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1 Obs & Gyn > Pelvic Pain and benign gynaecology > Flashcards

Pelvic Pain and benign gynaecology Flashcards

1
Q

Marsupialisation is used to treat which condition?

A

bartholin’s cyst
acute infection

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2
Q

Define fibroids

A

benign tumours of myometrium= oestrogen dependent tumour

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3
Q

List two sites of fibroids

A

sub-mucosal
intramural
sub-serosal

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4
Q

What happens to fibroids during pregnancy and menopause?

A

grows during pregnancy
shrinks after menopause

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5
Q

What is red degeneration?

A

miscarriage due to fibroids

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6
Q

What are the symptoms of fibroids?

A

heavy menstrual bleeding
abdo swelling
pressure symptoms
pain- torsion

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7
Q

How to diagnose fibroids?

A

confirm by USS
MRI to plan management

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8
Q

What is the management of fibroids?

A

medical
- HMB
- GnRH prior to surgery

surgical- hysterectomy, myomectomy

uterine artery embolisation

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9
Q

Name two benign conditions of the uterus

A

polyps
fibroids

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10
Q

Name two benign conditions of the vulva

A

bartholin cyst
lichen sclerosis
genital herpes

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11
Q

Name two benign fallopian tube conditions

A

hydrosalpinx
pelvic inflammatory disease

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12
Q

What are the causes of pelvic inflammatory disease?

A

chlamydia
e.coli
anaerobes

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13
Q

What are the risks of blockage in fallopian tubes?

A

infertility
ectopic pregnancy
chronic pelvic pain

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14
Q

Symptoms of pelvic inflammatory disease?

A

malaise
pain during sex
lower abdo pain (bilateral)
variable discharge

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15
Q

List three signs of PID?

A

pyrexia
tachy
distension and tenderness
RUQ
rebound and guarding

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16
Q

What is Fits-Hugh-curtis syndrome?

A

peri hepatic inflammation from PID

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17
Q

What are the investigations for PID?

A

pregnancy test
FBC +CRP
MSU- exclude UTI
STI swabs
Laparoscopy

18
Q

What is the management of PID?

A

empircal antibiotics broad spectrum (don’t wait for swab)

pain relief

19
Q

Which abx used for pelvic inflammatory disease?

A

ceftriazone 500 mg IM stat then doxy + metronidazole

20
Q

Define hydrosalpinx

A

Hydrosalpinx is the condition in which the end portion of a woman’s fallopian tube becomes fluid-filled and swollen, which can cause infertility.

21
Q

How are cysts diagnosed?

A

USS or CT or MRI
Ca125 and other markers- CEA, aFP, hCG

22
Q

What is the management of ovarian cyst?

A

conservative
remove if >6cm and/or symptomatic
ovarian cystectomy or oopherectomy
laparoscopic if possible

23
Q

List three types of ovarian cysts

A

functional cyst
dermoid cyst
epithelial cyst
endometriotic cyst

24
Q

What is dermoid cyst also known as?

A

benign cystic teratoma

25
Q

What are the tumour markers to assess for in ovarian cyst?

A

Ca125, AFP, HE4

26
Q

Which accidents are associated with cysts?

A

torsion
rupture

27
Q

Investigations for cysts

A

pregnancy test
MSU
vaginal swabs
FBC +CRP
Ca125
TV USS
laparoscopy

28
Q

What are the three types of endometriosis?

A

superficial peritoneal lesions
deep infiltrating lesions
ovarian cysts (endometriomas)

29
Q

What is the treament of lichen sclerosis?

A

dermovate= potent steroid

30
Q

Which virus causes genital herpes?

A

HSV-2

31
Q

What is the management of genital herpes?

A

aciclovir 5-10 days
increase fluid intake
vaseiline or lidocaine for painful micturation
salt water to prevent infection and promote healing

32
Q

What are the symptoms of endometriosis?

A

dysmenorrhoea
dyspareunia
pelvic pain
subfertility

33
Q

How is endometriosis diagnosed?

A

transvaginal USS

34
Q

How to manage endometriosis?

A

conservative
NSAIDs
Progesterone
OCP
Surgical
IVF

35
Q

Define nulliparous

A

“Nulliparous” is a fancy medical word used to describe a woman who hasn’t given birth to a child.

36
Q

What is a complication of herpes that affects the vulva?

A

post-herpetic neuralgia= hypersensitivity of vulval nerve fibres
Treatment= tricyclic antidepressants

37
Q

What is the management of chronic pelvic pain syndrome?

A

antispasmodics IBS
NSAIDs MSK
specialist referral
MDT- chronic pain services, pschology, physio, pscyhosexual therapy, self help groups

38
Q

30 year old female patient presents with acute lower abdominal pain. What are the gynaecological differentials?

A

cyst accident
pelvic inflammatory disease
ectopic pregnancy

39
Q

35 year old female patient with chronic lower abdo pain. What are your differentials?

A

endometriosis
chronic pelvic pain syndrome CPP

40
Q

What are the ligaments of the uterus?

A

broad (peritoneum)
ovarian
uterine ligaments

1 Obs & Gyn (31 decks)

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