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Obs & Gynae (Gynae) > Benign Gynaecological Tumours & Prolapse > Flashcards

Benign Gynaecological Tumours & Prolapse Flashcards

(54 cards)

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1
Q

What are the main risk factors for the development of a prolapse?

A

Childbirth, ageing and family history

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2
Q

What structures may be damaged in pregnancy and childbirth, which contribute to the development of a prolapse?

A

Levator ani muscle and pudendal nerve

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3
Q

Why does post-menopausal oestrogen deficiency lead to an increased risk of prolapse?

A

Atrophy of pelvic support

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4
Q

What is the main symptom of a prolapse?

A

Dragging sensation or a lump coming down

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5
Q

What happens to the symptoms of a prolapse as the day progresses?

A

They get worse

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6
Q

Why may prolapses result in bleeding/discharge?

A

Ulceration from friction

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7
Q

What are some features specific to a cystocele?

A

Incomplete emptying, frequency/hesitancy, recurrent UTIs

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8
Q

What are some features specific to a rectocele?

A

Constipation, digitation, faecal incontinence

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9
Q

What should always be examined first in a patient with a suspected prolapse and why?

A

The abdomen, to check for masses

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10
Q

How is a prolapse diagnosed?

A

On clinical examination, as the patient coughs

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11
Q

What are some conservative management options for a prolapse?

A

Weight loss, smoking cessation, pelvic floor exercises, pessaries

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12
Q

What is the most commonly used type of pessary?

A

Ring

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13
Q

Can you have sex with a ring pessary in?

A

Yes

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14
Q

How often should pessaries be changed?

A

Every 6 months

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15
Q

What is the biggest problem if a woman forgets that she has a pessary in?

A

Erosion

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16
Q

What medical treatment may be useful for post-menopausal women with a prolapse?

A

Low dose oestrogen pessaries or creams

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17
Q

Surgical treatment should not be offered for a prolapse unless the prolapse is below what level?

A

The introitus

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18
Q

Anterior colporrhaphy is used for which type of prolapse?

A

Cystocele

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19
Q

What are some surgical management options that could be used for a uterine prolapse?

A

Hysterectomy or sacrohysteropexy

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20
Q

Posterior colporrhaphy is used for which type of prolapse?

A

Rectocele

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21
Q

What surgical management option is available for a vaginal prolapse?

A

Sacrospinous fixation

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22
Q

What are uterine fibroids?

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A

Benign leiomyomas (benign smooth muscle tumours)

23
Q

Within which layer of the uterine wall do fibroids develop?

24
Q

It is unclear what causes fibroids to start growing, but once they have grown they are responsive to what?

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A

Oestrogen and progesterone

25
Fibroids are known for growing significantly when? And shrinking significantly when?
Growing in pregnancy and shrinking after the menopause
26
Fibroid degeneration is a common cause of abdominal pain when?
In mid-pregnancy
27
How does fibroid degeneration typically present?
Low grade fever, pain and vomiting
28
How is fibroid degeneration managed?
Rest and analgesia (it will resolve spontaneously in 4-7 days)
29
Rapid growth of a uterine mass is concerning, particularly in post-menopausal women, because it raises suspicion of what?
Uterine sarcoma
30
What effect do fibroids have on the menstrual cycle?
Menorrhagia
31
What is the imaging investigation of choice for uterine fibroids?
Trans-vaginal ultrasound
32
What medical treatment can be offered to women with symptomatic fibroids?
COCP, POP, Mirena-IUS
33
What medication can be given for 6 months to shrink fibroids before surgical resection?
GnRH analogues
34
What interventional radiological procedure is a treatment option for for fibroids?
Uterine artery embolisation
35
What is the first line surgical treatment for fibroids in women who want to preserve their fertility?
Myomectomy (hysteroscopically or laparoscopically)
36
What is the first line surgical treatment for fibroids in women who do not want children or who have completed their families?
Hysterectomy
37
What are the two types of physiological ovarian cysts?
Follicular and corpus luteum cysts
38
Which type of ovarian cyst is this describing: common, small, fluid-filled cysts which are generally asymptomatic and resolve spontaneously?
Physiological cysts
39
Which type of ovarian cyst is this describing: common cyst filled with altered blood at different stages of clot formation and breakdown, may present with pelvic pain?
Endometrioma
40
What is the origin of an ovarian teratoma?
Germ cell tumour
41
Which type of ovarian cyst is this describing: very common with a thick capsule, may contain fat, hair, teeth, bone etc and can be very large- 10% are bilateral?
Mature teratoma
42
Which type of ovarian cyst is this describing: common, may grow very large, can be complex and multi-locular and filled with thin, clear or thick, mucoid fluid?
Cystadenoma
43
What are the three features of the RMI tool used to differentiate between benign and malignant ovarian masses?
Menopausal status, CA125 and ultrasound appearance
44
How should simple ovarian cysts < 5cm be managed?
Serial ultrasound scans
45
How are symptomatic ovarian cysts or those > 5cm diameter managed?
Surgical excision
46
When should endometriomas > 6cm diameter be removed?
If the woman is undergoing asssisted conception treatment
47
What are some risk factors for ovarian torsion?
Ovarian mass, reproductive age, pregnancy
48
Patients presenting with sudden onset, deep-seated, colicky abdominal pain associated with vomiting and distress should raise suspicion of what diagnosis?
Ovarian torsion
49
A whirlpool pattern on ultrasound is suggestive of what diagnosis?
Ovarian torsion
50
What procedure is both diagnostic and therapeutic for an ovarian torsion?
Laparoscopy
51
Rokitansky's protruberance is associated with which benign ovarian cyst?
Dermoid cyst
52
Which type of benign ovarian cyst will cause pseudomyxoma peritonei if it ruptures?
Mucinous cystadenoma
53
What type of ovarian cyst is most commonly associated with Meig's syndrome?
Fibroma
54
What is the most common benign ovarian tumour in those aged < 25?
Dermoid cyst

Obs & Gynae (Gynae) (5 decks)

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