Gynaecology Flashcards

1
Q

name for fibroids?

A

uterine leiomyomata

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2
Q

what are fibroids?

A

benign tumours of the uterus, from SM and CT

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3
Q

what hormone are fibroids dependent one?

A

oestrogen

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4
Q

name and explain positions of fibroids?

A

subserosal - under visceral peritoneum

intramural - within uterine wall

submucosal - in endometrium

pedunculates - attached to uterin wall by peduncle

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5
Q

Rx for fibroids?

A

obesity

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6
Q

features of fibroids?

A

menorrhagia

dysmenorrhoea

mass

pain

bloating

fertility problems

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7
Q

Ix for fibroids?

A

US

biopsy

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8
Q

what decides the Tx for fibroids?

A

if fertility is desired

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9
Q

Tx for asympt fibroids?

A

none

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10
Q

Tx for fibroids if wanting fertility preserved?

A

GnRH analogues - mifepristone

myomectomy

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11
Q

Tx for fibroids if fertility is not desired?

A

hysterectomy

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12
Q

two types of ovarian cysts?

A

follicular cysts

corpus luteum cysts

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13
Q

how do follicular cysts occur?

A

GnRH stimulates means follicle persists (does not rupture)

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14
Q

how do CL cysts occur?

A

corpus luteum persists and fills with blood/fluid

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15
Q

Rx for ovarian cyst?

A

pre menopausal

early menarche

PCOS

endometriosis

pregnancy

tamoxifen use

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16
Q

features of ovarian cysts?

A

asymp

bleed

pain

swelling

bloating

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17
Q

Ix for ovarian cysts?

A

TVUS

serum Ca if over 40yrs

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18
Q

Tx for ovarian cysts?

A

pre menopausal - >5cm remove

post menopausal - >5cm treat conservatively

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19
Q

what is a cystocele?

A

anterior wall of vagina and bladder bulge out vagina

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20
Q

what is an enterocele?

A

small bowel extends between ant rectum and posterior vagina

21
Q

what is a rectocele?

A

herniation of ant wall of rectum into post wall of vagina

22
Q

what is a uterine prolapse?

A

when uterus slips from normal position into vagina

23
Q

Ix for prolapse?

A

US assessment of post void residual urine volume

24
Q

when staging prolapse, what is it measured in relation to?

A

hymen position

25
Q

Tx for prolapse? (not surgical)

A

pelvic floor exercises

pessary

topical oestrogen

26
Q

surgery for prolapse?

A

abdo sacrocolpopexy

uterosacral/sacrospinal ligament suspension

27
Q

what happens in endometriosis?

A

endometrial glands and stroma exist outside the uterine body

28
Q

how are cysts described in endometriosis?

A

chocolate cysts

29
Q

features of endometriosis?

A

inflam

pain

dyspareunia

depressed

mass

infertile

30
Q

Ix for endometriosis?

A

TVUS

31
Q

tx for endometriosis?

A

CCP

NSAIDs

GnRH agonist

surgery

32
Q

complications of endometriosis?

A

ectopic

malignancy

cysts

adhesions

33
Q

what do adipocytes produce and why does this increase risk of endometrial cancer?

A

aromatase, as it converts ovarian androgens to oestrogen

oestrogen causes endometrial proliferation

34
Q

what is menorrhagia?

A

prolonged and increased menstrual flow

35
Q

what is amenorrhoea?

A

absence of menstruation

36
Q

what is oligomenorrhoea?

A

menses at intervals of >35 days

37
Q

features of lichen sclerosis?

A

bruising

red

erosions

itch

38
Q

late features of lichen sclerosis?

A

flat, white, shiny vulva (eventually)

39
Q

Tx of lichen sclerosis?

A

clobetasol propionate cream

40
Q

Ix and Tx for leukoplakia of the vulva?

A

biopsy

topical steroids

41
Q

what is lichen simplex?

A

non specific inflammation of the vulva

42
Q

tx for lichen simplex?

A

vulval care

antihistamines

43
Q

where do bartholin’s glands lie? what do they do?

A

under labia minora

secrete lubricating mucus during sex

44
Q

how does bartholin’s abscess arise?

A

blockage of cyst

45
Q

treatment of bartholin’s abscess?

A

incision and drainage

46
Q

gold standard investigation for endometriosis?

A

laparotomy

47
Q

what is used for menorrhagia?

A

tranexamic acid

48
Q

what is used for dysmenorrhoea?

A

mefanamic acid

49
Q

at what thickness should endometrium be investigated?

A

pre menopausal >16mm

post menopausal >5mm