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Year 3 > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

tender inguinal lymphadenopathy and green urethral discharge

A

most likely gonorrhoea

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2
Q

management of gonorrhoea

A

ceftriaxone

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3
Q

when should a coil not be recommended

A

in patients with Pelvic inflammatory disease

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4
Q

when is COCP contraindicated

A

in over 40s and high BMI

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5
Q

what complications come with hormone replacement therapy

A

increased risk of breast cancer after 1 year of use
increased risk of endometrial cancer - in absence of progesterone
increased risk of VTE

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6
Q

indications for hormone replacement therapy

A

vasomotor symptoms- hot flushes, insomnia + headaches
loss of bone density
premature menopause

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7
Q

non-offensive vaginal discharge and microscopy showing gram negative diplococci

A

neisseria gonorrhoea

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8
Q

offensive yellow/green frothy discharge

A

Trichomoniasis

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9
Q

what is the role of Leydig cells?

A

produce testosterone
- produce and secrete in response to LH from anterior pituitary

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10
Q

what is the role of Sertoli cells?

A

secrete androgen binding protein, support developing sperm and form blood-testes barrier

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11
Q

what is the most common causes of postmenopausal bleeding?

A

vaginal atrophy
(atrophic vaginitis)

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12
Q

management of persistent urge incontinence

A

antimuscarinic - oxybutynin, tolterodine or darifenacin

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13
Q

what tests should be done for suspected PCOS?

A

pelvic ultrasound, FSH, LH, TSH, prolactin, testosterone and sex hormone-binding globulin (SHBG)

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14
Q

diagnostic criteria for PCOS

A

Rotterdam criteria
2/3 of following
infrequent/ no ovulation
clinical and/ or biochemical signs of hyperandrogenism
polycystic ovaries on US ( >12 follicles/ increased ovarian volume)

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15
Q

what antibiotic should be given to patients with PPROM?

A

10 days erythromycin

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16
Q

management of gestational diabetes

A

1st line (<7mmol/L) = diet of low glycaemic index foods and regular exercise
2nd line(>7mmol/L) = metformin and exercise
3rd line if still not under control = insulin (short acting)

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17
Q

medical management of incomplete miscarriage

A

if expectant management not worked then single dose of misoprostol

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18
Q

medical management of missed miscarriage

A

mifepristone then misoprostol 48hours later

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19
Q

treatment of pre-menstrual syndrome (PMS)

A

COCP
if contraindicated the fluoxetine

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20
Q

When should testing for asymptomatic patients be done?

A

4 weeks after exposure
if negative repeat at 12 weeks

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21
Q

presentation of Hepatitis A

A

flu-like symptoms, RUQ pain, tender hepatomegaly, deranged LFTs
(ALT is raised= viral hepatitis - HIV does not cause this)

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22
Q

Diagnosis and screening of HIV

A

combination test - HIV p24 antigen and HIV antibody

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23
Q

Examples of epithelial ovarian tumours

A

serous, mucinous, endometroid, clear cell , brenner

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24
Q

Classification of ovarian tumours

A

epithelial
germ cell
sex-cord
metastatic

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25
Q

first line investigation for suspected endometriosis

A

Trans vaginal ultrasound

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26
Q

contraindication for the progesterone only implant

A

active breasts cancer

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27
Q

Period of time that emergency contraceptives can be used?

A

levonorgestrel pill = up to 72 hours
Ulipristal = up to 120 hours
^ cautioned in patients with asthma - use IUD instead (copper coil)

28
Q

management for urge incontinence

A

bladder retraining
anti-muscarinic - e.g. oxybutynin
(avoided in elderly due to cholinergic burden)

29
Q

what is the first change that occurs during female puberty

A

breast development

30
Q

what type of epithelium lines the endocervix

A

simple columnar epithelium

31
Q

what type of epithelium lines the external part of cervix

A

stratified squamous epithelium

32
Q

what is a patient at increased risk of when taking progestogens?

A

breast cancer

33
Q

medical management of urge incontinence

A

oxybutynin

34
Q

medical management of stress incontinence

A

duloxetine

35
Q

first line pharmacological management of infertility in patients with PCOS

A

after weight loss
Clomifene

36
Q

most common type of ovarian cancer

A

epithelial ovarian cancer (serous)

37
Q

risk factors for endometrial cancer

A

‘unopposed oestrogen’ - e for estrogen and endometrium
-nullparity
-early menarche
-late menopause
- polycystic ovarian syndrome
- oestrogen-only hormone replacement therapy

38
Q

indications for surgical management of ectopic pregnancy

A

significant pain
adnexal mass >35mm
b-hCG level > 5000
foetal heartbeat present

39
Q

what is the most common type of vulval cancer

A

squamous cell carcinoma

40
Q

Investigation indicative of premature ovarian insufficiency

A

raised FSH and LH levels - underactivity of the ovaries -> lack of negative feedback on pituitary -> increase in gonadotropins

low oestradiol levels

41
Q

fishy vaginal discharge - what is it and management

A

bacterial vaginosis
metronidazole

42
Q

how is AIDS defined

A

evidence of an AIDS- defining illness alongside a CD4 count of <200 cells/mm3

43
Q

how does syphilis present

A

single painless genital ulcer

44
Q

medical management of atrophic vaginitis

A

topical oestrogen cream

45
Q

what should be suspected in any woman presenting with post-menopausal bleeding

A

endometrial cancer
all women >55 years should be referred using suspected cancer pathway

46
Q

first line investigation for suspected endometrial cancer

A

trans vaginal ultrasound - normal thickness <4mm

47
Q

what is the normal anatomical position of the uterus

A

anterverted and anteflexed

48
Q

where is hCG secreted from in early pregnancy and what affect does this have

A

hCG secreted by the syncytiotrophoblast
hCG stimulates corpus luteum to secrete progesterone

49
Q

which cells secrete testosterone

A

leydig cells

50
Q

what size of fibroid is indicative of surgery

A

> 3cm symptomatic

51
Q

first line treatment for pneumocystis pneumonia

A

co-trimoxazole

52
Q

how long is luteal phase

A

ALWAYS 14 days long

53
Q

what happens during the follicular phase

A

(menstrual and proliferative phase)
rapid GnRH pulsatility -> LH
slower GnRH release -> FSH

54
Q

what does oestrogen do

A

develops female sex characteristics
thins cervical mucus
during follicular phase -> negative feedback on GnRH

55
Q

what antibody can pass through the placenta

A

IgG - G for gestation

56
Q

what is the site of spermatogenesis

A

seminiferous tubules

57
Q

where does FSH act on in males and what is the outcome

A

FSH- acts on sertoli cells
plays role in spermatogenesis

58
Q

where does LH act on in males and what is the outcome

A

acts of leydig cells
plays role in testosterone production

59
Q

hypergonadotrophic hypogonadism FSH and LH levels and causes

A

lower than normal
ovarian failure- postmenopausal and premature ovarian
kleinfelter syndrome

60
Q

hypogonadotrophic hypogonadism FSH and LH levels and causes

A

lower than normal levels
hypopituitarism
prolactinoma
anabolic steroid use
kallman’s syndrome

61
Q

first line management for urge incontinence

A

bladder retraining

62
Q

first line management for stress incontinence

A

pelvic floor muscle training

63
Q

define an intramural fibroid

A

within myometrium layer

64
Q

define a subserosal fibroid

A

just below the outer layer of uterus

65
Q

define a submucosal fibroid

A

just below the lining of uterus (the endometrium)

66
Q
A

Year 3 (13 decks)

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