Gynaecology - fastest and pass medicine

Question 1

what is the most common cause of recurrent first trimester spontaneous miscarriage?

Answer 1

antiphospholipid syndrome

Question 2

what is the definition of recurrent miscarriage?

Answer 2

3 or more consecutive spontaneous abortions

Question 3

what are the causes of recurrent miscarriages? (5)

Answer 3

antiphospholipid syndrome 
endocrine disorders: poorly controlled diabetes mellitus/thyroid disorder, PCOS 
uterine abnormality - uterine septum 
parental  chromosomal abnormalities 
smoking

Question 4

symptoms of PMS regularly occur during which phase?

Answer 4

luteal phase of the menstrual cycle

Question 5

when do symptoms of PMS improve?

Answer 5

end of menstruation

Question 6

what are the symptoms of PMS? (4)

Answer 6

anxiety, irritability, bloating and nostalgia

Question 7

what is the lifestyle management of PMS?(4)

Answer 7

healthy diet, exercise, reduction in stress levels and regular sleep

Question 8

what is used to treat moderate to severe symptoms of PMS?

Answer 8

combined oral contraceptive pill and SSRIs

Question 9

what is not recommended as treatment of PMS symptoms?

Answer 9

pyridoxine and progesterone alone

Question 10

what are the commonest types of ovarian cysts?

Answer 10

follicular cysts

Question 11

what types of cysts occur due to non-rupture of the dominant follicle or failure of atresia in a non-dominant follicle?

Answer 11

follicular cysts

Question 12

what type of cyst occurs during the menstrual cycle if the pregnancy doesn’t occur and the corpus luteum doesn’t break down and disappear and its filled with blood or fluid

Answer 12

corpus luteal cyst

Question 13

what is the presentation of corpus luteum cyst?

Answer 13

intraperitoneal bleeding

Question 14

what is the most common type of ovarian cancer

Answer 14

serous carcinoma

Question 15

what are the features of PCOS? (7)

Answer 15

subfertility and infertility
menstrual disturbances: oligomenorrhea and amenorrhoea
hirsutism, acne (due to hyperandrogenism)
obesity
acanthosis nigricans (due to insulin resistance)

Question 16

what does PCOS pelvic ultrasound show?

Answer 16

multiple cysts on the ovaries

Question 17

what is the classic investigative feature of PCOS?

Answer 17

LH;FSH ratio is raised

Question 18

what do you need to check for in PCOS?

Answer 18

impaired glucose tolerance

Question 19

GnRH agonists may ——- the size of uterine fibroids?

Answer 19

reduce

Question 20

what can reduce the severity of fibroid-related bleeding?

Answer 20

progesterone receptor inhibitors

Question 21

what shouldn’t be taken 4-6 weeks prior to major surgery due to increased risk of venous thromboembolism?

Answer 21

COCP

Question 22

what are common associations with uterine fibroids?

Answer 22

more common in afro-caribbean women

rare before puberty, develop in response to estrogen and don’t tend to progress following menopause

Question 23

how do you diagnose uterine fibroids?

Answer 23

transvaginal ultrasound

Question 24

what is a complication of uterine fibroids?

Answer 24

red degeneration - hemorrhage into tumour

Question 25

when does red degeneration commonly occur?

Answer 25

during pregnancy

Question 26

reinfibulation is ----- and --------- be done under any circumstances

Answer 26

illegal and cannot

Question 27

which act advises that all forms of female genital cutting/modification of anon-medical reasons is illegal and cannot be performed underhand circumstances, not illegal to discuss it

Answer 27

the female genital mutilation act 2003

Question 28

``` which class of FMG is this: Partial or total removal of the clitoris and/or the prepuce (clitoridectomy). ```

Answer 28

type 1

Question 29

which class of FGM is this: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

Answer 29

type 2

Question 30

``` which class of FGM is this: Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). ```

Answer 30

type 3

Question 31

``` which class of FGM is this: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization. ```

Answer 31

type 4

Question 32

what is the treatment for vaginal vault prolapse?

Answer 32

sacrocolpoplexy

Question 33

what procedure suspends the vaginal apex to the sacral promontory?

Answer 33

sacrocolpoplexy

Question 34

what is the procedure when the vaginal wall is repaired following a cystocele?

Answer 34

anterior colporrhaphy

Question 35

what is the procedure when reconstruction of the vagina is done to make t'tighter" following childbirth e.g.

Answer 35

vaginoplasty

Question 36

what is the procedure when the uterus is removed via the vagina?

Answer 36

vaginal hysterectomy

Question 37

what is the procedure when the ovaries are removed?

Answer 37

bilateral oophorectomy

Question 38

what is called when there is descent of one of the pelvic organs resulting in protrusion on the vagina walls?

Answer 38

urogenital prolapse

Question 39

what percentage of women are affected by urogenital prolapse?

Answer 39

40%

Question 40

what are the risk factors for urogenital prolapse? (5)

Answer 40

increasing age multiparty, vaginal deliveries obesity spina bifida

Question 41

what is the presentation of urogenital prolapse?

Answer 41

sensation of pressure, heaviness, bearing down | urinary symptoms; incontinence, frequency, urgency

Question 42

what is the conservative management of urogenital prolapse?

Answer 42

weight loss, pelvic floor muscle exercises

Question 43

if the patient has asymptomatic and mild prolapse what is the treatment?

Answer 43

no treatment needed

Question 44

what are other options for treatment of urogenital prolapse?

Answer 44

ring pessary and surgery

Question 45

how do surgically treat cystocele/cystourethrocele?

Answer 45

anterior colporrhaphy, colposuspension

Question 46

how do you treat uterine prolapse?

Answer 46

hysterectomy, sacrohysteropexy

Question 47

how do you treat rectocele?

Answer 47

posterior colporrhapy