Gynaecology Flashcards
Mittelschmerz
Mid-cycle pain (unilateral lower abdominal), occurs during ovulation, 14 days before start of menstruation? (fluid in the cul-de-sac/pouch of douglas)
Anti-hypertensive & anti-androgen medication (used in PCOS)
Spironolactone
Clomiphene
SERM (selective oestrogen receptor modulator) - antagonist at oestrogen receptors in hypothalamus. Incr LH & FSH –> stimulates ovulation
Girl w normal external female genitalia, normal secondary sexual characteristic development. Primary amenorrhoea, absence uterus, inguinal masses
Androgen insensitivity syndrome (AIS) –> phenotypically female, genotypically male
What does the broad ligament contain?
Fold of peritoneum containing the mesosalphinx, mesometrium, mesovarium. Contains the ovaries, fallopian tubes & round ligaments
Most common type of incision for Caesareans
suprapubic incision (aka bikini incision / Pfannensteil incision) made at the pubic hairline
Short stature, webbed neck, broad shield-like chest w/o breast development
Turners syndrome (45 X) –> primary ovarian failure & no secondary sexual characteristics
Adult woman, virilisation, bilaterally enlarged solid-appearing ovaries, associated w insulin resistance
ovarian stromal hyperthecosis
3 main causes of virilisation in adult women:
- Ovarian stromal hyperthecosis
- Adrenal tumours
- Androgen-secreting ovarian tumours (Sertoli-Leydig cell tumour, luteoma of pregnancy)
elevated serum 17-hydroxyprogesterone concentration
Congenital adrenal hyperplasia (CAH)
Most common cancers to metastasise to the ovaries
GIT (stomach & colon)
Kruckenberg tumours
gastric tumours that metastasise to the ovary, contain signet ring cells
47XXY
Klinefelter’s syndrome (phenotypically male, may have undescended testes & develop secondary female sexual characteristics ie gynacomastia)
45X
Turner’s syndrome (phenotypically female, short-stature, POF, webbed neck, lymphedema of hands & feet, bicuspid aortic valve, preductal coartication, high arched palate, streak ovaries, no secondary sexual characteristics)
Streak ovaries
Turner’s syndrome
Severe morning sickness + symptoms of hyperthyroidism
Molar pregnancy (due to high lvls of bHCG)
Snowstorm appearance on USS
Molar pregnancy
Low urine unconjugated estriol levels
Suggestive of Down’s syndrome
Increased LDH (lactate dehydrogenase)
associated w dysgerminomas
AFP
Alpha-fetoprotein (markers of NTDs, hepatocellular carcinoma, endodermal sinus tumours)
Irregular, unpredictable bleeding w/i year of menarche
anovulatory dysfunctional uterine bleeding
Dyschezia
pain on defecation
Metromenorrhagia
irregular & unpredictable uterine bleeding
HELLP syndrome
Complication of pre-eclampsia (Haemolysis, Elevated Liver enzymes & Low Platelets). Characterised by high BP & proteinuria. Cx: placental abruption –> DIC
Painless 3rd trimester bleeding - top differential
placenta previ
Painless 3rd trimester bleeding - top differential
placenta abruption
Dysmenorrhoea, deep dyspareunia, dyschezia & adenexal tenderness
endometriosis
Mutations in nuclear testosterone receptor
AIS (androgen insensitivity syndrome)
Foetal hydantoin syndrome
Caused by antiepileptic agents (phenytoin, carbamazepine). CFs: intrauterine growth restriction (IUGR), microcephaly, cleft lip/palate, mental retardation, hypoplastic fingernails, distal limb deformities
Omphalocele
Viscera begin growing outside of the foetal body. Assoc w trisomy 13 & 18 + Beckwith-Wiedemann syndrome (exomphalos-macroglossia-gigantism syndrome)
Meningomyelocele
NTD assoc w sodium valproate & folate deficiency
Tocolytics
Drugs used to delay preterm labour: nifedipine (CCB), atosiban (oxytocin receptor antagonist)
Primary amenorrhoea, normal growth & development, normal secondary sexual characteristics, normal external genitalia. Shortened vaginal canal, normal ovaries, uterine remnants
Mullerian agenesis
Normal external female genitalia, blind short vaginal pouch, dysgenetic intra-abdominal testes, no uterus or fallopian tubes
17alpha hydroxylase deficiency
Chocolate cysts
Endometrial ovarian deposits (Cx of endometriosis). NB: endometriosis can cause elevated Ca-125
Anorexia, weight loss, hyperpigmentation of skin in sun-exposed area
Chronic adrenal insufficiency (addison’s disease)
Kallmann syndrome
Hypogonadotropic hypogonadism –> sexually juvenile women w normal XY karyotype.
Pathophys of breathlessness in pregnant women
increased minute ventilation (due to increased tidal volume)
Dysgerminomas
Assoc w Turner’s. “Fried egg” appearance. Sheets of large malignant cells w clear cytoplasm & round nuclei
Spindle-shaped cells w collagen deposits
fibroadenoma
Most common type of breast cancer
infiltrating ductal carcinoma (often assoc w fibrosis –> immobile & hard)
Peri-hepatic adhesions
Fitz-Hugh-Curtis lesions - complication of PID
