Gynaecology

Question 1

When is premature menopause?

Answer 1

Menopause before 40 weeks

Question 2

What effect does the copper IUD have?

Answer 2

Spermicidal

Question 3

What is primary amenorrhoea ?

Answer 3

Absence of menses by age 16

or absence of secondary sexual characteristic by 14

Question 4

What is the treatment of primary dysmenorrhea?

Answer 4

NSAID (Prostaglandin inhibitor)
OCP
Progestin IUD

Question 5

What is found on history of endometriosis?

Answer 5

Cyclical pelvic pain

Pain during sex

Question 6

What is found on history/exam of adenomyosis?

Answer 6

Menorrhagia
Enlarged uterus
Boggy uterus

Question 7

What is the treatment of endometriosis ?

Answer 7

OCP FIRST LINE

Question 8

What is the treatment of adenomyosis ?

Answer 8

NSAID first line

plus OCP or progestins

Question 9

When should endometrial biopsy be performed?

Answer 9

Endometrial thickness > 4mm in postmenopausal woman

Question 10

How is acute heavy bleeding managed?

Answer 10

High dose estrogen IV stabalise endometrium

Transition to OCP or add progestin when bleeding stalalised

Question 11

What is the deficiency in congenital adrenal hyperplasia?

Answer 11

21 hydroxylaze deficiency

Question 12

PCOS criteria?

Answer 12

1. Polycystic ovaries
2. Oligo-and/or an ovulation
3. Hyperandrogenism

Question 13

What is the presentation of PCOS?

Answer 13

Obesity 
menstrual cycle disruption 
Infertility 
Acne 
Hirstutusm 
Acanthosis nigricans 
Metabolic syndrome

Question 14

How to test for hyperandrogegism in PCOS?

Answer 14

Raised testosterone (free better than total)

Question 15

What is the treatment of PCOS in a woman not wanting to have bb’s?

Answer 15

OCP + metformin

Question 16

What is the treatment of PCOS in a woman wanting to have bb’s?

Answer 16

Clomiphene + metformin

Question 17

What is the treatment of bartholin cyst?

Answer 17

warm soaks

Question 18

What is the treatment of bartholin abscess

Answer 18

Aspiration and incision

Question 19

Treatment of BV?

Answer 19

Metronidazol or vaginal clyndamycin

Question 20

What is the treatment of PID?

Answer 20

Outpatient

• ceftriaxone IM 1 dose
• Doxycycline X 14 days
• +/- metronidazole X 14 daya

Question 21

Presentation of Toxic Shock Syndrome?

Answer 21

Fever 
Vomit 
Watery diarrhoea 
Desquamation at the palms and soles
Macular rash

Question 22

How is TSS diagnosed?

Answer 22

Clinical presentation:

• Fever > 38.9
• Hypotension
• Skin findings

Question 23

Treatment of TSS?

Answer 23

Rapid rehydration

Empiric abx: clindamycin + vancomycin

Question 24

Treatment of an asymptomatic fibroid?

Answer 24

Expectant management with annual pelvic exam

Question 25

What is the pharmacological management of fibroids?

Answer 25

OCP | Medroxyprogesterone or danazol to slow down the bleeding

Question 26

What is the surgical management of fibroids?

Answer 26

Woman who wants to have bb's: | - Abdominal or hysteroscopic myomectomy

Question 27

What is the commonest type of endometrial cancer?

Answer 27

Type I atypical endometrial hyperplasia

Question 28

What is the presentation of endometrial cancer?

Answer 28

Bleeding Pain Metabolic syndrome

Question 29

What is the most prevalent strains of HPV that cause cancer?

Answer 29

16 - SCC | 18 - adenocarcinoma

Question 30

What does gardasil protect against?

Answer 30

16, 18 | 6, 11 (warts)`

Question 31

Recommended age for pap smear?

Answer 31

21- 65 every 3 years

Question 32

What is the management of a woman who's pap smear comes back as ASCUS

Answer 32

> 30 yo - HPV DNA testing If positive: colposcopy If negative: repeat cytology in 12 mo < 30 yo - repeat cytology in 6 mo If Positive: colposcopy If negative: repeat cytology in 6 mo and if -ve can go back to 3 yearly

Question 33

What is the management of a woman who's pap smear comes back as ASC - H

Answer 33

Colposcopy

Question 34

What is the management of a woman who's pap smear comes back as atypical glandular cells of undetermined significance (AGUS)

Answer 34

Colposcopy +/- sampling

Question 35

What are the RF for vulvar cancer?

Answer 35

HPV 16, 18, 31 Lichen sclerosis Diabetes, obesity, HTN CVD...

Question 36

What are key words that describe lichen sclerosis?

Answer 36

Atrophic | Paper-like skin

Question 37

What is precocious puberty?

Answer 37

2ndary sexual characteristics before the age of 8

Question 38

How to investigate precocious puberty?

Answer 38

Bone age | GnRH stimulation test

Question 39

Treatment of central precocious puberty?

Answer 39

leuprolide

Question 40

Where does breast cancer spread?

Answer 40

Bone Liver Thyroid Prostate

Question 41

Which adjuvant treatment should ER/PR+ve breast cancer women get?

Answer 41

Tamoxifen | or aromatase inhibitor in postmenopausal women

Question 42

Which adjuvant treatment should HER2+ve breast cancer women get?

Answer 42

trastuzumab