obs and gynae peer teaching Flashcards

1
Q

what is an APH

A

vaginal bleeding from 24 weeks

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2
Q

Minor antepartum haemorhage volume

A

less than 50ml

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3
Q

major antepartum haemorhage volume

A

50-1000ml

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4
Q

massive antepartum haemorhage volume

A

1000+ml

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5
Q

cervical cancer cause

A

HPV 16 and 18

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6
Q

cervical cancer risk factors

A

HPV, no smear testing, combined contraceptive pill over 5 years, smoking, family History, immunosuppression

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7
Q

what is HPV 6 and 11 associated with

A

genital warts

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8
Q

Cervical cancer symptoms

A

vaginal bleeding, discharge and discomfort
change in bowel habits

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9
Q

Cervical cancer signs

A

bulky pelvis, mass, abnormal white/red patch on cervix, inflamation/ulceration

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10
Q

cervical cancer investigation

A

urgent colposcopy
CT abdo-pelvis - staging
swabs to excluding infection

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11
Q

cervical cancer screening program

A

ever 3 years from 25-49
every 5 years from 50-64

if HIV positive/immunocompromise screened annually

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12
Q

cervical cancer management

A

stage 1 - gold standard hysterectomy with lymph node clearance. to preserve fertility cone biopsy/LLETZ
Stage 2+ - radio + chemotherapy

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13
Q

endometrial cancer type

A

adenocarcinoma

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14
Q

cervical cancer type

A

squamous cell carcinoma
adenocarcinoma
small cell cancer

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15
Q

endometrial cancer risk factors

A

nulliparity, early menarche, late menopause, oestrogen only HRT, tamoxifen, obesity, type 2 diabetes, PCOS

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16
Q

endometrial cancer protective factors

A

smoking, combined oral contraceptive/Mirena coil, multiparity

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17
Q

endometrial cancer presentation and examination

A

post menopausal/postcoital/intermenstrual bleeding
enlarged uterus on examination

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18
Q

endometrial cancer investigation

A

2 week wait (age 55 with post menstrual bleeding) - transvaginal ultrasound
gold standard - hysteroscopy + biopsy

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19
Q

endometrial cancer treatment

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy

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20
Q

ovarian cancer type

A

epithelial cell/serous tumour - most common
benign - teratoma’s (contain teeth/skin)

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21
Q

ovarian caner risk factor

A

BRCA1/2, early menarche/late menopause, older age, nulliparity, smoking/obesity

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22
Q

ovarian cancer symptoms

A

bloating, loss of appetite, weight loss, pelvic pain, urinary frequency

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23
Q

ovarian cancer investigation

A

tumour marker CA125
pelvic ultrasound

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24
Q

ovarian cancer treatment

A

surgical
chemotherapy

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25
Q

vaginal cancer type

A

Squamous cell Carcinoma

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26
Q

Vaginal cancer risk factor

A

trans/non-binary with vagina, hysterectomy, HPV, HIV, 75+,

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27
Q

vaginal cancer symptoms

A

mass in vagina, ulcers, bleeding, itching, blood stained discharge

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28
Q

vaginal cancer investigation

A

speculum, colposcopy + biopsy

29
Q

vulval cancer type

A

squamous cell carcinoma

30
Q

vulval cancer risk facrors

A

75+, immunosuppression, HPV, lichen sclerosis

31
Q

vulval cancer presentation

A

lump/ulcer on labia majora, bleeding, pain, inguinal lymphadenopathy, lichen sclerosis

32
Q

Endometriosis symptoms

A

severe painful periods, cyclical pain, infertility, dyspareunia (pain around sex)
dysuria, haematuria

33
Q

endometriosis investigation

A

Transvaginal ultrasound - large endometriomas, chocolate cysts
gold standard - laparoscopy + biopsy

34
Q

endometriosis pathophysiology

A

endometrial cells outside of the uterus still undergo menstrual cycle and shed blood into abdomen causing inflamation - severe pain

35
Q

endometriosis management

A

pain - NSAIDS + paracetamol
medical - combined/progesterone only pill, GNRH
Mirena coil
surgical - laparoscopic ablation and adhesion removal

36
Q

endometriosis complications

A

infertility, pelvic ablations, rupture cysts, bowel obstruction, chronic pelvic pain

37
Q

Ovarian torsion symptoms

A

sudden onset unilateral pelvic pain, nausea + vomiting

38
Q

ovarian torsion cause

A
39
Q

ovarian torsion investigaiton

A
40
Q

ovarian torsion treatment

A

laproscopic surgery

41
Q

ovarian torsion complications

A
42
Q

what is adenomyosis

A

endometrial tissue in myometrium

43
Q

adenomyosis signs

A

enlarged boggy uterus

44
Q

adenomyosis investigation

A

transvaginal ultrasound
gold standard - hysterectomy+histology

45
Q

adenomyosis management

A
46
Q

adenomyosis complications

A

infertility, miscarriage, premature birth, small for gestational age, PPH

47
Q

pelvic inflamatory disease cause

A

STI - chlamydia, gonorea, mycoplasma
non-sti - haemophilius infuenzae/e.coli

48
Q

pelvic inflamatory disease symptoms

A
49
Q

Pelvic inflamatory disease investigations

A

swabs, HIV, syphilis - high vaginal swabs with pus cells
C125 can be raised

50
Q

pelvic inflamatory disease management

A

IM cephtriaxone - gonorea
doxycycline - chlamydia
metronidazole

51
Q

pelvic inflamatory disease complications

A
52
Q

what is fitz hugh curtis symdrome

A

inflamation of the liver capsule that causes adhesions

53
Q

PCOS symptoms

A

darkening under armpits (acanthosis nigricans), irregular periods/amenorrhea, hirsutism, male pattern hair loss, acne, obesity

54
Q

PCOS pathophysiology

A
55
Q

PCOS diagnostic criteria

A

anovulation
Polycusic overies
hyperandrogenism

56
Q

PCOS associated conditions

A
57
Q

PCOS investigations

A

transvaginal ultrasound - string of pearls,
raised testosterone

58
Q

PCOS management

A
59
Q

causes of primary amenorrhea

A
60
Q

causes of secondary amenorrhea

A
61
Q

what is primary vs secondary amenorrhea

A
62
Q

pcos criteria name

A

Rotterdam criteria

63
Q

what staging system is used for endometrial cancer

A

FIGO

64
Q

vaginal cancer management

A

chemo/radiotherapy. Surgery

65
Q

vulval cancer investigations

A

biopsy of lesion and sentinel lymph nodes
CT abdo pelvis staging

66
Q

vulval cancer management

A

wide local excision to remove cancer
groin lymph node dissection
chemo/radiotherapy

67
Q

endometriosis signs

A

tender nodularity on posterior vaginal fornix
tender vagina uterus and cervix on examination
reduced organ mobility

68
Q

What is chandelier sign

A

Pain on cervical motion tenderness