Gynaecology

Question 1

Acceptable thickness of endometrium with pcos?

Answer 1

<7mm unlikely to be endometrial hyperplasia

Question 2

Order of treatment for menorrhagia?

Answer 2

Mirena
Tranexamic or nsaids or coc
Norethisterone

Question 3

Severe pms incidence?

Answer 3

5%
(Gtg = 5-8% severe, 40% non-severe)
GABA and serotonin

Question 4

Bisphosphonates - mechanism and side effects?

Answer 4

Reduced bone resorption

Oesophageal irritation

Question 5

Incidence of ibs in chronic pelvic pain?

Answer 5

50%

Question 6

Incidence of nerve entrapment after pfannenstiel?

Answer 6

3.7%

Question 7

Prevalence of chronic pelvic pain?

Answer 7

1 in 6 (16%)
> 6 months
Hormonal tx for 3-6 months before laparoscopy

Question 8

Prevalence of endometriosis?

Answer 8

2-10%
Up to 50% in infertile women
1/3 adolescents with CPP

Question 9

Worldwide incidence FGM?

Girls at risk in U.K.?

Answer 9

2 million

20,000

Question 10

Lichen sclerosis incidence?

Answer 10

1/300 to 1/1000
25% of all women in vulval clinics
Most common vulval condition seen in hospital setting

Question 11

Pathology of lichen sclerosis?

Answer 11

Hyalisation of upper dermis

Question 12

Hyperemesis incidence?

Answer 12

0.3-3.6% vs 80% nausea and vomiting in pregnancy

Question 13

Hyperemesis increased OR VTE?

Answer 13

2.5-4.4

Question 14

Hyperemesis risk of recurrence?

Answer 14

15-81%

Question 15

Pcos ovulation after drilling?

Answer 15

> 60% and normalisation of androgens up to 20 years

Question 16

Effects of bariatric surgery?

Answer 16

60% weight loss, long term weight loss 14-25%, reduces diabetes, htn, lipids, mortality from cv disease. 0.1-1% mortality/morbidity

Question 17

When to consider bariatric surgery in pcos?

Answer 17

Bmi >40 or >35 and htn/ dm

Question 18

Increased risk endometrial cancer with pcos?

Answer 18

3 fold (et cut off <7mm

Question 19

Prevalence pcos?

Answer 19

2.2-26%, higher in south Asians

Question 20

Other variants of pms?

Answer 20

Underlying condition exacerbation, non-ovulating, non-menstruating, exogenous progesterone

Question 21

Diagnosing pms?

Answer 21

Prospective symptom diary for 2/12, or gnrh analogues 3/12 if uncertain

Question 22

Incidence of bladder pain syndrome in CPP?

Answer 22

38-84%

Question 23

Proportion of negative laps for CPP?

Answer 23

1/3 - 1/2

Question 24

What is gestrinone?

Answer 24

SPRM similar to danazol

Question 25

Incidence of adenomyosis?

Answer 25

1%

Question 26

Proportion of women with endo and concurrent adenomyosis? And IBS?

Answer 26

12% adenomyosis

10-15% IBS

Question 27

Incidence of pelvic congestion?

Answer 27

3.8% (pre-menstrual pain, worse on standing walking gardening, deep throbbing pain after intercourse)

Question 28

Incidence of GTD in caucasians and Asians?

Answer 28

1/750 and 1/400

Question 29

How to check for CAH late onset as differential for pcos?

Answer 29

17 hydroxyl progesterone (in follicular phase)