Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th Year - Management > Gynaecology - Management > Flashcards

Gynaecology - Management Flashcards

1
Q

PCB - Examination

A

Abdominal exam

Speculum
- Ectropion

Bimanual exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PCB - Investigations

A

HVS, VVS, Endocervical
- STI Screen

Smear/Colposcopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PCB - Management

A
  • Silver nitrate for ectropion
  • Polyp removal
  • Treat STI if present
  • Treat CIN if present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

IMB - Examination

A

Abdominal exam

Speculum
- Ectropion

Bimanual exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

IMB - Investigations

A

TV USS
- Endometrial thickness

Pipelle biopsy

Hysteroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Amenorrhoea - Classification

A

Primary - no period by 16

Secondary - no period for 6 months

Oligmenorrhoea = cycle longer than 35 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Amenorrhoea - Physiological

A

Pregnancy

Menopause

Lactation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Amenorrhoea - Pathological

A

Hypothalamus/hypogonadism

  • Anorexia
  • Athleticism

Pituitary
- adenoma

Hyperthyroid

Ovarian

  • PCOS
  • Premature ovarian failure (Turner’s syndome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pre-Menstrual Syndrome - Management

A

SSRIs

COCP (avoid progesterone only contraception)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PCOS - Investigations

A

USS Ovaries

Bloods

  • Increased testosterone
  • Increased LH
  • Low 21 day progesterone (no corpus luteum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PCOS - Management

A
  • Weight loss
  • For infertility - clomiphene, metformin
  • Oligmenorrhoea - COCP to induce bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PCOS - Complications

A

Diabetes

CVD

Endometrial/ovarian/breast Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

HRT - Contraindications

A

Absolute

  • current breast/endometrial Ca
  • vaginal bleeding
  • breast mass
  • VTE
  • Liver disease

Relative

  • Endometriosis
  • Fibroids
  • Fam hx breast/endometrial ca, VTE/liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HRT - Pros and Cons

A

Pros

  • Symptom relief
  • Less oesteoporosis

Cons

  • increase breast Ca
  • progest/oestrogen SE
  • VTE and CVD risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PMB - Investigations

A

Fast track TV USS

If more than 5mm

Urgent hysteroscopy and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PMB - Management

A

Endometrial Ca - oncology

Endometrial hyperplasia

  • Atypical cells = hysterectomy
  • Typical cells = Mirena/COCP

Vaginal Atrophy

  • Topical cream (local ok in breast Ca)
  • Lubrication and reassurance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PMB - Risk Factors

A

Increased Oestrogen = increased proliferation

  • Early menarche, late menopause
  • Oestrogen HRT
  • PCOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endometriosis - O/E

A

Bimanual

  • Fixed, retroverted, tender uterus
  • Bilateral cervical motion tenderness
  • Adnexal tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Endometriosis - Investigations

A

Laparotomy = diagnostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Endometriosis - Medical Management

A
  • NSAIDS
  • COCP back to back
  • Mirena
  • GnRH analogues (6 months max due to bone demineralisation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Endometriosis - Surgical Management

A
  • Ablation
  • Cystectomy
  • Hysterectomy (last resort) - may need HRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PID - Investigations

A

PT

Triple Swabs

Bloods

  • HIV
  • Syphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PID - Examination

A

Abdominal
Speculum
Bimanual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PID - When to treat?

A

Treat if lower abdo pain + one of:

  • Adnexal pain
  • Cervical motion tenderness
  • Adnexal mass

With negative PT

25
Q

PID - Abx

A

Ceftrioxone 500mg IM stat

Doxyclycline 100mg PO BD 14 days

Metronidazole 400mg BD 14 days

26
Q

PID - Complications

A

TF infertility

Increased risk ectopic

Fitz-Hugh-Curtis (peri-hepatitis)

Chronic pain

27
Q

Miscarriage

A
  • Refer to EPU
  • PT
  • TVUSS if positive
28
Q

Miscarriage - TV USS Empty

A
  • Complete miscarriage
  • PUL (safety net)
  • Too early (bHCG blood test)
29
Q

Miscarriage - Intrauterine Pregnancy

A
  • Heartbeat = viable
  • Too early = return 7-10 days
  • No heartbeat = incomplete/missed/inevitable miscarriage (requires management)
30
Q

Miscarriage - Options

A

Conservative
- <12 weeks

Surgical

  • Infection, bleeding, damage
  • 5% failure

Medical

  • Misoprostol <13 weeks
  • Preg test after 3 weeks to check success
  • 5% failure
  • increased risk of RPOC
31
Q

Ectopic Pregnancy - O/E

A
  • Shocked, collapse
  • Tenderness
  • Cervical motion tenderness
32
Q

Ectopic Investigations

A

PT

TV USS - empty or adnexal pregnancy

B-HCG over 48 hours - plateau (<66% rise)

33
Q

Ectopic - TV USS Findings

A
  • Free peritoneal fluid
  • Thickened endometrium
  • Adnexal mass
34
Q

Ectopic - Management

A

Medical <35mm/no heartbeat/bHCG <1500

  • Methotrexate
  • Need 6m contraception following as teratogenic

Surgical >35mm/heartbeat/pain/rupture
- Salpingectomy

35
Q

Molar Pregnancy - Causes

A

Complete
- 1 sperm, empty ovum 46XX

Partial
- 2 sperm, 1 egg

36
Q

Molar Pregnancy - Investigations

A

USS - Snowstorm appearance

Confirmed on histology

37
Q

Molar Pregnancy - Management

A

ERPC Suction and cutterage removal

Rising bHCG levels suggest malignancy (100% survival)

38
Q

Fibroids - Investigations

A

TV USS

39
Q

Fibroids - Medical Management

A

Wanting children
- Tranexamic Acid, Mefanamic Acid

Not wanting children

  • Mirena
  • COCP
  • GNRH
40
Q

Fibroids - Surgical Management

A
  • Resection
  • Myomectomy (keeps fertility)
  • UAE
  • Hysterectomy
41
Q

Stress Incontinence - Investigations

A

Urodynamics

  • urine leaks with no change in bladder pressure
  • Response to increase abdo pressure
42
Q

Stress Incontinence - Management

A
  • 3 months Pelvic floor exercises
  • Lose weight

Medical
- Duloxetine

Surgical

  • TV tape
  • Collagen/injectable
43
Q

Urge Incontinence - Investigations

A

Urodynamics

  • Involuntary increase in detrusor activity
  • Increased bladder pressure and leakage of urine
44
Q

Urge Incontinence - Management

A
  • Avoid caffeine
  • Stop smoking
  • Bladder retraining

Medical
- Anticholinergics - tolteradine, oxybutinin, TCAs

Surgical
- Botox

45
Q

Prolapse - Classification

A

I - Cervix within vagina
II - Cervix at introitus
III - Entire uterus outside vagina

46
Q

Prolapse - Management

A
  • Lose weight
  • Pelvic floor exercises
  • Pessary (ring, shelf, gelhorn)

Surgical

  • Ant/post repair
  • Hysterectomy (risk vault prolapse)
  • Vaginal Mesh
47
Q

Cervical Ca - Investigations

A

Colposcopy +/- biopsy
MRI Pelvis
CT abdomen and chest for staging

48
Q

Cervical Ca - Spread

A

Direct
- Vagina, bladder, peritoneum, bowel

Indirect
- Parametrial, internal, external and common iliac nodes

49
Q

Cervical Screening

A

Mild Dyskaryosis, Test for HPV

\+ve = colposcopy
-ve = return to normal screening

Moderate dyskaryosis or worse
= colposcopy

50
Q

CIN

A

CIN 1

  • mild, lower 1/3
  • Repeat 6/12/24 months then back to normal screening

CIN II

  • Moderate, lower 2/3
  • LETTZ
  • 6M, 12M, yearly for 9 years

CIN III

  • Severe, throughout
  • LETTZ
  • 6M, 12M, yearly for 9 years
51
Q

PMB ?Endometrial Ca - Investigations

A

TV USS - thickness >4mm

Biopsy/pipelle in clinic

Hysteroscopy

52
Q

Endometrial Ca - Risk Factors

A

Increased oestrogen

  • obesity, diabetes, sedentary
  • early menarche, late menopause
  • PCOS, HRT, Tamoxifen
53
Q

Ovarian Ca - Investigations

A

Pelvic USS

Ca-125

CT abdomen/pelvis for staging

54
Q

Ovarian Ca - Staging

A

I - ovaries
II - pelvis
III - small bowel or omentum
IV - Distant mets

55
Q

Subfertility - Lifestyle

A
  • Stop smoking
  • Folic acid 5mg
  • Lose weight (BMI <30)
  • Decrease alcohol intake
56
Q

Subfertility - Investigations

A

STI Screen

Mid-luteal progesterone (day 21 in 28 day cycle)

Sperm analysis

  • USS
  • Hysterosalpingogram
  • Lap and Dye
57
Q

Subfertility - Mx

A

PCOS

  • lose weight
  • Metformin, clomifene

Premature ovarian insufficiency

  • Stop smoking
  • Specialist referral
  • Egg donation

Tubal Factor

  • Intrauterine insemination
  • IVF
  • ICSI
58
Q

Fertility Treatment - Risks

A

Multiple pregnancy (10 x higher chance)

Ovarian hyperstimulation syndrome

  • fluid accumulation and dehydration due to increase capillary permeability
  • Young, PCOS, pregnant

4th Year - Management (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions