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Obs and Gynae > Obs and gynae passmed > Flashcards

Obs and gynae passmed Flashcards

1
Q

HNPCC/Lynch syndrome is a risk factor for which type of cancer?

A

Endometrial cancer

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2
Q

Complications of endometrioma?

A

Can rupture and cause intense pain

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3
Q

Drug of choice for medical management of ectopic pregnancy

A

Methotrexate

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4
Q

“snow storm” appearance on ultrasound

A

Hydatiform mole

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5
Q

How should you manage miscarriage if there is evidence of infection or increased risk of haemorrhage?

A

Surgical management

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6
Q

Criteria for diagnosing bacterial vaginosis

A

pH >4.5
Thin, white homogenous discharge
Clue cells on microscopy
Positive whiff test (addition of potassium hydroxide results in fishy odour)

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7
Q

Treatment of trichomonas vaginalis?

A

Metronidazole

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8
Q

Treatment of gonorrhoea?

A

IM ceftriaxone + oral azithromycin

azithromycin works synergistically but also treats chlamydia

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9
Q

Causes of vaginal discharge?

A

Physiological
Candida (thrush)
Trichomonas vaginalis
Bacterial vaginosis

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10
Q

Best imaging technique for adenomyosis

A

MRI pelvis

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11
Q

Diagnosis of PCOS requires which three features?

A

Polycystic ovaries
Oligomenorrhoea or amenorrhoea
Hirsutism

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12
Q

What test might you need to perform during pregnancy in women with PCOS?

A

Women with PCOS should be offered an oral glucose tolerance test as they are at a higher risk of developing type 2 diabetes

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13
Q

Sudden onset unilateral pelvic pain precipitated by intercourse or strenuous activity

A

Ruptured ovarian cyst

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14
Q

What class of drug is oxybutynin?

A

Anti-muscarinic

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15
Q

How should you manage simple endometrial hyperplasia?

A

Manage with high dose progestogens with repeat sampling in 3-4 months

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16
Q

What should you do if endometrial thickness is >4mm

A

Take a biopsy

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17
Q

If your smear comes back as mild dyskariosis, what should you do?

A

The sample should be tested for high risk HPV subtypes

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18
Q

Which type of ovarian tumour could cause atypical hyperplasia of the endometrium?

A

Granulosa cell tumour

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19
Q

Most common type of ovarian cancer

A

Serous carcinoma

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20
Q

Most common type of ovarian cyst

A

Follicular cyst

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21
Q

Torsion is more likely with this type of tumour than with other ovarian tumours

A

Dermoid cyst

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22
Q

This type of ovarian tumour could rupture and cause pseudomyxoma peritonei

A

Mucinous cystadenoma

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23
Q

Treatment of ovarian cancer?

A

Surgery +/- chemotherapy

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24
Q

Why should you avoid oxybutynin in old/frail people?

A

Should not use oxybutynin in old people due to increased risk of falls, safer options include solifenacin and tolteridone

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25
Q

Most common cause of recurrent first trimester spontaneous miscarriage?

A

Antiphospholipid syndrome

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26
Q

Whirlpool sign on ultrasound

A

Ovarian torsion

-you might see free pelvic fluid also

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27
Q

Which type of HPV are most likely to cause cervical cancer?

A

HPV 16 & 18

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28
Q

First line treatment for menorrhagia

A

IUS (mirena)

29
Q

Is mefenamic acid an NSAID?

A

Yes

30
Q

Is tranexamic acid an NSAID?

A

no

31
Q

Name two antimuscarinics which can be used in urge incontinence?

A

Oxybutynin, tolteridone

32
Q

What should you do if you find a simple cyst in a young person?

A

Ultrasound and then repeat ultrasound in 12 weeks - if cyst is still there then consider referral

33
Q

How often should HIV patients be screened?

A

Annually - they are at an increased risk of cervical cancer

34
Q

What is Sheehan’s syndrome?

A

When the pituitary doesn’t really work following ischaemia necrosis due to blood loss and hypovolaemic shock following birth

35
Q

What is premature ovarian failure?

A

The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40

36
Q

What might increase survival and decrease recurrence in cervical cancer?

A

Platinum based chemotherapy

37
Q

What might be used to treat haemorrhage in cervical cancer?

A

Radiotherapy might be used for haemorrhage

38
Q

Treatment of early stage cervical cancer in post-menopausal women

A

Simple hysterectomy

39
Q

How does metformin work in PCOS?

A

Increases peripheral insulin sensitivity - most patients with PCOS have a degree of insulin resistance, which in turn can lead to complicated changes in the hypothalamic-pituitary ovarian axis

40
Q

How might vulval carcinomas present?

A

They are commonly ulcerated and can present on the labium majora

41
Q

Individuals with BRCA1 mutation are at an increased risk of which type of cancers?

A

Breast and ovarian

42
Q

When would you see cervical excitation?

A

Pelvic inflammatory disease and ectopic pregnancy

i think also endometriosis

43
Q

What might present with pain during sexual intercourse?

A

PID

Endometriosis

44
Q

Gold standard investigation for patients with suspected endometriosis?

A

Laparoscopy

45
Q

Most common cause of post coital bleeding

A

Cervical ectropion

46
Q

What medication can be used prior to fibroid surgery?

A

Can give GnRH agonist before surgery e.g. leuprolide

47
Q

When should you offer test of cure?

A

Offer at 6 months (do cervical screening and HPV test of cure)

48
Q

Which non-hormonal methods may help vasomotor symptoms in menopause?

A

SSRIs (e.g. fluoxetine) and venlaxafine
Clonidine (but side effects)
A progestogen (e.g. norethisterone)

49
Q

Clonidine side effects

A

Dry mouth, dizziness, nausea

50
Q

PCOS increases risk of which type of cancer?

A

Endometrial cancer

51
Q

How do GnRH agonists help in fibroids?

A

They effectively turn off the ovaries, which causes the fibroids to shrink = easier to remove surgically

If patient wants to retain fertility, you should do myomectomy

52
Q

How big must a uterine fibroid be until you have to stop using the IUS?

A

You can use IUS until the uterine fibroid is 3cm

53
Q

Where is an ectopic pregnancy most likely to occur?

A

The ampulla of the fallopian tube

54
Q

What stage of endometrial cancer do most patients present with?

A

Most patients present with stage 1 cancer - can be treated with surgery

55
Q

Most common complication of termination of pregnancy

A

Infection (occurs in up to 10% of patients)

56
Q

How might cervical ectropion present?

A

With vaginal discharge and post-coital bleeding

57
Q

Treatment of thrush in pregnant women

A

Clotrimazole pessary

-oral fluconazole cannot be used as risk of congenital abnormalities

58
Q

Can you use fluconazole in pregnancy for treatment of thush?

A

No - risk of congenital abnormalities. Use clotrimazole pessary instead

59
Q

Cervical cancer and smoking

A

Somking increases risk of cervical cancer by two times

60
Q

Cervical cancer and parity

A

Risk of cervical cancer increases with parity

61
Q

First line treatment for period pain

A

NSAIDs e.g. ibuprofen

62
Q

Causes of primary amenorrhoea

A

Turner’s syndrome
Testicular feminisation
Congenital adrenal hyperplasia
Congenital malformations of the genital tract

63
Q

What is Asherman’s syndrome

A

Intrauterine adhesions (can occur after D&C)

64
Q

What should you do if you are pregnant and get your letter about cervical screening?

A

Get your smear done after you have had your baby, but need to wait at last 12 weeks until after you have given birth

65
Q

Most common complication of myomectomy?

A

Adhesions

66
Q

How would you diagnose vesicovaginal fistula?

A

Urinary dye studies

67
Q

If you are uncertain which type of incontinence someone has, and bladder diaries are inconclusive, what investigation should you perform?

A

Urodynamic studies

i remember a lecturer telling us these were quite horrid because it is uncomfortable and embarrassing for the woman

68
Q

This is the most common type of epithelial cell tumour

A

Serous cystadenoma

Obs and Gynae (8 decks)

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