GUM

Question 1

95% of testicular cancers are germ cell tumours. How can these be divided

Answer 1

1. Seminomas
2. Non-seminomas: embryonal, yolk sac, teratoma, choriocarcinoma

Question 2

95% of testicular cancers are germ cell tumours. Non-germ cell tumours (5%) include what two categories?

Answer 2

1. Leydig cell tumours
2. Sarcomas

Question 3

Method of action of COCP

Answer 3

Inhibits ovulation

Question 4

What does COCP increase risk of

Answer 4

Breast and cervical cancer
VTE

Question 5

What is the method of action of the progesterone only pill

Answer 5

Thickens cervical mucous

Question 6

What is the method of action of the progesterone injectable contraceptive (lasts 12 weeks)

Answer 6

1. Inhibits ovulation
2. Thickens cervical mucous

Question 7

What is the method of action of the progesterone implantable contraceptive (lasts 3 years)

Answer 7

1. Inhibits ovulation
2. Thickens cervical mucous

Question 8

What is the method of action of the intrauterine contraceptive device (IUD - copper coil)

Answer 8

Decreases sperm motility and survival

Question 9

What is the method of action of the intrauterine system (IUS - Mirena coil)

Answer 9

1. Prevents endometrial proliferation
2. Thickens cervical mucous

Question 10

How often is cervical screening for women?

Answer 10

25-49 years = 3 yearly
50-64 years = 5 yearly
Over 64 = self-referral, no screening

Question 11

Progestogen only pill absolute contraindications (UKMEC4)

Answer 11

Pregnancy
Breast cancer in the past 5 years

Question 12

Marfan’s syndrome mode of inheritance and gene involved

Answer 12

Autosomal dominant
FBN1 gene on Chr 15 that codes for fibrillin-1 protein

Question 13

What HPV viruses cause genital warts

Answer 13

HPV 6 and 11

Question 14

Often history of dysuria and urethral discharge
Swelling may be tender and eased by elevating testis
Most cases due to Chlamydia
Infections with other gram negative organisms may be associated with underlying structural abnormality

what is the diagnosis

Answer 14

Acute epididymo-orchitis

Question 15

Single or multiple lumps
Lie above and behind testis
May contain clear or opalescent fluid (spermatoceles)
Painless
Can ‘get above the lump’ on examination

what is the diagnosis

Answer 15

Epidiymal cysts

Question 16

Non painful, soft fluctuant swelling
Often possible to ‘get above it’ on examination
Usually contain clear fluid
Will often transilluminate
May be presenting feature of testicular cancer in young men

what is the diagnosis

Answer 16

hydrocoele

Question 17

what groin lump is not possible to “get above”

Answer 17

inguinal hernias