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General Medicine > Gynaecology > Flashcards

Gynaecology Flashcards

1
Q

Follicle cyst

A

follicle cysts form when the follicle doesn’t break open to release the egg each month - this causes the follicle to continue growing into a cyst

No symptoms - go away in 1-3 months

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2
Q

Corpus luteum cysts

A

once the follicle breaks open and releases the egg the empty follicle sac shrinks into a mass of cels called corpus luteum
corpus luteum makes hormones to prepare for the next egg of the menstrual cycle
corpus luteum cysts form if the sac doenst shrink
instead the sac reveals itself after the egg is released, and then fluid builds up inside
most corpus luteum cysts go away after a few weeks
they can grow to 4 inches wiede
they may bleed or twist the ovary and cause pain

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3
Q

Most common cause of ovarian cysts

A
  1. Hormonal problems
  2. Endometriosis
  3. Pregnancy
  4. Severe pelvic infections
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4
Q

Signs and symptoms of ovarian cysts

A

pressure, bloating, swelling or pain in the lower abdomen on the side of the cyst, pain may be sharp or dull and may come and go
if a cyst ruptures: it can cause sudden severe pain
if a cyst causes twisting of an ovary you may have pain along with nausea and vomiting
less common symptoms: pelvic pain, dull ache in lower back and things, problems emptying the bladder or bowel completely, pain during sex, unexplained weight gain, pin during your period, unusual vaginal bleeding, breast tenderness, needing to urinate more often

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5
Q

Eitiologies to exclude in the diagnosis of PCOS

A

congenital adrenal hyperplasia, androgen secreting tumours, Cushing syndrome, thyroid dysfunction and hyperprolactinaemia

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6
Q

Rotterdam Diagnostic criteria for PCOS

A

Two of the following three criteria are required:

oligo/anovulation
hyperandrogenism
clinical (hirsutism or less commonly male pattern alopecia) or
biochemical (raised FAI or free testosterone)
polycystic ovaries on ultrasound

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7
Q

First line treatment for PCOS

A

A lifestyle program that addresses a healthy diet with caloric restriction, behaviour change support and exercise to aid in weight loss and prevention of future weight gain

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8
Q

Medical management of infertility in PCOS

A

Clomiphene citrate

also metformin

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9
Q

Criteria for PID diagnosis

A

One of

adnexal tenderness, uterine tenderness, or cervical motion tenderness

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10
Q

bartholin’s glands

A

re 2 pea sized compound racemose glands located slightly posterior to the left and right of the opening of the vagina.
they secrete mucous to lubricate the vagina and are homologous to bulbourethral glands in males
located in the superficial perineal pouch

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11
Q

What levels are raised in PCOS?

A

Raised Free Androgen Index
Raised DHEAS
(Hyperandrogenemia)

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12
Q

Most common pelvic configuration

A

Gynecoid

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13
Q

Shape of an anthropoid pelvis

A

Heart shaped with a wider AP diameter than transverse

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14
Q

Android pelvis shape

A

Narrower and taller than the Gynecoid

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15
Q

What is the major blood supply to the pelvic organs

A

Internal iliac artery

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16
Q

Blood supply to the cervix

A

Cervical branch of the uterine artery

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17
Q

Stress Incontinence

A

Involuntary loss of urine with increased intra abdominal pressure (coughing, laughing, sneezing, walking, running)

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18
Q

Urge Incontinence

A

Urine loss associated with an abrupt sudden urge to void

19
Q

Neurological causes of urge incontinence

A

Multiple Sclerosis
Herniated Disc
Diabetes Mellitus

20
Q

Risk Factors for stress incontinence in women

A 
pelvic prolapse
pelvic surgery
childbirth
hypoestrogenic state (post menopause)
age
smoking
neurological/ pulmonary disease
21
Q

Treatment for stress Incontinence

A

TVT - Tension free vaginal tape

22
Q

Treatment for urge incontinence

A

behaviour modification
Kegel exercises
Medications - anticholinergics; ocybutynin

23
Q

prolapse

A

herniation due to failure of muscular and connective tissue supports of
pelvic floor
uterus and cervix

24
Q

avulsion of which ligament is most likely to cause an anterior compartment prolapse

A

arcus tendineus fascia pelvis (ATFP)

25
Q

Which 3 muscles make up the levator ani?

A

Pubococcygeus
Puborectalis
Iliococcygeus

26
Q

which nerve innervates the levator ani?

A

Pudendal nerve

27
Q

where does the pudendal nerve run in relation to the ischial spine

A

beneath and lateral to

28
Q

What does a stage 4 prolapse indicate

A

complete eversion of the genital tract

everything is out

29
Q

Risk Factors for prolapse

A 
Obesity
lifestyle
occupational
medical conditions: respiratory, menopause
iatrogenic factors
age
parity
30
Q

4 main things prolapse affects

A

Bladder
Bowel
Sex
Psyche

31
Q

main causes of prolapse

A

direct trauma

pelvic neuropathy

32
Q

most common presenting symptom of vaginal prolapse?

A

Pelvic heaviness

33
Q

Structural causes of vaginal prolapse

A

Pudenal neuropahty
avulsion of the pubococcygeus muscle
tearing of the arcus tendineus fascia pelvis
elongation of the uterosacral ligament

34
Q

in women with prolapse of the posterior vaginal compartmnet which symptom is pathognomic

A

digitation

35
Q

In a woman with stage IV vaginal prolapse requiring surgery, which one of the following is most appropriate regarding medical management of warfarin taken for controlled AF

A

Aim for INR of 1

36
Q

a deficient perineal body is most likely associated with

A

a wide genital hiatus

37
Q

Dysfunctional Uterine Bleeding

A

excessive, heavy, prolonged or frequent bleeding that is not due to pregnancy or any recognisable pelvic or systemic disease

38
Q

Name 3 drugs that interfere with the OCP

A

Phenytoin, Rifampicin and carbamazepine

39
Q

What mediates the increased risk of thromboembolic disease with OCPs

A

oestrogen stimulates production of clotting factors: VII and X and decreases levels of antithrombin III

40
Q

What is breakthrough bleeding due to on OCP

A

Atrophic endometrium

- increase oestrogen dose

41
Q

what is the OCP metabolised by

A

cytochrome P450
Drugs including anticonvulsants, antibiotics and some antriretrovirals all induce liver enzymes and result in faster metabolism

42
Q

Treatment for candida

A

single dose of fluconazole

43
Q

Lymphogranuloma venereum

A

caused by chronic infection with Chlamydia trachomatis

44
Q

Granuloma Inguinale

A

Donovonosis

General Medicine (15 decks)

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