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Medicine Year 5 > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

expectant management of miscarriage

A

less than 6w, bleeding and no pain with no haemorrhage of infection

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2
Q

management of incomplete miscarriage

A

vaginal misoprostal

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3
Q

diagnosis of miscarriage

A

transvaginal ultrasound showing no cardiac activity

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4
Q

os closed no cardiac activity

A

missed miscarriage

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5
Q

no retained products of conception

A

complete miscarriage

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6
Q

open os and heavy bleeding

A

inevitable miscarriage

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7
Q

vaginal bleeding but viable pregnancy with cardiac activity

A

threatened miscarriage

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8
Q

risk factor for 2nd trimester miscarriage

A

large cervical cone biopsy

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9
Q

medical management of TOP

A

mifepristone and prostaglandin

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10
Q

how long after TOP can the pregnancy test remain positive for

A

4 weeks

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11
Q

most common site of ectopic pregnancy

A

ampulla

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12
Q

most dangerous site of ectopic pregnancy

A

isthmus

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13
Q

endometriosis, PID and current IUS are risk factors for what

A

ectopic

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14
Q

increasing age, smoking, drugs, alcohol, caffiene, obesity, infection, unusual uterus, cervical incompetence, DM, HTN, thyroid, ibuprofen, methotrexate and retinoids are risk factors for what

A

miscarriage

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15
Q

5 indications for expectant management of ectopic

A

unruptured embryo less than 35mm with no cardiac activity, asymptomatic mum and declining hcg below 1000

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16
Q

medical management of ectopic

A

methotrexate

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17
Q

surgical management of ectopic

A

all cases larger than 35mm with hcg above 5000

salpingectomy 1st line
salpingotomy if infertility RF

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18
Q

risk of ondansetron in pregnancy

A

cleft lip/cleft palate

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19
Q

when do you refer for infertility

A

after 12m unless PMHx surgery/STI/mum over 35 or other abnormalities

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20
Q

3 criteria for hyperemesis gravidarum

A

5% pre-pregnancy weight loss
dehydration
electrolyte imbalance

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21
Q

snowstorm apperance and increased hcg

A

molar pregnancy

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22
Q

management of hyperemesis

A

cyclizine/promethazine

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23
Q

can you use metoclopramide in pregnancy

A

if necessary but max 5 days

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24
Q

management of an abnormal semen sample

A

repeat in 3m

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25
what condition can present with wernicke's encephalopathy
hyperemesis gravidarum (diplopia and ataxia)
26
how can you assess emesis in pregnancy
PUQE
27
medical management of PMS
SSRI continuous or in luteal phase
28
define menorrhagia
heavy bleeding (SUBJECTIVE)
29
when would you ultrasound for menorrhagia
if abnormal exam, pain or abnormal bleeding
30
management of menorrhagia
1st: IUS (mirena) 2nd: Tranexamic acid
31
define dysmenorrhoea
pain during periods
32
management of primary and secondary dysmenorrhoea
Primary: NSAID e.g. mefenamic acid Secondary: gynae referral
33
PC of fibroids
Menorrhagia and dysmenorrhea
34
Diagnosis of fibroids
usss
35
Management of fibroids
less than 3cm and no distortion: IUS, COCP, Tranexamic acid GnRH agonists reduce size short term (triptorelin)
36
Management of fibroids causing fertility issues
myomectomy
37
What is carenous degeneration
fibroids increase in size due to oestrogen in pregnancy faster than the blood can supply them presents with pain, pyrexia and nausea supportive
38
criteria to diagnose PCOS
2 of: 1. oligomenorrhoea 2. hyperanddrogenism 3. cysts on USS
39
role of metformin in PCOS
increases peripheral insulin sensitivity
40
treatment of infertility in PCOS
clomifene
41
how to reduce endometrial cancer risk in PCOS
induce a withdrawal bleed
42
type of cysts in endometriosis
chocolate
43
management of endometriosis
1st: NSAID/paracetamol 2nd: COCP/progestogen
44
sudden and intense pain with hx endometriosis
ruptured endometrioma
45
secondary amenorrhea with increased FSH/LH
Premature ovarian insufficiency
46
management of premature ovarian insufficiency
HRT/COCP until 50
47
primary amenorrhoea with increased FSH/LH
Turners
48
diagnosis of adenomyosis
MRI
49
whirlpool sign
ovarian torsion
50
most common cause of postcoital bleeding and RF
cervical ectropion (increased with COCP)
51
sudden onset unilateral pelvic pain after exercise/sex
ruptured ovarian cyst
52
most common benign ovarian cyst in under 25
Teratoma (dermoid cyst)
53
Rokitansky's proterberance
Teratoma (dermoid cyst)
54
cause of pseudomyxoma peritoni
mucinous cystadenoma rupture
55
most common ovarian cancer
serous carcinoma (cystadenoma epilthelial cell tumour)
56
Staging of ovarian cancer
1. confined to ovary 2. outside ovary within pelvis 3. outside pelvis in abdomen 4. mets
57
3 markers to measure in ovarian cancer
CA125, alpha feroprotein, beta hCG
58
prognosis of ovarian cancer is based off
US, menopausal status, CA125
59
older lady with labial lump and inguinal lymphadenopathy
vulval cancer
60
RF for endometrial cancer
increased unopposed oestrogen obesity, nulliparity, early menarche, late menopause, DM, Tamoxifen, PCOS, HNPCC
61
Which strains of HPV increase cervical cancer risk
16, 18 and 33
62
Inadequate smear
repeat in 3m 2 inadequate refer for colposcopy
63
HPV abnormal, cells normal
repeat in 12 m - normal then discharge - abnormal HPV then repeat again in 12m and still abnormal then colopscopy
64
HPV positive
annual cystology
65
HPV abnormal and cells abnormal
refer for colposcopy
66
which treatment of cervical cancer maintains fertility
stage 1a cone biopsy
67
smear postpartum
delay 3m unless previous abnormal smear
68
what gene is BRCA1
tumour suppressor (increased breast and ovarian)
69
Cottage cheese discharge
thrush
70
treatment of thrush (non-pregnant and pregnant)
Not pregnant: single oral flucanazole (recurrent = more) Pregnant: clotrimazole pessary
71
Most common cause of PID
chlamydia
72
thin purulent odourless discharge with dysuria, IM bleeding and dysparapeunia
gonorrhoea
73
gram negative diplococci
gonorrhoea
74
treatment of gonorrhoea
IM ceftriaxone
75
offensive musty, frothy green PV discharge with a strawberry cervix
trichomonas vaginalis
76
treatment of trichomonas vaginalis and bacterial vaginosis
oral metronidazole
77
thin white discharge with clue cells, fishy smell and pH 4.5
Bacterial vaginosis (need 3 of 4)
78
1st line investigation for incontinence
dipstick (DM)) and culture (UTI)
79
management of urge incontinence
1. bladder retraining 2. oxybutynin (antimuscarinic for detrusor overactivity)
80
who should you avoid prescribing oxybutynin to
elderly as increased falls
81
management of stress incontinence
pelvic floor exercises duloxetine
82
treatment of vaginal vault prolapse
sacrocolpoplexy
83
continuous dribbling incontinence after long labour in poor area
vesicovaginal fistulae
84
investigation for vesicovaginal fistulae
urinary dye studies
85
management of atrophic vaginitis
lubricants, moisturisers, topical oestrogen
86
bladder palpable after urination would indicate what
retention and overflow
87
treatment of vasomotor sx in menopause
SSRI e.g. fluoxetine
88
does transdermal HRT increase VTE risk
no
89
how long is mirena licensed for progesterone in HRT
4 years
90
benefit and risk of adding progesterone to HRT
increases breast cancer decreases endometrial cancer
91
what causes ovarian hyperstimulation syndrome
fertility treatment
92
define sheehan syndrome
hypopituitaism due to ischaemic necrosis from hypovolemic shock (blood loss)
93
what is asherrman's syndrome
intrauterine adhesions caused by D+C reduces endometrium response to oestrogen
94
2 conditions cervical excitation is found in
PID and ectopic

Medicine Year 5 (27 decks)

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