Specialist Gynaecology

Question 1

What % of moderate dyskaryosis will have CIN 2 or 3?

Answer 1

74%

Question 2

What % of severe dyskaryosis will have CIN 2 or 3?

Answer 2

80-90%

Question 3

What is the regression % of CIN 1

Answer 3

80%

Question 4

What is the regression % of CIN 2

Answer 4

40%

Question 5

What is the regression % of CIN 3

Answer 5

32%

Question 6

What is the cancer progression risk of CIN 1

Answer 6

1%

Question 7

What is the cancer progression risk of CIN 2

Answer 7

5%

Question 8

What is the cancer progression risk of CIN 3

Answer 8

12%

Question 9

What is BRACA inheritance pattern?

Answer 9

AD

Question 10

BRACA related cancers other than breast and ovarian

Answer 10

Fallopian tube, pancreas, prostate, peritoneal

Question 11

What is the risk of developing breast ca in BRACA 1 carriers?

Answer 11

55-65%

Question 12

What is the risk of developing ovarian ca in BRACA 1 carriers?

Answer 12

39%

Question 13

What is the risk of developing breast ca in BRACA 2 carriers?

Answer 13

45%

Question 14

What is the risk of developing ovarian ca in BRACA 2 carriers?

Answer 14

11-17%

Question 15

LYNCH syndrome- what cancers are at higher risk?

Answer 15

ovarian 1-38%

endometrial 15-60%

Question 16

Endometrial hyperplasia can cancer risk?

Answer 16

simple without- 1%, complex without 3% with 30-39%

Question 17

What’s the treatment for hyperplasia without atypia?

Answer 17

1st line 52mg IUS, 2nd line continuous progestogen ie medroxyprogesterone 10-20mg OD. For a minimum of 6 months but ideally 5 years

Question 18

What’s the surveillance for hyperplasia without atypia?

Answer 18

6 monthly biopsy, discharge when 2 consecutive -ves. UNLESS BMI >35 or oral progestogens and then annual biopsy

Question 19

When would you consider a hysterectomy in hyperplasia without atypia?

Answer 19

If atypia developes, no regression with treatment after 12 months, relapse after finishing treatment

Question 20

What are the different types of VIN?

Answer 20

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

Question 21

What about smears in people with VIN?

Answer 21

Annually for 5 years

Question 22

Hyperplasia WITH atypia what is the management and surveillance?

Answer 22

Ideally hysterectomy. If declines then follow up every 3 months, once 2 consecutive -ve biopsies then biopsy every 6- 12 months until hysterectomy

Question 23

Pre-menopausal ovarian cyst bloods

Answer 23

LDH, AFP, hCG, Ca125

Question 24

Pre-menopausal cyst follow up

Answer 24

<5cm none
5-7 and simple: yearly USS follow-up
>7cm MRI for characterisation

Question 25

What is the cancer risk of someone with a post-menopausal bleed?

Answer 25

General risk 10%

if high BMI 18%, if DM2 21%, if both 29%

Question 26

What is the risk of an endometrial polyp being malignant?

Answer 26

3%

Question 27

What are 1st line muscarinics?

Answer 27

oxybutynin (but don’t give to old and frail), tolteradine

Question 28

What is the repeat surgery rate in surgical management of prolapse

Answer 28

10%

Question 29

How long should a 1st line trial pf physiotherapy for stress incontinence be?

Answer 29

3 months

Question 30

When doing semen analysis how long should a man have abstained for prior?

Answer 30

2-5 days

Question 31

When doing semen analysis when should you repeat it if abnormal results?

Answer 31

3 months