Gynaecology Flashcards
Name 2 common causes of severe right lower abdominal pain other than ectopic pregnancy
Appendicitis
Ovarian torsion
Gallstones
Name 2 symptoms or signs that may make ectopic pregnancy more likely
Vaginal bleeding
Severe, constant pain
Ectopic pregnancy bedside investigation
hCG
Haemodynamically stable ectopic pregnancy
Investigation?
Ultrasound
Name 2 factors predisposing to ectopic pregnancy
PID
Surgery
Name 2 sites where a fertilised ovum may implant
Ampulla
Ithmus
Surgical management of ectopic pregnancy
A ectomy
Medical management of ectopic pregnancy
(if it was small with minimal symptoms)
Misoprostol
Name 3 risk factors for developing hyperemesis gravidarum
Obesity
Previous
Twins
Most important bedside investigation to perform in HG
urinary ketones
Name 2 blood tests you would perform
FBC
LFTs
hCG
Vitamins to prescribe in HG and rationale
vitamin D?
2 treatments for HG
Anti-emetics
fluids
ultrasound snowstorm appearance - likely diagnosis?
ovarian torsion
Define the following terms:
1. Missed miscarriage
2. Incomplete miscarriage
3. Inevitable miscarriage
- no bleeding + RPOC
- cervix dilated + RPOC
- Bleeding but cervix not dilated
2 blood tests to perform for miscarriage
hCG
FBC
3 management options for incomplete miscarriage
surgical evacuation
medical evacuation (misoprostol)
conservative
Investigation of RPOC after incomplete miscarriage
2 possible complications of surgical evacuation of the uterus?
infection
bleeding
Name 3 causes of recurrent spontaneous miscarriage
SLE
antiphospholipid syndrome
PCOS
Name 3 causes of menorrhagia
Uterus fibroids
PCOS
Menorrhagia investigations
FBC
TFTs
clotting studies
Ultrasound
LH and FSH
List 3 contraindications to the COCP
Smoking
Obesity
Breastfeeding
Breast cancer
Name a medication that could reduce dysfunctional uterine bleeding
Tranexamic acid
What 2 procedures could be offered before hysterectomy (for menorrhagia)
List 2 possible complications of a hysterectomy
Bleeding
Infection
Bladder damage
What serious diagnosis is possible in post-menopausal bleeding?
endometrial cancer
Name 2 risk factors for cervical cancer
Unprotected sex
Multiple sexual partners
Dyskaryosis on cervical smear - what investigation will the pt be referred for?
colposcopy
Explain the term ectropian
abnormal cells on the cervix that migrated from the uterus
Name a cause of ectropian
COCP
Explain what CIN III is
pre-malignant cell changes highly indicative of cervical cancer
What procedure can completely remove CIN III
loop LERTZZ or cone biopsy
Name the 2 histological types of cervical cancer
Investigation to assess local and distant spread of cervical invasive carcinoma
MRI
PET
Lymph node biopsy
List 2 gynaecological causes of acute left lower abdo pain
Ectopic
Ovarian torsion
Name 2 investigations to assess acute lower left abdo pain (gynae)
Ultrasound
hCG
What are the clinical features of ovarian torsion and how does it arise?
sudden severe pain
fever
nausea
Solid cystic ovarian mass with calcified structures that look similar to teeth - diagnosis?
How does this arise?
Prognosis to ovarian cancer?
dermatocystic tumour
germ cells
2 risk factors for ovarian cancer
BRCA1 gene
Smoking
What genetic mutations may increase the risk of ovarian cancer?
BRCA1
Give an example of a tumour marker used in ovarian cancer
CA-125
What is endometriosis
deposits of endometrial tissue in extra-endometrial places
Name 2 sites where endometrial foci may commonly be found
Abdomen
Uterus
Name a factor associated with endometriosis
Name 2 symptoms found in endometriosis
Cyclical pain
term used to describe endometrial glandular tissue found in the myometrium
2 complications of endometriosis
infertility
pain
Name 2 findings on vaginal examination in endometriosis
Name 2 medical treatments for endometriosis
COCP
analgesia
Name 2 possible surgical treatments for endometriosis
Laparoscopic removal
Hysterectomy
Explain the difference between primary and secondary infertility
Primary: genetic/irreversible
Secondary: reversible
Name 3 causes of female infertility
PCOS
endometriosis
Lifestyle changes to suggest for infertility
Diet
Exercise
Lose weight
Name 2 blood tests to look at ovulatory function
LH
FSH
Name 1 test to assess tubal patency
contrast adnexal scan
Name 2 possible symptoms of PCOS
Hirsuism
Weight gain
Acne
Name 2 medical treatments to treat PCOS-associated infertility
chlorazine
List an advantage and disadvantage of the following types of long-term contraception:
Laparoscopic tubal ligation
Hormone-releasing IUD
LTL
- advantage = long term
- disadvantage = invasive
IUD
- advantage - non-invasive
- disadvantage - short-term
IUD fitted and pt feels faint and bradycardic - likely explanation for this
its friggin painful
After IUD fitting, 6 days later acute lower abdo pain, purulent vaginal discharge and fever - diagnosis?
endometritis
Name 2 organisms that may be implicated in endometritis
E. coli
Staph aureus
How would you treat endometritis initially
antibiotics
2 possible complications of endometritis
Other than endometrial cancer, name 2 other causes of post-menopausal bleeding
Ovarian cancer
Atrophy
Physiological
What is the commonest histological type of endometrial carcinoma?
?
Name 2 risk factors for endometrial cancer
Smoking
Age
Name the initial imaging performed for post-menopausal bleeding
TV ultrasound
stage 1 and 2 endometrial cancer (tumour confined to uterus and cervix) - recommended treatment?
removal?
Name 2 treatments for stage 3 + endometrial cancer
chemo
Name 2 sites where endometrial cancer metastasises to
ovaries
bowel
liver
