Brainscape's Knowledge GenomeTM

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


See full index

Revision lectures > Gynae > Flashcards

Gynae Flashcards

1
Q

Primary amenorrhoea

A

Failure to start menstruating

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

Secondary amenorrhoea

A

Periods stop for over 6 months other than pregnancy

Hypothalamic pituitary ovarian axis disorders common

Ovarian and endometrial causes rare

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

Oligomenorrhoea

A

Infrequent periods

Common cause is PCOS or extremes of reproductive life

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

Menorrhagia

A

Excessive blood loss

Over 80mL/cycle

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

Dysmenorrhea

A

Painful periods

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

PCOS Management

A

Weight loss and exercise
Metformin if BMI over 25 and trying to conceive
COCO

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

Causes of menorrhagia

A

Girls - Pregnancy and dysfunctional uterine bleeding

Women - IUD, fibroids, endometriosis, adenomyosis, pelvic infection, polyps, hypothyroidism

Peri-menopausal - consider endometrial carcinoma

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

Treating menorrhagia

A

With contraception

  • 1st line is Mirena coil
  • 2nd is antifibrinolytics eg tranexamic acid taken when bleeding, or antiprostaglandins eg mefenamic acid taken when bleeding especially if also dysmenorrhea or COCP
  • 3rd line is progesterones IM or norethisterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When should women be prescribed cyclical combined HRT

A

If LMP was less than one year ago

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

When should women be prescribed continuous combined HRT

A

If they have…
Taken cyclical combined for at least one year
Or
It has been 1 year since LMP
Or
It has been at least 2 years since LMP if they had premature menopause (before age 40)

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

If the woman still has her uterus what should HRT consist of?

A

Progesterone and Oestrogen

Progesterone can reduce risk of endometrial cancer that exists with use of unopposed oestrogen

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

Diagnosis of fibroids?

A

Bulky uterus
Menorrhagia

Ix = trans vaginal USS

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

First line Tx of fibroids

A

Levonorgestrel releasing IUS

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

Gold standard investigation for patients with suspected endometriosis

A

Laparoscopy

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

First line endometriosis treatment if patient does NOT wish to conceive

A

COCP

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

Criteria for diagnosing bacterial vaginosis

A

3 of the following

  1. Thin, white homogenous discharge
  2. Clue cells in microscopy
  3. Vaginal pH over 4.5
  4. Positive whiff test (addition of potassium hydroxide results in fishy odour)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment for bacterial vaginosis

A

Oral metronidazole

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

Treatment for Trichomonas vaginalis

A

Oral metronidazole

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

Symptoms of suspected ovarian cancer

A 
Persistently any of these symptoms... 
Abdominal distension/bloating
Early satiety or loss of appetite
Pelvic or abdominal pain
Increased urinary urgency or frequency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Meigs Syndrome

A

Benign ovarian tumour
Ascites
Pleural effusion

21
Q

Cervical screening

Borderline or mild dyskaryisis

A

Original sample tested for HPV

  • if negative goes back to routine three yearly recall
  • if positive patient referred for colposcopy
22
Q

Cervical screening

Moderate dyskaryosis

A

Consistent with CIN II

Refer for urgent colposcopy

Within 2 weeks

23
Q

Cervical screening

Severe dyskaryosis

A

Consistent with CIN III

Refer for urgent colposcopy

Within 2 weeks

High risk subtypes of HPV such as 16, 18 & 33

24
Q

Cervical screening

Suspected invasive cancer

A

Refer for urgent colposcopy

Within 2 weeks

25
Q

Cervical screening

Inadequate smear

A

Repeat

If inadequate 3 times then assessment by colposcopy

26
Q

Premature ovarian failure definition

A

The onset of menopausal symptoms and elevated gonadotropin levels before the age of 40

27
Q

Causes of premature ovarian failure

A

Idiopathic - most commonly
Chemotherapy
Autoimmune
Radiation

Occurs in 1 in 100 women

28
Q

Post menopausal bleeding is…

A

Endometrial cancer until proven otherwise

29
Q

Risk factors for endometrial cancer

A 
Obesity
Nulliparity
Early menarche and late menopause
Unopposed oestrogen
Diabetes mellitus
Tamoxifen
PCOS
30
Q

First line investigation for endometrial cancer

A

Trans vaginal USS
- normal endometrial thickness of under 4mm has a high negative predictive value

Then hysteroscopy with endometrial biopsy

31
Q

Staging of ovarian cancer

1

A

Tumour confined to ovary

32
Q

Staging of ovarian cancer

2

A

Tumour outside ovary but within pelvis

33
Q

Staging of ovarian cancer

3

A

Tumour outside pelvis but within abdomen

34
Q

Staging of ovarian cancer

4

A

Distant metastasis

35
Q

Threatened miscarriage

A

Painless vaginal bleeding before 24 weeks

Usually at 6-9 weeks

Bleeding often less than menstruation

Cervical os closed

36
Q

Missed(delayed) miscarriage

A

Gestational sac with dead foetus before 20weeks without symptoms of expulsion

Light vaginal bleeding/discharge and symptoms of pregnancy which disappear. Usually no pain

Cervical os is closed

37
Q

Inevitable miscarriage

A

Heavy bleeding with clots and pain

Cervical os is open

38
Q

Incomplete miscarriage

A

Not all products of conception expelled

Pain and vaginal bleeding

Cervical os is open

39
Q

Ovarian Cysts

Physiological

Follicular

A

Commonest type of ovarian cyst

Due to non rupture of the dominant follicle or failure of atresia in a non dominant follicle

Commonly regressed after several menstrual cycles

40
Q

Ovarian Cysts

Physiological

Corpus luteum cyst

A

During menstrual cycle of pregnancy doesn’t occur corpus luteum should break down and disappear.. if this doesn’t occur the corpus luteum may fill with blood or fluid and form a cyst

More likely to present with intraperitoneal bleeding than follicular cysts

41
Q

Ovarian Cysts

Benign germ cell tumours

Dermoid cysts

A

Also called mature cystic teratomas. Usually lined with epithelial tissue and hence may contain skin appendages, hair and teeth

Most common ovarian tumour in women under 30

Median age diagnosis is 30

Bilateral in 10-20%

Usually asymptomatic. Torsion more likely than with other ovarian tumours

42
Q

Ovarian Cysts

Benign epithelial tumours
(Arise from the ovarian surface epithelium)

Serous cystadenoma

A

Most common benign epithelial tumour which bears a resemblance to the most common type of ovarian cancer (serous carcinoma)

Bilateral in 20%

43
Q

Ovarian Cysts

Benign epithelial tumours
(Arise from the ovarian surface epithelium)

Mucinous cystadenoma

A

Second most common benign epithelial tumour

Typically large and may become massive

If ruptures may cause pseudomyxoma peritonei

44
Q

First line treatment for symptomatic relief of endometriosis

A

NSAIDs and/or paracetamol

If analgesia helps then hormonal treatment such as COCP or progesterones should be tried

45
Q

Clinical features of endometriosis

A 
Chronic pelvic pain
Dysmenorrhea - pain often starts days before bleeding
Deep dyspareunia
Subfertility
Non gynae - urinary symptoms

On examination - reduced organ mobility, tender modularity in the posterior vaginal fornix and visible vaginal endometrotic lesions may be seen

46
Q

Urinary incontinence

First line urge incontinence

A

Bladder retraining

47
Q

Urinary incontinence

First line stress incontinence

A

Pelvic floor muscle training

48
Q

Need for contraception after the menopause

A

12 months after the last period in women over 50

24 months after the last period in women under 50

49
Q

Expectant management of an ectopic can only be performed for…

A
  1. An unruptured embryo
  2. <30mm in size
  3. Have no heartbeat
  4. Be asymptomatic
  5. Have a BhCG level of under 200lU/L and declining

Revision lectures (15 decks)

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