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YR 3 MED > OBS & GYNAE WK 3 > Flashcards

OBS & GYNAE WK 3 Flashcards

1
Q

what structure is in:
anterior compartment, middle, posterior, lateral

A

anterior - bladder
middle - uterus
posterior - bowel
lateral - adenexae

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2
Q

pelvic mass - symptoms
- uterine
- ovarian
- long/short term
- acute

A

uterine - pain
ovarian - bleeding
long term symptoms - benign
short term - malignant
acute - nausea w doubling pain

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3
Q

most common uterine tumour ?? and ix

A

fibroids

uss
mri

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4
Q

adnexal mass - what is it and ix??

A

pain or pressure in affected side

growth that develops around the uterus, usually in your ovaries, fallopian tubes and neighboring connective tissues

Ca125
USS
MRI

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5
Q

ix for pelvic mass
fibroids, pre-menopausal ovarian cysts, post-menopausal ovarian masses

A

USS
fibroids = MRI
pre-menopausal ovarian cysts = MRI, Ca125, AFP, HCG, LDH
postmenopausal ovarian masses = CT, Ca125

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6
Q

benign features on USS

A

unilocular
presence of solid components less than 7mm
no blood flow

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7
Q

malignant features

A

irregular solid tumour
at least 4 papillary structures

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8
Q

RMI

what does lower/higher RMI indicate??

A

riskof malignancy index
Ca125 test on its own is not that great but with MRI, v good

RMI <30
3 in 100 - ovarian cancer

RMI 30-200
20 in 100

RMI >200
75 in 100

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9
Q

FUNCTIONAL CYSTS

A

fine if less than 6 cm
benign

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10
Q

ENDOMETRIOTIC CYSTS

A

severe dysmenorrhea
dyspareunia
acute abdomen if ruptures

kissing ovaries

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11
Q

DERMOID CYST

A

may contain: teeth
sebaceous material
hair
aka teratoma
slow growing

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12
Q

BENIGN OVARIAN TUMOURS TX

A

conservative
medical - GnRH analogues, OCP
surgical - laparoscopic / laparotomy

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13
Q

3 TYPES OF FIBROIDS AND TX

A

subserosal - serosa (Outer layer)
intramural - myometrium
submucosal - endometrium (inner layer)

hormonal mx for bleeding
surgery - myomectomy, hysterectomy

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14
Q

malignant bowel obstruction
causes, symptoms, tx

A

Causes - adhesions, post radiotherapy, constipation

Nausea, vomiting, pain, anorexia, tinkling bowel sounds

gradual onset - over weeks

watch and wait
NG tube, mouth care
surgery

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15
Q

common causes of nausea and vomiting, medication??

A
  • Chemical
  • Metabolic
  • Raised ICP
  • Tumour
  • Movement related nausea
  • Oesophageal irritation

anti-emetics

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16
Q

endometrial carcinoma

A

50-60 yrs = peak group
under 40 = rare
2 types
staging is most important prognostic factor

17
Q

2 types of E.C and what are their precursors ??

A

type 1

type 2
serous

18
Q

known risk factor for endometrial cancer?? and whyyyy

A

OBESITY

Adipocytes express aromatase which converts androgens to oestrogens, inducing endometrial proliferation

19
Q

what syndrome is related to high risk of colorectal cancer and endometrial cancer

WHAT IS ITS GENETIC MUTATION??

A

LYNCH SYNDROME
aka HNPCC

AUTOSOMAL DOM
in DNA mismatch repair gene

20
Q

endometrial carcinoma staging

A

1-4
1 - confined to UTERUS
1a -
1b -
2
3a -
3b -
3c -
4 - distant metastasis

21
Q

carcinosarcoma - presence of what = worst prognosis??

A

rhabdomyosarcoma

22
Q

abnormalities of the myometrium - smooth muscle tumours ?? (2)

A

leiomyoma - fibroids (v common, associated w menorrhagia and infertility)

leiomyosarcoma (rare)

23
Q

endometrial stromal sarcoma

A

low vs high grade

abnormal uterine bleeding

24
Q

most common uterine sarcoma?? - most common symptoms ??

A

leiomyosarcoma

malignant tumour, spindle cell morphology, poor prognosis, >50 yrs old

abnormal vaginal bleeding
palpable pelvic mass and pain

25
Q

endometriod carcinoma - 3 grades, percentage of solid growth??

A

1 = <5%
2 = 6-50%
3 = >50%

26
Q

what supplies the ovary

A

ovarian artery branching off the abdominal aorta

27
Q

laparscopy vs robot-assisted

A

robot - costlier, same advantages as laparoscopy

28
Q

best tx for uterine cancer??

A

surgery !!!
hysterectomy
bso
plnd

29
Q

tx for cervical cancer??

A

dependant on stage and if completed family

up to stage 1B - surgery

chemoradiotherapy - for after stage 1

30
Q

tx for ovarian cancer??

A

chemotherapy and surgery combo
esp for after stages 3

31
Q

tx for vulval cancer??

A

wide local excision, groin nodes removal

32
Q

adjuvant vs neoadjuvant vs radical

A

adjuvant - following surgery
neoadjuvant - before surgery
radical - primary treatment

33
Q

what cancers use radiotherapy??

A

endometrial - adjuvant
cervical - radical
vulval - adjuvant, depends on histology results

34
Q

what cancers use chemotherapy??

A

ovarian - neoadjuvant / adjuvant (carboplatin)
cervical - concomitant (cisplatin)

YR 3 MED (23 decks)

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