Specialist Gynaecology Flashcards
What % of moderate dyskaryosis will have CIN 2 or 3?
74%
What % of severe dyskaryosis will have CIN 2 or 3?
80-90%
What is the regression % of CIN 1
80%
What is the regression % of CIN 2
40%
What is the regression % of CIN 3
32%
What is the cancer progression risk of CIN 1
1%
What is the cancer progression risk of CIN 2
5%
What is the cancer progression risk of CIN 3
12%
What is BRACA inheritance pattern?
AD
BRACA related cancers other than breast and ovarian
Fallopian tube, pancreas, prostate, peritoneal
What is the risk of developing breast ca in BRACA 1 carriers?
55-65%
What is the risk of developing ovarian ca in BRACA 1 carriers?
39%
What is the risk of developing breast ca in BRACA 2 carriers?
45%
What is the risk of developing ovarian ca in BRACA 2 carriers?
11-17%
LYNCH syndrome- what cancers are at higher risk?
ovarian 1-38%
endometrial 15-60%
Endometrial hyperplasia can cancer risk?
simple without- 1%, complex without 3% with 30-39%
What’s the treatment for hyperplasia without atypia?
1st line 52mg IUS, 2nd line continuous progestogen ie medroxyprogesterone 10-20mg OD. For a minimum of 6 months but ideally 5 years
What’s the surveillance for hyperplasia without atypia?
6 monthly biopsy, discharge when 2 consecutive -ves. UNLESS BMI >35 or oral progestogens and then annual biopsy
When would you consider a hysterectomy in hyperplasia without atypia?
If atypia developes, no regression with treatment after 12 months, relapse after finishing treatment
What are the different types of VIN?
Differentiated: inc risk of SCC, older women, associated wiht LS, unifocal and unicentric.
Usual (undifferentiated) type: lower risk, younger women, HPV associated, multifocal and multicentric
What about smears in people with VIN?
Annually for 5 years
Hyperplasia WITH atypia what is the management and surveillance?
Ideally hysterectomy. If declines then follow up every 3 months, once 2 consecutive -ve biopsies then biopsy every 6- 12 months until hysterectomy
Pre-menopausal ovarian cyst bloods
LDH, AFP, hCG, Ca125
Pre-menopausal cyst follow up
<5cm none
5-7 and simple: yearly USS follow-up
>7cm MRI for characterisation
What is the cancer risk of someone with a post-menopausal bleed?
General risk 10%
if high BMI 18%, if DM2 21%, if both 29%
What is the risk of an endometrial polyp being malignant?
3%
What are 1st line muscarinics?
oxybutynin (but don’t give to old and frail), tolteradine
What is the repeat surgery rate in surgical management of prolapse
10%
How long should a 1st line trial pf physiotherapy for stress incontinence be?
3 months
When doing semen analysis how long should a man have abstained for prior?
2-5 days
When doing semen analysis when should you repeat it if abnormal results?
3 months
