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Year 5-Gynaecology > passmed 03 > Flashcards

passmed 03 Flashcards

1
Q

dyskaryosis

A

cervical screening is HPV positive and shows abnormal changes in cervix

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2
Q

cryotherapy

A

use of extreme cold to destroy cancer cells

cold coagulation

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3
Q

after cervical intraepithelial neoplasia what is the follow up test date?

A

6 months after treatment

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4
Q

the luteal phase of the menstrual cycle is ?

A

always 14 days

serum progesterone 7 days prior to period is elevated this shows ovulation has occure
>30 nmol/l

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5
Q

menorrhagia first line

A

mirena - IUD

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6
Q

endometrial cancer stage 2 - adenocarcinoma

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy

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7
Q

> 4mm endometrial thickness suggests

A

endometrial cancer - hysteroscopy indicated with endometrial biopsy

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8
Q

what can be the location of an androgen secreting tumour?

A

ovary
adrenal glands

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9
Q

POI

causes?

A

idiopathic

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10
Q

endometriosis and fixed retroverted uterus

A

inflammation

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11
Q

routine cervical screening

A

every 5 years if over 50
every 3 years if 25-50

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12
Q

fibroid degeneration

A

uterine fibroids are sensitive to oestrogen and can therfore grow during pregnancy
if growth outstrips blood supply

low grade fever
pain
vomiting

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13
Q

role of Sex hormone binding globulin

A

plasma protein
binds steroid hormones oestrogen
testosterone
dihydrostestosterone

low concentrations increases concentration of unbound biologically active testosterone and dihydrotestosterone > leading ro hyperandrogenism which is associated wiht PCOS

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14
Q

when is colposcopy indicated when there is no cytological abnormality

A

on 3rd successive annual smear whichh is still HrHPV +

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15
Q

moa of oxybutinin

A

anti-muscarinic

treats detrusor muscle over activity

as contraction of detrusor muscle is controled by muscarinic cholinergic receptors

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16
Q

first line for hyperemesis gravidarum

A

antihistamines
promethazine

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17
Q

stress incontinence management ?

A

duloxetine
snri

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18
Q

whirl pool sign on TVUSS

A

ovarian torsion
free pelvic fluid
the fluid is from the transudate from ovarian capsule due to venous and lymphatic obstruction

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19
Q

differentiating ruptured ovarian cyst from torsion

A

acute onset pain / maximal at onset prior hx of cyst

torsion - gradual, progressive pain associated with hx pf sport

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20
Q

how to assess hyperemesis gravidarum?

A

pregnancy unique qauntification of emesis
PUQE

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21
Q

oral ondansetron during first trimester risk ?

A

cleft lip

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22
Q

what ovarian cysts should be biopsied?

A

multi-loculated - complex
high suspicion of ovarian malignancy

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23
Q

m rules for cysts

A

Irregular, solid tumour.
Ascites.
At least 4 papillary structures.
Irregular multilocular solid tumour with largest diameter ≥100 mm.
Very strong blood flow.

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24
Q

B rules for cysts

A

unilocular
presecence of solid components with largest diameter <7 mm
presence of acoustic shadows
smooth multilocular tumour with largest diameter

no blood flow

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25
Q

benign ovarian cysts can be divided into

A

germ cell tumours
epithelial
benign sex cord stromal tumours

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26
Q

management of adenomyosis

A

supportive - tranexamic

GnRH agonists
uterine artery embolistaion
hysterectomy

27
Q

whiff test

A

sample of discharge mixed with potassium hydroxide - if + semlls fishy

+ vaginosis

28
Q

clue cells

A

epithelial cells from the vagina that have loads of bacteria stuck to the surface so the edges look fuzzy

+ in vaginosis
mx - metronidazole

29
Q

what is the fitz-high-curtis syndrome ?

A

hepatic adhesions
> inflammation of the liver capsule

30
Q

medical management of ectopic

A

minimal symptooms
unruptured
serum less than 1500i/L

50mg of methotrexate

31
Q

what is used in emergency contraception?

A

urlipristal

32
Q

HIV +
and cervical cancer

how often to check?

A

increased cervical intra-epithelial neoplasia
risk

why?
decreased immune response and decreased clearance of HPV

annually

33
Q

which HPV is a risk for cervical?

A

16
18
33

34
Q

risk factors for cervical cancer?

A

smoking
human immunodeficiency virus
early first intercourse,
many sexual partners
high parity
lower socioeconomic status
combined oral contraceptive pill*

35
Q

mechanism of HPV causing cervical cancer?

A

hpv produces oncogenes
e6/7

e6 inhibits p53 tumour suppressor gene
E7 inhibits RB suppressor gene

36
Q

oestrogen effects on endometrium and how does this affect HRT in menopause

A

increased risk fo endometrial cancer as oestrogen stimualtes growth of endometrium

= endometrial hyperplasia

37
Q

persistent unexplained vulval skin lesion

A

2 week wait referral

unexplained vaginal lump / ulceration / bleeding

38
Q

lichen sclerosus management?

A

topical corticosteroids

causes patchy itchy white areas

itching and irritation

39
Q

how does trich present?

how is it investigate
management?

A

offensive
yellow-green discharge
strawberry cervix

high vaginal swab

metronidazole

40
Q

factors making candidiasis more likely?

A

DM
antibiotics
steroids
pregnancy

HIV

41
Q

complete androgen insensitivity

A

genitals appear female
but it is 46XY

but body does not respond to testosterone
> sex development of a typical male

x linked

check sex chromosmes
check for genetic change

measure sex hormone levels

42
Q

partial androgen insensitivity syndrome

A

where testosterone has some effect on sex development, so the genitals are often not as expected for boys or girls

enlarged clitoris

partially undescended testes
hypospadia s

43
Q

gender identity and CAI

A

raise as what?

female genitals
no testosterone response
always identify as female gender when they’re older

44
Q

what is a surgery for symptomatic fibroid in a young female patients

A

open myomectomy

s/e : adhesions

45
Q

features of fibroids?

bulk related symptoms ?

A

menorrhagia
> iron deficiency anaemia

lower abdominal pain
bloating
urinary symptoms

subfertility

rare: polycythaemia

46
Q

when can LNG-IUS not be used in fibroid management?

A

distortion of uterine cavity

47
Q

how can GnRH help in fibroids?

A

reduced size of fibroid

48
Q

pregnant women < 6 weeks with vaginal bleed and no pain?

A

manage expectantly

repeat urine pregnancy test after 7-10 days and reture if positive

49
Q

how doe intended parents become legal parents in surrogacy ?

A

Parental Order, provided for in Section 30 of the Human Fertilisation & Embryology Act.

50
Q

meig’s syndrome?
features?

A

benign ovarian tumour
ascites
pleural effusion

51
Q

ovarian tumours

4 types?

A

surface derived
germ cell

sex cord stromal tumours
metastasis

52
Q

krukenberg tumour?

A

metastatses from a GI tumour results in mucin-secreting signet ring cell
adenocarcinoma

53
Q

sex cord stromal tumour
malignant

A

granulosa cell tumour

> produces oestrogen > precocious puberty

or endometrial hyperplasia

contains call-exner bodies

54
Q

fibroma

A

solid tumour consisting of bundles of spindle shaped fibroblasts

assocuated with meigs syndrome

55
Q

germ cell tumours-

A

teratoma

if immature > malignant

contain ectodermal (hair)
mesodermal (bone)
endodermal

56
Q

dysgerminoma

A

associated with turner
secrete hCG, LDH

57
Q

yolk sac tumour features?

A

malignant germ cell tumour
secretes AFP

schiller-duval bodies pathogenomic

58
Q

choriocarcinoma

A

rare tumour that is part of GTD
spread to lungs

59
Q

laparotomy

A

is quicker so used in haemodynamic unstable

60
Q

hyperemesis gravidarum what has shown to reduce incidience?

A

smoking

61
Q

ovarian tumour associated with development of endometrial hyperplasia?

A

granulosa cell tumour

62
Q

migraine with aura HRT

A

topical cyclical

63
Q
A

Year 5-Gynaecology (20 decks)

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