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M4 Stuff > Gyn > Flashcards

Gyn Flashcards

1
Q

Diagnostic criteria for PCOS

A

Rotterdam Criteria
2/3 of
Clinical: Hirsutism or oligo-anovulation

Biochemical:Hyperandrogenism

Imaging: 12+ follicles of 2-9mm OR ovarian volume >10ml in one ovary

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2
Q

Difference between Pap smear and cervical screening

A

Pap smear looks for abnormal cells/metaplasia
Cervical screening looks for the HPV itself

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3
Q

Treatments for PCOS

A

FIRST LINE is weight loss target BMI. <25

Not planning for pregnancy
1)COCPs
2)Metformin

1)Aromatase inhibitors: Letrozole or clomiphene
2)exogenous gonadotropins
3)Metformin
4)laparoscopic ovarian drilling
5)IVF

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4
Q

Complications of PCOS

A

1)Irregular periods or amenorrhea
2) Difficulty with conception/fertility
3)ACNE and hirsutism
4)Metabolic syndrome: T2DM and obesity
5)Risk factor for endometrial cancer
6)CVD
7)Pregnancy loss

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5
Q

Difference between Tranexamic acid(TXA) and mefenamic acid(MFA)

A

TXA is an anti fibrinolyic for heavy bleeding

MFA is a Cox-2/PG inhibitor that as acts as pain relief

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6
Q

COCPs effect on cancer risk

A

Decreases risk of endometrial and ovarian Ca

Increases risk of breast and cervical Ca

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7
Q

Diagnosis of endometriosis

A

Clinical
-Fixed uterus
-Vaginorectal and uterosacral tenderness and nodularity on DRE
-laterally displaced cervix
-adnexal tenderness and masses

US pelvis: chocolate cysts

Lapascopy: ectopic endometrioma

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8
Q

What can Alpha feto protein be used a s a tumour marker for

A

Yolk sac tumour(Ovarian Ca) as well as HCC

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9
Q

When do protein S deficiency related miscarriages occur

A

2nd trimester

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10
Q

Cause of strawberry cervix and treatment

A

Trichomonas vaginalis infection->PO metronidazole

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11
Q

Causes of oligomenorrhea/ secondary amenorrhea

A

HPOA Axis

H: Physical, emotional, mental stress, antipsychotic drugs
P: Pituitary adenoma
O: PCOS,Premature ovarian failure(Idiopathic,Iatrogenic,thyroid dysfn, vasculitis)

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12
Q

tibolone contraindications

A

?

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13
Q

Drug to reduce HIV viral load in pregnancy

A

Zidovudine

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14
Q

Criteria for aspirin in early pregnancy

A

Major criteria
1. Previous Pre eclampsia
2. Pre gestational DM
3. Thrombophilia(APS, Protein C,S or anti thrombin iii deficiency,SLE)
4. Chronic HTN
5. CKD

Minor
1. Advanced maternal age >40
2. Obesity BMI >35
3. Nulliparity
4. Pregnancy interval >10years
5. FHx of pre eclampsia
6. Multiple pregnancy

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15
Q

Groups of causes of female infertility

A

Tubal causes
Ovarian causes
Uterine causes
Ovulatory/HPOA

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16
Q

Tubal causes of female infertility

A

Ectopic pregnancies/salpingectomy
Endometriosis
Pelvic inflammatory disease
Tubal ligation

17
Q

Ovarian causes of female infertility

A

Low ovarian reserve

18
Q

Uterine causes of female infertility

A

Endometrial polyps
Submucosal fibroids
Ashermanns syndrome

19
Q

Ovulatory/HPOA causes of infertility

A

Ovarian:
PCOS
Premature ovarian failure
Chromosomal eg Turners

Hypothalamic

Idiopathic hypogonadotrophic hypogonadism

20
Q

Groups of causes of recurrent pregnancy loss

A
  1. Problems with placental perfusion
  2. Uterine issues
  3. Chromosomal abnormalities
21
Q

Causes of male infertility

A

Pre Testicular
-hypothalamic hypogonadism,Kallmans syndrome
-Pituitary: hyperprolactinemia
-Exogenous hormones
-Thyroid dysfunction
Testicular
-congenital: Klinefelter or y chromosome microdeletion
-Acquired: Trauma, infection,varicocele, chemo/surg
Post testicular
-Vasectomy
-Cystic fibrosis

22
Q

High risk surgical-pathological features of endometrial cancer

A

> 2cm
=50% myoinvasion
Cervix involvement
Histo shows
i) grade 3 endometroid
ii) clear cell
iii)serous

23
Q

Endometrial Ca staging

A

FIGO staging
I: confined to uterus
II: extension to cervix
III: extension to pelvis
IV: Local or distant metastasis eg rectum,bladder

24
Q

Most common cause of post menopausal bleeding

A

Atrophic vaginitis

BUT endometrial ca until proven otherwise

25
Q

Cardinal signs and Sx of ovarian Ca

A

Nausea/Vomiting
Bloatedness
Distension
Pelvi-Abdominal mass
Urinary urgency/frequency
Early satiety/LOA/LOW

Generally NOT a/w uterine bleeding

26
Q

RFs of ovarian Ca

A

Also unopposed hyperestrogenism

Nulliparity
Early menarche
Late menopause
Endometriosis

Genetic
BCRA ½
HNPCC
Peutz Jeghers syndrome

27
Q

For ovarian cystectomy, why are the ovaries preserved if possible

A

To avoid early menopause and increased risk of cardiovascular disease

28
Q

Antibiotics for Pelvic Inflammatory

A

Ceftriaxone
Doxycycline
Metronidazole

29
Q

Gold standard for emergency contraception

A

Intra Uterine Copper Device

30
Q

What is in the morning after pill

A

Ulipristal, a progesterone receptor modulator

31
Q

What is used in a endometrial sampling

A

Pipelle biopsy

M4 Stuff (11 decks)

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