Gynae

Question 1

Outline the Fraser guidelines

Answer 1

1. The young person understands the practitioner’s advice.
2. The young person cannot be persuaded to inform
   parents
3. The young person is likely to begin/continue having
   intercourse with or without contraceptive treatment.
4. Unless receives contraceptive advice/treatment, physical or mental health (or both) are likely to suffer.

Question 2

Give some risk factors for endometrial cancer

Answer 2

Obesity, especially upper body obesity
Unopposed endogenous oestrogen (late menopause, low parity, anovulation)
oestrogen-secreting tumours - granulosa/theca cell ovarian tumours)
Unopposed exogenous oestrogen (tamoxifen, etc)
Family history of endometrial, breast, ovarian cancer, hereditary non-polyposis colon
cancer (Lynch syndrome), PTEN syndromes
Endometrial hyperplasia
PCOS
Radiotherapy
Weak: Insulin resistance, white ethnicity (RR of 2) compared to black women

Question 3

What are some causes of PMB?

Answer 3

Endometrial carcinoma
Due to vaginal atrophy
Polyps – endometrial or cervical
HRT – oestrogen withdrawal
Foreign body