Gynaecology

Question 1

What do you see on laparoscopy for Endometriosis?

Answer 1

• Showing red, puckered, black “matchsticks” lesions

- Chocolate cysts

Question 2

What are the 4D’s of endometriosis?

Answer 2

Dysmenorrhea, Dyspareunia, Dyschezia, Dysuria

Question 3

Three component symptoms of endometriosis?

Answer 3

Menstrual symptoms, Infertility and bladder/bowel symptoms

Question 4

How to diagnose endometriosis?

Answer 4

Laproscopy + Biopsy and histological exam

CA-125 may also be a marker present.

Question 5

Rotterdam criteria requires 2/3 of the following symptoms:

Answer 5

1. Oligo and/or anovulation
2. Clinical and/or biochemical signs of hyperandrogenism
3. Polycystic ovaries on pelvic U/S

And exclusion of other aetiologies (CAH, androgen secreting tumours, Cushing’s)

Question 6

What is adenomyosis?

Answer 6

Presence of endometrial tissue (glands and stroma) in the myometrium

Question 7

What are leiomyomas?

Answer 7

Bengin smooth muscle tumours of the uterus

Question 8

What is the clinical presentation of adenomyosis?

Answer 8

Dysmenorrhea, pelvic discomfort, and symptoms of an enlarged uterus

Question 9

Role of estrogen in leiomyomas?

Answer 9

Smooth muscle proliferation of the uterus

Question 10

Role of Progesterone in Myoma?

Answer 10

Stimulates production of proteins that inhibit apoptosis

Question 11

Four common group of symptoms for Myoma?

Answer 11

Abnromal uterine bleeding
Sub fertility
Mass effects
and Chronic pelvic pain

Question 12

Risk factors for endometrial cancer?

Answer 12

Obesity, nullparity, early menarche, late menopause (lots of (unopposed even worse) estrogen exposure), DM, Tamoxifen use

Question 13

What is Asherman’s syndrome?

Answer 13

Intrauterine adhesions that generally follow D &C.

Question 14

Pregnancy induced hypertension or preclampsia occurs after _____

Answer 14

20 weeks

Question 15

Cottage cheese like discharge….

Answer 15

Thrush - Candida albicans

Question 16

The most common cause of ovarian enlargement in women of reproductive age:

Answer 16

Follicular cysts

Question 17

A 27-year-old woman complains of an offensive ‘musty’, frothy, green vaginal discharge. On examination you an erythematous cervix with pinpoint areas of exudation

Answer 17

Trichomonis vaginalis

Question 18

How do you treat trichomonas vaginalis?

Answer 18

Oral metronidazole

Question 19

What are the four criteria points for bacterial vaginosis?

Answer 19

1. Thin, white homogenous discharge
2. Clue cells on microscopy: stipple vaginal epithelial cells
3. vaginal pH > 4.5
4. positive whiff test

Question 20

Strawberry cervix-

Answer 20

Trichomonas vaginalis

Question 21

Clue cells on microscopy: stipple vaginal epithelial cells

Answer 21

Bacterial vaginosis

Question 22

______ is used in initiating labour

Answer 22

Prostaglandin E2

Question 23

Abdominal ultrasound shows a 8cm mass in the right ovary. Histopathological analysis reveals Rokitansky’s protuberance

Answer 23

Teratoma (Dermatoid cyst)

Question 24

What are benign germ cell tumours?

Answer 24

Dermatoid cyst

Question 25

the most common benign epithelial tumour which bears a resemblance to the most common type of ovarian cancer (serous carcinoma)

Answer 25

Serous cystadenoma

Question 26

Corpeus Luteum cyst or Follicular cyst - which is more likely to present with interperitoneal bleeding?

Answer 26

CL cyst.

Question 27

Premature ovarian failure:

The onset of menopausal symptoms and elevated _____levels before the age of _____

Answer 27

The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40 years

Question 28

What is Meig’s syndrome?

Answer 28

Benign ovarian tumour, ascites and pleural effusion

Question 29

Smoking is an absolute contra indication to the COCP when ______

Answer 29

when Age >35 and smoking >15cig/day

Question 30

the COCP is contraindicated _______ weeks post partum

Answer 30

<6 weeks post partum

Question 31

Post menopausal bleeding is ____ until proven otherwise

Answer 31

Endometrial cancer

Question 32

The window period for the missed POP is

Answer 32

3 hrs

Question 33

In response to DIC you first give ____

Answer 33

FFP

Question 34

For women taking anti-epileptic medication firstline contraception is _____

Answer 34

Depoprovera, IUD, IUS

Question 35

Which anti-epileptic is not an issue with POP

Answer 35

Lamotrigine

Question 36

First line management for menorrhage? (Contraceptive)

Answer 36

IUS!

then COCP and then Depo Provera

Question 37

if this cyst rupture it can cause if ruptures may cause pseudomyxoma peritonei

Answer 37

Mucinous Cystadenoma

Question 38

Most common benign epithelial tumour (cyst)

Answer 38

Serous Cystadenoma

Question 39

How often should women be screened for breast cancer?

Answer 39

From 50-74, every 2 years

Question 40

What’s an endometrioma?

Answer 40

Endometrial tissue found on the ovaries

Question 41

If suspecting menopause - when would you actually test for FSH/LH levels?

Answer 41

You would test for them in a premature ovarian failure (Less than 40).

You can also do withdrawl progesterone testing?

Question 42

What treatment would you use in premature ovarian failure?

Answer 42

You would use COCP - more oestrogen the better :)

Question 43

Cyst likely to be an incidental finding on U/S. Most commonly occurs in women in their 20’s and needs surgical treatment:

Answer 43

Dermatoid cyst

Question 44

result of lack of fusion of Mullerian duct system:

Answer 44

Uterus didelphys