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Isleans Mrcog Part 2 > Benign Gynaecology > Flashcards

Benign Gynaecology Flashcards

1
Q

What is finesteride

A

Anti-androgen

Inhibits 5areductase therefore reduces conversion of testosterone to dibydroteatosterone

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2
Q

What is flutamide

A

Antiandrogen acting directly on the hair follicle

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3
Q

What is Cyproterone acetate

A

Anti androgen

Synthetic 17-hydroxyprogesterone derivative

Blocks androgen receptors and reduces LH

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4
Q

What is Eornithine

A

Cream that reduces hair growth

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5
Q

What is Gestrinone

A

Anti progesterone, anti oestrogen and weak androgen

Can cause masculisation of female Cetus therefore contraception indicated

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6
Q

What is the mechanism of tranexamic acid

A

Antifibrinolytic

Reduces endometrial tissue plasminogen activator

Reduces menstrual flow by 54%

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7
Q

What is the prevalence of endometriosis

A

10-20%

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8
Q

What is the threshold size for endometriomas, beyond which histology should be obtained to exclude malignancy

A

3cm

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9
Q

What is the prevalence of adenomyosis

A

1%

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10
Q

What is the Rome criteria

A

IBS: 3 months continuous or recurring abdo pain/irritation

2/+ of the following 25% of time

  • Change in frequency - >3 per day or <3 per week
  • Change in stool - hard/loose
  • Mucous
  • Altered sensation - urgency/straining
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11
Q

What are the features of pelvic congestion syndrome on Venography

A

Ovarian vein diameter >10mm
Uterine venous engorgement
Congestion of the ovarian plexus
Filling of the pelvic veins across the midline &/or filing the vulvovaginal thigh varicosities

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12
Q

What is the prevalence of pelvic congestion syndrome in women of childbearing age

A

3.8%

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13
Q

When can aromatase inhibitors be considered in the treatment of endometriosis

A

Rectovaginal endometriosis refractory to other medical or surgical treatment

Can be used in combination with cocp progestogens or GnRH analogues

Anastrazole, letrozole

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14
Q

What surgical interruption of pelvic nerve pathways is useful for treating endometriosis pain and which is not

A

LUNA laparoscopic uterosacral nerve ablation is NOT useful

PSN pre sacral neurectomy is useful but high risk surgery

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15
Q

What is the only proven method to reduce adhesion formation post surgery for endometriosis

A

Oxidised regenerated cellulose

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16
Q

Regarding endometriosis

Why and what postoperative treatment is given

A

After cystectomy for endometrioma - hormonal contraception for secondary prevention of endometrioma

Post op mirena or cocp for at least 18-24 months for secondary prevention of endometriosis associated dysmenorrhea (not non-menstrual pelvic pain or dyspareunia)

Do not use if seeking fertility

17
Q

What areas are not involved in lichen sclerosis

A

Vagina or mouth

18
Q

What is hyalization of the upper dermis pathognomonic of

A

Lichen sclerosis

19
Q

What % of women in vulval clinical are seen for lichen sclerosis

A

25%

20
Q

How many women undergo FGM worldwide annually according to the WHO

A

2million

21
Q

What is the estimated prevalence of endometriosis in women of reproductive age

A

2-10%

22
Q

What proportion of female adult population will complain of chronic pelvic pain

A

1 in 6

23
Q

What is the incidence of nerve entrapment following pfannensteil incision

A

3.7%

24
Q

What % of women presenting with chronic pelvic pain would you expect to find IBS

A

50%

25
Q

What’s the most common side effect of bisphosphonates

A

Oesophageal irritation

26
Q

What T score on DXA bone scan is diagnostic of osteoporosis

A

-2.5

> -1 is normal

27
Q

What neurotransmitters are thought to be involved in PMS

A

GABA and serotonin

28
Q

What % of women experience severe PMS

A

5%

29
Q

What procedure should be considered to prevent vault prolapse after vaginal hysterectomy

If the vault is above the Introitus
If the vault is at the introitus

A

Above - McCall cyldoplasty

At - sacrospinous fixation

30
Q

What is the treatment for patients with overactive bladder, not responding to antichokinergics, who also have faecal incontinence

A

Sacral neuromodulation

31
Q

What type of prolapse is most increased due to morbid obesity

A

Rectocele 75%

Cystocele 57%
Uterine prolapse 40%

32
Q

What is the incidence of denovo cystocele following sacrocolpopexy

A

31%

33
Q

What is the incidence of mesh erosion in sacrocolpopexy

A

2%

34
Q

What is a rokitanski nodule pathognomic of on USS

A

Dermoid - hair through fat

35
Q

What is the range of testosterone expected with PCOS

A

2-5

36
Q

What is the range of testosterone expected with tumour

A

8-10 tumour possible

>10 tumour likely

37
Q

Define recurrent UTI

A

> 3 uti infections in 12 month period

38
Q

Risk of requiring self catheterisation post Botox for OAB

A

15%

39
Q

What is the prevalence of OAB in adult females

A

13-16%

Isleans Mrcog Part 2 (26 decks)

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