Oxford Clinical Specialties II

Question 1

What are fibroids?

Answer 1

Fibroids are benign smooth muscle tumours of the uterus. They are leiomyomas

Question 2

Why do fibroids enlarge in pregnancy and on the combined pill; and atrophy after the menopause?

Answer 2

Fibroids are oestrogen-dependent

Question 3

What are the complications that may arise from fibroids?

Answer 3

Fibroids can lead to heavy or prolonged periods.
Fibroids can also press on the bladder and cause increased frequency; or on the veins, which can lead to oedematous legs and varicose veins.

Question 4

Can fibroids cause intermenstrual or postmenopausal bleeding?

Answer 4

No, fibroids do not generally cause intermenstrual or postmenopausal bleeding.

Question 5

What is red degeneration?

Answer 5

Red degeneration occurs when fibroids degenerate suddenly, usually when thrombosis of capsular vessels is followed by venous engorgement and inflammation

Question 6

What are the signs and symptoms of red degeneration?

Answer 6

Abdominal pain mimicking torsion of ovarian cyst,
Low grade fever,
Vomiting,
Localised peritoneal tenderness

Question 7

Why must postmenopausal vaginal bleeding be promptly investigated?

Answer 7

Postmenopausal vaginal bleeding highly suggest endometrial carcinoma

Question 8

What are the types of benign tumours that can develop in the ovaries and which is most common?

Answer 8

Functional ovarian tumours are most common.

Others are neoplastic or endometriotic cysts

Question 9

What does increased fetal nuchal translucency indicate?

Answer 9

Increased fetal nuchal translucency indicates fluid accumulation in the neck, and may reflect fetal heart failure.

Question 10

What is the substance produced in fetal liver and GI tract that can be used to test for problems like spina bifida and anencephaly in the unborn fetus?

Answer 10

alpha fetoprotein

Question 11

How is alpha fetoprotein monitored?

Answer 11

Alpha fetoprotein is monitored in the urine of pregnant women.

Question 12

What does elevated levels of alpha fetoprotein suggestive of?

Answer 12

Elevated levels of alpha fetoprotein can be suggestive of omphalocoele, neural tube defects, and gastrochisis

Question 13

Give 4 reasons for increased symphyseal-fundus height?

Answer 13

Macrosomia, polyhydramnios, high BMI, fibroid uterus

Question 14

What are the 3 reasons for decreased symphyseal-fundus distance?

Answer 14

intrauterine growth retardation, oligohydramnios, transverse lie