Gynaecology Flashcards
Acceptable thickness of endometrium with pcos?
<7mm unlikely to be endometrial hyperplasia
Order of treatment for menorrhagia?
Mirena
Tranexamic or nsaids or coc
Norethisterone
Severe pms incidence?
5%
(Gtg = 5-8% severe, 40% non-severe)
GABA and serotonin
Bisphosphonates - mechanism and side effects?
Reduced bone resorption
Oesophageal irritation
Incidence of ibs in chronic pelvic pain?
50%
Incidence of nerve entrapment after pfannenstiel?
3.7%
Prevalence of chronic pelvic pain?
1 in 6 (16%)
> 6 months
Hormonal tx for 3-6 months before laparoscopy
Prevalence of endometriosis?
2-10%
Up to 50% in infertile women
1/3 adolescents with CPP
Worldwide incidence FGM?
Girls at risk in U.K.?
2 million
20,000
Lichen sclerosis incidence?
1/300 to 1/1000
25% of all women in vulval clinics
Most common vulval condition seen in hospital setting
Pathology of lichen sclerosis?
Hyalisation of upper dermis
Hyperemesis incidence?
0.3-3.6% vs 80% nausea and vomiting in pregnancy
Hyperemesis increased OR VTE?
2.5-4.4
Hyperemesis risk of recurrence?
15-81%
Pcos ovulation after drilling?
> 60% and normalisation of androgens up to 20 years
Effects of bariatric surgery?
60% weight loss, long term weight loss 14-25%, reduces diabetes, htn, lipids, mortality from cv disease. 0.1-1% mortality/morbidity
When to consider bariatric surgery in pcos?
Bmi >40 or >35 and htn/ dm
Increased risk endometrial cancer with pcos?
3 fold (et cut off <7mm
Prevalence pcos?
2.2-26%, higher in south Asians
Other variants of pms?
Underlying condition exacerbation, non-ovulating, non-menstruating, exogenous progesterone
Diagnosing pms?
Prospective symptom diary for 2/12, or gnrh analogues 3/12 if uncertain
Incidence of bladder pain syndrome in CPP?
38-84%
Proportion of negative laps for CPP?
1/3 - 1/2
What is gestrinone?
SPRM similar to danazol
Incidence of adenomyosis?
1%
Proportion of women with endo and concurrent adenomyosis? And IBS?
12% adenomyosis
10-15% IBS
Incidence of pelvic congestion?
3.8% (pre-menstrual pain, worse on standing walking gardening, deep throbbing pain after intercourse)
Incidence of GTD in caucasians and Asians?
1/750 and 1/400
How to check for CAH late onset as differential for pcos?
17 hydroxyl progesterone (in follicular phase)
