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Obstetrics & Gynaecology BAB > PCB > Flashcards

PCB Flashcards

1
Q

What is PCB ?

A

A PCB is any Bleeding that occurs immediately after sex, unless if it’s your first time which is normal

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2
Q

All PCBs are what ?

A

All PCBs are cervical carcinomas until proven otherwise

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3
Q

When a women presents with a PCB, what 2 things should do ?

A

Perform an examination of cervix and cervical smear

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4
Q

After performing the relevant investigations for a PCB, you get an abnormal result; what do you do then ?

A

Refer for Colposcopy

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5
Q

For a PCB, you must do a screen to rule out a sexual infection, what is it ?

A

Screen for chlamydia and treat if positive

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6
Q

What are the 3 common differentials for PCB ?

A

Cervical carcinoma, cervical polyps and cervical ectropion

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7
Q

cervical carcinomas are 90% what and are a few of what are Cervical carcinomas ?

A

Cervical cancers are 90% SCC and a few are adenocarcinomas

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8
Q

Why is the incidence of cervical cancer decreasing ?

A

Due to cervical cancer screen

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9
Q

What is the mnemonic for the risk factor for cervical cancer ?
What are the risk factors for cervical cancer ?

A

HIPS C
HPV types 16, 18, and 31; 13 high risk exposure; High parity
Immunocompromised individuals: long term steroids, HIV, transplant patients
Promiscuity: multiple partners
Smoking
COCP

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10
Q

What is the mnemonic for the spread of cervical cancer ?

Where can cervical cancer spread to ?

A

BRUV; Bladder, rectum, uterus and vagina

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11
Q

What is the incidence for cervical cancer ?

A

Bimodal (30s,80s)

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12
Q

What is the peak age incidence for cervical cancer ?

A

25-49

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13
Q

How does cervical cancer present (2) ?

A

PCB or IMB/HMB or rarely PMB

Offensive vaginal discharge

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14
Q

What are the late signs of cervical cancer ? (2)

A

Haematuria or rectal pain and bleeding

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15
Q

What will you find on examination of a patient with cervical cancer ?

A

Initially, cervix appears normal then becomes ulcerated and is replaced by an irregular mass

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16
Q

If abnormal cervix examination and smear, what’s the next step ?

A

Refer for colposcopy

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17
Q

What are the 3 investigations done for cervical cancer including staging ?

A

Bloods: FBC, U and Es
Imaging: Punch biopsy and CXR
Staging: EUA, colposcopy and MRI Pelvis

18
Q

Why is EUA (examination under anaesthetic) less often used ?

A

EUA is less often used as MRI is more accurate

19
Q

Treatment of cervical cancer depends on the stage, what are the different stages ?

A

Stage 1: lesions confined to the cervix; Stage 2: invasion of Vagina but not pelvic side wall; Stage 3: invasion of lower vagina or pelvic wall or causing uteric obstruction; Stage 4: invasion of bladder or rectal mucosa or beyond the true pelvis

20
Q

What is the treatment for cervical cancer stage 1ai ?

A

Cone biopsy or simple hysterectomy

21
Q

What is the treatment for cervical cancer stage 1aii-1bi ?

A

Laparoscopic Lymphadectomy (confirm LNs -ve) and radical tracheloctomy (to preserve fertility)

22
Q

What is the treatment for cervical cancer stage 1bii-2a ?

A

Radical hysterectomy (if LNs -ve) or chemoradiothwrapy (if LNs +ve)

23
Q

What is another name for radical hysterectomy ?

A

Wertheim hysterectomy

24
Q

What is the treatment for cervical cancer stage, 2b-4?

A

Chemo-radiotherapy alone

25
Q

What is the prognosis of cervical cancer and what does this depend on (3) ?

A

Lymph node involvement clinical staging and histological grading

26
Q

What is cervical ectropion?

A

Red area of columnar epithelium around the os

27
Q

Cervical ectropion is common in those that what ? (2)

A

Young and on the COCP

28
Q

How would a cervical ectropion present ?

A

Usually asymptomatic; PCB with/without vaginal discharge

29
Q

What is the treatment for cervical ectropion? (2)

A

Cryotherapy or diathermy

30
Q

What is a cervical polyp ?

A

Benign tumour

31
Q

Cervical polyps are common in what age group ?

A

In those over 40

32
Q

How does a cervical polyp present ? (1)

A

PCB (usually on contact) or IMB/PMB

33
Q

How does the PCB usually occur in a cervical polyp ?

A

On contact; so during sex

34
Q

How would you treat a cervical polyp ? (1)

A

Avulse and sent for histology

35
Q

What are the groups of other causes ?

A

Cervicitis (chronic or acute) and infection (PID)

36
Q

Why does acute cervicitis usually occur and what is the treatment ?

A

Rare and occurs due infection and RX: Abx

37
Q

Why does chronic cervicitis usually occur ? (2)

A

Due infectionand inflammation of ectropion

38
Q

chronic cervicitis is a common cause of ?

A

Increased vaginal discharge

39
Q

What is the treatment for chronic cervicitis?

A

Abx with/without cryotherapy/ diathermy

40
Q

What 3 infections can cause PCB ?

A

Chlamydia, gonorrhoea, trichomoniasis

41
Q

Which is more common during pregnancy: cervical polo or ectropion

A

Ectropion

Obstetrics & Gynaecology BAB (25 decks)

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