Gynaecological Problems

Question 1

What is the overall prevalence of malignancy in endometrial polyps?

Answer 1

3%

Question 2

What is the definition of puberty?

Answer 2

Becoming capable of sexual reproduction (not 2• sexual characteristics)

Question 3

What is the risk of progression of endometrial hyperplasia without atypical to cancer over 20 years?

Answer 3

<5%

Question 4

What is the definition of delayed puberty in girls?

Answer 4

Absence of breast development beyond 13 years (not amenorrhoea?!)

Question 5

What does the erosive form of lichen planus look like?

Answer 5

Well-demarcated, glazed erythema with violaceous border

Question 6

How does lichen simplex present?

Answer 6

Chronic vulval eczema
Generalised itchy skin irritation
Thickened, leathery, scaly skin

Question 7

How do we identify or rule out rectal endometriosis?

Answer 7

TVUS

Question 8

Which cancer does HRT reduce the risk of?

Answer 8

Colorectal

Question 9

Which cancers are more common in endometriosis?

Answer 9

Ovarian & non-Hodgkin’s lymphoma

Question 10

What is the risk of underlying endometrial cancer for PMB in different groups?

Answer 10

1. Overall: 10%
2. > 80: 25%
3. > 50: 1%
4. Obese: 18%
5. Diabetes: 21%
6. Obese & diabetes: 30%

Question 11

What are the first-line treatments for HMB, in order?

Answer 11

1. LNG-IUS
2. TXA or NSAIDs (latter if also pain)
3. Progesterone-only contraception

Question 12

How should a 50-70mm simple cyst be followed up in a premenopausal woman?

Answer 12

Yearly US follow-up

Question 13

What is the risk of a symptomatic ovarian mass being malignant in a premenopausal woman?

Answer 13

1:1000

Question 14

What is the rate of endometrial hyperplasia with atypia to cancer over 10-20 years?

Answer 14

30%