routine referral to gynae, yearly US

181
Q

Give 2 types of sex cord-stromal tumours?

A

1) Sertoli-Leydig

2) Granulosa cell

182
Q

At what age should pelvic US not be used for the diagnosis of PCOS?

A

In those with a gynaecological age <8 years (i.e. <8 years post-menarche) due to high incidence of multi-follicular ovaries in this life stage.

183
Q

When is ovarian torsion most likely to occur?

A

During pregnancy

184
Q

How are cysts in postmenopausal women managed?

A

Get Ca125

If raised –> 2ww referral

185
Q

What type of ovarian cyst can become huge, taking up lots of space in the pelvis and abdomen?

A

Mucinous cystadenoma

186
Q

Is ovarian torsion more common with benign or malignant cysts?

A

BENIGN

187
Q

When can ovarian torsion occur with NORMAL ovaries (i.e. no tumour)?

Why?

A

Before menarche

Girls have longer infundibulopelvic ligaments that can twist more easily.

188
Q

What are the 2 first line bisphosphonate treatments in osteoporosis?

A

1) Alendronate

2) Risedronate

189
Q

What should be corrected before starting bisphosphonates?

A

Hypocalcemia/vitamin D deficiency

190
Q
A

Yr 4 - PassMed Corrections (36 decks)

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