Gynaecology Flashcards
Causes of delayed puberty with short stature
Turner’s syndrome
Prader - willi syndrome
Noonan’s syndrome
Causes of delayed puberty with normal stature
PCOS
Androgen sensitivity
Kallman’s syndrome
Klinefelter’s syndrome
What are polyps
Small, benign tumours of the uterine cavity with endometrial origin
0.2-1.5% become malignant
Symptoms of polyps
Can be asymptomatic
HMB and IMB
May prolapse through cervix
Management of polyps
80% managed with outpatient hysteroscopy
Surgical:
- hysteroscopic resection with diathermy
- hysteroscopy + morcellation if large
- avulsion
Investigations for polyps
Transvaginal US
Hysteroscopy
What are fibroids / leiomyomata
Benign tumours of the uterine cavity - myometrial origin
Risk factors for endometrial cancer
- Excess oestrogen
- nulliparity
- early menarche
- late menopause
- unopposed oestrogen - Metabolic syndrome
- obesity
- diabetes mellitus
- PCOS - Tamoxifen
- Hereditary non polyposis colorectal carcinoma
Protective factors for endometrial cancer
Multiparity
Combined OC pill
Smoking
Features of endometrial cancer
Post menopausal bleeding
Menorrhagia / IMB
Pain signifies extensive disease
Vaginal discharge
Investigations for endometrial cancer
All women >55 with post menopausal bleeding should be referred using suspected cancer pathway
- TV USS
- hysteroscopy with endometrial biopsy
Management of endometrial cancer
Surgery
- total hysterectomy with bilateral salpingo-oophorectomy
- high risk disease may have postoperative radiotherapy
Risk factors for ovarian cancer
Mutations of the BRCA1 / BRCA2 gene
Many ovulations : early menarche, late menopause, nulliparity
Classic presentation of androgen insensitivity syndrome
Well developed breasts
Scanty pubic hair
Blind ending vagina
