gynae

Question 1

rotterdam criteria for PCOS

Answer 1

hyperandrogenism (acne, weight gain)
polycystic ovaries (US)
irregular ovulation

Question 2

management of PCOS

Answer 2

weight loss and exercise
explanation of increased risk of diabetes CVS risk and endometrial cancer

Co-cyprindrol
Combined oral contraceptive pill (COCP):
Metformin

if trying to get pregnant-
Clomiphene
Metformin
Ovarian drilling
Gonadotrophins

Question 3

what can be a risk of unopposed oestrogen

Answer 3

endometrial cancer
trest with combined osterogen and progestogen therpay unless hysterectomy

Question 4

vulval cancer most common

Answer 4

squamous cell carcinomas.

Question 5

what dont you do in cases of suspected placenta praevia

Answer 5

a digital vaginal exam should not be performed prior to an ultrasound in placenta praevia, as it can provoke a severe haemorrhage and worsen the patient’s condition.

Question 6

signs of ectopic pregancy

Answer 6

Amenorrhoea
abdominal and shoulder tip pain
abdominal distension haemodynamic instability

Question 7

what tumour marker is raised in ovarian cancer

Answer 7

CA 125

Question 8

ovarian cancer symptoms

Answer 8

often presents late with non-specific symptoms, such as bloating, early satiety, and new onset stress incontinence in middle aged women
bowel obstruction

Question 9

ovarian cancer types

Answer 9

epithelial 90%
germ cell (AFP marker, bHCG and young women)
stromal 5%

Question 10

what is most appropriate contraception for after pregnancy

Answer 10

progesterone only hormonal pill can be started any time after birth
Intrauterine contraception is not recommended to be fitted within four weeks of delivery
Use of oestrogen-containing hormonal contraceptives is contraindicated immediately (<6 weeks) post partum in breastfeeding women due to increased risk of venous thromboembolism

Question 11

management of urinary incontinence

Answer 11

pelvic training
duloxetine
anticholinergics (for urge)
tension free vaginal tape - first line surgical procedure for treatment
colposuspension and tension free vaginal tape

Question 12

managment of overactive bladder syndrome

Answer 12

fluid intake moderation, reduction of caffeine and fizzy drinks, smoking cessation
bladder training
oral antimuscarinics/anticholinergic
transdermal antimuscarinics/anticholinergic- kentera patch
TCAs
botulinum toxin
neuromodulation