Conditions women's health (FCM)

Question 1

In a patient with endometriosis, what would you expect to see on laparoscopy?

Answer 1

• chocolate coloured spots

Question 2

What are some risk factors for endometrial cancer? (3 things)

Answer 2

1. Obesity
   (they have more fat tissue, which converts testosterone into oestrogen in the fat tissue. More oestrogen stimulates the uterus)
2. Hypertension
3. Type 2 diabetes

Question 3

What are possible causes of increased CA-125? (7 things)

Answer 3

1. Cancer (Ovarian)
2. mensuration
3. Early pregnancy
4. Endometriosis
5. Fibroids
6. Ascites (from cirrhosis)
7. Pelvic infection

Question 4

Signs and symptoms of cervical cancer?

Answer 4

1. Weight loss
2. Night sweats
3. Spotting
4. Increased vaginal discharge
5. Dyspareunia
6. Post- menopausal bleeding
7. Post coital bleeding

Question 5

What is bacterial vaginosis? What are the symptoms?

Answer 5

Common cause for unusual vaginal discharge in women. It is not a sexually transmitted infection but it can increase the risk of you getting a STI.

Symptoms:

• Fishy smell after sex
• greyish- white thin watery discharge
• NO soreness or itching
• Bathing, douching, vaginal washes don’t help the symptoms

Question 6

Management for BV ? (in pregnant and non pregnant women)

Answer 6

NOT- PREGNANT:

If asymptomatic:
- No treatment unless she’s undergoing termination of pregnancy

Symptomatic:

• Avoid precipitating factors
• Oral metronidazole 400mg BD for 5-7/7

If they can’t tolerate oral
- Intravaginal metronidazole gel 0.75% OD for 5/7

NO TEST OF CURE IF SX RESOLVE!

PREGNANT:

Asymptomatic:
- Discuss with obstetrician if treatment is appropriate

Symptomatic:
- Same treatment as those who are not pregnant

Question 7

What is placental previa?

Answer 7

This is where the placenta covers the cervix during the last months of pregnancy (low lying placenta). it can cause bleeding before or during labour

Question 8

How would you manage a breast lump that you don’t think is malignant?

Answer 8

uss?

Question 9

How do you differentiate endometriosis from adenomyosis?

Answer 9

It differs because of where the tissue grows

Adenomyosis: Endometrial tissue grows into the muscle of the uterus

Endometriosis: Endometrial tissue grows outside the uterus and may involve the ovaries, fallopian tubes, pelvic side walls, or bowel.
(pain on defecation often in the vignette)

Question 10

How long before the progesterone only pill becomes effective?

Answer 10

Effective after 48 hours

Question 11

What role does oestrogen and progesterone play in HRT?

Answer 11

Oestrogen is for symptomatic relief and progesterone is protective against oestrogen adverse effects

Question 12

Which blood test results would be indicative of menopause?

Answer 12

High FSH. high LH and low oestrogen