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Year 4 - ObGyn > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

Gynae
- Benign
- Oncology

A

Gynae

  • Benign
    1. Fibroids
    2. Pelvic pain
    3. Menstrual problems
  • Oncology
    1. Cervical screening
    2. Colposcopy
    3. Postmenopausal bleeding
    4. Cancers
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2
Q

Obstetrics
- Care indications

A

Obstetrics
- Care indications

  1. Pre-conceptual/Antenatal
  2. High risk pregnancy
  3. Labour and delivery
  4. Puerperium
  5. Emergencies
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3
Q

Gynae History
- Structure

A

Gynae History
- Structure

  1. Reason for attendance
  2. Menstrual history
    - First day of LMP
    - Number of days and flow
    - Cycle
    - Bleeding (inter/post coit)
    - Menarche age
    - Pain
  3. Contraception/HRT
  4. Previous gynae history
    - Smear and result
    - Problems and treatments/operations
    - (PID, STI, cysts, smear, myomectomy/hysterectomy/prolapse)
  5. Obstetric history
    - Gravidity and parity
    - Pregnancy outcomes/modes
    - Birth weights
  6. Medical and surgical
    - Blood transfusion/complication
    - Anaesthesia/complication
  7. Medications/allergies
  8. Social history
    - Support
    - Social services, domestic violence, MH
    - Smoking/drugs/alcohol
  9. Sexual
    - STI
    - Partners
  10. FH
    - Cancers
    - DM, HTN, CVD, VTE
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4
Q

Gynaecology
- Common complaints

A

Gynaecology
- Common complaints

  1. Periods
    - painful/heavy/irregular
  2. Pain
    - Pelvic/on intercourse
  3. Urinary incontinence
  4. Prolapse
  5. Infertility/Sterilisation
  6. Bleeding
    - Pregnancy/postmenopausal
  7. PID/discharge
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5
Q

Menstrual cycle
- HPA Hormones

A

Menstrual cycle
- Hormones

  1. GnRH
    - Hypothalamus
  2. LH/FST
    - Pituitary
  3. Oestrogen/progesterone
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6
Q

Menstrual cycle
- Start event

A

Menstrual cycle
- Start event

  1. First day of menses
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7
Q

Menstrual cycle
- Phases

A

Menstrual cycle
- Phases

  1. Follicular
    - proliferative
  2. Luteal
    - Secretory
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8
Q

Follicular phase
- Development of….

A

Follicular phase
- Development of….

  1. Dominant follicle
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9
Q

Luteal phase
- Development of…

A

Luteal phase
- Development of

  1. Corpus luteum
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10
Q

Menstrual hormone peaks

  1. FSH
  2. LH
  3. E2
  4. P
A

Menstrual hormone peaks

  1. FSH
    - First day of menses (day 0)
    - Ovulation (14)
  2. LH
    - Ovulation (14)
  3. E2
    - Before ovulation (before 14)
    - before menses
  4. P
    - Luteal phase
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11
Q

Normal cycles
- Length
- Regularity
- MBL

A

Normal cycles

  • Length
    1. 24-32
  • Regularity
    2. Best aged 20-40y
    3. Shorter pre-menopause, longer post-
  • MBL
  • 37-43ml
  • 9-14% >80ml (likely anaemic)
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12
Q

Menstrual blood loss
- Factors

A

Menstrual blood loss
- Factors

  1. Age - increases
  2. Genetics (twin-studies)
  3. Parity (+ve correlation)
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13
Q

Menstrual acronyms

  1. HMB
  2. Metro
  3. IMB
  4. PCB
  5. Oligo
  6. Amen
A

Menstrual acronyms

  1. HMB
    - menorrhagia
  2. Metrorrhagia
    - irregular
  3. IMB
    - Inter-menstrual
  4. PCB
    - Post-coital
  5. Oligomenorrhea
    - Infrequent
  6. Amenorrhoea
    - Absent
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14
Q

DUB

  • 60% is…
  • Definition
A

DUB

  1. Heavy menstrual bleeding
    - no recognisable pelvic pathology
    - no pregnancy/bleeding disorders
    - Exclusion
  2. 60% is Primary Menorrhagia
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15
Q

AUB/HMB

  • Pathologies
  • Medical/clotting
  • Other
A

AUB/HMB

  • Pathologies
    1. Fibroids
    2. Adenomyosis/endometriosis
    3. IUCD
    4. PID
    5. Polyps
  • Medical/clotting
    1. Hypothyroid
    2. Liver
    3. Von Willebrand’s
    4. Thrombocytopenia/ leukaemia
    5. Platelets/coags
  • Other
    1. Cancer
    2. Hyperplasia
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16
Q

AUB
- Clinical Assessment

A

AUB
- Clinical Assessment

Subjective
1. Only 50% have greater than normal loss
2. Only 60% with MBL<80ml consider them heavy

Best measure
1. QoL
- Work/social/clothing/bedding/sleep

  1. Anaemia
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17
Q

HMB
- Assessment

A

HMB
- Assessment

  • Low risk
    1. <45y, No IMB, No RFs for endometrial cancer
    2. History +Exam + FBC
    3. First line treatment
  • High risk
    1. >45y, IMB, Suspicious, RFs
    2. Hx + Ex + FBC + USS + Hysteroscopy & Biopsy
    3. First line treatment
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18
Q

HMB
Medical Mx

A

HMB Medical Mx

  • Symptomatic
    1. Tranexamic acid
    2. mefenamic acid
  • Fibroids
    1. GnRH analogues
    2. Esmya (ulipristal acetate)
  • Hormonal control
    1. POP
    2. LARC (long-acting reversible)
    eg. Mirena (prog)
    3. Implant
    4. Depo-Provera
  • Hormonal control-combined
    1. COCP
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19
Q

HMB
- Surgical Mx

A

HMB Surgical Mx

  • Polyps
    1. Hysteroscopic removal
    (MYOSURE)
  • Fibroids
    1. Myomectomy
    2. Uterine artery embolization
  • Family complete
    1. Endometrial ablation
    (NOVAURE)
    2. Hysterectomy
    (Lap or open)
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20
Q

HMB
- Emergency management

A

HMB
- Emergency management

  1. Tranexamic acid
  2. Norethisterone
    - 5mg po dts
    - up to 7 days or 3 weeks on, 1 week off
  3. GnRH analogues
    - Monthly injection
    - downregulate cycle (medical menopause)
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21
Q

Tranexamic acid
- effects

A

Tranexamic acid (anti-fibrinolytic)
- effects

  1. Plasminogen inhibition (tPA)
  2. Reduces MBL by 50%
  3. ADRs
    - Nausea, abdo cramp
    - Dizziness, tinnitus
    - Rash
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22
Q

Mefenamic acid
- Effects

A

Mefenamic acid
- Effects

  1. NSAID
    - Inhibit PG production
  2. Reduces MBL by 20-44%
  3. ADRs
    - GI
    - Dizziness/headaches
    - Liver
    - Asthma & Renal
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23
Q

Infrequent/absent periods
- Definitions

A

Infrequent/absent periods

Oligomenorrhea
1. Cycle is slow
- 35 days - 6 months

Amenorrhoea
1º No menarche by 16

2º Absent for 3/12 if regular
- Absent for 6/12 if oligomenorrheic

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24
Q

Oligomenorrhea
- Causes

A

Oligomenorrhea
- Causes

  1. Constitutional
  • Anovulation
    1. PCOS
    2. Thyroid
    3. Prolactinoma
    4. CAH
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25
Q

Amenorrhoea
- Causes

A

Amenorrhoea
- Causes

  • Physiological
    1. Pre-pubertal
    2. Pregnancy
    3. Menopause

Pathological
1. Cryptomenorrhea
- Hematocolpos
- Hematometra

  1. Uterine/endometrial cause
  2. Ovarian
  3. Pituitary/hypothalamic
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26
Q

Amenorrhoea
- Primary causes

A

Amenorrhoea
- Primary causes

  1. Delayed puberty
  2. Imperforate hymen
  3. Absent vagina
  4. Mullerian agenesis
  5. Turner
  6. PCOS (rare primary)
  7. CAH
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27
Q

Amenorrhoea causes
- Secondary

A

Secondary amenorrhoea

  1. Pregnancy
  2. PCOS
  3. Premature menopause
  4. Prolactinoma
  5. Thyroid disease
  6. Cushing’s
  7. EDs
  8. Syndromes
    - Asherman (scarring)
    - Sheehan (bleeding)
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28
Q

Amenorrhoea
- FSH investigation

A

Amenorrhoea
- FSH investigation

  1. Pituitary/hypothalamus
    - Low FSH
  2. Ovary
    - High FSH
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29
Q

Primary Amenorrhoea
- Primary Ix pathway

A

Primary Amenorrhoea
- Ix

  1. Pregnancy test
  2. TSH
  3. Prolactin
  4. LH/FSH
    a. Low FSH
    - constitutional delay, ED, exercise, stress, illness

b. High FSH
- Uterus? (Mullerian agenesis XX, androgen insensitivity XY)
- Karyotyping? (Turner Xo, Premature menopause XX)

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30
Q

Secondary Amenorrhoea
- Ix

A

Secondary Amenorrhoea
- Ix

  1. Pregnancy
  2. TSH
  3. Prolactin
  4. High FSH
    - Premature menopause
    - Turner mosai
  5. Normal FSH
    - PCOS
    - Uterine adhesions
  6. Low FSH
    - ED, exercise, stress, illness, sheehan
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31
Q

PCOS

  • Features
A

PCOS
- Features

  1. Hyperandrogenism
    - Acne
    - Hirsutism
    - Obesity
  2. Anovulation
    - Oligo/amenorrhoea
    - Multiple follicles on US (12+ in one or both ovaries)
    and/or
    - Increased ovarian volume (>10cm3)
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32
Q

Rotterdam criteria
- PCOS

A

Rotterdam criteria
- PCOS

Two or more of:

  1. Clinical/biochemical signs of hyperandrogenism
  2. Oligo/amenorrhoea
  3. US features
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33
Q

PCOS
- DDx

A

PCOS
- DDx

  1. Obesity
  2. Premature ovarian failure
  3. Thyroid
  4. Prolactinoma
  5. CAH/ Androgen tumour/ Cushing’s
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34
Q

PCOS
- Ix

A

PCOS
- Ix

  1. SHBG
    - Sex hormone binding globulin
  2. Total testosterone
  3. FAI
    - Free androgen index
  4. FSH/LH
  5. TFT
  6. Prolactin
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35
Q

PCOS
- General Mx

A

PCOS
- General Mx

  1. Weight loss
  2. Healthy lifestyle
  3. Glucose tolerance screening
  4. MH screening
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36
Q

PCOS
- Specific Mx

  1. Periods
  2. Conception
  3. Androgenism
A

PCOS
- Specific Mx

  • Periods
    1. COCP
    2. Cyclical progestogens
  • Conception
    1. BMI
    2. Folic acid
    3. Fertility + semenalysis
    4. Fertility referral
    5. Ovulation induction
  • Androgenism
    1. COCP
    2. Acne standards
    3. Hair removal
37
Q

Gynae cancer
- Locations

A

Gynae cancer
- Locations

  1. Cervix
  2. Uterus
  3. Ovary
  4. Vagina and vulval
38
Q

Cervical cancer
1. Deaths/Annual incidence
2. Preventability

A

Cervical cancer

  1. Deaths/annual incidence
    850/3,100
  2. Preventability
    99.8%
39
Q

Uterine cancer
1. Deaths/Annual incidence
2. Preventability

A

Uterine cancer
1. Deaths/Annual incidence
- 2,400/9,000

  1. Preventability
    - 34%
40
Q

Ovarian cancer
1. Deaths/Annual incidence
2. Preventability

A

Ovarian cancer

  1. Deaths/Annual incidence
    - 4,200/7,300
  2. Preventability
    - 11%
41
Q

Vagina
1. Deaths/Annual incidence
2. Preventability

A

Vagina

  1. Deaths/Annual incidence
    - 100/230
  2. Preventability
    - 75%
42
Q

Uterine cancer
- Peak age

A

Uterine cancer
- Peak age

75-79yo

43
Q

Endometrial ca
- Peak age

A

Endometrial ca
- Peak age

64-74

44
Q

Endometrial ca

  • Increased risk
  • Lowered risk
A

Endometrial ca

  • Increased risk
    Unopposed oestrogen
    1. Obesity
    2. Early menarche/late menopause
    3. Nulliparity
    4. PCOS
    5. Tamoxifen
    6. Endometrial polyps
    7. BRCA
    8. DM, PD
  • Reduced risk
    1. Continuous combined HRT
    2. COCP
    3. Physical activity
  1. Smoking
  2. Tea&coffee
  • Lowered risk
45
Q

Endometrial cancer
- Presentation

A

Endometrial cancer
- Presentation

  1. Present Early
  • Pre-menopausal (1% risk)
    1. Prolonged, frequent bleeding
    2. IMB
  • Post menopausal
    1. PMB (10% risk)
    2. Discharge
  • Blood-stained, water, purulent
46
Q

Endometrial pathologies

  • Pre-malignant
  • Malignant
A

Endometrial pathologies

  • Pre-malignant
    1. Endometrial hyperplasia
  • Malignant
    1. Type I (80%)
  • Adenocarcinoma
  1. Type II (20%)
    - Papillary Serous
    - Clear Cell
    - Carcinosarcoma
  2. Sarcoma (rare)
47
Q

Endometrial hyperplasia
- Subtypes
- Mx

A

Endometrial hyperplasia

  • Subtypes
    1. Complex or without atypia
    2. Atypical (25-50% coexistent malignancy)
  • Mx
    1. Progestagens
    2. Surgery
48
Q

FIGO
- Staging
- 5 year survival

A

FIGO Staging

  1. Limited to myometrium
    - 80%
  2. Cervical spread
    - 60%
  3. Uterine serosa
    - 40%
  4. Bladder/bowel/distant
    - 20%
49
Q

Endometrial cancers
- Dx

A

Endometrial cancers
- Dx

  1. Endometrial sampling
    - Pipelle or D&C
  2. Hysteroscopy
    - Gold standard
  3. Transvaginal US
    - PMB
    - >5mm endometrial thickness cutoff
50
Q

Endometrial cancer
- Treatment

A

Endometrial cancer
- Treatment

  1. Surgical (80%)
    - Hysterectomy + salpingo-oopherectomy
    - Laparo/open
  2. Non-surgical
    - Progestagens
    - Primary radiotherapy
  3. Adjuvant radiotherapy (high risk)
    - External beam
    - Brachytherapy
  4. Palliation
    - Chemo, radio
    - Hormonal, palliative
51
Q

One-stop PMB clinic
- Ix

A

One-stop PMB clinic
- Ix

  1. Hx&Ex
  2. FBC
  3. TUS
  4. Hysteroscopy and Endo biopsy
52
Q

Ovarian cancer
- Peak age

A

Ovarian cancer

  • Peak age
    70-74yo
53
Q

Ovarian cancer
- Cell lines

A

Ovarian cancer

  • Cell lines
  1. Surface epithelium (85-90%)
    - Serous (50%) (B or M)
    - Mucinous (10%) (B or M)
    - Endometriod (10%)
    - Clear cell (5%)
    - Brenner tumours
  2. Germ cells
    - Teratoma (B)
    - Dysgerminoma (HCG)
    - Yolk sac (AFP)
    - Choriocarcinoma
  3. Stroma/sex cord
    - Granulosa cell
    - Theca cell (B)
    - Sertoli-Leydic Cell
    - Fibroma
  4. Misc/meta
    - Lymphoma
    - Metastasis
    - Krukenberg (Mucinous signet ring)
54
Q

Ovarian cancer
- Risk factors

A

Ovarian cancer
- Risk factors

  1. Unopposed oestrogen
  2. Nulliparity
  3. Many menses
  4. Family Hx
  5. BRCA
  6. Endometriosis
55
Q

Ovarian cancer
- Genetic risk

  1. BRCA 1
  2. BRCA 2
  3. Two relatives
  4. One relative
  5. HNPCC
A

Ovarian cancer
- Genetic risk

  1. BRCA 1 (50%)
  2. BRCA 2 (27%)
  3. Two relatives (23%)
  4. One relative (10%)
  5. HNPCC (12%)
56
Q

Ovarian cancer
- Presentation

A

Ovarian cancer
- Presentation

  1. Abdo swelling (50%)
  2. Pain (50%)
  3. Anorexia (20%)
  4. N&V (20%)
  5. Weight loss (15%)
  6. Vaginal bleeding (15%)
57
Q

Ovarian cancer
- Workup

A

Ovarian cancer
- Workup

  1. Pelvic Ex
  2. US
  3. FBC, UE, LFT
  4. CA125
  5. CT
  6. Ascitic tap cytology
  7. Surgical exploration
  8. Histopathology
58
Q

Ovarian cancer
- Staging and survival

A

Ovarian cancer
- Staging and survival

  1. Ovary (90%)
  2. Pelvic organs (60%)
  3. Peritoneal cavity (30%)
  4. Distant metastasis (5%)
59
Q

Ovarian cancer
- Treatment

A

Ovarian cancer
- Treatment

  1. Surgery + chemo
    - TAH + BSO and debulking
    - Platinum and Taxane
    - Consider oophorectomy only
  2. Non-epithelial tumours
    - Conservative surgery
    - Chemo
  3. Recurrent disease
    - Palliative chemo
60
Q

Ovarian cancer
- Presentation

A

Ovarian cancer
- Presentation

  1. Older patient, high BMI
  2. Abdominal distension, anorexia, change in bowel habit
  3. Nulliparous
    - unsuccessful infertility treatment
  4. Family history of ovarian and endometrial
61
Q

Ovarian cancer
- Dx

A

Ovarian cancer
- Dx

  1. Hx & Ex
  2. Ca125
  3. US abdo/pelvis
62
Q

Cervical cancer
- Age distribution
- Histology

A

Cervical cancer

  • Age distribution
    1. Bimodal
    2. 30s and 80s
  • Histology
    1. 66% squamous
    2. 15% adenocarcinoma
63
Q

Cervical cancer
- RFs

A

Cervical cancer
- RFs

  1. Young age first intercourse
  2. Multiple sex partners
  3. No barrier
  4. Smoking
  5. COCP long-term
  6. Immunosuppression/HIV
  7. Not screened or vacinated
64
Q

HPV

  1. Oncogenic types
  2. Low risk types
A

HPV

  1. Oncogenic types
    - 16, 18
    - 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68
  2. Low risk types
    - 6, 11
    - 42, 43, 44
65
Q

HPV
- Pathology
- Infection course
- Prevalence age 50

A

HPV

  • Pathology
    1. Proteins E6 & E7
    2. Suppression of p53 tumour suppressor gene
    3. Keratinocytes
  • Infection course
    1. 8 months on average
    2. Late teens and early twenties common
  • Prevalence age 50
    1. Down to 5%
66
Q

Cervical cancer natural history
- HPV
- CIN

A

Cervical cancer natural history
- HPV
1. Asymptomatic
2. Cleared or persists

  • CIN
    1. Asymptomatic
    2. Regress, persists, or progress
  • 60% CIN1 spontaneous regression
  • 30% of CIN3 invasion over 5-10 years
67
Q

CIN
- Condition
- Location
- Symptoms

A

CIN

  • Condition
    1. Pre-malignant
  • Location
    2. TZ junction (transitional zone)
  • Symptoms
    0. Asymptomatic
  1. PCB/PMB
  2. IMB/blood stained discharge
  3. Advanced - Fistulae, renal failure, radiculopathy, lower limb oedema
68
Q

CIN

  • Classification
A

CIN
- Classification

  1. CIN1
    - <33% of BM involvement
  2. CIN2
    - <66% of BM involvement
  3. CIN3
    - >66% of BM involvement
69
Q

Cervical ca
- Staging

A

Cervical ca
- Staging

  1. Confined to cervix
    A Microinvasive (<5mm d x 7mm w)
    B Clinical lesion
  2. Beyond cervix
    A Upper 1/3 vagina
    b Parametrium
  3. Pelvic spread
    A Lower 1/3 of vagina
    B Pelvic side wall
  4. Distant spread
    A Adjacent organs
    B Distant sites
70
Q

Cervical cancer Mx

  • Micro invasive
  • Clinical lesions (1b-2a)
  • Clinical lesions beyond stage 2a
  • Lymph nodal involvement
  • Recurrent disease
A

Cervical cancer mx

  • Micro invasive
    1. Conservative
  • Cone biopsy
    3. Hysterectomy
  • Clinical lesions (1b-2a)
    1. Wertheim’s (radical) hysterectomy
    2. Or Chemo-radio
  • Clinical lesions beyond stage 2a
    1. Chemo-radio
  • Lymph nodal involvement
    1. Post-op radiotherapy
  • Recurrent disease
    1. Radio
    2. Chemo
    3. Exenteration
    4. Palliation
71
Q

Cervical cancer
- Treatment complications

  1. Surgery
  2. Radiotherapy
A

Cervical cancer
- Treatment complications

  1. Surgery
    - Infection/VTE/Haemorrhage
    - Vesicovaginal fistula
    - Bladder dysfunction
    - Lymphocyst formation
    - Short vagina
  2. Radiotherapy
    - Vaginal dryness/stenosis
    - Cystitis/proctitis
    - Loss of ovarian function
72
Q

Cervical cancer
- Staging
- 5 year survival

A

Cervical cancer

IA - 86-99%
IB - 80-90%

II - 65-69%
III - 40-43%

IV - 15-20%

73
Q

Cervical screening
- Invitation frequency

A

Cervical screening
- Invitation frequency

25-50
- 3 yearly

50-65
- 5 yearly

65+
- Selected patients

74
Q

Cervical cytology
- Classifications

A

Cervical cytology
- Classifications

  1. Inadequate
  2. Normal
  3. Borderline
  4. Mild dyskaryosis
  5. Moderate dyskaryosis
  6. Severe dyskaryosis
  7. Possible invasion
75
Q

Colposcopy
- Equipment
- Indication

A

Colposcopy

  • Equipment
    1. Low-power binocular microscopy
  • Indication
    2. Look for features suggestive of CIN or invasion
  • Abnormal vascular pattern
    eg. mosaicism or punctuation
  • Abnormal staining
    eg. aceto-white, brown iodine
76
Q

Cervical CIN
- Treatment

A

Cervical CIN
- Treatment

  1. See-and-treat
  2. Excisional
    - LLETZ
    - Large loop excision of transformation zone
    - Cold knife cone
  3. Destructive
    - Cryocautery
    - Diathermy
    - Laser vaporisation
  4. Follow-up colposcopy
77
Q

CIN
- Diagnosis stages

A

CIN
- Diagnosis stages

  1. Smear
    - Cytology
    - Dyskaryosis
  2. Colposcopy
    - Opinion on visual assessment
  3. Biopsy
    - Histological diagnosis
    - CIN 1/2/3
78
Q

HSV vaccination
- Regimen

A

HSV vaccination
- Regimen

  1. Gardasil 6, 11, 16, 18
    (Cervarix 16,18)
  2. 3 injections
    - over 6 months
    - Prior to SI
    - 5 years protection
    .
79
Q

VIN
- Condition
- Symptoms
- Treatment

A

VIN

  • Condition
    1. Vulvar intraepithelial neoplasia
    2. Premalignant
  • can resolve or progress
  • Symptoms
    0. None
    1. Itching/burning/pain
  • Treatment
    1. Antihistamine
    2. Imiquimod
    3. Surgical excision
80
Q

VIN
- RFs

A

VIN
- RFs

  1. HPV
  2. HSV 2
  3. Immunosuppression
  4. Chronic irritation
  5. Lichen sclerosus
81
Q

Vulval cancer

  • Epidemiology
  • Types
  • Treatment
A

Vulval cancer

  • Epidemiology
    1. Very rare
    2. Elderly patients
  • Types
    1. Usually SCC
  • 50% HPV
  • 50% chronic skin disease
  • Treatment
    0. 75% 5 year survival
    1. Surgery
    2. Chemo-radio
82
Q

Menarche
-Precocious
- Late

A

Menarche

-Precocious
1. Age 8

  • Late
    2. 14 with no 2°
    3. 16 with 2°
83
Q

Ovarian cancers
- Type by age

A

Ovarian cancers
- Type by age

  1. Young
    - Germ cell
  2. Middle
    - Stromal
  3. Older
    - Epithelial
84
Q

BRCA1 & BRCA 2
- Lifetime ovarian risk

A

BRCA1 & BRCA 2
- Lifetime ovarian risk

  1. BRCA 1
    - 50% risk
  2. BRCA 2
    - 27% risk
85
Q

CA125
- Tumor marker

A

CA125
- Tumor marker

  1. Epithelial tumors
86
Q

Germ Cell Tumor
- markers

A

Germ Cell Tumor
- markers

  1. BetaHCG
  2. AFP
  3. LDH
87
Q

Cervical
- Virology
- Cytology
- Histology

A

Cervical

  • Virology
    1. +Ve or -ve
  • Cytology
    1. Low grade dyskariosis
    2. High grade dyskariosis
  • Moderate or severe
  • Histology
    CIN 1 (will regress)
    CIN 2 or 3 - treat before progression
88
Q

Gynae cancer mainstays
- Uterus
- ovary
- cervix

A

Gynae cancer mainstays

  • Uterus
    1. Surgery
  • ovary
    1. Surgery and chemo (radio)
  • cervix
    1. Early surgery
    2. Later chemo(radio)

Year 4 - ObGyn (9 decks)

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