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FINALS > Gynae > Flashcards

Gynae Flashcards

1
Q

What is needed following a medical termination of pregnancy?

A

Multiple level pregnancy test in 2 weeks

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2
Q

Management of vaginal thrush?

A

Oral fluconazole

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3
Q

Enlarged boggy uterus?

A

Adenomyosis

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4
Q

What is a C/I to injectable progesterone contraceptives?

A

Current breast cancer

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5
Q

Management of pregnant women who are<6 weeks gestation with painless bleeding?

A

Expectant management - repeat test in 7 days

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6
Q

Imaging of choice for adenomyosis?

A

Transvaginal US

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7
Q

How long should women wait before starting regular hormonal contraception after taking ulipristal?

A

5 days

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8
Q

Management of 2 missed pills in week 3?

A

Take an active pill and omit the pill-free interval

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9
Q

What is acceptable with nearly all anti epileptic drugs?

A

Breastfeeding

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10
Q

Risks of HRT?

A
  • Increased risk of breast cancer
  • Increased risk of endometrial cancer(if no progresterone)
  • Increased risk of VTE
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11
Q

Unopposed oestrogen increases the risk of?

A

Endometrial cancer

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12
Q

If one pill missed, what is the next steps?

A

Take the next pill ASAP then continue as normal

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13
Q

If 2 pills are missed in week 2, what is the next steps?

A

No emergency contraception needed if previous 7 days have been taken correctly

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14
Q

What is the drug of choice for reversing respiratory depression caused by mag sulphate?

A

Calcium Gluconate

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15
Q

When should anti-D prophylaxis be given to women who are having an abortion?

A

If rhesus negative and after 10 weeks gestation

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16
Q

Management of switching from IUD to COCP

A

No additional contraception needed if removed on day 1-5
If later, barrier contraception needed for 7 days

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17
Q

When should oestrogen containing contraceptives be discontinued before surgery requiring immobilisation?

A

4 weeks before

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18
Q

COCP protects against which cancers?

A

Ovarian and endometrial

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19
Q

Presence of heartbeat on US of ectopic suggests what?

A

Surgical management needed

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20
Q

When do women require contraception post partum?

A

After 21 days

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21
Q

First line for menorrhagia?

A

Mirena IUS

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22
Q

Risk factors for premature ovarian failure?

A

positive family history, exposure to chemotherapy/radiation and autoimmune disease.

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23
Q

Which contraceptives are not affected by enzyme inducing drugs?

A
  • Copper IUD
  • Injection
  • Mirena
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24
Q

When is anti-D given?

A

28 and 34 weeks

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25
Q

What are the normal blood test results for PCOS?

A
  • Raised LH:FSH ratio
  • Normal/Raised testosterone
  • SHBG is normal/low
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26
Q

Most common ovarian cancer type?

A

Epithelial cell tumour

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27
Q

Most common type of fibroid?

A

Intramural fibroid

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28
Q

Vulval itching with white atrophic patches of skin?

A

Lichen sclerosis

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29
Q

What can be precipitated by antibiotic exposure?

A

Fungal infection

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30
Q

Current breast cancer is a C/I to what?

A

All hormonal contraceptives

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31
Q

Management of all postmenopausal women with atypical endometrial hyperplasia

A

Hysterectomy with bilateral salpingo-oophorectomy

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32
Q

Itching and vaginal burning with latex condoms?

A

Irritant contact dermatitis

33
Q

blue and bulging membrane with a mass protruding from behind

A

Imperforate hymen

34
Q

Failure of the corpus luteum to regress can lead to what?

A

Corpus luteal cyst

35
Q

Why is a urine dip done when patients have hyperemesis gravidarum?

A

Assess for ketones as these would suggest ketosis/starvation

36
Q

What vitamin can be given to patients with hyperemesis?

A

Thiamine to prevent Wernickes

37
Q

What are causes of recurrent spontaneous miscarriages?

A
  • Antiphospholipid
  • Infection
  • Uterine/Cervical abnormalities
38
Q

What is CIN and how do you differ between CIN1/2/3?

A

CIN - premalignant condition where abnormally diving cells have now invaded below the basement membrane
1 - 1/3 of epithelium 2 - 2/3 of epithelium, 3 - 3/3 of epithelium

39
Q

What are types of cervical cancer?

A

Squamous cell and adenocarcinoma

40
Q

What is the investigation of choice to look for local and distant spread of invasive cervical carcinoma?

A

CT

41
Q

What is an ectropion?

A

growth of endocervical columnar epithelium outside of the external os

42
Q

Side effects of GnRH agonists?

A

Menopausal symptoms
Loss of bone mineral density

43
Q

What causes ovarian torsion?

A

Small cyst ruptures on a free pedicle, restricting its blood supply causing potential ovarian necrosis

44
Q

How do dermoid cysts arise?

A

Derived from primitive germ cells which can differentiate into any body tissue

45
Q

What are signs of endometriosis on examination?

A
  • Fixed, retroverted uterus
  • Tender uterus
  • Enlarged ovaries
  • Uterosacral ligament nodules
  • Visible lesions
46
Q

Primary vs secondary infertility

A

Primary - couple have never been able to conceive
Secondary - couple have achieved conception in the past

47
Q

Management of infertility in PCOS?

A
  • Metformin
  • Clomiphene
  • Gonadotrophins
48
Q

What is the classic PCOS triad?

A
  • Hyperandrogenism
  • Ovulatory dysfunction
  • Polycystic ovaries
49
Q

What bloods would you measure for ovulatory function?

A
  • Day 21 progesterone
  • FSH/LH
  • Oestradiol
50
Q

What are C/I to IUD insertion?

A
  • STI/PID
  • Ovarian/Endometrial/Cervical cancer
51
Q

Why can women sometimes feel faint and become bradycardic during IUD insertion?

A

Cervical shock leads to vasovagal which causes reflex bradycardia

52
Q

Where does endometrial cancer metastasize?

A
  • Inguinal lymph nodes
  • Lung
  • Bone
  • Liver
  • Peritoneum
53
Q

What are non contraceptive ways to manage menorrhagia?

A
  • Tranexamic acid
  • Aspirin
  • Indomethacin
  • Mefenamic acid
54
Q

What are common places for endometrial tissue to grow?

A
  • Ovaries
  • Pouch of Douglas
  • Uterosacral ligaments
55
Q

What markers should be done in suspected ovarian cancer?

A
  • CA125
  • AFP
  • BHCG
56
Q

What are risk factors for uterovaginal prolapse?

A
  • Multiparity
  • Raised intrabdominal pressure
  • Menopause
  • Hysterectomy
57
Q

What can be done to prevent prolapse?

A
  • Pelvic floor excercises
  • Support the vaginal vault during hysterectomy
58
Q

What is management of prolapse?

A
  • Pessaries
  • Physio
  • Surgical repair
59
Q

What can cause oligohydramnios?

A
  • PROM, renal agenesis, foetal abnormalities, IUGR
60
Q

What complications can occur with oligohydramnios?

A
  • Resp difficulties
  • Skull deformities
  • IUGR
  • Pulmonary hypoplasia
  • Cord compression
  • Shoulder dystocia
  • Foetal hypoxia
61
Q

What is the management of oligohydramnios?

A
  • Encourage maternal hydration
  • Oligoinfusion
62
Q

When should serum progesterone levels be taken to check ovulation?

A

7 days before next expected period

63
Q

Missed pill rules

A
  • If 1 missed (any time in cycle): take it and continue as normal
  • If 2 or more missed: take it and use condoms for 7 days
  • If 2 or more missed in week 1 and she has had sex this week or previous pill-free interval: + emergency contraception
  • If 2 or more missed in week 3: start next pack as soon as she finishes current pack
64
Q

Management of stage 1 cervical cancer to maintain fertility?

A

Cone biopsy

65
Q

Which should be measured when thinking about premature ovarian insufficiency?

A

FSH - will be raised

66
Q

What is the first line management for prolapse?

A
  • If asymptomatic: nothing
  • Conservative: weight loss and pelvic floor excercises
  • Pessary
  • Surgery: colporrhaphy
67
Q

Which hormone surges just before ovulation?

A

LH

68
Q

What is a fibroid?

A

Benign smooth muscle tumour originating from the myometrium

69
Q

Most common tumour in young women?

A

Germ cell tumour

70
Q

Lichen sclerosus needs what to be treated?

A

Potent topical steroid

71
Q

Woman recently stopped breastfeeding with lump?

A

Galactocele

72
Q

PCOS increases the risk of what?

A

Endometrial and ovarian cancer

73
Q

What should be given to induce a withdrawal bleed when thinking about cancer in someone with PCOS?

A

Oral cyclical progestogen

74
Q

When should a follow up smear after LLETZ be done?

A

6 months

75
Q

Premenstrual syndrome management

A

COCP
SSRI

76
Q

Before sterilisation, how long must women have been on effective contraception for?

A

1 month

77
Q

HEAVY MENSTRUAL BLEEDING

A
78
Q

MITTELSCHMERZ

A
79
Q

NIPPLE DISCHARGE

A

FINALS (36 decks)

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