Gynae MCQs Flashcards
How is HSIL managed?
Proceed to colposcopy
LEEP/cold coagulation/cone biopsy
How is LSIL managed?
If HPV - → routine recall
If HPV + → colposcopy
How is ASCUS managed?
If HPV - → routine recall
If HPV + → colposcopy
What nodes does cervical cancer metastasise to?
Parametrial nodes
What is the stage of cervical carcinoma causes hydronephrosis?
Stage 3B
What stage of cervical carcinoma involves the lower 1/3 of the vagina?
Stage 3A
What are the risk factors for cervical cancer?
Multiple sexual partners
Early onset of sexual activities
High risk sexual partner
Immunosupression
Smoking
What type of epithelium lines the vulva?
Squamous
How is vulvar carcinoma diagnosed?
Punch biopsy plus staging scans (CXR, CT-TAP)
What are the risk factors for endometrial cancer?
Unopposed oestrogen (HRT, tamoxifen, obesity, early menarche, nulliparity)
Genetics (HNPCC)
Diabetes
What is the likely diagnosis in a 72yo female presenting with PV bleeding?
Endometrial cancer
What are the risk factors for ovarian cancer?
Increased age
Increased ovulation
Genetic (BRCA)
What is the most common type of benign ovarian neoplasm?
Serous cystadenoma
What is the most common type of malignant ovarian neoplasm?
Serous carcinoma (surface derived epithelial tumours)
What is the tumour marker in ovarian cancer?
CA-125
Is granuloma inguinale caused by chlamydia?
No
What are the symptoms of gonorrhoea?
Urethritis (dysuria)
Purulent discharge
Fever
How is chlamydia treated?
Azithromycin 1g/doxycycline and treat the partner
How is gonnorhoea treated?
Ceftriazone 500mg and azithromycin 1g
Treat partner
What are the features associated with PID?
Multiple sexual partners
Cervical motion tenderness
Muco-purulent discharge
What is the most common pelvic cause of primary amenorrhoea?
Gonadal dysgenesis
What is the most common cause of primary amenorrhoea?
Idiopathic hypothalamic (weight loss, exercise)
What type of visual disturbance is caused by a pituitary adenoma?
Bitemporal hemianopia
What is the most common cause of anovulatory subfertility?
PCOS
How is PCOS managed?
Fertility (metformin, clomifene)
Fertility not desired (weight loss, COCP)
What is the clinical presentation of endometriosis?
Chronic pelvic pain
Dysmenorrhoea
Dyspareunia
Frozen pelvis
Nodules in rectum and pouch of Douglas
What is procidentia?
Complete pelvic prolapse below the introitus
What are the symptoms of rectocele?
Sensation of pressure in the pelvis
Lower abdo pain
Dyspareunia
Tenesmus
How is a woman with stress incontinence 4 weeks postpartum managed?
Normal up to 6 months - reassure and reassess
What type of urinary incontinence is caused by detrusor instability?
Urge incontinence
What are the first and second line treatments for a woman with stress incontinence?
1st → pelvic floor exercises
2nd → duloxetine
What ligament supports the ovary?
Broad ligament
What is the most common and highest death rate for women in all cancers?
Breast cancer
Which gynaecological cancers has the highest rate of new cases?
Endometrial cancer
Which gynaecological cancer has the highest death rate?
Ovarian cancer
What is the first-line treatment for endometrial hyperplasia without atypia?
Progesterone therapy (Mirena IUS)
What is the treatment of atypical endometrial hyperplasia?
Hysterectomy
What are the tumours associated with Lynch syndrome?
Colon, endometrial, ovarian
What factors are protective in uterine cancer?
COC, POP, smoking
Which nodes does endometrial spread to?
Pelvic then para-aortic
