what are the three types of cyst accident?
haemorrhage
torsion
rupture
features and treatment of a haemorrhagic ovarian cyst?
pain relieved by NSAIDs
treated conservatively
features of ovarian torsion?
acute, severe pain not relieved by NSAIDS
diagnosed via laparoscopic surgery
risk of ovary infarct
which cyst is most likely to be in torsion?
> 5cm
dermoid cyst
which type of cyst most commonly ruptures?
functional cyst in young women after trauma/contact sports
most common benign ovarian masses?
functional cyst endometriotic cyst dermoid cyst fibroma borderline ovarian tumour
triad seen in meigs syndrome?
benign cyst (fibroma)
ascites
pleural effusion
transudate (protein <30g/L)*
describe what is meant by cervical excitation?
acute pain is felt when the cervix is moved during a bimanual vaginal exam
main investigations for a pelvic mass?
abdominal and bi manual exam
serum Ca125
pelvic transvaginal USS
what is a heterotopic pregnancy?
twins - one is in the uterus and one is ectopic
which drug is used in the medical management of an ectopic/PUL?
methotrexate
what are the two surgical options for managing a tubal ectopic?
salpingotomy (remove ectopic only)
salpingectomy (remove ectopic and tube)
is ovarian torsion a surgical emergency?
yes - risk of ovarian infarct
features of pelvic inflammatory disease?
bilateral lower abdominal pain
deep dyspareunia
abnormal PV bleeding and discharge
N&V in 50% of PID cases
differential diagnosis for PID?
appendicitis
treatment for PID?
14 days metronidazole + doxycycline
remove IUD if patient is not better in 7 days
which HSV types cause genital ulcers?
HSV 1 - oral ulcers
HSV 2 - genital ulcers
but there is considerable overlap
features of genital herpes?
multiple painful ulcers, urinary retention, dysuria
treatment of genital herpes?
oral aciclovir
catheterisation
local anaesthetic gel
when should a pregnant woman with HSV be advised to have an elective C-section?
if her primary herpes attack occurs at >28 weeks of gestation
features of HSV on a pap smear?
3 M’s
Multinucleated giant cells
Margination of chromatin
Moulding of the nuclei
