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Gynae > March 2015 recall > Flashcards

March 2015 recall Flashcards

1
Q

Male who was previously fertile now is azoospermic with low FSH and low testosterone, most likely cause?

A

Anabolic steroids

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2
Q

What is the best fertility management for a patient with bilateral hydrosalpinges

A

B/L salpingectomy and IVF
(the salpingectomy will improve chances of IVF)

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3
Q

What is the definition of WHO class 3 ovulaton disorder?

A

Hypergonadotrophic, hypoestrogenic
(High FSH and LH, low estrogen)
- premature ovarian failure
5%

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4
Q

What is the definition of WHO class 1 ovulation disorder?

A

Hypogonadotrophic, hypoestrogenic
-pituitary failure, hyperprolactinaemia
15%

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5
Q

What is the definition of WHO class 2 ovulation disorder?

A

Hypogonadotrophic, normoestrogenic
Axis/ pituitary dysfunction
80%

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6
Q

What scoring system is used to evaluate hirsuitism?

A

Ferrimen Gallwey
0-4
9 areas
Score >8 defines hirsuitism

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7
Q

What is the rotterdam criteria?

A

<9 cycles a year or over 35 days between cycles
Hyperandrogenism eg. Hirsuitism or biochemical (free andogen index >5)
Polycystic ovaries (>12 in one ovary, or 1 ovary >10cm3 in volume)

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8
Q

How do you calculate free androgen index?

A

Total testosterone x 100
Divided by SHBG

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9
Q

If testosterone is >5, what does this suggest?

A

More likely to represent an androgen secreting tumour.
PCOS testosterone is usually <5

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10
Q

Ultrasound features of corpus luteum?

A

Simple to complex cystic lesion
Thick walled
Colour doppler, surrounded with ‘ring of fire’

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11
Q

Ultrasound features of follicular cyst?

A

2.5-6cm, thin walled
Anechoic cyst

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12
Q

Ultrasound features of dermoid cyst?

A

Solid, hyperechoic lines- ‘dermoid mesh’
Rokitansky nodule, dermoid plug
Ectodermal

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13
Q

What percentage of dermoids are bilateral?

A

10-15%

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14
Q

Ultrasound features of endometrioma?

A

low level internal homogeneous internal echoes- ‘ground glass’ appearance
Unilocular

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15
Q

How common is the corpus luteum ipsilateral to the ectopic pregnancy side?

A

70-85%

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16
Q

What clinical picture is given in klinefelter infertility?

A

Oligospermia
Gynaecomastia
Small testes

17
Q

Risk of breast cancer in Klinefelters?

A

4%

18
Q

Women with recurrent UTI + bladder pain has a cystoscopy and shows multiple small haemorrhagic areas, diagnosis?

A

Interstitial cystitis/ bladder pain syndrome

19
Q

What bacteria is the syphillis chancroid caused by?

A

Haemophillus ducreyi

20
Q

Risk of uterine perforation during surgical mx of miscarriage

A

1/1000, up to 15/1000

21
Q

Risk of infection in surgical mx of miscarriage

A

40/1000
Same as risk of RPOC

22
Q

What are the absolute contraindications to UAE

A

Acute infection
Wish to maintain fertility
Absolute refusal of hysterectomy
Pregnancy
Asymptomatic fibroids

23
Q

What is the common bacteria assoc with IUCD infection? And characteristics?

A

Actinomyoces
Gram pos
Sulphur granules

24
Q

Histology of granuloma cell tumour?

A

Call-Exener bodies

25
Q

Histology of krukenberg tumour?

A

Signet ring cells

26
Q

Histology of serous epithelial tumours?

A

Psamomma bodies

27
Q

How does letrozole work?

A

Aromatase inhibitor

28
Q

Risk of recurrence of BV?

A

58%

29
Q

What are the features of mayer rokitansky syndrome (MRKH syndrome)

A

Underdeveloped vagina and uterus- congenital abnormality
Usually present with primary amenorrhoea

30
Q

What is the emergency contraception choice in a patient with epilepsy if copper IUD is not acceptable?

A

Double dose of lenovelle

31
Q

How long before an operation do you need to stop warfarin?

A

5 days

32
Q

When to stop rivaroxaban/ dabigatran pre op?

A

24 hrs

33
Q

If a woman is lost to follow up for colposcopy what sort of investigation should take place?

A

Incident report
Then report to clinical governance
Then root cause analysis

34
Q

How soon after CIN treatment are you followed up?

A

6 months

35
Q

What is the management option of an incompletely excised CIN after LLETZ?

A

Under 50-
Over 50- repeat LLETZ (unless CGIN in which case they need a cone biopsy)

36
Q

How do you follow up a patient who has hysterectomy with incomplete excised CIN?

A

CIN 1, vault sample at 6,12, 24mth
CIN 2/3 vault sample at 6,12 and annually for 9 more years.

37
Q

How long can you conservatively manage CIN 2 for?

A

24 months.
Can’t be present in more than 2 quadrants. Colposcopy must have been adequate enough to rule out CIN 3/ invasive lesion. Must agree to 6 monthly repeat colp.
If present at 24 months needs LLETZ

Gynae (7 decks)

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