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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
benign ovarian cysts can be divided into
germ cell tumours epithelial benign sex cord stromal tumours
26
management of adenomyosis
supportive - tranexamic GnRH agonists uterine artery embolistaion hysterectomy
27
whiff test
sample of discharge mixed with potassium hydroxide - if + semlls fishy + vaginosis
28
clue cells
epithelial cells from the vagina that have loads of bacteria stuck to the surface so the edges look fuzzy + in vaginosis mx - metronidazole
29
what is the fitz-high-curtis syndrome ?
hepatic adhesions > inflammation of the liver capsule
30
medical management of ectopic
minimal symptooms unruptured serum less than 1500i/L 50mg of methotrexate
31
what is used in emergency contraception?
urlipristal
32
HIV + and cervical cancer how often to check?
increased cervical intra-epithelial neoplasia risk why? decreased immune response and decreased clearance of HPV annually
33
which HPV is a risk for cervical?
16 18 33
34
risk factors for cervical cancer?
smoking human immunodeficiency virus early first intercourse, many sexual partners high parity lower socioeconomic status combined oral contraceptive pill*
35
mechanism of HPV causing cervical cancer?
hpv produces oncogenes e6/7 e6 inhibits p53 tumour suppressor gene E7 inhibits RB suppressor gene
36
oestrogen effects on endometrium and how does this affect HRT in menopause
increased risk fo endometrial cancer as oestrogen stimualtes growth of endometrium = endometrial hyperplasia
37
persistent unexplained vulval skin lesion
2 week wait referral unexplained vaginal lump / ulceration / bleeding
38
lichen sclerosus management?
topical corticosteroids causes patchy itchy white areas itching and irritation
39
how does trich present? how is it investigate management?
offensive yellow-green discharge strawberry cervix high vaginal swab metronidazole
40
factors making candidiasis more likely?
DM antibiotics steroids pregnancy HIV
41
complete androgen insensitivity
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
partial androgen insensitivity syndrome
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
gender identity and CAI
raise as what? female genitals no testosterone response always identify as female gender when they're older
44
what is a surgery for symptomatic fibroid in a young female patients
open myomectomy s/e : adhesions
45
features of fibroids? bulk related symptoms ?
menorrhagia > iron deficiency anaemia lower abdominal pain bloating urinary symptoms subfertility rare: polycythaemia
46
when can LNG-IUS not be used in fibroid management?
distortion of uterine cavity
47
how can GnRH help in fibroids?
reduced size of fibroid
48
pregnant women < 6 weeks with vaginal bleed and no pain?
manage expectantly repeat urine pregnancy test after 7-10 days and reture if positive
49
how doe intended parents become legal parents in surrogacy ?
Parental Order, provided for in Section 30 of the Human Fertilisation & Embryology Act.
50
meig's syndrome? features?
benign ovarian tumour ascites pleural effusion
51
ovarian tumours 4 types?
surface derived germ cell sex cord stromal tumours metastasis
52
krukenberg tumour?
metastatses from a GI tumour results in mucin-secreting signet ring cell adenocarcinoma
53
sex cord stromal tumour malignant
granulosa cell tumour > produces oestrogen > precocious puberty or endometrial hyperplasia contains call-exner bodies
54
fibroma
solid tumour consisting of bundles of spindle shaped fibroblasts assocuated with meigs syndrome
55
germ cell tumours-
teratoma if immature > malignant contain ectodermal (hair) mesodermal (bone) endodermal
56
dysgerminoma
associated with turner secrete hCG, LDH
57
yolk sac tumour features?
malignant germ cell tumour secretes AFP schiller-duval bodies pathogenomic
58
choriocarcinoma
rare tumour that is part of GTD spread to lungs
59
laparotomy
is quicker so used in haemodynamic unstable
60
hyperemesis gravidarum what has shown to reduce incidience?
smoking
61
ovarian tumour associated with development of endometrial hyperplasia?
granulosa cell tumour
62
migraine with aura HRT
topical cyclical
63

Year 5-Gynaecology (20 decks)

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