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PART 1 > Gynae > Flashcards

Gynae Flashcards

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1
Q

Incidence of ectopic pregnancies in UK

A

12,000 per year
(roughly 10 in 1,000 pregnancies)

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2
Q

Mortality rate of ectopic pregnancy in UK

A

0.2%

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3
Q

Incidence of choriocarcinoma in UK

A

1 per 50,000 pregnancies

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4
Q

Most common cause of abnormal PV discharge in women of childbearing age

A

BV

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5
Q

Premature menopause age

A

<40

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6
Q

How does ovarian cancer metastasise?

A

Transcoelomic (across the peritoneal cavity)

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7
Q

How does choriocarcinoma spread?

A

Haematogenous

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8
Q

First line management for hirsutism in PCOS

A

Topical eflorithine (only used in >19 yrs old and not for those who are pregnant or breastfeeding)

Dianette (co-cyprindol) is an alternative

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9
Q

‘Bunch of grapes’ sign on TVUS is likely to represent what in a pregnant patient?

A

Complete mole

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10
Q

Name 3 features of cervical dysplasia

A

Anisocytosis (unequal cell size)
Poikilocytosis (abnormal cell shape)
Hyperchromatism (overly pigmented)

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11
Q

Infection most strongly associated with ectopic pregnancy

A

Chlamydia

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12
Q

How is BV diagnosed?

A

Amsels criteria
3/4 needed for diagnosis

  1. Thin white homogenous discharge
  2. Clue cells on microscopy wet mount
  3. pH >4.5
  4. Fishy odour when adding alkali (10% KOH)
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13
Q

How many oocytes do we have at birth?

A

1 million

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14
Q

Definition of complete miscarriage

A

All products of conception are expelled
Bleeding stopped

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15
Q

Definition of threatened miscarriage

A

Viability unknown
PV bleeding

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16
Q

Definition of inevitable miscarriage

A

PV bleeding
Cervical os open

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17
Q

Definition of missed ( / delayed) miscarriage

A

Non viable foetus / POC
Products remain in uterus and have not been expelled

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18
Q

Incidence of hyperemesis gravidarum

A

1.5% of pregnancies

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19
Q

Name of scoring system for PCOS

A

Rotterdam

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20
Q

Rotterdam criteria for PCOS

A

> 2 are diagnostic

  1. Polycystic ovaries (>12 or increased ovarian volume greater tna 10cm3)
  2. Oligo / an-ovulation
  3. Clinical +/- biochemical hyperandrogenism (biochemical= high LH)
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21
Q

When can a hysterosalpingography be performed in relation to the menstrual cycle?

A

Assuming a 28 day cycle: day 6-12

(risk of irradiating a pregnancy after day 12)

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22
Q

Guidelines on RhD in medical abortion <10/40

A

Not routinely required

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23
Q

Which HPV are protected against with gardasil

A

6, 11, 16, 18

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24
Q

Prevalence of antiphospholipid in those with recurrent miscarriages

A

15%

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25
Incidence molar pregnancy
1 / 1,000 (=0.1%)
26
Rate of infertility in endometriosis
40%
27
Criteria on USS for PCOS
>12 peripheral follicles Ovarian volume increased to >10cm
28
Tubal infertility rate after one episode of PID
12.5%
29
Which 2 muscle groups are assessed in urodynamic testing
Detrusor Urethral sphincter
30
What, if any, abx requirement is there in surgical termination of pregnancy
Doxycycline / metronidazole for 3 days
31
How many ovulation disorders are there
3 I - hypogonadotrophic, hypooestrogenic II - normogonadotrophic, normooestrogenic III - hypergonadotrophic,hypooestrogenic
32
What class of ovulation disorder is PCOS
33
Lifetime risk of endometrial cancer in Lynch syndrome
40%
34
Psammoma bodies associated with what
Serous ovarian cancer
35
Risk of vulval SCC with VIN
15%
36
What % of women with gonorrhoea get PID
15%
37
Incidence ovarian cancer per 100k women
22
38
How does ullipristal prevent pregnancy
Inhibit ovulation
39
How long can you use clomiphene for
6 months
40
Incidence of strawberry cervix in trichomoniasis
2%
41
First line treatment of menorrhagia
IUS (mirena)
42
What percentage of patients with endometrial hyperplasia without atypia will progress to having endometrial cancer?
<5%
43
What type of lesions are HPV 6 and 11 associated with?
Low grade squamous intraepithelial lesions of cervix (warts essentially)
44
What type of vaccine is gardasil
Recombinant of virus like proteins
45
What stage is endometrial cancer with inguinal LN involvement (and what is 5 yr survival)
Stage 4B 5 year survival = 15%
46
What % of women have asymptomatic candida colonisation
20% non pregnant 40% pregnant
47
What effect does pregnancy have on risk of developing fibroids?
Pregnancy reduces risk of fibroids
48
Causes of congenital absence of uterus
Mullerian agenesis syndrome (aka Rokitansky Kuser Hauser) CAIS (aka testicular feminisation syndrome) MAS = 1 / 5,000. 46XX CAIS = 1 / 40,000. 46XY
49
Average age at diagnosis of endometrial cancer
60 (however peak incidence is in age group 70-74)
50
Considering ovarian cancer, at what RMI score should you 2WW?
>250 RMI = Ca125 x menopausal score x ultrasound score
51
When to give anti-d in abortion
After 10+0
52
Most common genotype of partial mole
69XXY Complete mole is usually 46XX / 46XY
53
Risk of miscarriage in 40-44 year olds
50%
54
Most common form of fibroid degeneration
Hyaline degeneration (red degeneration most common in pregnancy)
55
At what gestation is a yolk sac at its largest
10/40
56
Which hormone peaks at day 21 of a 28 day menstrual cycle?
Progesterone LH, FSH, oestrogen all peak just before ovulation
57
Infertility rate in endometriosis
40%
58
At what time during menstrual cycle should hysterosalpingography be performed?
Day 6-12 (prior to ovulation incase of pregnancy)
59
How to calculate RMI
Ultrasound score x menopause score x Ca125 Ultrasound score: 0 if no findings 1 if 1 finding 3 if >2 findings Menopause score: 1 premenopause 3 post menopause
60
Origin of Gartner's duct cyst
Mesonephric duct - incomplete regression
61
Which ovarian malignancy is associated with endometriosis?
Clear cell
62
Partial mole karyotype
69XXX = 90% 69XXY / 69XYY rare
63
Complete mole karyotype
46XX 46XY less common
64
Choriocarcinoma means of metastasis
Haematogenous
65
Type of ovarian cancer associated with BRCA1
Papillary serous cystadenoma

PART 1 (12 decks)

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