gynae qz pass med

Question 1

ovarian torsion

Answer 1

1. whirl pool sign on ultrasound
2. RF - reproductive age, pregnancy, ovarioan hyperstimulation syndrome
3. mx - laproscopy for diagnosis and mx

Question 2

fibroid degeneration

Answer 2

1. high risk of ocurring during pregnancy if u have the fibroids (fever, pain and vomiting)

Question 3

endometrial hyperplasia

Answer 3

1. abnormal proliferation of menstrual cycle
2. intermenstrual bleeding
3. atypia - high dose progestogens and IUS and repeat sampling
4. atypia - hysterectomy

Question 4

Meig’s syndrome

Answer 4

1. fibroma

2. pleural effusion

Question 5

Mx of endometrial cancer

Answer 5

1. stage 1 and 2 - total abdominal hysterectomy with bilateral saplingo oophorectomy
2. progestogen therapy if npt sutible for sugery

Question 6

ovrflow incontinence

Answer 6

1. high voiding detrusor pressure
2. low peak flow - bladder outlet obstruction
3. voiding symptoms also suggestive of a bladder outlet obstruction

Question 7

imperforate hymen

Answer 7

1. blocks passage of menses - primary amenorrhea

2. build up of pelvic pain causes increase in pain and bloating

Question 8

ruptured ovarian cyst

Answer 8

1. sudden onset unilateral pain after sexual intercourse or exercise.
2. US - free fluid in the pelvic cavity
3. corpus luteal cysts are the most common to ruptur

Question 9

mittelschmerz

Answer 9

sharp onset mid cycle pain and may have recurrent episodes

Question 10

Menopause mx

Answer 10

1. diagnosed if
   - > 50 without 1 year
   - < 50 without 2 years
2. HRT
   no womb - oestrogen HRT
   yes womb - combine HRT

LMP < 1 year - cyclical combined HRT
LMP > 1 year - continous combined HRT

3. vasomotor sx - fluoxetine, citalopram

Question 11

UKMEC3 - disadv>adv

Answer 11

1. > 35 years old and smoker of <15 cig
2. migraine
3. immobility
4. breat feeding - 6 weeks to 6 months postpartum

Question 12

UKMEC4 - never

Answer 12

1. > 35 and smoker of >15 cig
2. breast feeding and < 6 weeks post partum
3. person hx - pe/dvt/stroke

Question 13

PCOS

Answer 13

1. pelvic ultrasound - shows cysts
2. Raised FSH and FH / testosterone/prolactin/
3. check for impaired glucose intolerance
4. hyperinsulinaemia