Part 8

Question 1

what is used to screen for ovarian cancer?

Answer 1

Ca125 (CEA ay also be done to rule out bowel cancer)

Question 2

Most common ovarian cancer?

most common in under 25s?

Answer 2

Serous (from epithelium)

Teratoma

Question 3

Tx of ovarian cancer

Answer 3

Surgical removal + chemo

Question 4

What maintains acidic environment in normal vaginal flora?

If there is an imbalance it may lead to?

Answer 4

Lactobaccilus

Bacterial Vaginosis (fishy, clue cells, metronidazole)

Question 5

Prostatis treatment?

Answer 5

May be secondary to UTI
MSSU, 1st pass urine + PCR
Ciprofloxacin

Question 6

Can’t see can’t pee can’t bend the knee

Answer 6

Reiter’s syndrome

Question 7

PID with RUQ pain

Answer 7

Fitz Hugh Curtis Syndrome

Question 8

gonorrhea on microscope

and TX?

Answer 8

Gram - ve diplococci (2 kidney beans)

IM Ceftriaxone

Question 9

treatment of syphillis?

Answer 9

IM penicillin

Question 10

HSV that cause genital Herpes?

Cold sores?

Answer 10

HSV2

HSV1

Question 11

green frothy discharge + strawberry cervix

Tx

Answer 11

trichomonas vaginalis

Metronidazole

Question 12

Contact tracing period for chlamydia

Answer 12

4 weeks (male urethral)
6 months (endocervix, anal, oral)

Question 13

Contact tracing gonorrhea

Answer 13

2 weeks (male urethral)
3 months (endocervix, anal, oral)

Question 14

Contraindications to COCP/ring/patch

Answer 14

Prevents ovulation + may cause VTE, PE, Stroke etc

Breastfeeding, migraine with aura, PMH of breast cancer, VTE, smoking >15/day, BMI >35 (UKMEC 4)

Question 15

relationship between COCP and cancer

Answer 15

protective against Ovarian + endometrial cancer

Increased risk of breast + cervical cancer

Question 16

How is COCP taken

Answer 16

up to day 5 of cycle
after day 5 requires 7 days additional contraception
miss 2 take 7 days additional contraception

Question 17

what is POP

Answer 17

Progesterone only pill
It’s shit, has to be taken same time very day
thickens cervical mucus (not the best contraceptive)

Question 18

What emergency contraception options are there?

Answer 18

Oral levonelle- up to 72 hours post UPSI
Oral ella one- up to 120 hours post UPSI
Copper IUD- up to 120 hours post UPSI (toxic to egg and sperm)

ALWAYS do a pregnancy test at 3 weeks

Question 19

How does depo provera work?

Answer 19

12 weekly injections

inhibits ovulation, thickens mucous, thins endometrium

Weight gain, osteoperosis

started up to day 5 (beyond requires 1 week of contraception)

Question 20

how long is IUD used and when is it given?

Answer 20

5 years

within 7 days of cycle, up to 5 days post-UPSI, <48 hrs or >4 weeks postpartum, immediately post TOP

Question 21

how long is IUS used and what are the benefits?

Answer 21

5 years

affects implantation as it thins endometrium

Lighter, less frequent periods

Question 22

What is the best contraception?

Answer 22

Implant (3 years)

Inhibits ovulation

Question 23

Extra info for post vasectomy?

Answer 23

Sperm live in tubes for 8 weeks- use additional contraception for at least 8 weeks!

Post vasectomy semen analysis is required to exclude failure!

Question 24

If sperm count is really low, what is a better treatment than IUI? + it’s indications?

Answer 24

ICSI (intracytoplasmic sperm injection)

• Severe male factor infertility
• Previous failed fertilisation with IVF
• Preimplantation genetic diagnosis (checking the genes or chromosomes of your embryos for a specific genetic condition.)

Question 25

Indications for IVF

Answer 25

• Unexplained infertility (> 2 years durations)
• Pelvic disease (endometriosis, tubal disease, fibroids)
• Anovulatory infertility (after failed ovulation induction)
• Failed Intra-uterine insemination (after 6 cycles)

Question 26

Main complications of ACT

Answer 26

Ectopic pregnancy (risk higher in IVF), surgical risks of oocyte retrieval/sperm aspiration, failed fertilisation (4%), miscarriage, failed treatment

Question 27

undescended testes, resulting in lowered sperm count and increased risk of testicular cancer.

Answer 27

cryptochordism