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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
Q

What type of urinary incontinence is when there is a sudden compelling desire to urinate?

A

Urge

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26
Q

What is the pathology of an overactive bladder?

A

Involuntary detrusor contractions

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27
Q

How do you classify overactive bladder?

A

Wet and dry

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28
Q

Give 4 examples of storage urinary incontinence symptoms

A

Freq, nocturia, urgency, incontinence

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29
Q

Give 3 examples of voiding urinary incontinence symptoms

A

Hesitancy, strain, poor flow

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30
Q

What Ix should you do for all F PTx presenting with urinary incontinence?

A

Urinalysis + post-void residual

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31
Q

What Ix should you do for a patient presenting with urinary incontinence and you suspect a tumour?

A

Urinalysis + post-void residual + cystoscopy

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32
Q

What are lifestyle measures you should recommend for patients PC urinary incontinence?

A
33
Q

What is the 1st line drug Mx of urinary incontinence? And what class is it in?

A

PO oxybutynin

Antimuscarinic

34
Q

When are antimuscarinics CI?

A

Dementia / elderly

35
Q

What are the SEs of antimuscarinic?

A

Dry mouth, constipation, blurred vision, somnolence, confuse

36
Q

What drug is an alternative to antimuscarinics in the Mx of the urinary incontinence? And what drug class does it belong to?

A

B3 agonist mirabegron

37
Q

What drug is the Mx of nocturia?

A

Desmopressin

38
Q

What is the Mx of vaginal atrophy?

A

TOP estrogen

39
Q

Chronic constipation is a RF for pelvic organ prolapse. T or F

A

True

40
Q

What is the commonest type of pelvic organ prolapse?

A

Cystocele (bladder)

41
Q

How does a cystocele present?

A

Bulge
Incomplete bladder empty
Urge / stress incontinent

42
Q

How does uterine prolapse present?

A 
Dragging
Back pain
Mass
Dyspareunia
Difficulty inserting / retaining tampon
43
Q

What are the stages of uterine prolapse?

A 
0: none
I: 1cm above hymen
II
III: >1cm beyond hymen
IV: complete vaginal eversion
44
Q

What is the 1st line Mx of uterine prolapse?

A

Pessary

45
Q

What is the Ix for pelvic organ prolapse and why?

A

US to exclude mass

46
Q

What imaging modality is used for bowel dysfunction and pre surgery for pelvic organ prolapse?

A

MRI

47
Q

How is male infertility classified?

A

Obstructive and non-obstructive

48
Q

Give 3 causes of obstructive male infertility?

A

CF, vasectomy, infection

49
Q

Give 5 causes of non-obstructive male infertility?

A

Mumps orchiditis
Chemo / radio
Cryptorchidism
Systemic illness

50
Q

Is idiopathic male infertility obstructive or non-obstructive?

A

Non-obstructive

51
Q

Is Klinefelters male infertility obstructive or non-obstructive?

A

Non-obstructive

52
Q

Is testis cancer male infertility obstructive or non-obstructive?

A

Non-obstructive

53
Q

What effect does obstructive male infertility have on:

  • Testis volume
  • 2ndry sexual characteristics
  • LH
  • FSH
  • T
A

All normal

54
Q

What effect does obstructive male infertility have on:

  • Testis volume
  • 2ndry sexual characteristics
  • LH
  • FSH
  • T
A
  • Testis volume DECREASED
  • 2ndry sexual characteristics DECREASED
  • LH INCREASED
  • FSH INCREASED
  • T NOT SURE
55
Q

What effects does a raised PRL have on LH and FSH?

A

Decreases them

56
Q

What is the 1st line Ix for male factor infertility?

A

Semen analysis

57
Q

What is analysed in semen analysis?

A

Vol, density (no.), motility, progression, morphology

58
Q

What is normal testicular volume in an adult and a pre-pubertal male?

A

Pre-pubertal 1-3 mls

Adult 12-25 mls

59
Q

A testicular volume less than what is likely infertile?

A

5 mls

60
Q

What is the 2nd line Ix for male infertility?

A

Repeat semen analysis
Hormone profile
Karyotype

61
Q

What is the pathology of endometriosis?

A

Endometrial glands + stroma present outside uterine wall

62
Q

Where are some common locations of endometriosis deposits?

A

Ovary, peritoneum, pouch of Douglas, cervix, vulva, vagina, bladder, bowel

63
Q

Endometriotic cysts on the ovary can cause what symptoms?

A

Dysmenorrhea, premenstrual pain, tender nodular mass, subfertile, dyspareunia

64
Q

How is endometriosis diagnosed?

A

For an official diagnosis laparoscopy is required

65
Q

What is the management of endometriosis

A

1st line for S+S control contraception or mefenamic acid

Surgery to improve fertility

66
Q

What are some complications of endometriosis?

A

Endometrioid carcinoma
Ectopic
Subfertility

67
Q

What is required for a diagnosis of PCOS?

A

⅔ of:

  • Oligo/amenorrhea
  • Clinical / biochemical raised androgens
  • Polycystic on US
68
Q

What effect does PCOS have on

  • Estrogen
  • Testosterone
  • LH
  • FSH
  • BG
  • SHBG
  • Ovarian volume
  • Tubal patency
A
  • Normal or raised E
  • Raised T
  • Raised LH
  • Normal FSH
  • Raised BG
  • Low SHBG
  • Increased ovarian vol
  • Patent tubes
69
Q

What is the commonest cause of anovulatory infertility?

A

PCOS

70
Q

What is the 1st line Mx to decrease androgens in PCOS? What is 1st line Mx of ovulation induction? What should also be supplemented?

A

Decrease androgens 1st line OCP

Ovulation induction 1st line metformin + clomiphene citrate

Supplement folic acid

71
Q

What age is premature ovarian failure?

A

Under 40

72
Q

What effect does premature ovarian failure have on LH, FSH and estrogen?

A

Raised LH and FSH

Low estrogen

73
Q

What is the genotype in Turner’s syndrome?

A

XO

74
Q

What is the genotype in Klinefelter’s syndrome?

A

47XXY

75
Q

What effect does Klinefelter’s syndrome have on LH, FSH, SHBG, T and E?

A

Raised LH and FSH
Raised SHBG
Low T
Raised E

76
Q

What condition can cause wide space nipples, a broad chest, webbed neck, hypothyroidism and osteoporosis?

A

Turner’s syndrome

77
Q

Does Turner’s syndrome cause primary or secondary infertility?

A

Primary infertility

Primary amenorrhea

78
Q

What is the mechanism of tamoxifen?

A

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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