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YEAR 3 REVISION > Gynaecology and EPU > Flashcards

Gynaecology and EPU Flashcards

1
Q

When is cervical screening performed?

A

Every 3 years from the ages of 25-50, then every 5 years from the ages of 50-64

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2
Q

What is the virus called that, if it progresses, causes cervical cancer?

A

HPV (Human Papillomavirus)

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3
Q

What are the 2 types of cells of the cervix?

A

Squamous and columnar

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4
Q

Describe HPV

A
  • Infects genital area
  • Normally asymptomatic and resolves spontaneously
  • If it is persistent, can cause cancer
  • Found at screening = organise biopsy
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5
Q

What are the 5 types of treatment available for cervical cancer?

A
  1. LLETZ
  2. Cold coagulation
  3. Cryocautery
  4. Cone biopsy
  5. Laser treatment
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6
Q

What is a LLETZ procedure?

A

Killing abnormal cells using a loop with an electrical current - under local anaesthetic

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7
Q

What is cold coagulation?

A

Killing abnormal cells using a heated probe

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8
Q

What is cryocautery?

A

Abnormal cells are frozen and destroyed

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9
Q

What is a cone biopsy?

A

A cone-shaped piece of tissue is cut out that contains abnormal cells - under GA

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10
Q

What is laser treatment?

A

A laser is used to pinpoint and destroy abnormal cells

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11
Q

If a woman is due a smear test when she falls pregnant, how soon after delivery should she have one?

A

3 months

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12
Q

Why is it not advised to have a smear test procedure during pregnancy?

A

Risk of preterm labour

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13
Q

What are the 5 most common sites for an ectopic pregnancy?

A
  1. Fallopian tube
  2. Abdomen
  3. Cervix
  4. Ovary
  5. CS scar
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14
Q

What is a heterotopic pregnancy?

A

Ectopic and IU pregnancy occur at the same time

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15
Q

What are some of the symptoms of an ectopic pregnancy?

A
  • Abdo pain
  • Vaginal bleeding
  • Breast tenderness
  • Shoulder tip pain
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16
Q

What are the 2 types of surgery that can be performed on the fallopian tubes?

A
  1. Salpingectomy = surgical removal of tubes

2. Salpingotomy = creating an opening in the tubes

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17
Q

What medication is sometimes given for an ectopic pregnancy?

A

Methotrexate - an immunosuppressant which stops cells from dividing

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18
Q

When must methotrexate not be used?

A

Heterotopic pregnancy - will stop the IU pregnancy from growing

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19
Q

What are the 4 types of miscarriage?

A

The spontaneous loss of a pregnancy before 24 weeks gestation

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20
Q

What is an early miscarriage?

A

Occurs <13/40

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21
Q

What is a late miscarriage?

A

Occurs between 13-24/40

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22
Q

What are the 5 classifications of miscarriage?

A
  1. Complete
  2. Incomplete
  3. Missed
  4. Threatened
  5. Inevitable
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23
Q

What is a complete miscarriage?

A
  • All products of conception expelled

- Bleeding stopped

24
Q

What is an incomplete miscarriage?

A
  • Diagnosed non-viable pregnancy

- Bleeding continues

25
Q

What is a missed miscarriage?

A

Diagnosed miscarriage with no pain or bleeding

26
Q

What is a threatened miscarriage?

A

Vaginal bleeding in the first 24 weeks of pregnancy

27
Q

What is an inevitable miscarriage?

A

Diagnosed miscarriage where bleeding is occurring and the cervix is open (this will proceed to complete/ incomplete)

28
Q

What are the 3 types of miscarriage management?

A
  1. Expectant
  2. Medical
  3. Surgical
29
Q

What is expectant management of a miscarriage?

A

Wait for 7-14 days for foetus to pass naturally

30
Q

What would be some contraindications for expectant management of miscarriage?

A
  • Increased risk of haemorrhage
  • Previous trauma
  • Evidence of infection
31
Q

What is medical management of a miscarriage?

A
  • Misoprostol given
  • Must be admitted if bleeding hasn’t started within 24 hours
  • Prescribe pain relief and anti-emetic
  • Take pregnancy test 3 weeks post treatment
32
Q

If the pregnancy test 3 weeks after medical management is positive, what might this indicate?

A

Molar or ectopic pregnancy

33
Q

What is surgical management of a miscarriage?

A

ERPC (evacuation of retained products of conception)

- Vacuum aspiration under local anaesthetic or ERPC under GA

34
Q

What must be given after surgical management of miscarriage?

A

Anti-D to Rh-ve women

35
Q

What is gestational trophoblastic disease?

A

A group of conditions in which tumours grow inside the uterus

36
Q

What are the symptoms of gestational trophoblastic disease?

A
  • Abnormal pv bleeding
  • Uterus larger than expected
  • Severe N+V
  • High BP in early pregnancy
37
Q

What is the treatment for gestational trophoblastic disease?

A
  • Suction curettage (for molar pregnancies)
  • Pregnancy test 3 weeks after treatment
  • Anti-D prophylaxis for Rh-ve women
38
Q

What is PCOS?

A
  • Polycystic ovary syndrome
  • ?Caused by excess insulin = increased testosterone production
  • No dominant follicle so none reach maturity
39
Q

What are the symptoms of PCOS?

A
  • Infrequent/ anovulation
  • Hirsutism (male-pattern hair growth)
  • Male-pattern alopecia
  • Acne
  • Elevated testosterone levels
40
Q

What is the treatment for PCOS?

A
  • Clomiphene (clomid)
  • Combined contraceptive pill
  • Surgery
  • Metformin
41
Q

How does Clomiphene treat PCOS?

A

It induces ovulation

42
Q

How is surgery used to treat PCOS?

A

Laparoscopic ovarian drilling used to destroy cells that are producing testosterone and increase levels of FSH to attempt to restore ovulation and fertility

43
Q

How is the combined contraceptive pill used to treat PCOS?

A

Controls excessive hair growth and hair loss by increasing oestrogen and progesterone levels

44
Q

How is metformin used to treat PCOS?

A
  • Lowers insulin levels = lower testosterone
  • Stimulates ovulation
  • Not licensed in UK for PCOS treatment but can be used ‘off-label’
45
Q

What is endometriosis?

A

Endometrial tissue found outside of the uterus

46
Q

What are the symptoms of endometriosis?

A
  • Abdominal cramps
  • Dyspareunia
  • Infertility
  • Pain on defecation
  • Chronic pelvic pain
47
Q

How is endometrisos treated?

A

(No cure for endometriosis)

  • Combined contraceptive pill
  • POP
  • Surgery
48
Q

How does the combined contraceptive pill/ POP help with endometriosis?

A

Reduces oestrogen levels to reduce production of endometrial tissue

49
Q

How is surgery used to treat endometriosis?

A
  • Laparoscopy treatment to remove tissue/ cysts

- Hysterectomy

50
Q

If a woman has had 3 or more miscarriages, what investigations should take place?

A

Blood tests to determine antibodies in blood (looking for Lupus)

51
Q

What is Lupus?

A
  • Disease in which the immune system attacks organs, causing swelling and excessive blood clotting
  • Can cause clots in the placenta, causing miscarriage
52
Q

What colposcopy investigations can be performed during pregnancy?

A
  • Can perform biopsy

- Avoid LLETZ procedures unless cancerous cells found

53
Q

What advice should be given after a colposcopy procedure?

A
  • Cramping and small amount of pv bleeding normal
  • Avoid strenuous exercise for 2-3 weeks
  • No baths or tampons for 2-3 weeks
54
Q

How is a miscarriage diagnosed?

A
  • CRL >7mm and no FH activity
  • No foetal pole or yolk sac seen
  • 2nd sonographer must check findings
55
Q

How is Hyperemesis diagnosed?

A
  • > 5% pre-pregnancy weight loss
  • Dehydration
  • Electrolyte imbalance
56
Q

What is a molar pregnancy?

A

There is cell growth present but they don’t differentiate into a foetus

57
Q

What should women be advised to do 2 weeks after a miscarriage?

A

Pregnancy test (progesterone can remain high for up to 2 weeks after end of pregnancy, so test may be positive before then)

YEAR 3 REVISION (49 decks)

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