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Part 2 > Gynae stats > Flashcards

Gynae stats Flashcards

1
Q

Endometrial hyperplasia without atypia becoming cancer over 20 years

A

5%

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2
Q

Endometrial cancer prevalence

A

Most common gynae cancer

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3
Q

Risk of endometrial hyperplasia with negative endometrial biopsy

A

2%

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4
Q

Probability of endometrial hyperplasia if endometrial thickness below cut-off on TVUS (5mm)

A

1%

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5
Q

Mortality rate tubo-ovarian abscess with sepsis

A

5-10%

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6
Q

TOA in nulliparous women

A

60%

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7
Q

PID who develop TOA

A

15-35%

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8
Q

With TOA percentage of positive chlamydia and gonorrhoea

A

25%

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9
Q

TOA treatment effectiveness with antibiotics

A

70%

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10
Q

Risk of associated malignancy post-menopausal TOA

A

47%

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11
Q

Chronic pelvic pain after TOA

A

12% after one
30% after two
67% after three

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12
Q

Subfertility after TOA

A

Up to 70%

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13
Q

Mental capacity act 2005 age

A

> 16 years old

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14
Q

Recurrent miscarriage

A

1%

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15
Q

Second trimester miscarriage

A

1-2%

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16
Q

Risk of miscarriage after 3 miscarriages

A

40%

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17
Q

Miscarriage risk age 12-29

A

11-13%

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18
Q

Miscarriage risk age 30-34

A

15%

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19
Q

Miscarriage risk age 34-39

A

25%

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20
Q

Miscarriage risk age 40-44

A

51%

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21
Q

Miscarriage risk age >45

A

93%

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22
Q

Antiphospholipid antibodies in recurrent miscarriage

A

15%

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23
Q

Antiphospholipid antibodies in normal obstetric population

A

2%

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24
Q

Live birth rate in APS without medical intervention in recurrent miscarriage

A

10%

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25
Q

Balanced structural chromosomal abnormality in recurrent miscarriage

A

2-5%

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26
Q

Chromosomal abnormality in recurrent miscarriage

A

30-57%

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27
Q

Uterine anomalies in recurrent miscarriage

A

1.8-37%

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28
Q

Term delivery rate with uterine anomaly

A

50%

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29
Q

Live birth rate after PIGD and IVF

A

20-30%

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30
Q

Incidence postmenopausal ovarian cysts

A

5-17%

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31
Q

Complete mole

A

46XX

80% duplication single sperm in empty ovum

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32
Q

Partial mole

A

69XXY

90% triploid, 2 paternal and 1 maternal

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33
Q

GTD incidence

A

1 in 714

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34
Q

Molar chemo rate

A

5-8%

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35
Q

Molar detection rate at US

A

56%

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36
Q

Chance live birth with coexisting mole

A

25%

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37
Q

Partial mole chemo

A

0.5%

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38
Q

Complete mole chemo

A

15%

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39
Q

Postpartum GTN chemo

A

1 in 50,000

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40
Q

Risk repeat molar

A

1 in 80

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41
Q

Precocious puberty

A

1: 5,000 - 10,000
10: 1 female:male

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42
Q

Birth defects

A

2-3% major

10% minor

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43
Q

Translocation T21

A

2-3%

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44
Q

Chromosomal abnormalities

A

75% miscarriage

0.6% live births

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45
Q

T21

A

1 in 700 births
60% miscarry
20% stillborn

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46
Q

Risk of T21

A 
<25 is 1:1300
30 is 1:900
35 is 1:360
40 is 1:100
42 is 1:55
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47
Q

T21 cause

A

96% non-dysjunction in meiosis

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48
Q

Recurrence risk T21

A

0.55-0.75%

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49
Q

Edwards T18

A

1 in 3000

95% miscarry

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50
Q

T18 cause

A

95% maternal non dysjunction

5% paternal non dysjunction

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51
Q

T21 most common cardiac defect

A

AVSD

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52
Q

T18 most common cardiac defect

A

VSD

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53
Q

Patau T13

A

1 in 5000

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54
Q

Turner XO

A

1 in 2500
Can die of co-arctation
Can be mosiaic

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55
Q

Kleinfelters 47XXY

A

1 in 1000

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56
Q

Triple X 47XXX

A

1 in 1000

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57
Q

Multiple Y, 47XYY

A

1 in 1000

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58
Q

Risk ovarian ca BRCA1

A

40-60%

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59
Q

Risk ovarian ca BRCA2

A

10-20%

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60
Q

Risk breast ca BRCA1

A

60-85%

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61
Q

Risk breast ca BRCA2

A

45-60%

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62
Q

Semen volume

A

1.5ml

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63
Q

Semen pH

A

> 7.2

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64
Q

Semen concentration

A

15 million per ml

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65
Q

Total sperm number

A

39 million

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66
Q

Sperm morphology (normal forms)

A

4%

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67
Q

Sperm motility

A

40% motile

32% progressive motility

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68
Q

Raised Ca125 in early ovarian ca

A

50%

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69
Q

RMI sensitivity and specificity

A

Sensitivity 78%

Specificity 87%

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70
Q

M and B rule sensitivity and specificity

A

Sensitivity 95%

Specificity 91%

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71
Q

Sperm vitality (live)

A

58%

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72
Q

Dexa scan Z score

A

Compares bone density with that of an average person of the same age and sex

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73
Q

Dexa T score

A

Compares bone density to healthy 30 year old

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73
Q

Vulval cancer

A

3.7 in 100,000

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74
Q

Risk VIN to invasive

A

4%

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75
Q

Vulva cancer

A

90% SCC

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76
Q

Survival vulval cancer no nodes

A

> 80%

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77
Q

Survival vulval cancer with nodes

A

Inguinal 50%

Iliac or pelvic 15-20%

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78
Q

Recurrence vulval cancer

A

15-33%

Vulval mets 69.5%

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79
Q

Ovarian mass rate

A

10%

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80
Q

Risk of ovarian mass being malignant pre-menopausal

A

1 in 1000

81
Q

Suspected ovarian masses which are non ovarian

A

10%

82
Q

Peritonitis with spillage of dermoid

A

0.2%

83
Q

Ovarian cancer linked to gene defects

A

10%

84
Q

Risk reduction with BRCA after BSO

A

> 50%

85
Q

5 year survival ovarian cancer

A

Stage 1 - 78%
Stage 2 - 61%
Stage 3 - 28%
Stage 4 - 19%

86
Q

Increase in endometrial cancer rate

A

25%

87
Q

Percentage of endometrial ca linked to lifestyle

A

37%

88
Q

Incidence of endometrial cancer

A

28 per 100,000

89
Q

Age endometrial cancer

A

< 40 years 2-5%

Peak 65-75 years

90
Q

Reduction endometrial ca risk pregnancy

A

30% first, 25% subsequent

91
Q

Risk endometrial ca with HNPCC (lynch 2)

A

40-60% risk
70% lifetime risk colon cancer
3-14% ovarian cancer

92
Q

Risk endometrial ca with tamoxifen

A

Increase 2 per 10,000 cases

93
Q

Percentage women in PMB clinic with endometrial ca

A

10%

94
Q

Cervical cancer rate

A

8.4 per 100,000

4th common worldwide, 12th UK

95
Q

Cervical screening reduction cervical cancer

A

20%

7% decrease mortality per year

96
Q

HPV prevalence

A

25%

10% persistent

97
Q

HPV 16 and 18 cause cervical cancer

A

70%

98
Q

High grade dyskaryosis, chance of CIN2/3

A

72-94%

99
Q

CIN1 regression rate

A

50%

100
Q

If CGIN excised but margins positive chance of invasive disease

A

5%

101
Q

Risk of CIN with VIN

A

24%

102
Q

Risk ectopic

A

1%

11 in 1000

103
Q

Morbidity with ectopic

A

0.2 per 1000

104
Q

TVUS diagnostic for ectopic

A

Sensitivity 87-99%

Specificity 94-99%

105
Q

TVUS findings ectopic

A

Adnexal mass 50-60%
Empty GS 20-40%
YS/pole 15-20%
Pseudo sac 20%

106
Q

+HCG with IU sac and no adnexal mass

A

99.98% IUP

107
Q

False negative laparoscopy ectopic

A

3-4.5%

108
Q

Failure pipelle biopsy

A

7%

13-15% post menopausal

109
Q

Polyps associated with endometrial hyperplasia

A

10%

110
Q

Positive hysteroscopy endometrial disease

A

70% chance endometrial ca

111
Q

Negative hysteroscopy for endometrial disease

A

2.5% chance endometrial cancer

112
Q

Malignant potential complex atypical hyperplasia

A

50-75%

113
Q

Pathology endometrial cancer

A

70-75% endometriod adenocarcinoma
5-10% papillary serous
4% clear cell

114
Q

Rauri is

A

The boss

115
Q

Repeat ectopic pregnancy

A

8% after salpingotomy

5% after salpingectomy

116
Q

Persistent trophoblastic tissue after salpingotomy

A

3.9-11%

117
Q

Success methotrexate with ectopic

A

65-95%

118
Q

2nd dose methotrexate needed

A

27%

119
Q

Success expectant management ectopic

A

57-100%

120
Q

Cervical ectopic

A

<1% ectopics

121
Q

CS scar pregnancy

A

0.05% pregnancies

122
Q

Interstitial ectopic

A

1-6.3% of ectopic pregnancies

123
Q

Cornual ectopic

A

1 in 76,000 pregnancies

Rarest form ectopic

124
Q

Recurrent ectopic rate

A

18.5%

125
Q

Coffee bean nucleus

A

Brenner tumour

126
Q

Endometriosis tumour

A

Endometriod adenocarcinoma if undifferentiated becomes ovarian clear cell carcinoma

127
Q

Walthard cell rest

A

Glomerular tissue - Brenner

128
Q

Hobnail nucleous

A

OCCC

129
Q

Psammona body

A

Serous epithelial ovarian cancer

130
Q

Honeycomb cyst

A

Mucinous epithelial ovarian cancer

131
Q

Fish flesh tumour, teenagers

A

Dysgerminoma

High LDG, all phos, HCG

132
Q

Schiller Duvall bodies

A 
Endodermal sinus (yolk sac)
High AFP
133
Q

Rokitanskys protuberance

A

Teratoma (dermoid)

Cystic masses with solid area

134
Q

Call Exner bodies

A

Granulosa tumours

Eosiniphiliic fluid spaces

135
Q

Meigs syndrome

A

Ascites, plural effusion, benign ovarian tumour (fibroma, Brenner, granulosa)

136
Q

Crescent sign US

A

Benign - rim normal tissue around cyst

137
Q

Spiders web coagulum US

A

Haemorrhagic cyst

138
Q

US sausage mass and incomplete septa

A

Hydrosalpinx/PID

+ bright flecks - gas - TOA

139
Q

Endometriosis

A

2-10%

140
Q

Endometriosis infertile women

A

40-50%

141
Q

Complication risk at laparoscopy

A

1 in 500

2% if severe endo

142
Q

Incidence PMS

A

10%

143
Q

Risk of cervical cancer with normal smear

A

1 in 5000

144
Q

If low grade cervical smear changes chance of HPV+

A

85%

145
Q

Koilocytes

A

HPV

146
Q

Normal FBS

A

pH >7.25

Repeat in 1 hour if trace remains abnormal

147
Q

Borderline FBS

A

pH 7.21-7.24

Repeat in 30 mins of trace remains abnormal

148
Q

Acidotic FBS

A

pH <7.20

149
Q

Risk if fam hx ovarian ca

A

1 member = 5%

2 members = 7%

150
Q

Hereditary ovarian cancer

A

10-25%

90% if that is BRCA

151
Q

Reduction cancer risk BSO with BRCA

A

80-96% reduction ovarian cancer
60-76% reduction mortality
1-6% risk peritoneal cancer

152
Q

Normal micturation velocity

A

15 mls/sec for at least 150mls

153
Q

Uroflowmetry post void volumes

A

<50cc normal

>100cc abnormal

154
Q

Oestrogen is

A

C18

155
Q

Testosterone is

A

C19

156
Q

Progesterone is

A

C21

157
Q

Primary amenorrhoea

A

0.3%
No periods by 16 or
No 2ndary sexual characteristics by 14

158
Q

Cause 1ary amenorrhoea

A 
Gonadal dysgenesis (43%)
Mullerian agenesis (15%)
Constitutional delay (14%)
PCOS (7%)
159
Q

Normal 2ndary sexual, high LH:FSH ratio or normal FSH

A

PCOS

160
Q

No 2ndary sexual, high FSH, hypertension, high Na, K, Cl

A

CAH
21 hydroxylase deficiency - no aldosterone or cortisol
17 hydroxy- steroids in the urine

161
Q

No 2ndary sexual, high FSH and LH, short

A

Turners

162
Q

No 2ndary sexual, high FSH, LH, normal height

A

Male karyotype

Ovarian failure

163
Q

Low LH, FSH low/normal - hypo hypo

A

Weight loss, stress, T1DM, anorexia

164
Q

Testosterone >5nmol/l

A

Androgen insensitivity, androgen tumours, cushings, late CAH

165
Q

Male karyotype XY, normal testosterone, female phenotype, small breasts, no pubic hair

A

1 in 60,000
Androgen insensitivity syndrome - no receptors
No mullerian, gonads inguinal

166
Q

Male karyotype, normal testosterone, female/ambiguous phenotype, virilisation at puberty

A

5a reductase deficiency, not able to convert test to active DHT which makes external genitalia and gets rid of mullerian

167
Q

Kallmanns syndrome

A

1 in 50,000
Congenital absence GnRH neurons
Hypo hypo
Anosmia/ colour blind

168
Q

Hypopituitarism then low GH, gonadotropin, adrenocortico, then TFTs

A

Sheehan’s

169
Q

High FSH >25 x 2, amenorrhoea

A

Premature ovarian failure

170
Q

Hypoplastic vagina, absent uterus, ovaries present, 46XX

A

1 in 5000
MRKH
Mullerian agenesis
Renal issues

171
Q

High test and DHEAS

A

Adrenal gland tumour

DHEA in test converted to DHEAS In zone reticularis

172
Q

Male with 3B hydroxy steroid dehydrogenase deficiency

A

Under virilised - micropenis

173
Q

Low SHBG in PCO

A

High insulin levels

174
Q

Cushings

A

Cortisol excess, high BMI, buffalo hump, striae

175
Q

Male karyotype, normal external genitalia, female organs

A

Swire syndrome
No MIF so cannot break down mullarian
Had DHT so normal external genitalia

176
Q

Galactorrhea which is prolactinoma

A

80%

177
Q

Recurrence microadenoma in pregnancy

A

3%

178
Q

Recurrence macroadenoma in pregnancy

A

30%

179
Q

1 standard deviation

A

68%

180
Q

2 standard deviation

A

95%

181
Q

3 standard deviation

A

99.7%

182
Q

Standard error

A

Measure of spread vs population
Looks like a p value
= SD/✔️mean +-2SD

183
Q

Sensitivity

A

TP/TP+FN

Ability of a test to correctly identify people with a disease

184
Q

Specificity

A

TN/TN+FP

Ability of test to correctly identify people who do not have disease

185
Q

PPV

A

TP/TP+FP

How likely that a patient has the disease it the test is positive?

186
Q

NPV

A

TN/TN+FN

How likely is it that the person does not have the disease of the test is negative

187
Q

Likelihood ratio

A

Sensitivity/1-specificity

188
Q

Odds ratio

A

TP x TN/ FN x FP

Odds of disease in the exposed vs odds of disease in non exposed

189
Q

Relative risk

A

PPV/ NPV
1 = not difference
< 1 less likely
> 1 more likely

190
Q

NNT

A

1/ARR

191
Q

Null hypothesis

A

Statement of no significant difference

192
Q

Type 1 error

A

False positive
Reject the null hypothesis when it was true
Fire alarm without fire
Saying medical treatment works if it doesn’t

193
Q

Type 2 error

A

False negative
Accepting null hypothesis when it should be rejected
Fire without fire alarm
Saying a medicine doesn’t work when it does

194
Q

Weight loss HG

A

5%

195
Q

Unable to climb stairs, loss feeling ant/ med thigh and medial calf

A

Femoral L2-4

196
Q

Burning pain from CS to mons labia and thigh

A

Ilioinguinal or iliohypogastric

197
Q

Sensory loss upper medial thigh and weak hip adductors

A

Obturator nerve

198
Q

Sensory loss beneath knee, and weakness hip extension and knee flex ion, foot drop

A

Sciatic and peroneal nerve

Associated lithotomy

199
Q

Gluteal, perineal pain, vulval pain, worse seated

A

Pudendal nerve

200
Q

HCG follow up

A

If HCG normal within 56 days then 6 months from evac
If not normal in 56 days 6 months from normal
Do not conceive for 1 year

201
Q

Early menopause with GTN chemo

A

1 year with single agent

3 years with multi agent

Part 2 (2 decks)

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