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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
Q

what condition can present with wernicke’s encephalopathy

A

hyperemesis gravidarum (diplopia and ataxia)

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26
Q

how can you assess emesis in pregnancy

A

PUQE

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27
Q

medical management of PMS

A

SSRI continuous or in luteal phase

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28
Q

define menorrhagia

A

heavy bleeding (SUBJECTIVE)

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29
Q

when would you ultrasound for menorrhagia

A

if abnormal exam, pain or abnormal bleeding

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30
Q

management of menorrhagia

A

1st: IUS (mirena)
2nd: Tranexamic acid

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31
Q

define dysmenorrhoea

A

pain during periods

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32
Q

management of primary and secondary dysmenorrhoea

A

Primary: NSAID e.g. mefenamic acid
Secondary: gynae referral

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33
Q

PC of fibroids

A

Menorrhagia and dysmenorrhea

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34
Q

Diagnosis of fibroids

A

usss

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35
Q

Management of fibroids

A

less than 3cm and no distortion: IUS, COCP, Tranexamic acid
GnRH agonists reduce size short term (triptorelin)

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36
Q

Management of fibroids causing fertility issues

A

myomectomy

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37
Q

What is carenous degeneration

A

fibroids increase in size due to oestrogen in pregnancy faster than the blood can supply them
presents with pain, pyrexia and nausea
supportive

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38
Q

criteria to diagnose PCOS

A

2 of:
1. oligomenorrhoea
2. hyperanddrogenism
3. cysts on USS

39
Q

role of metformin in PCOS

A

increases peripheral insulin sensitivity

40
Q

treatment of infertility in PCOS

A

clomifene

41
Q

how to reduce endometrial cancer risk in PCOS

A

induce a withdrawal bleed

42
Q

type of cysts in endometriosis

A

chocolate

43
Q

management of endometriosis

A

1st: NSAID/paracetamol
2nd: COCP/progestogen

44
Q

sudden and intense pain with hx endometriosis

A

ruptured endometrioma

45
Q

secondary amenorrhea with increased FSH/LH

A

Premature ovarian insufficiency

46
Q

management of premature ovarian insufficiency

A

HRT/COCP until 50

47
Q

primary amenorrhoea with increased FSH/LH

A

Turners

48
Q

diagnosis of adenomyosis

A

MRI

49
Q

whirlpool sign

A

ovarian torsion

50
Q

most common cause of postcoital bleeding and RF

A

cervical ectropion (increased with COCP)

51
Q

sudden onset unilateral pelvic pain after exercise/sex

A

ruptured ovarian cyst

52
Q

most common benign ovarian cyst in under 25

A

Teratoma (dermoid cyst)

53
Q

Rokitansky’s proterberance

A

Teratoma (dermoid cyst)

54
Q

cause of pseudomyxoma peritoni

A

mucinous cystadenoma rupture

55
Q

most common ovarian cancer

A

serous carcinoma (cystadenoma epilthelial cell tumour)

56
Q

Staging of ovarian cancer

A
  1. confined to ovary
  2. outside ovary within pelvis
  3. outside pelvis in abdomen
  4. mets
57
Q

3 markers to measure in ovarian cancer

A

CA125, alpha feroprotein, beta hCG

58
Q

prognosis of ovarian cancer is based off

A

US, menopausal status, CA125

59
Q

older lady with labial lump and inguinal lymphadenopathy

A

vulval cancer

60
Q

RF for endometrial cancer

A

increased unopposed oestrogen
obesity, nulliparity, early menarche, late menopause, DM, Tamoxifen, PCOS, HNPCC

61
Q

Which strains of HPV increase cervical cancer risk

A

16, 18 and 33

62
Q

Inadequate smear

A

repeat in 3m
2 inadequate refer for colposcopy

63
Q

HPV abnormal, cells normal

A

repeat in 12 m
- normal then discharge
- abnormal HPV then repeat again in 12m and still abnormal then colopscopy

64
Q

HPV positive

A

annual cystology

65
Q

HPV abnormal and cells abnormal

A

refer for colposcopy

66
Q

which treatment of cervical cancer maintains fertility

A

stage 1a cone biopsy

67
Q

smear postpartum

A

delay 3m unless previous abnormal smear

68
Q

what gene is BRCA1

A

tumour suppressor (increased breast and ovarian)

69
Q

Cottage cheese discharge

A

thrush

70
Q

treatment of thrush (non-pregnant and pregnant)

A

Not pregnant: single oral flucanazole (recurrent = more)
Pregnant: clotrimazole pessary

71
Q

Most common cause of PID

A

chlamydia

72
Q

thin purulent odourless discharge with dysuria, IM bleeding and dysparapeunia

A

gonorrhoea

73
Q

gram negative diplococci

A

gonorrhoea

74
Q

treatment of gonorrhoea

A

IM ceftriaxone

75
Q

offensive musty, frothy green PV discharge with a strawberry cervix

A

trichomonas vaginalis

76
Q

treatment of trichomonas vaginalis and bacterial vaginosis

A

oral metronidazole

77
Q

thin white discharge with clue cells, fishy smell and pH 4.5

A

Bacterial vaginosis (need 3 of 4)

78
Q

1st line investigation for incontinence

A

dipstick (DM)) and culture (UTI)

79
Q

management of urge incontinence

A
  1. bladder retraining
  2. oxybutynin (antimuscarinic for detrusor overactivity)
80
Q

who should you avoid prescribing oxybutynin to

A

elderly as increased falls

81
Q

management of stress incontinence

A

pelvic floor exercises
duloxetine

82
Q

treatment of vaginal vault prolapse

A

sacrocolpoplexy

83
Q

continuous dribbling incontinence after long labour in poor area

A

vesicovaginal fistulae

84
Q

investigation for vesicovaginal fistulae

A

urinary dye studies

85
Q

management of atrophic vaginitis

A

lubricants, moisturisers, topical oestrogen

86
Q

bladder palpable after urination would indicate what

A

retention and overflow

87
Q

treatment of vasomotor sx in menopause

A

SSRI e.g. fluoxetine

88
Q

does transdermal HRT increase VTE risk

A

no

89
Q

how long is mirena licensed for progesterone in HRT

A

4 years

90
Q

benefit and risk of adding progesterone to HRT

A

increases breast cancer
decreases endometrial cancer

91
Q

what causes ovarian hyperstimulation syndrome

A

fertility treatment

92
Q

define sheehan syndrome

A

hypopituitaism due to ischaemic necrosis from hypovolemic shock (blood loss)

93
Q

what is asherrman’s syndrome

A

intrauterine adhesions caused by D+C
reduces endometrium response to oestrogen

94
Q

2 conditions cervical excitation is found in

A

PID and ectopic

Medicine Year 5 (27 decks)

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