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Gynaecology Flashcards

(100 cards)

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1
Q

What develops from mullerian ducts?

A

Upper vagina, cervix, uterus and fallopian tubes

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2
Q

What suppresses the growth of paramesonephric ducts in males?

A

Anti-mullerian hormone

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3
Q

What is a bicornuate uterus?

A

Two horns to the uterus giving it a heart shaped appearance

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4
Q

What are some complications of a bicornuate uterus?

A

Miscarriage, premature birth and malpresentation

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5
Q

What is an imperforate hymen?

A

Hymen at the vagina entrance is fully formed without an opening

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6
Q

What is vaginal hypoplasia?

A

Abnormally small vagina

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7
Q

What is thelarche?

A

Breast bud development

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8
Q

What is menarche?

A

First period - the last manifestation of puberty in females

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9
Q

What is adrenarche?

A

Development of pubic hair

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10
Q

What is menopause?

A

Permanent end to menstruation - none for 12 months

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11
Q

What is the average age of menopause?

A

51 years

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12
Q

What is perimenopause?

A

Time around the menopause with vasomotor symptoms and irregular periods around 45 years old

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13
Q

What is premature menopause?

A

Before age 40

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14
Q

What are some perimenopausal symptoms?

A

Hot flushes, low mood, irregular periods, joint pain, heavier periods, reduced libido, vaginal dryness

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15
Q

What is the 1st line management of menopause?

A

Lifestyle - regular exercise, weight loss, stop smokingW

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16
Q

What is 2nd line management for menopause?

A

HRT

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17
Q

What are the risks with systemic HRT?

A

Increased risk of breast cancer and VTE

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18
Q

What are some contraindications for HRT?

A

Liver disease
Pregnancy
History of breast cancer
History of idiopathic VTE

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19
Q

What is adenomyosis?

A

Endometrial tissue inside the myometrium

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20
Q

What is the presentation of adenomyosis?

A

Dysmenorrhoea, menorrhagia, dyspareunia, infertility

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21
Q

What is the 1st line diagnosis for adenomyosis?

A

Transvaginal USS of the pelvis

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22
Q

What is the gold standard diagnosis for adenomyosis?

A

Histological examination of the uterus after hysterectomy

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23
Q

What is the 1st line contraception in adenomyosis?

A

Mirena coil

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24
Q

What is Asherman’s syndrome?

A

Adhesions form within the uterus following uterus damage usually after pregnancy

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25
What is the presentation of ashermans syndrome?
Secondary amenorrhoea Lighter periods Infertility Dysmenorrhoea
26
What is the gold standard diagnosis for ashermans syndrome?
Hysteroscopy
27
What is lichen sclerosis?
Chronic inflammatory skin condition with shiny porcelain white patches often on labia, perianal skin and perineum
28
What is atrophic vaginitis?
Dryness and atrophy of vaginal mucosa due to lack of oestrogen in menopause
29
What is the presentation of atrophic vaginitis?
Dryness Itching Painful sex Bleeding from infection Recurrent UTI Sparse pubic hair Pale mucosa
30
What is the management of atrophic vaginitis?
Vaginal lubricants Topical oestrogen
31
What is the most common type of vulval cancer?
Squamous cell carcinomas
32
What is the presentation of vulval cancer?
Vulval lump Ulceration Bleeding Pain Itching Lymphadenopathy in the groin
33
Where does vulval cancer most frequently affect?
Labia majora
34
What are 80% of cervical cancers?
Squamous cell carcinomas
35
What is cervical cancer strongly associated with?
HPV
36
When is HPV vaccinated against?
12-13 years old
37
What is the most common cause of cervical cancer?
HPV infection
38
Which strains of HPV are responsible for cervical cancer?
16 and 18
39
When is cervical cancer screened for?
Every 3 years aged 25-49 and every 5 years aged 50-64 years
40
What do strains 6 and 11 of HPV cause?
Genital warts
41
What are 80% of endometrial cancers?
Adenocarcinomas
42
Any woman presenting with postmenopausal bleeding has what until proven otherwise?
Endometrial cancer
43
What are 2 key risk factors of endometrial cancer?
Obesity and diabetes
44
Where can endometrial cancer metastasise to?
Pelvic and para-aortic lymph nodes
45
What is endometrial hyperplasia?
A precancerous condition with thickening of the endometrium
46
How is endometrial hyperplasia treated?
Progestogens - coil and oral
47
Why is obesity a risk factor for endometrial cancer?
Adipose tissue is a source of oestrogen containing aromatase that converts testosterone into oestrogen
48
Why is PCOS a risk factor for endometrial cancer?
Lack of ovulation so no corpus luteum producing progesterone
49
Why is smoking protective for endometrial cancer?
It is anti-oestrogenic
50
What is the presentation of endometrial cancer?
Postmenopausal bleeding Postcoital bleeding Haematuria Anaemia Raised platelet count
51
What is the 1st line investigation for endometrial cancer?
Transvaginal USS with endometrial thickness over 5mm being abnormal
52
What is the 1st line management for endometrial cancer?
Hysterectomy with BSO
53
What are intrauterine polyps?
Small benign tumours that grow into the uterine cavity
54
What is endometriosis?
Presence of ectopic endometrial tissue outside the uterus
55
What is tissue in the ovaries in endometriosis called?
Chocolate cysts
56
What is the main symptom of endometriosis?
Pelvic pain
57
What is the presentation of endometriosis?
Cyclical abdominal pain Painful sex Painful periods Infertility Difficulty pooping Tender vagina and cervix
58
What may be visible on examination for endometriosis?
Endometrial tissue in the vagina on speculum exam particularly in posterior fornix
59
What is the gold standard diagnosis for endometriosis?
Diagnostic laparoscopy
60
What is the 1st line management for endometriosis?
NSAID
61
What is the 2nd line management for endometriosis?
GnRH agonist or GnRH antagonist
62
What is the final surgical option for endometriosis?
Hysterectomy
63
What are fibroids?
Benign uterine tumours made of smooth muscle and connective tissue
64
What are fibroids derived from?
Myometrial stem cells
65
What do fibroids express?
Higher than normal numbers of oestrogen and progesterone receptors
66
What do fibroids cause?
Heavy menstrual bleeding
67
What is a pedunclated fibroid?
On a stalk
68
What are some symptoms of fibroids?
Menorrhagia Prolonged menstruation Bloating or abdominal fullness Reduced fertility Palpable pelvic mass Abdominal pain worse on menstruation
69
What is red degeneration?
Ischaemia, infarction and necrosis of fibroids from disrupted blood supply
70
What is the 1st line treatment for fibroids?
Tranexamic acid and contraception
71
What is the 2nd line treatment for fibroids?
GnRH agonist
72
What is a hydatidiform mole?
Type of tumour that grows like a pregnancy in the uterus
73
What does hydatidiform mole show on pelvic USS?
Snowstorm appearance
74
What is prolactin produced by?
The anterior pituitary, breast and prostate
75
What are some causes of hyperprolactinaemia?
Prolactinoma Hypothyroidism PCOS Dopamine antagonists
76
What is some management for galactorrhoea?
Dopamine agonists such as Bromcriptine or cabergoline
77
What is the commonest subtype of ovarian cancer?
Serous epithelial carcinoma
78
What is the origin of 90% of ovarian cancers?
Epithelial
79
What are some risk factors for ovarian cancer?
BRCA1/ BRCA2 mutations Increasing age Family history Obesity Smoking
80
What are some symptoms of ovarian cancer?
Urinary frequency Palpable abdominal mass Ascites Vague GI symptoms of bloating, altered bowel habits and nausea Ovarian mass
81
What is the 1st line investigation for ovarian cancer?
Abdominal and pelvic examination
82
What is the tumour marker for ovarian cancer?
CA-125
83
What can CA-125 be raised in?
Ovarian cancer Endometriosis Fibroids Adenomyosis Liver disease Pregnancy Pelvic infection
84
What is the 1st line management for ovarian cancer?
Radical hysterectomy Appendectomy Lymph node dissection Pelvic washout
85
What is the most common ovarian cyst?
Follicular
86
What is Meig's Syndrome?
Triad of ovarian fibroma, pleural effusion and ascites
87
What is ovarian torsion?
Ovary twists in relation to surrounding connective tissue, fallopian tube and blood supply
88
What is the presentation of ovarian torsion?
Sudden onset severe unilateral pelvic pain Nausea and vomiting Localised tenderness Pelvic palpable mass
89
What is the gold standard diagnosis for ovarian torsion?
Laparaoscopic surgery
90
What does ovarian torsion show on pelvic USS?
Whirlpool sign
91
What is PID?
Inflammation and infection of pelvic organs caused by infection spreading through the cervix
92
What is the most common cause of PID?
STI
93
What is the presentation of PID?
Pelvic or lower abdominal pain Abnormal vaginal discharge Fever Pelvic tenderness Inflamed cervix Painful sex
94
What is the Rotterdam Criteria for PCOS?
Oligoovulation or anovulation Hyperandrogenism - hirsutism and acne Polycystic ovaries on USS
95
What is the presentation of PCOS?
Oligomenorrhoea Infertility Acne Hirsutism Hair loss Insulin resistance and diabete
96
What is the gold standard diagnosis for PCOS?
Transvaginal USS
97
What does the transvaginal USS show for PCOS?
12+ follicles on one ovary or ovarian volume of more than 10cm3
98
What is medications for PCOS when fertility is desired?
Clomifene or Letrozole
99
What is the 1st line medication for PCOS when fertility is not desired?
COCP
100
What does clomifene do?
Stimulates ovulation

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