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Gynae + GUM > Gynaecological disease > Flashcards

Gynaecological disease Flashcards

1
Q

What is 3rd degree uterine prolapse?

A

Uterine descent with cervical protrusion beyond the introitus

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2
Q

Is 3rd degree uterine prolapse painful?

A

No. Unless ulcerated

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3
Q

Does 3rd degree uterine prolapse cause difficulty defecating?

A

Yes by pressure on the anterior wall of the rectum.

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4
Q

Can 3rd degree uterine prolapse cause urinary incontinence?

A

Yes.

Or retention

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5
Q

Possible symptoms of endometriosis

A 
Ovulation pain
Mid cycle lower abdominal pain
Heavy menstruation
Dysmenorrhoea 
Dysparunia
Dysuria 
Haematuria
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6
Q

What is primary vulvodynia?

A

Chronic vulval pain of more than 3 months dating from 1st sexual experience or tampon use

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7
Q

What is secondary vulvodynia?

A

Chronic vulval pain of more than 3 months developing after previous pain free sexual intercourse

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8
Q

Associations with vulvodynia

A

Change in sexual partner
Thrush
STI
Depression

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9
Q

Most common cause of vaginal discharge

A

Bacterial vaginosis

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10
Q

Effect of bacterial vaginosis (BV) on vaginal PH

A

Loss of normal vaginal acidity.

PH increases to greater than 4.5.

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11
Q

Symptoms of BV

A

50% are asymptomatic.

Fishy-smelling vaginal discharge

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12
Q

Non infective causes of abnormal vaginal discharge?

A 
Retained foreign body, 
Iflammation due to allergy or irritation, 
Tumours, 
Atrophic vaginitis,
Cervical ectopy,
Cervical polyps
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13
Q

Drugs for heavy menstrual bleeding

A 
Mefenamic acid
Tranexamic acid
Norethisterone day 15 or 19 - 26
Levornagesterel IUD
Danazol
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14
Q

How frequent should HIV +Ve women have cervical smears?

A

Yearly.

Despite CD4 count

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15
Q

What is the recommended frequency of cervical smears for women aged 25-49?

A

3 yearly

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16
Q

What is the recommended frequency of cervical smears for women aged 50-64?

A

5 yearly

17
Q

What is Ashermans syndrome?

A

Interuterine adhesions ranging from complete obliteration to minimal adhesions

18
Q

What is Sheehan syndrome

A

Intrapartum pituitary haemorrhage

19
Q

Does smoking affect the menopause?

A

Yes, makes it earlier

20
Q

Define postmenopausal bleeding

A

PV bleeding occurring at least 12 months after the cessation of menstruation

21
Q

Causes of postmenopausal bleeding include

A 
Vaginal atrophy
Endometrial carcinoma
Endometrial hyperplasia
Cervical cancer
Ovarian cancer
Liver cirrhosis
22
Q

A retroverted uterus may be associated with what symptoms

A

none
Backache
dyspareunia

23
Q

Characteristics of lichen sclerosis

A

Thickened skin and accentuated markings of the vulva

Itching and pain

24
Q

What is the malignant potential of lichen sclerosis in %

A

Potential of squamous cell carcinoma of the vulva in 2 - 5%

25
Q

Treatment of lichen sclerosis

A

Topical steroids
Bland emollient
Avoid irritants, heat and allergens

26
Q

What may koilocites on a cervical smear suggest

A

Human papilloma virus infection

27
Q

Possible presentation of antiphospholipid syndrome

A 
Recurrent miscarriage
Arterial or venous thrombosis
Livedo reticularis rash
Stroke
Adrenal haemorrhage
Migraine
Myelitis
Myocardial infarction
Multi-infarct dementia
28
Q

Antibodies found in antiphospholipid syndrome

A

Anti-cardiolipin antibodies

29
Q

What is premenstrual syndrome

A

Physical and/or psychological symptoms affecting some women up to 10 days prior to menstruation. Acne, breast tenderness, bloating, fatigue, nervousness, irritability, emotional disturbance, headache, mood changes.
Usually resolves with or after menstruation .

30
Q

When and how often is cervical smear screening offered

A

25-49 3 yearly

49-64 5 yearly

31
Q

What happens to CIN on colposcopy when acetic acid and iodine are applied

A

Aceto-white change

Failure of iodine staining

32
Q

Symptoms of cervical ectropion

A

Asymptomatic
Mucoid discharge
PCB

33
Q

Causes of dysparunia

A 
Vulvovaginitis (esp thichomoniasis and candida)
Vaginal cysts
Infected bartholins gland
Post menopause
Congenitally small ostium / thick hymen 
Deep retroverted uterus 
Chronic pelvic infection
Endometriosis
Adenomyosis
Pelvic tumours
Ectopic pregnancy

Gynae + GUM (7 decks)

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