Brainscape's Knowledge GenomeTM

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


See full index

ONG > Gynae > Flashcards

Gynae Flashcards

1
Q

4 causes of secondary amenorrhoea

A

Premature menopause
hypothalamic hypogonadism
hyperprolactinaemia
PCOS

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

treatment hyperprolactinemia

A

bromocriptine, cabergoline, surgery

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

causes of AUB (acronym)

A 
Polyps
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet specified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

indications for endometrial biopsy in women with menorrhagia or IMB

A 
>40 with recent onset
non responsive to tx
endometrial thickness >10
polyps suspected
with IMB
RF for cancer (nulliparity, FHx, PCOS, obesity, DM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Menorrhagia medical treatment
1st line
2nd line
3rd line

A

1st: IUS
2nd: tranexamic acid or mefanamic acid (NSAIDS), COC
3rd: progestogens, GnRH

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

menorrhagia surgical tx options

A
  • polyp removal
  • endometrial ablation techniques
  • transcervical resection of fibroid
  • myomectomy
  • hysterectomy
  • uterine artery ablation (for fibroids, avoid surgery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IMB Ix

A
  • Hb
  • smear
  • ultrasound if <35 and not responded to treatment or >35
  • endometriosis biopsy if meet criteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ectropion tx

A

cryotherapy

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

polyps causing IMB tx

A

avulsed and sent history

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

treatment precocious puberty

A

GnRH agonists to inhibit sex hormone secretion

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

what are common association with secondary dysmenorrhoea and what ix useful

A

deep dyspareunia, menorrhagia/oligomenorrhagia

ix: pelvic US and laparoscopy

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

ss difference between primary and secondary dysmenorrhea

A

primary coincides with menstruation and responds to NSAIDS or ovulation suppression
secondary pain precedes and can be relieved by menstruation

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

define precocious puberty

A

menstruation before 10 or secondary characteristics before 8

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

causes of precocious puberty

A
  • most no cause found
  • increased GnRH (central cause): men, encephalitis, hydrocephaly, CNS tumours, hypothyroidism (tx GnRH ag)
  • increased oestrogen secretion: ovarian/adrenal tumours, McCune-Albright syndrome (tx anti-androgenic progesterone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is congenital adrenal hyperplasia

A 
increased androgen function in a genetic female
AR
cortisol production defective as 21-hydroxylase deficiency. ACTH excess -> increased androgen
ambiguous genitalia (large clitoris, amenorrhoea)
glucocorticoid deficiency -> addisonian crisis
tx = mineralocorticoid replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

androgen insensitivity syndrome

A

reduced androgen function in a genetic male. converted to oestrogen. appear female. present when ‘she’ presents with amenorrhoea. uterus absent. rudimentary testes (need removal).

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

PMS key feature of SS

A

CYCLICAL (luteal phase). ss tension, irritable, breast pain, depression, loss control, aggression, GI

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

treatments for PMS

A

continuous oral contraceptive
SSRIs
HRT oestrogen patch
GnRH and add-back oestrogen (pseudomenopause, only in severe cases)
endometrial ablation (reduces hormones?)
?bilat oophorectomy but add back coc or HRT
supplements: evening primrose oil, pyridaxime (B6), Vitex Agnus, CBT

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

what are the ovaries attached to

A

ovarian fossa overlying ureters
attached to broad ligament by mesovarium
pelvic side wall by infundibulopelvic ligament
uterus by ovarian ligament

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

blood supply ovary

A

ovarian artery and anastomosis with branches of uterine artery in the broad ligament

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

outer layer of ovary is

A

germinal epithelium

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

what cells secrete oestrogen

A

theca cells and granulose cells of growing follicles in the cortex

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

most common cause of gonadal dysgenesis (one of the problems of gonadal development)

A

Turners syndrome

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

investigations for ovarian cyst

A

CA125
TVUSS
?CT

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

management ovarian cyst emergency

A

laparotomy (or laparoscopy)
fluid resus
if rupture, abscess or PID broad spec Abs

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

ovarian carcinoma with worst prog

A

clear cell carcinoma (type of epithelial)

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

types of ovarian cyst in

1) premonopausal
2) postmenopausal

A

1) GC tumours (do hCG, AFP), follicular, lutein, benign epi tumours, endometriosis
2) benign epi or malignancy

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

5 year survival for ovarian cancer

A

<50%

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

investigations for ovarian cyst

A

CA125
TVUSS
?CT

30
Q

management ovarian cyst emergency

A

laparotomy (or laparoscopy)
fluid resus
if rupture, abscess or PID broad spec Abs

31
Q

ovarian carcinoma with worst prog

A

clear cell carcinoma (type of epithelial)

32
Q

where are batholin’s glands and what infects them

A

behind labia minor, e.coli/staph

33
Q

5 year survival for ovarian cancer

A

<50%

34
Q

lichen simplex appearance

A

thickened, hypo/hyperpigmented, often lava major

35
Q

investigation and management of lichen sclerosis

A

lichen sclerosus: biopsy as can -> scc carcinoma. ultra potent steroid cream eg clobetasol

36
Q

management vulvodynia/vulvar dysaethesia

A

can be provoked or spontaneous, generalised or local (vestibular). gabapentin or amitriptyline

37
Q

treatment bartholin’s

A

incision and drainage, may do marsupialisation

38
Q

what are the two types of vulval intraepithelial neoplasia, present with pruritus or pain

A

1) usual type. common. warty, basaloid mixed. very varied appearance. HPV 16, CIN, smoking and IS ass.
2) differentiated type. rarer. ass lichen sclerosis. older. unifocal ulcer or plaque. risk progression ca high. link keratinising SCC vulva

39
Q

percentage of genital tract carcinomas made up of

1) vulval carcinoma
2) vagina malignancies

A

5%

2%

40
Q

vulval carcinoma aetiology

A

de no vo (although VIN is pre Mal stage)
lichen sclerosis, IS, smoking, Paget’s disease of vulva
95% SCC

41
Q

ss vulval carcinoma

A

pruritus, discharge, bleeding, ulcer, mass

42
Q

key mx points vulval carcinoma

A

1a: wide local excision, no inguinal lymphadenectomy
other stages: <4cm not suspicious SLNB
if can’t do, bigger or pos mets in nodes -> wide local excision and groin lymphadenectomy
can add radio
reconstructive surgery

43
Q

prognosis vulval carcinoma

prognosis vaginal carcinoma

A

vulval: stage 1 90%, 3-4 40%

primary carcinoma vagina: 50% 5yr average

44
Q

what is clear cell carcinoma of vagina ass with

A

in utero exposure to DES (50s-70s)

45
Q

emergency investigations for pelvic infection

A

triple swabs
FBC, CRP, WCC
Pelvic USS
Laparoscopy with fibril biopsy and culture GS

46
Q

emergency management for pelvic infection

A

analgesia
IM ceftriaxone + po doxycycline and metronidazole or ofloxacin with metronidazole
febrile do IV
review 24hrs if no improvement -> laparoscopy
abscess -> drainage under US or lap
treat sexual partners

47
Q

how do uterine sarcomas (v rare) present

A

irreg or post menopausal bleeding
tx hysterectomy + chemo/radio
30% 5 yr survival

48
Q

which is the most common genital tract carcinoma

A

endometrial carcinoma
1% cumulative risk by 75
peak 60, rare pre menopausal

49
Q

most common type of endometrial cancer

A

90% low grade adenocarcinoma of columnar endometrial glands

50
Q

RF endometrial cancer

A

unopposed oestrogen:

obesity, PCOS, tamoxifen use, ovarian granulose cell tumour, DM, Lynch type 2 syndrome

51
Q

management of endometrial hyperplasia

A

hysterectomy
or
progestogens (IUS/continuous), 3-6m hysteroscopy and endometrial biopsy

52
Q

ss endo carcinoma:

A

post meno bleed
irreg or IMB
recent onset menorrhagia

53
Q

investigation endo cancer

A

USS
Endo biopsy or hysteroscopy. biopsy for dx
MRI estimate Myometrial invasion or if higher risk histology
CXR exclude pulmonary spread
fitness for surgery: FBC, renal, glucose, CXR, ECG

54
Q

when is recurrence endo ca most likely and where

A

vaginal vault within 3 years

55
Q

poor prognostic factors

A

older, advanced clinical stage, adenosquamous, high grade, deep myo invasion

56
Q

management endometrial cancer

A

hysterectomy

if high risk and ?LN involvement -> external beam radiotherapy, vaginal vault radio (chemo limited)

57
Q

causes and ix/mx

A

antiphospholipid syndrome - Antiphospholipid AB screen (repeat 6weeks if pos), aspirin and LMWH
TFTs
uterine ab - pelvic USS, HSG, MRI
amniocentesis/CVS
PCOS
Chr ab - karyotype fetal tissue then parents

58
Q

chorioamnionitis mx

A

IV ABX and deliver asap (CS)

59
Q

gestational trophoblastic disease types

A

hydatiform mole
- complete mole (no fetal tissue just proliferation swollen cv)
- partial mole (variable fetus, triploid)
malignant change
- invasive mole
- choriocarcinoma
gestational trophoblastic carcinoma (fast increase hCG)

60
Q

ix/mx GTD

A
  • USS snowstorm, high serum hCG
  • Management suction curettage, hits confirm, serial monitor hCG
  • Register supra regional centre
  • OC after ERPC
  • avoid pregnancy til after monitoring
61
Q

which types of miscarriage is os open

A

inevitable and incomplete

closed for threatened (uterus normal for date), complete (uterus non-gravid) and missed (uterus small for date)

62
Q

define spontaneous miscarriage and how common is it

A

fetus dies before 24 completed weeks of pregnancy (15% pregs). Most before 12 weeks

63
Q

IX spontaneous miscarriage

A
  • USS (TVUSS if <7 weeks), FHR from 6/40, beat from 22 days, see on TVUSS 1 week after)
  • hCG over 48hrs. more than 50% decrease non viable
  • FBC, RH status, G and S. give if surgically managed
64
Q

what do you have to do before allowing a complete miscarriage home

A

check uterus empty. not heavy bleeding.

65
Q

which types of miscarriage is os open

A

inevitable and incomplete

closed for threatened, complete and missed

66
Q

management of miscarriage

A

light bleeding - expectant or medical management (pv/po misoprostol)
heavy bleeding - IM ergometrine, ERPC
read notes

67
Q

management for TOP

A

1) bloods, Hb, G and S, Rh status, test haemoglobinopathies
2) Rh -ve, give anti-D within 72 hours
3) chlamydia screen, risk assess for others and screen if need
4) discuss contraception
5) medical: mifepristone and misoprostol
(KCL if after 22 weeks)
surgical: 7-13 weeks suction curettage. >14 weeks dilatation and evacuation (preop misoprostol and ABX)

68
Q

Ectopic presentation

A 
abdo pain colicky to constant
bleed
collapse
cervical excitation
adnexal tenderness
Uterine small for date and Os closed
69
Q

ectopic hCG levels

A

between 60% increase and 50% decline over

70
Q

indications for surgical management of ectopic

A

> 35mm, >5000IU hCG, significant pain, ?coexisting preg

ONG (6 decks)

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