gynae Flashcards
When is the most appropriate time to measure serum progesterone levels? (infertility)
7 days before next period
Congenital adrenal hyperplasia has the following biochemical abnormalities;
________ plasma 17-hydroxyprogesterone levels
__________ plasma 21-deoxycortisol levels
____________urinary adrenocorticosteroid metabolites
Increased plasma 17-hydroxyprogesterone levels
Increased plasma 21-deoxycortisol levels
Increased urinary adrenocorticosteroid metabolites
how does CAH present? What is the pattern of inheritance?
early menarche, large stature, facial hair
autosomal recessive
Malignancy + raised CK → ?
polymyositis
most common ovarian cyst:
most common epithelial cell tumour:
most common ovarian cyst: folicular cyst
most common epithelial cell tumour: serous cystadenoma
which cyst, if it ruptures, may cause pseudomyxoma peritonei?
Mucinous cystadenoma
which hormonal contraception is least likley to be affected by enzyme inducers
Depo-provera
syphilis vs herpes - how to differentiate?
herpes: multiple, painful ulcers + lymphadenopathy
syphilis: single, non-tender ulcer + lymphadenopathy
Stereotypical PCOS results:
raised LH:FSH ratio
testosterone may be normal or mildly elevated
SHBG is normal to low
17-hydroxyprogesterone is required to distinguish between
late-onset CAH and PCOS
Women should be encouraged to take folic acid 400mcg OD __________________________
3 months before conception up to 12 weeks gestation
combined contraceptive patch: If the delay in changing the patch is less than 48 hours, __________________
it should be changed immediately and no further precautions are needed
The only effective treatment for large fibroids causing problems with fertility is
myomectomy
is past Hx of breast cancer a C/I to COCP?
yes
All patients with secondary dysmenorrhoea _____________
need to be referred to gynaecology for investigation
galactocele vs breast abscess
Galactoceles can be clinically differentiated from a breast abscesses because they are painless and non-tender on examination, and there will be no local or systemic signs of infection.
Premature ovarian failure can be diagnosed in women less than 40 years of age with menopausal like symptoms and_____________
increased levels of FSH measured twice with at least a month between measurements
Pregnant women with blood pressure________mmHg are likely to be admitted and observed
≥ 160/110
Bladder still palpable after urination, think
overflow incontinence
An 80 year-old woman presents to her GP with a 1.5cm ulcerated lesion on her left labium majus. Dx?
Vulval carcinomas
what will be normal/raised in PCOS
LH and FSH will usually be normal or raised. Anti-Mullerian hormone (AMH) if measured will also be high due to anovulation
, LH and FSH will usually be normal or raised. Anti-Mullerian hormone (AMH) if measured will also be high due to anovulation
Menorrhagia, anaemia, bulk-related symptoms e.g. bloating/urinary frequency →
? uterine fibroids
Ankylosing spondylitis features - the ‘A’s
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
cerebellar ataxia, and without limb ataxia (i.e. finger-nose ataxia) the lesion is more likely to be in the cerebellar vermis
Cerebellar hemisphere - finger-nose ataxia
otitis externa Tx
topical cipro + dexamethasome
Blood stained discharge is most likely to be associated with
a papiloma
how would duct ectasia present
green-brown discharge and an abscess with puss discharging from the nipple. The latter will also be associated with red, swollen, warm skin of the breast.
What advice do you give him with regards to vasectomy as a form of contraception?
Vasectomy isn’t an immediate form of contraception; semen analysis must be performed and azoospermia confirmed before used as contraception
__________is recommended after a woman has had a wide-local excision as this may reduce the risk of recurrence by around two-thirds
Whole breast radiotherapy
RF for ectopic?
endometriosis
Invitations for cervical cancer screening
are sent every three years between the ages of 25 and 49, and every 5 years between the ages of 50 and 64.
do you use beta-histines for vestibular neuritis?
No
To confirm ovulation:
Take the serum progesterone level 7 days prior to the expected next period
Micrometastases or 2 macrometastases on sentinel lymph node biopsy during breast-conserving surgery →
Close, don’t dissect.
A 22 year female who is 24 weeks pregnant presents with frank haematuria. She is sexually active. She has had a previous pregnancy resulting in caesarean section.
Pregnancy and frank haematuria, especially if there is a history of placenta previa or prior caesarean section, should indicate this diagnosis. There is invasive placental implantation into the myometrium, which can rarely extend into the bladder causing severe bleeding.
[genital warts Mx]
multiple, non-keratinised warts:
solitary, keratinised warts:
multiple, non-keratinised warts: topical podophyllum
solitary, keratinised warts: cryotherapy
Painless genital pustule → ulcer → painful inguinal lymphadenopathy → proctocolitis =
lymphogranuloma venereum
_____________typically have normal AFP and HCG. These are usually raised in teratomas and yolk sac tumours
Seminomas
Ix to do before starting woman on Herceptin? (trastuzumab)
Echo - cardiotoxicity
