Gynaecology Flashcards
What are the top 3 gynecological causes of acute abdominal pain?
- PID
- Ovarian Torsion
- Follicular cysts/Mittelschmerz
PID is associated with fever and nausea/vomiting; Ovarian torsion is characterized by acute intermittent pelvic pain; Follicular cysts cause mid-cycle pain often relieved by NSAIDs.
What are the associated symptoms of PID?
- Fever
- Nausea/Vomiting
PID is often linked with a history of multiple sex partners and sexually transmitted infections.
What is the treatment for PID?
- Azithromycin + Ceftriaxone
- PO Levofloxacin + Metronidazole for 2 weeks
- Admit for IV antibiotics if unstable or suspected tubo-ovarian abscess
Treatment aims to cover for gonorrhea and chlamydia.
What is the hallmark sign of ovarian torsion?
Acute intermittent pelvic pain with nausea/vomiting
Patients may be scared to move due to the severity of the pain.
What is the diagnostic method for ovarian torsion?
Ultrasound and Doppler of ovarian blood supply
This helps assess blood flow to the affected ovary.
What are the top 2 non-gynecological causes of acute abdominal pain?
- Renal Stones
- Constipation
Renal stones may present with hematuria; constipation may cause abdominal tenderness and requires hydration and fiber.
What is a common presentation of interstitial cystitis?
Pelvic pain nearly daily with recurrent urinary tract infections
This condition often leads to a tender anterior vaginal wall.
What are the top 3 gynecological causes of chronic pelvic pain?
- Teratoma/Dermoid cyst
- Endometriosis/Endometrioma
- Leiomyoma/Fibroids
These conditions can lead to significant symptoms and complications.
What is a teratoma?
A tumor made of all 3 germ layers
It can lead to struma ovarii tumor and has a risk of malignant transformation.
What is the treatment for endometriosis?
- Surgery if >3 cm
- Medical management with progestins or GnRh agonist
Progestins can cause endometrial tissue atrophy.
What is the most common type of cervical cancer?
Squamous cell carcinoma (SCC)
SCC accounts for 90% of cervical cancer cases.
What screening recommendations exist for cervical cancer?
- Ages 25-44: every 3 years
- Ages 45-60: every 5 years after 2 consecutive normal results
- High-risk: annually from age 20
High-risk groups include HIV-positive individuals and those exposed to diethylstilbestrol (DES).
What is the Bethesda classification for cervical cytology?
- LSIL (Low grade squamous intra-epithelial lesion)
- HSIL (High grade squamous intra-epithelial lesion)
- Atypical squamous cells (ASC)
LSIL includes HPV-associated changes; HSIL indicates moderate/severe dyskaryosis.
What is the main risk factor for endometrial cancer?
Excessive unopposed estrogen stimulation
This significantly increases the risk of developing endometrial cancer.
What are the common symptoms of endometrial cancer?
- Postmenopausal bleeding (PMB)
- Abnormal vaginal discharge
- Intermenstrual bleeding (IMB)
These symptoms often lead to further evaluation and diagnosis.