Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AMC MCQ - Key points > Gynae > Flashcards

Gynae Flashcards

1
Q

Describe the first step in the investigation of primary amenorrhea when there is a positive uterus but no breast development.

A

Karyotyping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the management approach for mullerian agenesis in individuals with XX chromosomes?

A

Elongation of the vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the recommended management for androgen insensitivity syndrome in individuals with XY chromosomes?

A

Removal of testes after puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the initial step when encountering secondary amenorrhea?

A

Perform a pregnancy test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define the most common site of fibroids.

A

Intramural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the treatment for fibroids.

A

Myomectomy; consider giving GnRH 3-6 months before the operation

Many fibroids cause debilitating symptoms that greatly affect a woman’s quality of life. Traditional surgical treatment options include myomectomy and hysterectomy.
https://www.racgp.org.au › …PDF
Uterine fibroids: Investigation and current management trends - RACGP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the diagnosis and treatment for red degeneration of a fibroid in a pregnant individual with abdominal pain and fever?

A

Diagnosis: Red degeneration of the fibroid; Treatment: Analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the management of imperforate hymen.

A

Surgery under anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the first-line treatment for primary dysmenorrhea?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the common symptoms associated with endometriosis.

A

Infertility, dysmenorrhea, dysuria, dyschezia, dyspareunia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most important investigation for polycystic ovary syndrome (PCOS)?

A

Testosterone (free and total)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the management of adenomyosis.

A

Start with OCPs; if unsuccessful, consider total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH, BSO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the treatment options for severe cases of endometriosis.

A

GnRH analogues or leuprolide (androgen) for younger patients; TAH, BSO for older patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most important advice for patients with PCOS?

A

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define the diagnosis of premature ovarian failure in a female in her 30s.

A

Premature ovarian failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain the treatment options for premature ovarian failure.

A

OCPs for sexually active individuals not planning children, HRT for those not sexually active but desiring children, IVF with egg donation for those wanting to conceive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the treatment of bacterial vaginosis.

A

Oral metronidazole is used for treatment of bacterial vaginosis, and partner treatment is not necessary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the diagnostic method for trichomonas vaginalis?

A

Trichomonas vaginalis can be diagnosed by observing motile flagellated organisms under a microscope.

Site/Specimen
Test
Consideration
High vaginal swab
NAAT
Preferred option in people with a vagina.
Should ideally be clinician collected if the patient is symptomatic but can be self-collected if client declines examination.
First pass urine (FPU)
NAAT
Available in major laboratories in each state.
NAAT – Nucleic Acid Amplification Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is trichomonas vaginalis treated?

A

Trichomonas vaginalis is treated with oral metronidazole, and partner treatment is required.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define the diagnostic method for candida vaginalis.

A

Candida vaginalis can be diagnosed by observing thick, cheesy, odorless pseudohyphae under a microscope.

Investigations
Vulvovaginal candidiasis is usually diagnosed by culture and/or direct microscopy. Culture
is done on Sabourand dextrose agar and a high vaginal specimen is placed into conven- tional bacterial transport mediums. Light microscopic examination of high vaginal secretions may show spores and pseudohy- phae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for candida vaginalis?

A

Candida vaginalis is treated with oral fluconazole, with fluconazole cream used in pregnancy, and partner treatment is not necessary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the cause of cyclic vulvo-vaginitis.

A

Candida is the cause of cyclic vulvo-vaginitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for recurrent vulvovaginitis?

A

Recurrent vulvovaginitis is treated with oral fluconazole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the initial step in managing post-menopausal women with a history of vulvar itching?

A

The first step is to perform a punch biopsy.

Vulvar lichen sclerosus can be diagnosed clinically; however, if there is diagnostic uncertainty, a biopsy should be considered. A biopsy should be taken by a clinician with appropriate training and skill and pathology interpreted by a dermatopathologist. Further investigations include a low vaginal swab to rule out candidiasis and thyroid function tests.racgp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is lichen sclerosis treated?

A

Lichen sclerosis is treated with cortisone cream, but a punch biopsy is done first to rule out malignancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the screening test for Chlamydia.

A

All sexually active females aged 15-29 should undergo Chlamydia screening annually.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the most common cause of cervical muco-purulent discharge in females?

A

Chlamydia is the most common cause of cervical muco-purulent discharge in females.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the recommended treatment for Chlamydia infection?

A

Chlamydia is treated with azithromycin and ceftriaxone to cover both Chlamydia and gonorrhea, and partner tracing is crucial.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the screening recommendations for cervical cancer using pap smear.

A

Pap smear screening should start 2 years after starting intercourse or at age >18, with screening every 2 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the management approach for abnormal pap smear results in the presence of infection?

A

Repeat screening after treating the infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is HPV vaccine administered in females aged……. years?

A

HPV vaccine should be given to all females aged 9-45, ideally before sexual activity begins.

32
Q

What is the most common risk factor for endometrial cancer?

A

Obesity is the most common risk factor for endometrial cancer.

33
Q

Describe the best investigation for suspected endometrial cancer.

A

Hysteroscopy and biopsy are the best methods for investigating suspected endometrial cancer.

34
Q

What are females with BRCA1 and BRCA2 mutations at increased risk for?

A

Females with BRCA1 and BRCA2 mutations are at increased risk for ovarian and breast cancer.

35
Q

What is the next step in managing an ovarian cyst in an older female found on ultrasound?

A

Perform a CA125 test, even if the cyst appears simple on ultrasound.

36
Q

Describe stress incontinence

A

Urinary incontinence with increased intra-abdominal pressure, such as coughing or laughing, is known as stress incontinence. It is the most common cause of incontinence in females.

37
Q

What is the investigation of choice for stress incontinence?

A

Urodynamics is the preferred investigation for stress incontinence.

38
Q

How is stress incontinence treated as a first line?

A

Kegel exercises are the initial treatment for stress incontinence.

39
Q

What is the management if there is no response to kegel exercises for stress incontinence?

A

Surgery, such as total abdominal hysterectomy or vaginal hysterectomy, is considered.

40
Q

Describe urge incontinence

A

Urge incontinence is characterized by a strong, unexpected urge to void that is not related to position.

41
Q

What is the first-line treatment for urge incontinence?

A

Bladder training is the primary treatment for urge incontinence. If unsuccessful, anticholinergics or tricyclic antidepressants may be considered.

42
Q

What is overflow incontinence commonly seen in patients with long-standing diabetes mellitus?

A

Overflow incontinence is urinary incontinence in patients with long-standing diabetes mellitus.

43
Q

What is the main ligament supporting the uterus?

A

The main ligament supporting the uterus is the uterosacral ligament.

44
Q

What is the second most common site of endometriosis?

A

The uterosacral ligament is the second most common site of endometriosis.

45
Q

What is the most common cause of pelvic inflammatory disease (PID)?

A

Chlamydia is the most common cause of pelvic inflammatory disease, followed by gonorrhea.

46
Q

Describe the management of a painful ulcer on the genitalia in an adult

A

An adult with a painful ulcer on the genitalia is presumed to have herpes simplex virus (HSV) until proven otherwise.

The management of a painful genital ulcer in an adult, including chancroid caused by Haemophilus ducreyi, involves several key steps, as per RACGP guidelines:

  1. History and Physical Examination: Assess sexual history, recent infections, and associated symptoms such as fever or lymphadenopathy.
  2. Inspection: Examine the ulcer, noting its characteristics (e.g., painful, soft, undermined edges, and purulent base for chancroid).
  1. Swabs:
    • HSV PCR: Swab for herpes simplex virus (types 1 and 2).
    • Treponema pallidum PCR: Swab for syphilis.
    • Haemophilus ducreyi PCR: Swab for chancroid.
    • Additional Tests: If lymphogranuloma venereum (LGV) or other conditions like monkeypox are suspected, appropriate PCR tests should be included.
  2. Serology: Test for HIV, hepatitis A, B, and C, syphilis, and other STIs (chlamydia and gonorrhea).
  1. HSV: Antiviral treatment with valaciclovir or acyclovir.
  2. Syphilis: Benzathine benzylpenicillin for syphilis. Early syphilis (primary, secondary, or early latent) typically requires a single dose; late latent or unknown duration requires weekly doses for three weeks.
  3. Chancroid:
    • First-Line Treatment: Azithromycin 1 g orally as a single dose or ceftriaxone 250 mg intramuscularly as a single dose.
    • Alternative Treatments: Ciprofloxacin 500 mg orally twice daily for three days or erythromycin 500 mg orally four times daily for seven days.
  • Jarisch-Herxheimer Reaction: Monitor for this reaction in syphilis treatment, which may cause fever, chills, and muscle aches. Treat with analgesics and rest.
  • Syphilis: Repeat RPR at 3, 6, and 12 months to ensure adequate response.
  • General: Educate on sexual health, including condom use and regular STI screening.
  • Notification: Syphilis and chancroid are notifiable diseases in Australia.
  • Contact Tracing: Notify and test sexual partners from the preceding three months to prevent further transmission.
  • Pain Management: Provide appropriate analgesics.
  • Sexual Abstinence: Advise patients to abstain from sexual activity until treatment is complete and symptoms have resolved.

These comprehensive steps ensure that painful genital ulcers, including those caused by Haemophilus ducreyi, are managed effectively and safely oai_citation:1,RACGP - Genital ulcers oai_citation:2,www.aafp.org oai_citation:3,RACGP - Carotid artery stenosis.

47
Q

What is the most common type of ovarian cyst?

A

Follicular cysts are the most common type of ovarian cyst.

48
Q

What is the initial management of precocious puberty?

A

The first step in managing precocious puberty is to perform an x-ray to determine bone age.

49
Q

Describe premature thelarche

A

Premature thelarche is characterized by breast development before the age of 3 years without other secondary sexual characteristics.

50
Q

What is the process of abortion in Australia?

A

The process of abortion in Australia involves counseling first, followed by obtaining informed consent before the procedure is performed.

51
Q

Who can give informed consent for abortion in Australia?

A

Competent patients over 16 years old, those over 14 who are independent, parents or guardians for those under 14, and sexual assault authorities for minors exposed to rape can provide informed consent for abortion.

52
Q

Who is allowed to perform abortions in Australia?

A

Only physicians are permitted to perform abortions in Australia.

53
Q

Where should abortions be performed in Australia?

A

Abortions should only be carried out in tertiary hospitals, regardless of the distance.

54
Q

What is the investigation of choice for diagnosing osteoporosis?

A

Dual-energy X-ray absorptiometry (DEXA) scan is the preferred investigation for diagnosing osteoporosis.

55
Q

How is a DEXA scan result interpreted if it falls between -1 and -2.5?

A

A DEXA scan result between -1 and -2.5 indicates osteopenia.

56
Q

Describe the criteria for diagnosing osteoporosis.

A

T-score less than -2.5 or presence of a minimal trauma fracture.

57
Q

What is the preferred imaging modality for suspected osteoporotic bone fractures?

A

X-ray.

58
Q

How is osteoporosis typically prevented?

A

With calcium and vitamin D supplementation.

59
Q

Define the treatment of choice for osteoporosis.

A

Bisphosphonates, even if calcium and vitamin D are already being taken.

60
Q

What is the recommended treatment for osteoporosis in patients with a history of breast cancer?

A

Raloxifene (SERM).

61
Q

Describe the most common symptom of menopause and the primary indication for hormone replacement therapy (HRT).

A

Hot flushing is the most common symptom, and it is the primary indication for HRT.

62
Q

What is the most common cause of dysfunctional bleeding at the beginning of puberty?

A

Anovulation.

63
Q

How should menopause with irregular bleeding be managed until proven otherwise?

A

With hysteroscopy and biopsy.

64
Q

Define the most common cause of post-menopausal bleeding.

A

Atrophic vaginitis.

65
Q

What is the recommended emergency contraception in case of condom rupture or unplanned pregnancy?

A

Levonorgestrel 750mg.

66
Q

Describe the management approach if a patient on oral contraceptive pills (OCPs) develops chloasma.

A

Stop estrogen.

67
Q

What is the next step if a patient on OCPs develops hypertension?

A

Stop OCPs first and then check response.

68
Q

What is the most common indication of OCPs after delivery when breastfeeding frequency is low?

A

Low frequency of breastfeeding.

69
Q

What is the first step in the evaluation of an infertile couple?

A

Semen analysis.

70
Q

What is the most common cause of decreased sperm count?

A

Alcohol.

71
Q

What does a positive progesterone withdrawal test (withdrawal bleeding) indicate?

A

Anovulation.

72
Q

What is the most common cause of infertility in a couple where the male has no offspring and the female is in her 40s with 2 offspring?

A

Female (anovulation due to aging).

73
Q

What is the main site of action of low-dose progestin-only pills?

A

Cervix.

74
Q

Where is the main site of action of combined oral contraceptives?

A

Hypothalamo pituitary ovarian axis.

75
Q

What is the most common cause of infertility in females with normal examination findings?

A

Tube adhesion.

76
Q

What is the best investigation for Chlamydia?

A

PCR first catch urine.

77
Q

Describe the most common malignancy in polycystic ovaries.

A

Breast cancer.

AMC MCQ - Key points (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions