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Medicine Year 4 > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

What is the whirlpool sign a sign of?

A

Ovarian torsion

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2
Q

Pharmacological treatment for PCOS infertility

A

Clomifene

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3
Q

How often do women aged 25-49 attend for a cervical smear

A

every 3 years

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4
Q

what site of ectopic pregnancy increases the risk of rupture

A

isthmus

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5
Q

What is the most common ovarian cancer

A

serous carcinoma

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6
Q

medical treatments for endometroosis

A

NSAIDs
COCP
GnRH analogues

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7
Q

4 classic symptoms of endometriosis

A

pelvic pain
dysmenorrhoea
dyspareunia
subfertility

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8
Q

first line treatment for primary dysmenorrhoea

A

NSAIDs e.g. mefenamic acid

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9
Q

diagnosis of mild pain in pregnancy

A

threatened miscarriage

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10
Q

most common identifiable cause of postcoital bleeding

A

cervical ectropion

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11
Q

When do you measure mid luteal progesterone when fertility testing

A

7 days before the end of the cycle (day 21)

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12
Q

pharmacological management of stress incontinence

A

duloxetine

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13
Q

pharmacological treatment for ovulation induction to treat fertility

A

letrozole

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14
Q

if a semen sample is abnormal then when should a repeat test be arranged?

A

3 months later

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15
Q

Diagnosis in patients with continuous dribbling incontinence after prolonged labour from an area with limited obstetric services

A

Vesicovaginal fistulae

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16
Q

Medical management of miscarriage

A

Give vaginal misoprostol alone

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17
Q

Cause of post menopausal bleeding

A

Granulosa cell tumours

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18
Q

What is the best measure of ovulation

A

Progesterone 7 days before

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19
Q

What are women with PCOS at increased risk of?

A

Ovarian hyperstimulation syndrome

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20
Q

What does PCOS increase the risk of?

A

Endometrial cancer

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21
Q

Patient with secondary dysmenorrhoea

A

Refer to gynae for invesitgation

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22
Q

Pharmacological management and clinical diagnosis of bacterial vaginosis

A

Strawberry cervic

Oral metronidazole

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23
Q

Pharmacological management of gram negative gonorrhoea

A

IM ceftriaxone

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24
Q

What can smoking help with in pregnancy (but obvs don’t do it lol)

A

Sickness

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25
Q

Investigation for adenomyosis

A

MRI

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26
Q

Investigation for recurrent thrush

A

Diabetes

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27
Q

Medical abortion at any gestation

A

Mifepristone followed by at least one episode of prostaglandins

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28
Q

Pharmacological management of PMS

A

SSRI during the luteal phase

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29
Q

Downside of adding a progesterone to HRT

A

Increases the risk of breast cancer

30
Q

What is Rokitansky’s protuberance

A

Dermoid cyst (teratoma)

31
Q

What does endometriosis increase the risk of?

A

Ectopic pregnancy

32
Q

Pharmacological management to reduce the size of uterine fibroids

A

GnRH agonists e.g. triptorelin

33
Q

Strong risk factor for endometrial cancer

A

HNPCC/Lynch Syndrome

34
Q

What would you do if a cervical smear sample was inadequate

A

Repeat the smear in 3 months

35
Q

What would you do if HPV was abnormal but the cells were normal

A

Repeat the test in 12 months then:

  • if normal HPV then discharge to regular screening
  • If abnormal HPV then repeat again 12 months later and if still abnormal then colposcopy
36
Q

What would you do if the HPV and cells were abnormal on a smear?

A

Refer to colposcopy

37
Q

First line for non pregnant women with vaginal thrush

how does it present?

A

Single dose oral fluconazole

creamy white odourless discharge

38
Q

When can you give an IUS for heavy periods in a female with a fibroid?

A

If the fibroid is less than 3cm

39
Q

Multi-loculated ovarian cyst with strong blood flow - management

A

Refer for biopsy, high suspicion of malignancy

40
Q

Known cause of fertility (e.g. PCOS) when would you refer to fertility services?
What treatment would they recieve?

A

Immediately

Clomifene or metformin 1st line then laparoscopic ovarian drilling or gonadotrophins

41
Q

Widely spaced nipples, systolic murmur and primary amenorrhoea - diagnosis and 1st line investigation to prove it

A

Turners Syndrome

Increased FSH/LH

42
Q

Cervical ectopion

A
43
Q

Post coital bleeding, excessive discharge, pregnant and previously took the COCP

A

Cervical ectropion

Increased columnar epithelium

44
Q

Mechanism of action of oxybutynin and what is it used for

A

Anti muscarinic for overactive bladder

45
Q

Most common type of ovarian pathology associated with Meigs’ syndrome
What 2 things is it associated with?

A

Fibroma

Associated with ascites and pleural effusion

46
Q

Most common benign ovarian tumour in women under the age of 25 years

A

Dermoid cyst (teratoma)

47
Q

Most common cause of ovarian enlargement in women of a reproductive age

A

Follicular cyst

48
Q

Is migraine with aura a contraindication for HRT?

A

No

49
Q

Patient with LMP over 12 months ago with some recent vaginal bleeding, HRT?

A

Contraindicated, needs further investigation

50
Q

Menopausal lady with hot flushes who does not want HRT

A

Fluoxetine for vasomotor Sx

51
Q

Older lady with labial lump and inguinal lymphadenopathy

A

Vulval carcinoma

52
Q

Unilateral labial swelling with pain whilst walking and dysparapeunia in a woman of childbearing age

A

Bartholians Cyst

53
Q

Treatment for vaginal vault prolapse

A

Sacrocolpopexy

54
Q

Chronic pelvic and sacral pain with menstruation, tender posterior vaginal fornix with uterine motion tenderness

A

Endometriosis

55
Q

Gold standard investigation for endometriosis

A

Laparoscopy

56
Q

How does ovarian cancer initially spread?

A

Local spread within the pelvic region

then to the abdomen

57
Q

Investigation for continuous dribbling incontinence

A

Urinary dye studies

58
Q

Diagnosis of PCOS

A

2/3 of the following:
Infrequent or no ovulation
Clinical or biochemical signs of hyperandrogenism or elevated levels of total or free testosterone
Polycystic ovaries on ultrasonography or increased ovarian volume

59
Q

Snow storm appearance on ultrasound

A

Complete hyadtidiform mole

60
Q

MOA of metformin in PCOS

A

Increases peripheral insulin sensitivity

61
Q

Women who are HIV positive, how often should they attend a cervical smear?

A

Annual cervical cytology

62
Q

Management of patient with secondary amenorrhoea

A

All patients with secondary dysmenorrhoea need to be referred to gynaecology for investigation

63
Q

What are the three components of the RMI for ovarian cancer?

A

US findings, menopausal status and CA125 levels

64
Q

Ovarian cyst that if ruptures may cause pseudomyxoma peritonei

A

Mucinous cystadenoma

65
Q

The most common type of epithelial cell tumour

A

Serous cystadenoma

66
Q

Ovarian cyst that may contain skin appendages, hair and teeth

A

Dermoid cyst (teratoma)

67
Q

What increases the risk of hyperemesis gravidarum

A

Multiple pregnancy

68
Q

For how many weeks after terination is the HCG positive

A

4 weeks

69
Q

First line pharmacological management of nausea and vomiting in pregnancy

A

Prochlorperazine

70
Q

How long after pregnancy do you have to wait until you have a smear test

A

3 months post-partum unless missed screening or previous abnormal smears

Medicine Year 4 (13 decks)

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