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Weak spots > Gyne > Flashcards

Gyne Flashcards

1
Q

What is the main risk of oestrogen only hrt

A

Endometrial cancer

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2
Q

What is the impace of COCP on cancer

A

Ovarian and endometrial = protective
breast and and cervical = increase

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3
Q

What is the most common ovarian cancer

A

Serous carcinoma

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4
Q

asymptomatic simple cyst on ovary

A

Follicular (common)

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5
Q

Severe Pre eclampsia plus abdo pain first line

A

IV magnesium sulphate

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6
Q

Oestrogen receptor positive pre menopause

A

Tamoxifen

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7
Q

Oestrogen receptor positivd post menopausal

A

Anastrozole -aromatase inhibitor

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8
Q

What is a sign of ovarian cancer

A

Ascites with multilocular lesions

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9
Q

What is a sign of ovarian torsion

A

Wirlpool

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10
Q

What is a sign of pcos on ultrasound

A

String of pearls

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11
Q

Syphilis treatment

A

Intramuscular benzathine penicillin G

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12
Q

Neurosyphilis presentstion

A

Confusion, personality change, recent memory loss
Positive rombergs test and absent knee reflexes

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13
Q

Painless ulcers on genitals and enlarged inguinal lymph nodes

A

Syphilis

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14
Q

Painful genital ulcer and tender swollen inguinal lymph nodes
Gram negative rods

A

Chancroid - haemophilus ducreyi

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15
Q

Ulcers with vesicles

A

Herpes

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16
Q

2 stages of menstrual cycle

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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17
Q

What happens in luteal phase

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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18
Q

What happened in follicular stage

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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19
Q

Cocp contraindications

A

Breastfeeding under 6w post partum
Smoking over age 35
BMI over 40
Migraine with aura
History of VTE
Major surgery

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20
Q

Contraindications for ulipristal acetate emergency contraception

A

Crohns
Allergy
Breast feeding
Hepatic dysfunction
Asthma

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21
Q

Endometriosis signs

A

Visible endometrial tissue in vagina (posterior fornix)
Fixed retroverted uterus
Pain on examination

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22
Q

Miscarriage risk factors

A

Previous miscarriage
Smoking/alcohol
Advanced maternal age
Phospholipid syndrome

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23
Q

Causes of recurrent miscarriage

A

Anti phospholipid syndrome - causes placental insufficiency
Uterine abnormality/bicornuate uterus
Ashermans syndrome

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24
Q

Cervical cancer risk factors

A

Hiv
Smoking
Many sexual partners
High parity
Combined oral contraceptive pill

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25
Q

Which HPV causes cervical cancer

A

16/18

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26
Q

Prolapse risk factors

A

Obesity
Chronic Constipation
Multiple vaginal delivery
COPD

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27
Q

Types of prolapse

A

Cystocele
Rectocele
Uterine prolapse
Vault prolapse

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28
Q

Fitz Hugh Curtis syndrome cause + finding

A

Prolonged chlamydia infection
violin string adhesions between liver and peritoneum

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29
Q

What thyroid hormone abnormality is molar pregnancy

A

High T3/T4
Low TSH

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30
Q

A 65-year-old woman presents with vulval itching and white, shiny plaques on the vulva. On examination, the lesions are atrophic and involve the perianal area.

what condition an what first-line treatment?

A

lichen sclerosis - white shiny plaques

topical clobetasol propionate/dermovate

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31
Q

Which of the types of twin configuration is most common in twin-twin transfusion syndrome?

A

Monochorionic diamniotic twins

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32
Q

where is a ruptured ectopic most likely to occur

A

isthmus of fallopian tube

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33
Q

what is the recurrence rate after 1 ectopic pregnancy

A

18.5%

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34
Q

Most common site of ectopic

A

ampulla of fallopian tube

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35
Q

Criteria for 2 week wait breast referral with ages

A

Over 30 with unexplained lump
Over 50 with nipple discharge or retraction

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36
Q

Which serum marker for breast cancer

A

CA15-3

37
Q

how long post pregnancy should a woman wait for cervical cancer screening

A

3 months

38
Q

A 55-year-old female patient presents to her GP complaining of breast pain and a new hard lump. She mentioned she recently injured her breasts on a door. Her past medical history includes diabetes and hypertension, and she has a BMI of 34. What is the most likely diagnosis?

A

fat necrosis

39
Q

What cancer marker is used for ovarian cancer

A

Ca125

40
Q

What blood test results indicates menopause

A

High fsh

41
Q

What is the order of movements of the fetus during delivery

A

Flextion, internal rotation, extension, external rotation

42
Q

A 22 year old woman attends the Emergency Department with pain and tenderness of the left breast for 48 hours. She is breastfeeding. She has a swollen right breast with a 5 cm mass which is red and tender and several tender enlarged nodes under the arm. She has a fever of 38ºC, pulse of 78 bpm and BP of 120/80 mmHg.

what condition

A

breast abbcess

43
Q

what occurs in primary syphilis

A

small papule and painless enlarged lymph nodes - lasts 2-6 weeks

44
Q

small papule and painless enlarged lymph nodes - lasts 2-6 weeks
what

A

primary symphilis

45
Q

what occurs in secondary syphilis

A

4-8 weeks after primary lesion
macularpapular rash - not itchy
fever, headache and lymphadenopathy rarely

46
Q

4-8 weeks after primary painless red papule
macularpapular rash - not itchy
fever, headache and lymphadenopathy rarely
what

A

secondary syphilis

47
Q

complications of syphilis

A

neurosyphilis
cardiosyphilis - aortitis

48
Q

IUGR diagnostic

A

Abdominal circumference/estimated foetal weight less than the 10th centile for gestation
oligohydramnios, abnormal UA Doppler, poor interval growth velocity,
EFW <3rd centile

49
Q

chlamydia treatment

A

doxycycline 100mg twice a day for 7 days
CI - breast feeding/pregnant

Azithromycin 1g stat then 500mg once a day for 2 days

50
Q

Thrush treatment

A

Oral fluconazole
If preggers - Clotrimazole intravaginal pessary

51
Q

Bacterial vaginosis presentation

A

Thin grey discharge
Fishy

52
Q

Bacterial vaginosis treatment

A

Oral metronidazole
Vaginal clindamycin cream

53
Q

Hot flushes treatment

A

Hrt
Fluoxetine ssri

54
Q

Stress incontinence medication

A

Duloxitine

55
Q

Strength of pelvic muscle contraction score

A

Oxford score
5 - strong
0 - nothing

56
Q

First line investigation stress incontinence

A

Urine dipstick and bladder diary

57
Q

5 treatment for stress incontinence

A

Weight loss
Stopping smoking/asthma control
Pelvic floor excersice - 3 months
Duloxitine
Surgery

58
Q

Overactive bladder treatment

A

Bladder retraining
Solifenacin (anticholinergic)
Mirabegron (beta 3 agonist)
Botox injections
Sacral nerve stimulation

IN THIS ORDER

59
Q

Most common infertility cause

A

30% Male factor

25% ovulatory factor

60
Q

Preconception advice

A

400 micrograms folic acid (high risk 5mg)
Vitamin D
Healthy diet/excersice
Normal weight

61
Q

Complication of hormonal fertility treatment

A

Ovarian hyper stimulation syndrome

62
Q

Ovarian hyper stimulation syndrome

A

Abdo pain
Vomiting
Recent IVF

Large ovary size
Ascites
Hypo-osmolarity
Thromboembolism

63
Q

IUGR risk factors

A

Booking BMI
Smoking
Previous IUGR/Pre eclampsia

64
Q

investigations for 3rd trimester foetus

A

ultrasound foetal growth measurments/amniotic fluid measurement
doppler umbilical artery waveform
cardiotocography

65
Q

2 medications for premature babies

A

steroids - lung maturation
magnesium sulfate - neuroprotection

66
Q

cause of raised urea/creatinine in ovarian cancer

A

renal tract obstruction or dehydration leading to loss of third space fluid

67
Q

cause of anaemia in cancer

A

presence of cancer/anaemia of chronic disease

68
Q

what investigations in ovarian cancer

A

ultrasound abdo pelvis
CT chest abdo pelvis
CA125

69
Q

Pcos diagnostic criteria

A

Rotterdam

2/3
Oligomenorrhea
Polycystic overies
Hyperandrogenism

70
Q

3 blood tests in Pcos

A

Testosterone
FSH
TSH

71
Q

Treatment for hormonal acne

A

Combined Oral contraceptive pill
Antibiotics
Azelaic acid

72
Q

Black skin in armpits/neck/groin

Name and what condition

A

Acanthosis Nigricans

Insulin resistance

73
Q

Downs syndrome signs

A

Short stature
Short neck
Single Palmer crease
Sandel toe gap
Flat occiput
Prominent epicanthic folds

74
Q

Antenatal chromosome testing

A

Combined test - 11-14 weeks
Quadruple test - 15-20

75
Q

Gestational diabetes complications

A

Macrosomia
Shoulder dystocia
Pre-term birth
Neonatal hypoglycemia

76
Q

Most common breast cancer

A

Invasive ductal carcinoma of no special type

77
Q

What is used to asses risk of 5 year recurrence of breast cancer

A

Nottingham prognostic index

78
Q

Fibroadenoma presentation + pathophysiology

A

Firm, rubbery, painless, mobile lump.

Benign tumour of epithelial breast duct tissue

79
Q

When operation on fibroadenoma

A

Over 3cm - rare

80
Q

If one relative with breast cancer, what indicates referral

A

Bilateral
Under 40
Male

81
Q

Prophylactic BRCA surgery

A

Bilateral mastectomy with bilateral oophorectomy

82
Q

Breast screening age

A

50 to 70 every 3 years

83
Q

Differential for nipple discharge

A

Physiological
Galactorrhoea
Mammary duct ectasia
Carcinoma

84
Q

Green nipple discharge

What and who

A

Mammary duct ectasia - dilation of large breast duct
Post menopausal women

85
Q

What medication causes gynaecomastia

A

Spironalactone (most common)
Antipsychotics
Digoxin

86
Q

Causes of gynaecomastia

A

Kallmans/Klinefelter s syndrome
Mumps/testicular failure
Testicular cancer

87
Q

Blood tests gynaecomastia

A

TFT
U+E

FSH
LH
PROLACTIN
testosterone

88
Q

Medication for gynaecomastia

A

Tamoxifen (selective oestrogen receptor modulator)

Weak spots (7 decks)

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