Week 3

Question 1

What is the main symptom of fibroids (apart from subserosal fibroids)?

Answer 1

Bleeding

Question 2

What is the main symptom of subserosal fibroids?

Answer 2

Pain

Question 3

What happens to a woman’s fibroids when she goes through the menopause?

Answer 3

The fibroids are still there but as fibroids grow under the influence of oestrogen and progesterone, they no longer cause any problems

Question 4

What diagnosis are you worried about if fibroids continue to get worse after the menopause?

Answer 4

Leiomyosarcoma

Question 5

Which reproductive organ can have borderline tumours?

Answer 5

Ovaries

Question 6

What is the first line management of fibroids?

Answer 6

The intrauterine system (IUS)
If they dont want contraception then,

Question 7

What are the surgical options of management of fibroids?

Answer 7

Hysterectomy (removes all or part of the uterus) or Myomectomy (just removes the fibroids)

Question 8

How do you carry out a myomectomy of subserosal fibroids?

Answer 8

laparoscopically

Question 9

How do you carry out a myomectomy of intracavitary fibroids?

Answer 9

Hysteroscopically

Question 10

What form of inheritance is Lynch syndrome?

Answer 10

Autosomal dominant

Question 11

Define Lynch syndrome

Answer 11

A cancer predisposition syndrome: high risk of colorectal syndrome, high risk of endometrial cancer and increased risk of ovarian cancer

Question 12

What are some risk factors for endometrial cancer?

Answer 12

Obesity
PCOS
Lynch syndrome

Question 13

What are the 2 main types of Uterine cancer?

Answer 13

Type 1: Endometrioid and mucinous carcinoma- 80%
Type 2: Serous and clear cell carcinoma- 20%

Question 14

Which type of uterine cancer is related to unopposed oestrogen?

Answer 14

Type 1- endometrioid

Question 15

What is the primary treatment of stage II, II and IV cervical cancer?

Answer 15

Radical radiotherapy

Question 16

What is the most common presentation of endometrial cancer?

Answer 16

Post menopausal bleeding

Question 17

How do you manage low risk stage I ovarian cancer?

Answer 17

Optimal surgical staging
- no adjuvant chemotherapy

Question 18

How do you manage high risk stage I ovarian cancer?

Answer 18

Optimal surgical staging with adjuvant chemotherapy consisting of 6 cycles of carboplatin

Question 19

How do you manage advanced (stage II-IV) ovarian cancer?

Question 20

How do IUSs and oral contraceptives affect your ovarian and endometrial cancer risks?

Answer 20

IUSs and oral contraceptives decrease your ovarian and endometrial cancer risk

Question 21

How do we manage CIN II and CIN III?

Answer 21

Cold coagulation and LLETZ (long loop excision transformation zone)

Question 22

What do you do if you vomit within 3 hours of taking an oral contraceptive pill?

Answer 22

Cry and take another pill, then take the next dose at the usual time

Question 23

When during your cycle do you need to continue using another form of contraception after starting the COC?

Answer 23

If you start at any time out with the first 5 days of your period

Question 24

How soon after having a baby can you start combined oral contraceptives?

Answer 24

21 days (3 weeks) if you’re not breastfeeding
6 weeks if you’re breastfeeding

Question 25

How soon after having a baby can you get an IUS or IUD inserted?

Answer 25

within the first 48hrs or after 4 weeks

Question 26

When can you start POP after giving birth?

Answer 26

At any time

Question 27

How can large endometriotic cysts present?

Answer 27

With a pelvic mass and high CA125 levels
(not usually assymptomatic)

Question 28

Do fibroids affect your CA125 level?

Answer 28

No
haha kelly got it wrong