Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sheff 3a > Gynae Flashcards > Flashcards

Gynae Flashcards

1
Q

Outline the hormonal involvement in start of puberty for girls

A

Hypothalamus - GnRH pulses

  • > Pit - FSH + LH
  • > Oestrogen release from ovaries
  • > 2ndary characteristics (Thearche is first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 phases of me trial cycle? What happens to endometrium at each? Key hormonal changes?

A

Day 1-4: Menstruation
Endometrium shreds

Day 5-13: Proliferative / follicular
Proliferative endometrium
-GnRH -> FSL/LH release -> follicular growth
-Follicles produce oestrogen which has -ve feedback (only one follicle matures)
-Increased oestrogen levels -> LH surge followed by ovulation around 36 hrs later

Day 14-28: Secretory (luteal) phase
Secretary endometrium
-Follicle becomes corpus luteum -> produce oestrogen and >progesterone
-Progesterone peak at day 21
-Lack of fertilisation -> endometrium breaks down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is androgen insensitivity syndrome?

A 
Genetically male 46XY 
Female phenotype (5a-reductive deficiency)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference between hypergonadotropic hypogonadism and hypogonadotrophic hypogonadism and Egs?

A

Hypergonadotrophic - Ovarian
Congenital - turner
Acquired - PCOS

Hypogonadotrophic - Hypothalamic
Psychological - stress, low weight
Low GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of outflow tract obstruction in amenorrhea ?

A

Vaginal agencies
Imperforate hymen
Transverse vaginal septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mx of prolactin secreting adenomas?

A

Bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do adrenal / thyroid cause amenorrhea? What would you see in hypothyroidism?

A

Overactive / under-active thyroid can cause

Hypothyroid -> raised prolactin and amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which ligaments connect uterus to cervix? Pelvic wall?

A

Uterosacral and cardinal

Broad (continuous with Fallopian tubes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why can HB be low and high with fibroids ?

A

Menorrhagia / IMB -> low

Fibroids can secrete erythropoietin -> high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Endocervix and ectocervix epithelium ? What happens in cervical ectropion ?

A

Endo - columnar
Ecto - Squamous (continuous with vagina)

Endocervix is visible - Often normal in pregnancy / COCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Morphological damage in hpv

A

Koiliocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Follow up of CIN 1? CINII/III

A

6/12, 1 year, 2 year

As above then yearly for 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Screening for Cervial ca every?

A

25-49 - every 3 ears

Every 5 years until 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Staging of cervical ca named?

A

FIGO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mx of cervical Ca if no LN? LN+ve?

A

-ve - Radical abdominal hysterectomy

+ve - Chemo radio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Basics of lichen simplex? Lichen Planus? Lichen sclerosis?

A 
Simplex 
Long Hx of itching and soreness 
-may be inflamed and thickened with hyper/Po pigmentation 
-Avoid irritants (Eg soap) 
Mx - Emolient, steroid cream

Planus
Purplish lesions in Angelita area
Mx- High strength steroid creams

Sclerosis

  • Usually post menopausal
  • Itching and sorenes
  • Pink-white papules which coalesce to form parchment like skin fissures
  • Risk of vulval Ca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a bartholian cyst? Complication?

A

Glands behind labia minora get blocked -> cyst

Staph / ecoli infection -> abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

2 types of VIN ? Mx?

A

Usual - HPV
Most common in <45

Differentiated - due to lichen sclerosis
>45

Local excision, lazer therapy, topical immunomodulators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is clear cell Ca? Who gets it?

A

Adenocarcinoma of vagina

-Daughters born to mothers given DES in pregnancy (used to prevent miscarriage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ovarian tumours
Epithelial?
Germ cell?
Sex cord?

A

Epithelial
Serous adenocarcinoma
Mucinous adenocarcinoma - risk of pseudomyoxoma peritonei if rupture

Germ cell
Teratomas
Dysgermioma

Sex cord
Granulosa cell tumours - secrete high levels of inhibit and oestrogen
Thecomas - Can secrete oestrogen and androgens
Fibromas - Meigs

21
Q

Where are mets to ovary commonly from?

If they contain signet-ring cells what are they?

A

Breast and GI

Krukenberg tumours

22
Q

2 antimuscarinic drugs for OAB (urge) incontinence?

A

Oxybutynin

Tolterodine

23
Q

Drug for IBS?

A

Mebeverine

24
Q

Which infection do you get clue cells?

A

BV

25
Q

Chlamydia called?
Main complication?
Syndrome?
Mx?

A

Chlamydia trachomatis
PID
Rieters - Urethitis, conjunctivitis, arthritis
Doxycycline or azithromycin

26
Q

Gonorrhoea called?
Under microscope?
Mx?

A

Neisseria gonorrheoa
Gram -ve diplococcus
Ceftriaxone

27
Q

Genital warts caused by?

Mx?

A

HPV 6+11
Topical imiquimod cream
Cryotherapy

28
Q

Cause of herpes?
Features?
MX?

A

HSV -2 (1 but less common)
Primary infection the worst - Multiple painful vesicles (little blisters)
-often get local lymphadenopathy, dysuria and systemic Sx

Acyclovir

29
Q

Cause of syphilis? Stages? Important thing to remember? Mx?

A

Treponema pallidum
1- painless ulcer
2- rash, flu like + warty genital/anal growths
3 [rare] - Dementia, gummata of skin and bone

1 and 2 are carry high risk of congenital infection in pregnancy

IM penicillin

30
Q

Trichomonas cause? Key features? Mx?

A

Trincomonas vaginalis
Grey/green discharge - itch and soreness
Dyspareunia
Strawberry cervix

Metronidazole

31
Q 
Screening 
Asx female?
Sx?
Asx male? 
Sx?
Asx MSM? 
Sx?
A

Female
Asx - cervical swab for C+G, blood for Syphillis and HIV
Sx - Urethral swab for G culture, Triple swab

Male
Asx - First void urine for C+G, Blood for S+HIV
Sx - + Urethral swab for G culture

MSM
Asx - Urethral swab for G culture, first void urine C+G, rectal/pharyngeal swab for C+G, Blood for S+HIV+HepB/C
Sx - +urethral and rectal slides -> gram stain + culture

32
Q

What makes up the triple swab

A

2x endocervical for C+G

High vaginal for BV, trichomonas + thrush

33
Q

5 parts of Fraser criteria ?

A

1 - able to UNDERSTAND

2- doctor TRIED TO PERSUADE to inform parents (or allow him to)

3- She will CONTINUE to have intercourse without contraception

4- Her PHYSICAL / MENTAL health is likely to suffer

5- Her BEST INTERESTS require the prescriber to give contraception ± treatment without parental consent

34
Q

How does the COCP work?
Advantages? (Give 2)
Disadvantages?
CIs?

A

Inhibiting ovulation
Thickening cervical mucus
Thinning endometrium

Advantages

  • Reversible, reliable, 12 hour window
  • Decreased dysmenorrhea and menorrhagia
  • protective against ovarian + endometrial Ca
  • Reduces risk of PID

Disadvantages

  • No STI protection
  • risk of thromboembolic disease
  • Decreased effectiveness if D+V
  • cant be used in smokers >35
CI
Smokers >35
BMI >35 
Hx of VTE 
Migraine with aura
35
Q 
POP 
How does it work? 
What’s in it? 
Advantages?
Disadvantages? 
What to do if a missed dose?
A

Thickens cervical mucus
Thins endometrium
Decreases tubal motility
Stops ovulation

Cerazette - desogestrel, Micronor - norehisterone

Advantages

  • Suitable for smokers >35, migraine with aura, HTN
  • Avoids oestrogenic side effects - Breast tenderness, headache, nausea

Disadvantages

  • Less effective than COCP
  • 3hr window (cerazette is 12hr)
  • Functional ovarian cyst may develop
  • Can disrupt menstrual pattern

If missed by 3hr (12 for cerazette) then another should be taken ASAP and use condoms for 2 days

36
Q

Depo provera given how often?
Mechanism?
Advantages?
Disadvantages?

A

Progesterone infection every 12 weeks
Suppresses FSH+LH -> inhibits ovulation

Advantages

  • little user dependence -> good for compliance
  • Over half are amernorrhoeic after 1 year

Disadvantages

  • Irregular bleeding for first 3/12
  • Delay in return to fertility
  • Weight gain (2kg in 1st year)
  • Bone density reduced - regained after stoppping
37
Q

Implant mechanism ?> how long does it last?
Advantages?
Disadvantages?

A

Progesterone - suppress LH/FSH -> inhibits ovulation
3 years

Advantages

  • Low dose, long acting, reversible
  • Reduces dysmenorrhea & Montreal blood loss

Disadvantages

  • Irregular bleeding for up to 1 year
  • Infection at implant site
38
Q

Inter-uterine system hormone? How long?
Advantages?
Disadvantages?

A

Levonorgestrel (progesterone)
5 years

Advantages

  • Very effective
  • few systemic side effects
  • Decreased dysmenorrhea and menstrual blood loss
  • decreased with of ectopic

Disadvantages

  • Risk of PID after fitting
  • Irregular bleeding especially in first 3/12
39
Q

What is the morning after pill? How long can it be taken? Success?

A

1.5mg of levonorgestrel
95% success in 24 hours
55% at 72 hrs

40
Q

What can be used as non hormonal emergency contraception? Disadvantages?

A

Copper IUD
-Most effective method after 72 hrs

Painful on insertion
Risk of PID
Risk of uterine perforation

41
Q

Common side effects of progesterone ?

A 
Depression 
Weight gain
Acne 
Pre menstrual syndrome like sx 
Irregular bleeding 
Reduced libido
42
Q

Oestrogenic side effects

A 
Nausea 
Headaches 
Increased mucus 
Fluid retention &amp; weight gain 
HTN 
Breast tenderness &amp; fullness
43
Q

3 non hormonal contraception

A

Barrier - condom / caps
Natural family planning
Lactational amenorrhea - when fully breast feeding
Male / female sterilisation

44
Q

2 methods for female sterilisation

A

Filshie clips

Enssure micro inserts

45
Q

Primary vs secondary subfertility

A

Primary - never conceived

46
Q

4 conditions required for pregnancy?

A

Egg must be produced
-anovulation

Adequate sperm

Sperm must reach egg
-Tubal

Egg must implant

47
Q

Physiology of sperm production

What is seen in normal semen analysis

A

LH -> leydig cells -> testosterone
->serotonin cells -synthesis and transport of sperm

Volume >2ml
Motility >50%
Number >20million
Morphology >40% normal

48
Q

Causes of abnormal sperm release

A

Idiopathic

Drug exposure - alcohol, smoking, industrial chemicals, anabolic steroids

Varicocele

Kartagner’s syndrome - ciliary dyskinesia 
CF - congenital vas deferns absence 
Retrograde ejaculation 
Mumps 
Anti-sperm antibodies
49
Q

Methods of IVF ? Indications?

A

Inter uterine insemination

  • Unexplained sub-fertility, cervical / sexual problems
  • Cheaper but less effective than IVF

In-vitro fertilisation

  • Doesn’t require patent tubes
  • Does need ovarian reserve -> cant use in ovarian dysgenesis / failure

Intercytoplasmic sperm injection (ICSI)
-useful for severe male factors

Oocyte donation
-genetic disease, premature ovarian failure

Sheff 3a (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions