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4th Year SB > OBGYN > Flashcards

OBGYN Flashcards

1
Q

what is histology of ectocervix

A

stratified squamous

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2
Q

what is histology of endocervix

A

columnar (glandular)

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3
Q

what is histology of transition zone

A

squamo-columnar junction

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4
Q

what is does the normal menstrual cycle composed of

A

Normal Menstrual Cycle:
Cycle length usually 28 days
Between 21-35days

Day 1-14 = follicular phase (↑ FSH & oestrogen)

Day 14 – 28 = luteal phase (↑ LH & progesterone)

Ovulation occurs 24-36hours post LH surge

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5
Q

tx for DUB

A

1st line = mirena IUS

2nd line = cOCP, POP

non-hormonal = tranexamic acid

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6
Q

what is a normal vaginal flora

A

lactobacillis

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7
Q

buzzword = itchy, white, curd-like

A

candida

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8
Q

buzzword = Fishy, watery discharge, clue cells on microscopy, increased pH

A

bacterial vaginosis

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9
Q

Most common, asymptomatic or urethritis (M), discharge (F)

A

chlamydia

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10
Q

Gram positive diplococci (kidney bean shaped)

A

gonorrhoea

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11
Q

Painful genital ulcer

A

herpes

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12
Q

what causes genital warts

A

HPV 6 and 11

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13
Q

buzzword = Musty smelling, frothy discharge, strawberry cervix

A

trichomonas

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14
Q

Ix for chlamydia and gonorrhoea

A

FEMALE 1st line = Endocervical swab

MALE 1st line = first pass urine for PCR/NAAY

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15
Q

Ix for syphilis

A

Screening = ELISA

Specific = TPPA

Monitoring = VDRL

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16
Q

Ix for herpes

A

swab ulcer for PCR

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17
Q

Ix for tricomonas

A

high vaginal swab

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18
Q

Mx of candida

A

topical clotrimazole/oral fluconazole

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19
Q

MX of chlamydia and gonorrhoea

A

C = PO Doxy

G = IM ceftriaxone

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20
Q

what is post-menopausal bleeding most suggestive of

A

endometrial cancer

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21
Q

Menorrhagia/dysmenorrhoea + bulky uterus =

A

fibroid

22
Q

Abdo distension, “clothes don’t fit”, SOB =

A

ovarian tumour

23
Q

adenoma + ascites + pleural effusion =

A

meig’s syndrome

24
Q

cOCP + increased discharge =

A

ectropion

25
Q

Contact bleeding/dyspareunia =

A

cervical cancer

26
Q

Fat, acne, oligomenorrhoea =

A

PCOS

27
Q

what is the tumour markers for = ovarian, bowel, pancreas, breast

A

CA125 - ovarian

CEA – bowel

CA19-9 – pancreas

CA15-3 - breast

28
Q

how is CIN 2 and 3 treated

A

LLETZ

- large loop excision of transition zone

29
Q

what investigation should be offered to a woman with symptoms suggest of cervical cancer

A

colposcopy

[not smear as that is screening not diagnostic]

30
Q

what is the cervical screening program

A

A smear test is offered to all women between the ages of 25-64 years

25-49 years: 3-yearly screening
50-64 years: 5-yearly screening

31
Q

what are risk factors for cervical cancer

A

Smoking

Increased no. of sexual partners & younger age

HPV 16 & 18

32
Q

risk factors for endometrial cancer

A

Exposure to oestrogen

  • HRT
  • Tamoxifen
  • PCOS & Lynch syndrome (HNPCC)
  • Increased BMI (increased aromatase)
33
Q

Ix for endometrial cancer

A

1st line = TVUSS [shows increased endometrial thickness]

34
Q

Tx for endometrial cancer

A

Hysterectomy + bilateral salpingo-oophrectomy

chemo/radiotherapy if required

35
Q

Tx for adenomyosis

A

hysterectomy

36
Q

Tx for PCOS

A

1st line = Weight loss, metformin
2nd line = No pregnancy: cOCP – dianette
3rd line = Pregnancy – clomifene +/- metformin
4th line = Hirsutism – eflornithine cream/ laser treatment

37
Q

Bartholins cyst v abscess?

A

Bartholin’s cyst– typically soft, fluctuant and non-tender

Bartholin’s abscess– typically tense and hard, with surrounding cellulitis

38
Q

cause and Sx of overactive/urge incontinence

A

Urgency, frequency, nocturia – detrusor over-activity

39
Q

Tx for urge incontinence

A

bladder diary
bladder training
Oxybutinin [s.e. increase risk of falls in elderly]

40
Q

Tx for stress incontinence

A

pelvic floor training

duloxetine [SNRI]

41
Q

Ix only done in stress incontinence

A

urodynamic studies

42
Q

Tx for vault prolapse

A

sacrospinous fixation

43
Q

Tx for Incident cystocele picked up on cervical screening

A

pelvic floor exercises

44
Q

Tx for elderly woman with prolapse and multiple co-morbidities

A

pessary

45
Q

surgical treatment for bartholin’s abscess

A

marsupialization

46
Q

OGTT results for people without diabetes

A

fasting value before test = < 6

at 2 hours = < 7.8

47
Q

OGTT results for people with impaired glucose tolerance

A

fasting value before test = 6 - 7

at 2 hours = 7.9 - 11

48
Q

OGTT results for people with diabetes

A

fasting value before test = > 7

at 2 hours = > 11

49
Q

diagnostic criteria for diabetes

A

If the patient is symptomatic:
fasting glucose greater than or equal to 7.0 mmol/l
random glucose greater than or equal to 11.1 mmol/l (or after 75g oral glucose tolerance test)

50
Q

what is the screening for gestational diabetes

A

women who’ve previously had gestational diabetes a OGTT should be performed after booking (8-12weeks) and at 24-28 weeks if the first test is normal.

women with any of the other risk factors should be offered an OGTT at 24-28 weeks

51
Q

diagnostic criteria for gestational diabetes

A

fasting glucose is >= 5.6 mmol/l

2-hour glucose is >= 7.8 mmol/l

4th Year SB (22 decks)

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