Gynaecology

Question 1

name for fibroids?

Answer 1

uterine leiomyomata

Question 2

what are fibroids?

Answer 2

benign tumours of the uterus, from SM and CT

Question 3

what hormone are fibroids dependent one?

Answer 3

oestrogen

Question 4

name and explain positions of fibroids?

Answer 4

subserosal - under visceral peritoneum

intramural - within uterine wall

submucosal - in endometrium

pedunculates - attached to uterin wall by peduncle

Question 5

Rx for fibroids?

Answer 5

obesity

Question 6

features of fibroids?

Answer 6

menorrhagia

dysmenorrhoea

mass

pain

bloating

fertility problems

Question 7

Ix for fibroids?

Answer 7

US

biopsy

Question 8

what decides the Tx for fibroids?

Answer 8

if fertility is desired

Question 9

Tx for asympt fibroids?

Answer 9

none

Question 10

Tx for fibroids if wanting fertility preserved?

Answer 10

GnRH analogues - mifepristone

myomectomy

Question 11

Tx for fibroids if fertility is not desired?

Answer 11

hysterectomy

Question 12

two types of ovarian cysts?

Answer 12

follicular cysts

corpus luteum cysts

Question 13

how do follicular cysts occur?

Answer 13

GnRH stimulates means follicle persists (does not rupture)

Question 14

how do CL cysts occur?

Answer 14

corpus luteum persists and fills with blood/fluid

Question 15

Rx for ovarian cyst?

Answer 15

pre menopausal

early menarche

PCOS

endometriosis

pregnancy

tamoxifen use

Question 16

features of ovarian cysts?

Answer 16

asymp

bleed

pain

swelling

bloating

Question 17

Ix for ovarian cysts?

Answer 17

TVUS

serum Ca if over 40yrs

Question 18

Tx for ovarian cysts?

Answer 18

pre menopausal - >5cm remove

post menopausal - >5cm treat conservatively

Question 19

what is a cystocele?

Answer 19

anterior wall of vagina and bladder bulge out vagina

Question 20

what is an enterocele?

Answer 20

small bowel extends between ant rectum and posterior vagina

Question 21

what is a rectocele?

Answer 21

herniation of ant wall of rectum into post wall of vagina

Question 22

what is a uterine prolapse?

Answer 22

when uterus slips from normal position into vagina

Question 23

Ix for prolapse?

Answer 23

US assessment of post void residual urine volume

Question 24

when staging prolapse, what is it measured in relation to?

Answer 24

hymen position

Question 25

Tx for prolapse? (not surgical)

Answer 25

pelvic floor exercises pessary topical oestrogen

Question 26

surgery for prolapse?

Answer 26

abdo sacrocolpopexy uterosacral/sacrospinal ligament suspension

Question 27

what happens in endometriosis?

Answer 27

endometrial glands and stroma exist outside the uterine body

Question 28

how are cysts described in endometriosis?

Answer 28

chocolate cysts

Question 29

features of endometriosis?

Answer 29

inflam pain dyspareunia depressed mass infertile

Question 30

Ix for endometriosis?

Answer 30

TVUS

Question 31

tx for endometriosis?

Answer 31

CCP NSAIDs GnRH agonist surgery

Question 32

complications of endometriosis?

Answer 32

ectopic malignancy cysts adhesions

Question 33

what do adipocytes produce and why does this increase risk of endometrial cancer?

Answer 33

aromatase, as it converts ovarian androgens to oestrogen oestrogen causes endometrial proliferation

Question 34

what is menorrhagia?

Answer 34

prolonged and increased menstrual flow

Question 35

what is amenorrhoea?

Answer 35

absence of menstruation

Question 36

what is oligomenorrhoea?

Answer 36

menses at intervals of \>35 days

Question 37

features of lichen sclerosis?

Answer 37

bruising red erosions itch

Question 38

late features of lichen sclerosis?

Answer 38

flat, white, shiny vulva (eventually)

Question 39

Tx of lichen sclerosis?

Answer 39

clobetasol propionate cream

Question 40

Ix and Tx for leukoplakia of the vulva?

Answer 40

biopsy topical steroids

Question 41

what is lichen simplex?

Answer 41

non specific inflammation of the vulva

Question 42

tx for lichen simplex?

Answer 42

vulval care antihistamines

Question 43

where do bartholin's glands lie? what do they do?

Answer 43

under labia minora secrete lubricating mucus during sex

Question 44

how does bartholin's abscess arise?

Answer 44

blockage of cyst

Question 45

treatment of bartholin's abscess?

Answer 45

incision and drainage

Question 46

gold standard investigation for endometriosis?

Answer 46

laparotomy

Question 47

what is used for menorrhagia?

Answer 47

tranexamic acid

Question 48

what is used for dysmenorrhoea?

Answer 48

mefanamic acid

Question 49

at what thickness should endometrium be investigated?

Answer 49

pre menopausal \>16mm post menopausal \>5mm