Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

What is a cystocele?

A

= bladder prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary vs secondary amenorrhoea?

A

Primary: no periods however, has never had a period before

Secondary: not having periods (but has had periods before)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kind of cells line the cervix?

A

= columnar epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of epithelial cells line the vagina?

A

= squamous epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is ectropion cervix?

A

= this occurs when columnar epithelial cells that are usually restricted to the cervix extend into the vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypothalamic-pituitary-gonadal axis: What does the hypothalamus release?

A

= gonadotrophin releasing hormone (GnRH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypothalamic-pituitary-gonadal axis: GnRH stimulates the anterior pituitary to produce what 2 hormones?

A
  • luteinising hormone (LH)
  • follicle-stimulating hormone (FSH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What to the theca granulosa cells around the follicles secrete?

A

= oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What effect does oestrogen have on the hypothalamus + anterior pituitary?

A

= negative feedback effect, suppress’ the release of GnRH, LH + FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is progesterone produced after ovulation?

A

= corpus luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

From 10 weeks gestation onwards where is progesterone produced from?

A

= placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When does puberty start for girls + boys?

A

Girls: 8-14
Boys: 9-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Do overweight children go through puberty earlier or later? and why?

A

= earlier

Aromatase is an enzyme found in adipose (fat) tissue, that is important in the creation of oestrogen. Therefore, the more adipose tissue present, the higher the quantity of the enzyme response for oestrogen creation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Tanner Staging system?

A

= objective classification system that providers use to document and track the development and sequence of secondary sex characteristics of children during puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 2 phases make up the menstrual cycle?

A

= follicular + luteal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are follicles made up of?

A

= oocyte, surrounded by granulosa cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

4 key stages of development in the ovaries

A
  • primordial follicles
  • primary follicles
  • secondary follicles
    antra follicles (AKA, Graafian follicles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

At which stage does a follicle develop FSH receptors + require stimulation to continue developing?

A

= secondary follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the bartholin’s glands?

A

= situated within the vestibule, just lateral to the introitus

Their primary function is to secrete a lubricating fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of bartholin cysts?

A

= incision + drainage (under local)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Majority of cervical cancers?

A

= squamous cell carcinoma (70-80%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which HPV virus’ increase your risk factor of developing cervical cancer? (2)

A
  • HPV 16
  • HPV 18
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

First-line investigation for cervical cancer?

A

= urgent colposcopy

(allows visualisation + biopsy of cervix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cervical cancer screening is for all women + people with a cervix between which ages?

A

= 25-64 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How often are women called for cervical screening? (2)

A

Between 25-49 - every 3 years
49-64 - every 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Gardasil is a vaccination used + protects against what?

A

= HPV (types 6,11,16,18,31,33,45,52 and 58)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Primary vs. secondary dysmenorrhoea

A

Primary = idiopathic, and occurs in the absence of pelvic pathology

Secondary = associated with underlying pathology such as endometriosis, pelvic inflammatory disease, or uterine fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What imaging can be used to investigate ectopic pregnancy?

A

= pelvic USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is an ectopic pregnancy?

A

= medical condition in which the fertilised egg, or embryo, implants and begins to grow outside of the uterine cavity, usually in the fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Investigations for an ectopic pregnancy (2)

A
  • pregnancy test
  • transvaginal USS (to locate pregnancy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Medical management for an ectopic pregnancy

A

= Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a salpingectomy?

A

= removal of one or both Fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Main risk factor for endometrial cancer?

A

= exposure to unopposed oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Scan used to help investigate endometrial cancer?

A

= transvaginal USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is a hysterectomy with bilateral salpingo-oophorectomy?

A

= the removal of one (unilateral) or both (bilateral) of your ovaries and fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is endometriosis?

A

= a gynaecological condition where endometrium-like tissue, which typically lines the uterus, proliferates outside the uterine cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Gold-standard diagnostic tool for endometriosis?

(however, NOT first-line)

A

= diagnostic laparoscopy

(carries a small risk of complications (e.g., bowel perforation))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Imaging which can be used to diagnose endometriosis

A

= transvaginal USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are fibroids?

A

= benign smooth muscle tumours originating from the myometrium of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are uterine leiomyomas also known as?

A

= fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Investigation for a genital prolapse?

A

= pelvic examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is a good option for a women who may not be suitable for surgery to provide symptomatic relief for their genital prolapse?

A

= pessary use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are vasomotor symptoms? (2)

A

Cardinal symptoms of menopause

  • hot flashes
  • night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Which route of HRT delivery is preferred if the women is at risk of VTE?

  • oral
  • vaginal (via pessary)
  • transdermal
A
  • transdermal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the chances (%), of a couple conceiving within 1 year if the women is younger than 40 years, they don’t use contraception, and have regular intercourse?

A

= 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Investigations for infertility (3)

A
  • hormonal studies
  • semen analysis
  • USS, hysterosalpingography or laparoscopy to evaluate uterus, Fallopian tubes + ovaries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is lichen sclerosus?

A

= inflammatory dermatological condition which predominantly affects the genital and anal regions of the body but can present elsewhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Are males or females more likely to suffer from lichen sclerosus?

A

= females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Management of lichen sclerosus (3)

A
  • topical corticosteroids
  • avoidance of soaps
  • emollients, to relieve dryness + soothe itching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is menopause?

A

= describes the permanent cessation of menstruation, characterised by at least 12 months of amenorrhoea in otherwise healthy women > 45, who are not using hormonal contraception

51
Q

What is perimenopause?

A

= this period begins when symptoms of menopause start and continues until 12 months after the last menstrual period

52
Q

What 2 types of HRT are available, and who are they for?

A
  • continuous, for postmenopausal women not having periods
  • cyclical, for perimenopausal women still having periods
53
Q

Benefits of HRT (2)

A
  • relieve vasomotor + urogenital symptoms
  • reduce risk of osteoporosis
54
Q

Risk involved in HRT (3)

A

Increased risk of

  • breast cancer
  • endometrial cancers
  • VTEs
55
Q

What is menorrhagia?

A

= excessive blood loss during a menstrual period to an extent that substantially affects a woman’s quality of life

56
Q

Investigations for menorrhagia (including imaging) (3)

A
  • FBC + iron studies
  • clotting screen
  • transvaginal USS
57
Q

Treatment options for menorrhagia (4)

A
  • Mirena coil
  • Mefenamic acid (NSAID)
  • Tranexamic acid
  • hormonal contraception (e.g., combined oral contraceptive pill)

In rare cases refractory to medical management: endometrial ablation, or hysterectomy may be considered

58
Q

What is a miscarriage?

A

= defined as the loss of pregnancy prior to 24 weeks gestation

59
Q

Clinical feaures of a miscarriage (3)

A
  • pain
  • vaginal bleeding
  • vaginal tissue loss
60
Q

In a threatened miscarriage is the cervical os open or closed?

A

= closed

61
Q

In an inevitable miscarriage is the cervical os open or closed?

A

= open

62
Q

In a complete miscarriage is the cervical os open or closed?

A

= usually closed

63
Q

In a missed miscarriage is the cervical os open or closed?

A

= closed

64
Q

Imaging used in suspected miscarriage?

A

= transvaginal USS

65
Q

Medical management for a miscarriage?

A

= Misoprostol

66
Q

Surigical management of a miscarriage?

A

= dilation + currettage

67
Q

What is ‘expectant management’ in regards to a miscarriage?

A

= allow products of conception to naturally expel

68
Q

What is a recurrent miscarriage?

A

= defined as loss of 3 or more consecutive pregnancies

69
Q

Which of the following types of ovarian cancer is usually cystic in nature?

  • epithelial ovarian tumour
  • germ cell tumours
  • sex cord stromal tumours
A
  • epithelial ovarian tumour
70
Q

Which of the following types of ovarian cancer accounts for approximately 90%?

  • epithelial ovarian tumour
  • germ cell tumours
  • sex cord stromal tumours
A
  • epithelial ovarian tumour
71
Q

Which of the following types of ovarian cancer most commonly arise in young women?

  • epithelial ovarian tumour
  • germ cell tumours
  • sex cord stromal tumours
A
  • germ cell tumours
72
Q

Which of the following types of ovarian cancer predominantely spread via the lymphatic route?

  • epithelial ovarian tumour
  • germ cell tumours
  • sex cord stromal tumours
A
  • germ cell tumours
73
Q

Which of the following types of ovarian cancer can be identified (tumour marker) by alpha-fetoprotein and sometimes beta human chorionic gonadotrophin (beta-hCG)?

  • epithelial ovarian tumour
  • germ cell tumours
  • sex cord stromal tumours
A
  • germ cell tumours
74
Q

What is a Krukenberg tumour?

A

= refers to a ‘signet ring’ sub-type of tumour, typically GI origin, which has metastasised to the ovary

75
Q

Signs and symptoms of ovarian cancer? (4)

A
  • Abdominal discomfort
  • Bloating
  • Early satiety (=feeling full after small amount of food)
  • Urinary frequency or change in bowel habits
76
Q

Investigations for ovarian cancer (2)

A
  • bloods, CA-125
  • pelvic + abomdinal USS
77
Q

What imaging is used to help stage ovarian cancer?

A

= CT scan

78
Q

What is an ovarian cyst?

A

= fluid-filled sac that develops within or on the surface of an ovary

79
Q

Investigations for an ovarian cyst (2)

A
  • pregnancy test, to eclude ectopic pregnancy
  • diagnostic laparoscopy - particularly when patient is unstable
80
Q

What is overactive bladder syndrome?

A

= chronic condition that results from hyperactivity of the detrusor muscle, a layer of the urinary bladder wall

81
Q

Symptoms associated with overactive bladder syndrome (4)

A
  • urinary urgency
  • urge incontinence
  • frequency
  • nocturia
82
Q

3 key investigations in suspected overactive bladder syndrome

A
  • urinalysis + culture (rule out infection)
  • frequency/ volume chart
  • urodynamics (evaluate bladder muscle function)
83
Q

Non-pharmacological management for overactive bladder syndrome (2)

A
  • behaviour modification (including reducing oral intake, avoiding caffeine and alcohol)
  • bladder retraining (aim to increase the interval between the voids)
84
Q

What is pelvic inflammatory disease (PID)?

A

= condition that arises when an infection spread from the vagina to the cervix, and subsequently to the upper genital tract

85
Q

How is pelvic inflammatory disease (PID) predominately spread?

A

= via sexual contact

86
Q

RUQ pain alongside PID suggests?

A

= Fitz-Hugh-Curtis Syndrome

87
Q

Management of pelvic inflammatory

A

= a combination of antibiotics

(ceftriaxone (IM) + doxycycline + metronidazole OR, ofloxacin + metronidazole)

+ analgesia

88
Q

Complications of PID (3)

A
  • chroinc pelvic pain (40%)
  • infertility (15%)
  • ectopic pregnancy (1%)
89
Q

What is Fitz-Hugh Curtis Sydrome?

A

= occurs when adhesions form between the anterior liver capsule and the anterior abdominal wall of the diaphragm in the context of PID

90
Q

Definitive diagnosis + treatment of Fitz-Hugh Curtis Sydrome

A

= laparoscopy + administration of antibiotics

91
Q

What is polycystic ovary syndrome (PCOS) disorder characterisded by? (3)

A
  • hyperandrogenism (manifesting as oligomennorhea, hirtuitism and acne)
  • ovulation disorders
  • polycystic orvarian morphology
92
Q

Biochemical findings in PCOS (3)

A

LH:FSH ratio - increase (>2)

Total testosterone - may be normal or slightly elevated

Fasting + oral glucose tolerance tests (OGTT) - used to diagnose insulin resistance

93
Q

Imaging used in suspected PCOS

A

transabdominal + transvaginal USS

94
Q

Rotterdam diagnostic criteriaa: PCOS can be diagnosed if..

A

At least 2 of the following criteria are met:

  • polycystic ovaries (>12 cysts seen on imaging, or volume >10 cubic cm)
  • oligo-/anovulation
  • clinical or biochemical features of hyperandrogenism
95
Q

PCOS: pharmacological treatment for women not planning pregnancy (3)

A
  • Co-cyprindrol
  • combined oral contaceptive pill (COCP)
  • Metformin
96
Q

What may cause post-coital bleeding (5)

A
  • cervical ectropion
  • endocervical and cervical polyps
  • cervical cancer
  • sexually transmitted infections
  • atrophic vaginitis
97
Q

What is postmenopausal bleeding defined as (2)

A

In women who are NOT receiving HRT = any vaginal bleeding that occurs more than 12 months after LMP

If a women is receiving HRT = any vaginal bleeding that occurs more than 6 months after menstruation has stopped

98
Q

What is pre-menstrual syndrome (PMS)?

A

= refers to a cluster of psychological, physical, and behavioural symptoms that occur in the luteal phase of the menstrual cycle and cause distress or disruption to the patient’s life

99
Q

Non-pharcological management for pre-menstrual syndrome (PMS) (5)

A
  • diet changes
  • increase exercise
  • vitamin supplementation (vit B)
  • stress reduction
  • CBT
100
Q

What is premature ovarian insufficiency (POI)?

A

= medical condition characterised by the onset of menopause in a women aged < 40. The term ‘premature’ is used to highlight the early onset of menopause compared to the normal age range

101
Q

Investigations for pre-mature ovarian insufficiency (POI)

A
  • raised FSH levels (indicative of menopause)

Levels should be repeated at least once more to ensure result was not anomalous

102
Q

Management for premature ovarian insufficiency (POI) (2)

A

Primary management: offer HRT until at least the age of normal menopause

Psychological support - due to potential mental health impacts of early menopause

103
Q

What is primary amenorrhoea?

A

= failure of menstrual periods to start by 15 years of age in a female with normal growth and secondary sexual characteristics

This condition may also be diagnosed at age 13 in the presence of absent pubertal maturation as well as absent menses

104
Q

Investigations for primary amenorrhoea

A
  • hormonal tests (assess FSH, LH, estradiol)
  • genetic tests
105
Q

What is secondary amenorrhoea?

A

= absence of menstruation for 6 months or longer in a woman who has previously had regular menstrual cycles

106
Q

Most commonly vulval cancer are?

A

= squamous cell carcinomas

107
Q

Risk factors of vulval cancer (3)

A
  • increasing age
  • exposure to HPV
  • condition that cause chronic inflammation to the vulva
108
Q

Primary management of vulval cancer

A

= surgery

(in advanced cases, radiotherapy with or without chemotherapy)

109
Q

Commonest gynaecological cancer?

A

= endometrial

110
Q

What is endometrial hyperplasia?

A

= pre-cancerous condition involving thickening of the endometrium

111
Q

How is endometrial hyperplasia treated?

A

= treated by specialist using Progesterone, with either:

  • intrauterine system (e.g., Mirena coil)
  • continuous oral progesterone (e.g., medroxyprogesterone or levonorgestrel)
112
Q

Most common type of endometrial cancer?

A

= adenocarcinoma

113
Q

NICE: 2 week-wait urgent cancer referral criteria for suspected endometrial cancer? (2)

A
  • postmenopausal bleeding (>12 months after the last menstrual period)

Referral for transvaginal USS in women >55 with:
- unexplained vaginal discharge
- visible haematuria + raised platelets, anaemia, or elevated glucose levels

114
Q

Investigations for suspected endometrial cancer (3)

A
  • transvaginal USS (for endometrial thickness)
  • pipelle biopsy (highly sensitive)
  • hysteroscopy (for biopsy)
115
Q

Non-malignant causes for a rasied CA125 (6)

A
  • endometriosis
  • fibroids
  • adenomyosis
  • pelvic infection
  • liver disease
  • pregnancy
116
Q

Physical examination findings which justify a 2-week-wait referral for suspected ovarian cancer (3)

A
  • ascites
  • pelvic mass (unless clearly due to fibroids)
  • abdominal mass
117
Q

Hereditary nonpolyposis colorectal cancer (HNPCC) increases your risk of developing? (2)

A
  • colorectal cancer
  • endometrial cancer
118
Q

What is a large loop excision of the transformation zone (LLETZ)?

A

= procedure where a heated loop of wire is used to remove the tissue of the cervix

119
Q

What is Erb’s palsy?

A

= a paralysis of the arm caused by the injury to the upper group of the main nerves supplying it, specifically the upper trunk C5-C6 of the brachial plexus (can occur during birth)

120
Q

Which STI is most the most likely causative agent?

23-year-old man presents with dysuria and penile discharge. Microbiology reveals Gram negative diplococci

  • chlamydia
  • gonorrhoea
  • syphilis
  • bacterial vaginosis
  • candida albicans
  • trichomoniasis
A
  • gonorrhoea
121
Q

Which STI is most the most likely causative agent?

30-year-old womena presents with vulval itch, dysuria and a creamy vaginal discharge

  • chlamydia
  • gonorrhoea
  • syphilis
  • bacterial vaginosis
  • candida albicans
  • trichomoniasis
A
  • candida albicans
122
Q

Which STI is most the most likely causative agent?

35-year-old man presents with a painless 1cm ulcer on his penis

  • chlamydia
  • gonorrhoea
  • syphilis
  • bacterial vaginosis
  • candida albicans
  • trichomoniasis
A
  • syphilis
123
Q
A

Year 4 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions