Obs&gynae Flashcards
Risk factors for endometrial cancer
Obesity, late menopause, t2dm, early menarche, nulliparity, oestrogen only hrt, hereditary conditions such as lunch syndrome , tamoxifen
Presentation of endometrial cancer
Post menopausal vaginal bleeding
Intermenstrual bleeding
May have uterine mass
Abdo pain and mass
Most common ovarian cancer
Epithelial cell tumours ( specifically serous carcinomas)
Presentation of ovarian cancer
Abdominal bloating and distension
Early satiety
Loss of appetite
Pelvic pain
Urinary symptoms
Tumour marker for ovarian cancer
Ca125
3 things which make up risk of malignancy index (RMI)
Menopausal status
Uss findings
Ca125 level
Why might ca125 be falsely raised
Endometriosis , adenomyosis, pelvic infections, liver disease, pregnancy
Presentation of endometriosis
Cyclical abdominal pain or pelvic pain
Deep dispareunia
Painful periods
Infertility
Cyclical bleeding from other sites
Pathophysiology of endometriosis
Endometrial tissue is present outside the uterus
It responds to hormones in the same way as the endometrium so it sheds and bleeds during the cycle
How long after unsuccessful trying will infertility be explored
18 months
Investigations of endometriosis
Laparoscopy and biopsy - gold standard
Pelvic uss
What can be seen on pelvic uss of endometriosis
Endometriomas and chocolate cysts
Management of endometriosis
NSAIDs for pain relief
Hormonal medications - cocp, pop, Mirena coil,
Laparoscopic surgery and hysterectomy
Presentation of ovarian torsion
Sudden onset severe unilateral pelvic pain
May have nausea and vomiting
What is adenomyosis
The presence of endometrial tissue within the myometrium (muscle layer)
Presentation of adenomyosis
Painful periods, heavy periods, dyspareunia
Key examination finding of adenomyosis
Enlarged boggy uterus
Management of adenomyosis
Contraception- mirena coil, combined oral contraceptive, cyclical oral progesterone
Tranexamic acid
Uterine artery embolisatjon
Hysterectomy
What appearance may be seen on ultrasound of PCOS
String of pearls appearance
What criteria is used to diagnose pcos
Rotterdam criteria
- anovulation/ oligo/amenorrhors
- polycystic ovaries on scan
- raised androgens (hirtuism and acne)
