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Women's Health > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

What develops from mullerian ducts?

A

Upper vagina, cervix, uterus and fallopian tubes

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2
Q

What suppresses the growth of paramesonephric ducts in males?

A

Anti-mullerian hormone

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3
Q

What is a bicornuate uterus?

A

Two horns to the uterus giving it a heart shaped appearance

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4
Q

What are some complications of a bicornuate uterus?

A

Miscarriage, premature birth and malpresentation

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5
Q

What is an imperforate hymen?

A

Hymen at the vagina entrance is fully formed without an opening

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6
Q

What is vaginal hypoplasia?

A

Abnormally small vagina

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7
Q

What is thelarche?

A

Breast bud development

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8
Q

What is menarche?

A

First period - the last manifestation of puberty in females

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9
Q

What is adrenarche?

A

Development of pubic hair

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10
Q

What is menopause?

A

Permanent end to menstruation - none for 12 months

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11
Q

What is the average age of menopause?

A

51 years

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12
Q

What is perimenopause?

A

Time around the menopause with vasomotor symptoms and irregular periods around 45 years old

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13
Q

What is premature menopause?

A

Before age 40

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14
Q

What are some perimenopausal symptoms?

A

Hot flushes, low mood, irregular periods, joint pain, heavier periods, reduced libido, vaginal dryness

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15
Q

What is the 1st line management of menopause?

A

Lifestyle - regular exercise, weight loss, stop smokingW

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16
Q

What is 2nd line management for menopause?

A

HRT

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17
Q

What are the risks with systemic HRT?

A

Increased risk of breast cancer and VTE

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18
Q

What are some contraindications for HRT?

A

Liver disease
Pregnancy
History of breast cancer
History of idiopathic VTE

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19
Q

What is adenomyosis?

A

Endometrial tissue inside the myometrium

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20
Q

What is the presentation of adenomyosis?

A

Dysmenorrhoea, menorrhagia, dyspareunia, infertility

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21
Q

What is the 1st line diagnosis for adenomyosis?

A

Transvaginal USS of the pelvis

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22
Q

What is the gold standard diagnosis for adenomyosis?

A

Histological examination of the uterus after hysterectomy

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23
Q

What is the 1st line contraception in adenomyosis?

A

Mirena coil

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24
Q

What is Asherman’s syndrome?

A

Adhesions form within the uterus following uterus damage usually after pregnancy

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25
Q

What is the presentation of ashermans syndrome?

A

Secondary amenorrhoea
Lighter periods
Infertility
Dysmenorrhoea

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26
Q

What is the gold standard diagnosis for ashermans syndrome?

A

Hysteroscopy

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27
Q

What is lichen sclerosis?

A

Chronic inflammatory skin condition with shiny porcelain white patches often on labia, perianal skin and perineum

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28
Q

What is atrophic vaginitis?

A

Dryness and atrophy of vaginal mucosa due to lack of oestrogen in menopause

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29
Q

What is the presentation of atrophic vaginitis?

A

Dryness
Itching
Painful sex
Bleeding from infection
Recurrent UTI
Sparse pubic hair
Pale mucosa

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30
Q

What is the management of atrophic vaginitis?

A

Vaginal lubricants
Topical oestrogen

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31
Q

What is the most common type of vulval cancer?

A

Squamous cell carcinomas

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32
Q

What is the presentation of vulval cancer?

A

Vulval lump
Ulceration
Bleeding
Pain
Itching
Lymphadenopathy in the groin

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33
Q

Where does vulval cancer most frequently affect?

A

Labia majora

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34
Q

What are 80% of cervical cancers?

A

Squamous cell carcinomas

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35
Q

What is cervical cancer strongly associated with?

A

HPV

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36
Q

When is HPV vaccinated against?

A

12-13 years old

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37
Q

What is the most common cause of cervical cancer?

A

HPV infection

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38
Q

Which strains of HPV are responsible for cervical cancer?

A

16 and 18

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39
Q

When is cervical cancer screened for?

A

Every 3 years aged 25-49 and every 5 years aged 50-64 years

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40
Q

What do strains 6 and 11 of HPV cause?

A

Genital warts

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41
Q

What are 80% of endometrial cancers?

A

Adenocarcinomas

42
Q

Any woman presenting with postmenopausal bleeding has what until proven otherwise?

A

Endometrial cancer

43
Q

What are 2 key risk factors of endometrial cancer?

A

Obesity and diabetes

44
Q

Where can endometrial cancer metastasise to?

A

Pelvic and para-aortic lymph nodes

45
Q

What is endometrial hyperplasia?

A

A precancerous condition with thickening of the endometrium

46
Q

How is endometrial hyperplasia treated?

A

Progestogens - coil and oral

47
Q

Why is obesity a risk factor for endometrial cancer?

A

Adipose tissue is a source of oestrogen containing aromatase that converts testosterone into oestrogen

48
Q

Why is PCOS a risk factor for endometrial cancer?

A

Lack of ovulation so no corpus luteum producing progesterone

49
Q

Why is smoking protective for endometrial cancer?

A

It is anti-oestrogenic

50
Q

What is the presentation of endometrial cancer?

A

Postmenopausal bleeding
Postcoital bleeding
Haematuria
Anaemia
Raised platelet count

51
Q

What is the 1st line investigation for endometrial cancer?

A

Transvaginal USS with endometrial thickness over 5mm being abnormal

52
Q

What is the 1st line management for endometrial cancer?

A

Hysterectomy with BSO

53
Q

What are intrauterine polyps?

A

Small benign tumours that grow into the uterine cavity

54
Q

What is endometriosis?

A

Presence of ectopic endometrial tissue outside the uterus

55
Q

What is tissue in the ovaries in endometriosis called?

A

Chocolate cysts

56
Q

What is the main symptom of endometriosis?

A

Pelvic pain

57
Q

What is the presentation of endometriosis?

A

Cyclical abdominal pain
Painful sex
Painful periods
Infertility
Difficulty pooping
Tender vagina and cervix

58
Q

What may be visible on examination for endometriosis?

A

Endometrial tissue in the vagina on speculum exam particularly in posterior fornix

59
Q

What is the gold standard diagnosis for endometriosis?

A

Diagnostic laparoscopy

60
Q

What is the 1st line management for endometriosis?

A

NSAID

61
Q

What is the 2nd line management for endometriosis?

A

GnRH agonist or GnRH antagonist

62
Q

What is the final surgical option for endometriosis?

A

Hysterectomy

63
Q

What are fibroids?

A

Benign uterine tumours made of smooth muscle and connective tissue

64
Q

What are fibroids derived from?

A

Myometrial stem cells

65
Q

What do fibroids express?

A

Higher than normal numbers of oestrogen and progesterone receptors

66
Q

What do fibroids cause?

A

Heavy menstrual bleeding

67
Q

What is a pedunclated fibroid?

A

On a stalk

68
Q

What are some symptoms of fibroids?

A

Menorrhagia
Prolonged menstruation
Bloating or abdominal fullness
Reduced fertility
Palpable pelvic mass
Abdominal pain worse on menstruation

69
Q

What is red degeneration?

A

Ischaemia, infarction and necrosis of fibroids from disrupted blood supply

70
Q

What is the 1st line treatment for fibroids?

A

Tranexamic acid and contraception

71
Q

What is the 2nd line treatment for fibroids?

A

GnRH agonist

72
Q

What is a hydatidiform mole?

A

Type of tumour that grows like a pregnancy in the uterus

73
Q

What does hydatidiform mole show on pelvic USS?

A

Snowstorm appearance

74
Q

What is prolactin produced by?

A

The anterior pituitary, breast and prostate

75
Q

What are some causes of hyperprolactinaemia?

A

Prolactinoma
Hypothyroidism
PCOS
Dopamine antagonists

76
Q

What is some management for galactorrhoea?

A

Dopamine agonists such as Bromcriptine or cabergoline

77
Q

What is the commonest subtype of ovarian cancer?

A

Serous epithelial carcinoma

78
Q

What is the origin of 90% of ovarian cancers?

A

Epithelial

79
Q

What are some risk factors for ovarian cancer?

A

BRCA1/ BRCA2 mutations
Increasing age
Family history
Obesity
Smoking

80
Q

What are some symptoms of ovarian cancer?

A

Urinary frequency
Palpable abdominal mass
Ascites
Vague GI symptoms of bloating, altered bowel habits and nausea
Ovarian mass

81
Q

What is the 1st line investigation for ovarian cancer?

A

Abdominal and pelvic examination

82
Q

What is the tumour marker for ovarian cancer?

A

CA-125

83
Q

What can CA-125 be raised in?

A

Ovarian cancer
Endometriosis
Fibroids
Adenomyosis
Liver disease
Pregnancy
Pelvic infection

84
Q

What is the 1st line management for ovarian cancer?

A

Radical hysterectomy
Appendectomy
Lymph node dissection
Pelvic washout

85
Q

What is the most common ovarian cyst?

A

Follicular

86
Q

What is Meig’s Syndrome?

A

Triad of ovarian fibroma, pleural effusion and ascites

87
Q

What is ovarian torsion?

A

Ovary twists in relation to surrounding connective tissue, fallopian tube and blood supply

88
Q

What is the presentation of ovarian torsion?

A

Sudden onset severe unilateral pelvic pain
Nausea and vomiting
Localised tenderness
Pelvic palpable mass

89
Q

What is the gold standard diagnosis for ovarian torsion?

A

Laparaoscopic surgery

90
Q

What does ovarian torsion show on pelvic USS?

A

Whirlpool sign

91
Q

What is PID?

A

Inflammation and infection of pelvic organs caused by infection spreading through the cervix

92
Q

What is the most common cause of PID?

A

STI

93
Q

What is the presentation of PID?

A

Pelvic or lower abdominal pain
Abnormal vaginal discharge
Fever
Pelvic tenderness
Inflamed cervix
Painful sex

94
Q

What is the Rotterdam Criteria for PCOS?

A

Oligoovulation or anovulation
Hyperandrogenism - hirsutism and acne
Polycystic ovaries on USS

95
Q

What is the presentation of PCOS?

A

Oligomenorrhoea
Infertility
Acne
Hirsutism
Hair loss
Insulin resistance and diabete

96
Q

What is the gold standard diagnosis for PCOS?

A

Transvaginal USS

97
Q

What does the transvaginal USS show for PCOS?

A

12+ follicles on one ovary or ovarian volume of more than 10cm3

98
Q

What is medications for PCOS when fertility is desired?

A

Clomifene or Letrozole

99
Q

What is the 1st line medication for PCOS when fertility is not desired?

A

COCP

100
Q

What does clomifene do?

A

Stimulates ovulation

Women's Health (8 decks)

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