Gynaecology Flashcards
name for fibroids?
uterine leiomyomata
what are fibroids?
benign tumours of the uterus, from SM and CT
what hormone are fibroids dependent one?
oestrogen
name and explain positions of fibroids?
subserosal - under visceral peritoneum
intramural - within uterine wall
submucosal - in endometrium
pedunculates - attached to uterin wall by peduncle
Rx for fibroids?
obesity
features of fibroids?
menorrhagia
dysmenorrhoea
mass
pain
bloating
fertility problems
Ix for fibroids?
US
biopsy
what decides the Tx for fibroids?
if fertility is desired
Tx for asympt fibroids?
none
Tx for fibroids if wanting fertility preserved?
GnRH analogues - mifepristone
myomectomy
Tx for fibroids if fertility is not desired?
hysterectomy
two types of ovarian cysts?
follicular cysts
corpus luteum cysts
how do follicular cysts occur?
GnRH stimulates means follicle persists (does not rupture)
how do CL cysts occur?
corpus luteum persists and fills with blood/fluid
Rx for ovarian cyst?
pre menopausal
early menarche
PCOS
endometriosis
pregnancy
tamoxifen use
features of ovarian cysts?
asymp
bleed
pain
swelling
bloating
Ix for ovarian cysts?
TVUS
serum Ca if over 40yrs
Tx for ovarian cysts?
pre menopausal - >5cm remove
post menopausal - >5cm treat conservatively
what is a cystocele?
anterior wall of vagina and bladder bulge out vagina
what is an enterocele?
small bowel extends between ant rectum and posterior vagina
what is a rectocele?
herniation of ant wall of rectum into post wall of vagina
what is a uterine prolapse?
when uterus slips from normal position into vagina
Ix for prolapse?
US assessment of post void residual urine volume
when staging prolapse, what is it measured in relation to?
hymen position
Tx for prolapse? (not surgical)
pelvic floor exercises
pessary
topical oestrogen
surgery for prolapse?
abdo sacrocolpopexy
uterosacral/sacrospinal ligament suspension
what happens in endometriosis?
endometrial glands and stroma exist outside the uterine body
how are cysts described in endometriosis?
chocolate cysts
features of endometriosis?
inflam
pain
dyspareunia
depressed
mass
infertile
Ix for endometriosis?
TVUS
tx for endometriosis?
CCP
NSAIDs
GnRH agonist
surgery
complications of endometriosis?
ectopic
malignancy
cysts
adhesions
what do adipocytes produce and why does this increase risk of endometrial cancer?
aromatase, as it converts ovarian androgens to oestrogen
oestrogen causes endometrial proliferation
what is menorrhagia?
prolonged and increased menstrual flow
what is amenorrhoea?
absence of menstruation
what is oligomenorrhoea?
menses at intervals of >35 days
features of lichen sclerosis?
bruising
red
erosions
itch
late features of lichen sclerosis?
flat, white, shiny vulva (eventually)
Tx of lichen sclerosis?
clobetasol propionate cream
Ix and Tx for leukoplakia of the vulva?
biopsy
topical steroids
what is lichen simplex?
non specific inflammation of the vulva
tx for lichen simplex?
vulval care
antihistamines
where do bartholin’s glands lie? what do they do?
under labia minora
secrete lubricating mucus during sex
how does bartholin’s abscess arise?
blockage of cyst
treatment of bartholin’s abscess?
incision and drainage
gold standard investigation for endometriosis?
laparotomy
what is used for menorrhagia?
tranexamic acid
what is used for dysmenorrhoea?
mefanamic acid
at what thickness should endometrium be investigated?
pre menopausal >16mm
post menopausal >5mm
