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Y3 Reproductive > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

What is metrorrhagia?

A

Regular intermenstrual bleeding

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2
Q

What is polymenorrhoea?

A

<21day interval

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3
Q

What is polymenorrhagia?

A

Increased bleeding in frequent cycle

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4
Q

What is oligomenorrhea?

A

Interval >35day

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5
Q

What is menorrhagia?

A

Prolonged + increased menstrual flow

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6
Q

What is the commonest cause of abnormal uterine bleeding?

A

Dysfunctional uterine bleeding

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7
Q

What is adenomyosis?

A

Endometrial glands + stroma in myometrium

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8
Q

How might adenomyosis present?

A

Menorrhagia and dysmenorrhea

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9
Q

What is the commonest cause of endometritis?

A

Infection

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10
Q

What is dysfunctional uterine bleeding?

A

Non-organic

Hormonal stimulation to endometrium disrupted

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11
Q

Does the corpus luteum form in dysfunctional uterine bleeding DUB?

A

No

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12
Q

What type of dysfunctional uterine bleeding is most common in young and pre-menopausal women? It is the commonest type

A

Anovulatory

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13
Q

How does anovulatory DUB present?

A

Irregular periods

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14
Q

What type of dysfunctional uterine bleeding is most common in women aged 35-45?

A

Ovulatory luteal phase deficiency

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15
Q

How does ovulatory luteal phase deficiency present?

A

Regular heavy period

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16
Q

What is the pathology behind ovulatory luteal phase deficiency?

A

Poor progesterone production, hence poor corpus luteum forms

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17
Q

How is dysfunctional uterine bleeding diagnosed?

A

Exclusion

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18
Q

What imaging modality is 1st line when investigating dysfunctional uterine bleeding?

A

Transvaginal US

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19
Q

When investigating DUB, if TVUS is +ve, what is the next step?

A

Endometrial biopsy

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20
Q

What blood tests should be done when Ix DUB?

A

FBC, TSH, coag screen, LFT, Cr

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21
Q

What is the 1st line Mx options for menorrhagia?

A

NSAID mefenamic acid OR

CHC

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22
Q

What is the name of the daycase procedure that is the last line Mx of DUB?

A

Endometrial ablation

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23
Q

What are the 3 types of urinary incontinence?

A

Stress
Urge
Mixed

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24
Q

What type of urinary incontinence occurs on exertion, sneezing or coughing?

A

Stress

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25
What type of urinary incontinence is when there is a sudden compelling desire to urinate?
Urge
26
What is the pathology of an overactive bladder?
Involuntary detrusor contractions
27
How do you classify overactive bladder?
Wet and dry
28
Give 4 examples of storage urinary incontinence symptoms
Freq, nocturia, urgency, incontinence
29
Give 3 examples of voiding urinary incontinence symptoms
Hesitancy, strain, poor flow
30
What Ix should you do for all F PTx presenting with urinary incontinence?
Urinalysis + post-void residual
31
What Ix should you do for a patient presenting with urinary incontinence and you suspect a tumour?
Urinalysis + post-void residual + cystoscopy
32
What are lifestyle measures you should recommend for patients PC urinary incontinence?
33
What is the 1st line drug Mx of urinary incontinence? And what class is it in?
PO oxybutynin | Antimuscarinic
34
When are antimuscarinics CI?
Dementia / elderly
35
What are the SEs of antimuscarinic?
Dry mouth, constipation, blurred vision, somnolence, confuse
36
What drug is an alternative to antimuscarinics in the Mx of the urinary incontinence? And what drug class does it belong to?
B3 agonist mirabegron
37
What drug is the Mx of nocturia?
Desmopressin
38
What is the Mx of vaginal atrophy?
TOP estrogen
39
Chronic constipation is a RF for pelvic organ prolapse. T or F
True
40
What is the commonest type of pelvic organ prolapse?
Cystocele (bladder)
41
How does a cystocele present?
Bulge Incomplete bladder empty Urge / stress incontinent
42
How does uterine prolapse present?
``` Dragging Back pain Mass Dyspareunia Difficulty inserting / retaining tampon ```
43
What are the stages of uterine prolapse?
``` 0: none I: 1cm above hymen II III: >1cm beyond hymen IV: complete vaginal eversion ```
44
What is the 1st line Mx of uterine prolapse?
Pessary
45
What is the Ix for pelvic organ prolapse and why?
US to exclude mass
46
What imaging modality is used for bowel dysfunction and pre surgery for pelvic organ prolapse?
MRI
47
How is male infertility classified?
Obstructive and non-obstructive
48
Give 3 causes of obstructive male infertility?
CF, vasectomy, infection
49
Give 5 causes of non-obstructive male infertility?
Mumps orchiditis Chemo / radio Cryptorchidism Systemic illness
50
Is idiopathic male infertility obstructive or non-obstructive?
Non-obstructive
51
Is Klinefelters male infertility obstructive or non-obstructive?
Non-obstructive
52
Is testis cancer male infertility obstructive or non-obstructive?
Non-obstructive
53
What effect does obstructive male infertility have on: - Testis volume - 2ndry sexual characteristics - LH - FSH - T
All normal
54
What effect does obstructive male infertility have on: - Testis volume - 2ndry sexual characteristics - LH - FSH - T
- Testis volume DECREASED - 2ndry sexual characteristics DECREASED - LH INCREASED - FSH INCREASED - T NOT SURE
55
What effects does a raised PRL have on LH and FSH?
Decreases them
56
What is the 1st line Ix for male factor infertility?
Semen analysis
57
What is analysed in semen analysis?
Vol, density (no.), motility, progression, morphology
58
What is normal testicular volume in an adult and a pre-pubertal male?
Pre-pubertal 1-3 mls | Adult 12-25 mls
59
A testicular volume less than what is likely infertile?
5 mls
60
What is the 2nd line Ix for male infertility?
Repeat semen analysis Hormone profile Karyotype
61
What is the pathology of endometriosis?
Endometrial glands + stroma present outside uterine wall
62
Where are some common locations of endometriosis deposits?
Ovary, peritoneum, pouch of Douglas, cervix, vulva, vagina, bladder, bowel
63
Endometriotic cysts on the ovary can cause what symptoms?
Dysmenorrhea, premenstrual pain, tender nodular mass, subfertile, dyspareunia
64
How is endometriosis diagnosed?
For an official diagnosis laparoscopy is required
65
What is the management of endometriosis
1st line for S+S control contraception or mefenamic acid Surgery to improve fertility
66
What are some complications of endometriosis?
Endometrioid carcinoma Ectopic Subfertility
67
What is required for a diagnosis of PCOS?
⅔ of: - Oligo/amenorrhea - Clinical / biochemical raised androgens - Polycystic on US
68
What effect does PCOS have on - Estrogen - Testosterone - LH - FSH - BG - SHBG - Ovarian volume - Tubal patency
- Normal or raised E - Raised T - Raised LH - Normal FSH - Raised BG - Low SHBG - Increased ovarian vol - Patent tubes
69
What is the commonest cause of anovulatory infertility?
PCOS
70
What is the 1st line Mx to decrease androgens in PCOS? What is 1st line Mx of ovulation induction? What should also be supplemented?
Decrease androgens 1st line OCP Ovulation induction 1st line metformin + clomiphene citrate Supplement folic acid
71
What age is premature ovarian failure?
Under 40
72
What effect does premature ovarian failure have on LH, FSH and estrogen?
Raised LH and FSH | Low estrogen
73
What is the genotype in Turner's syndrome?
XO
74
What is the genotype in Klinefelter's syndrome?
47XXY
75
What effect does Klinefelter's syndrome have on LH, FSH, SHBG, T and E?
Raised LH and FSH Raised SHBG Low T Raised E
76
What condition can cause wide space nipples, a broad chest, webbed neck, hypothyroidism and osteoporosis?
Turner's syndrome
77
Does Turner's syndrome cause primary or secondary infertility?
Primary infertility | Primary amenorrhea
78
What is the mechanism of tamoxifen?
Anti-estrogen (Block estrogen receptors in the breast but stimulates them in the ovaries hence good for breast cancer but increases endometrial cancer risk)

Y3 Reproductive (28 decks)

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