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Gyne Flashcards

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1
Q

What is the main risk of oestrogen only hrt

A

Endometrial cancer

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2
Q

What is the impace of COCP on cancer

A

Ovarian and endometrial = protective
breast and and cervical = increase

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3
Q

What is the most common ovarian cancer

A

Serous carcinoma

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4
Q

asymptomatic simple cyst on ovary

A

Follicular (common)

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5
Q

Severe Pre eclampsia plus abdo pain first line

A

IV magnesium sulphate

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6
Q

Oestrogen receptor positive pre menopause

A

Tamoxifen

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7
Q

Oestrogen receptor positivd post menopausal

A

Anastrozole -aromatase inhibitor

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8
Q

What is a sign of ovarian cancer

A

Ascites with multilocular lesions

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9
Q

What is a sign of ovarian torsion

A

Wirlpool

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10
Q

What is a sign of pcos on ultrasound

A

String of pearls

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11
Q

Syphilis treatment

A

Intramuscular benzathine penicillin G

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12
Q

Neurosyphilis presentstion

A

Confusion, personality change, recent memory loss
Positive rombergs test and absent knee reflexes

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13
Q

Painless ulcers on genitals and enlarged inguinal lymph nodes

A

Syphilis

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14
Q

Painful genital ulcer and tender swollen inguinal lymph nodes
Gram negative rods

A

Chancroid - haemophilus ducreyi

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15
Q

Ulcers with vesicles

A

Herpes

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16
Q

2 stages of menstrual cycle

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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17
Q

What happens in luteal phase

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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18
Q

What happened in follicular stage

A

Luteal - FSH stimulates follicle maturation and LH spike causes release

Follicular - corpus luteum of collapsing follicle secretes progesteone to maintain lining. No hCG means corpus luteum degenerates. Then no progesterone

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19
Q

Cocp contraindications

A

Breastfeeding under 6w post partum
Smoking over age 35
BMI over 40
Migraine with aura
History of VTE
Major surgery

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20
Q

Contraindications for ulipristal acetate emergency contraception

A

Crohns
Allergy
Breast feeding
Hepatic dysfunction
Asthma

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21
Q

Endometriosis signs

A

Visible endometrial tissue in vagina (posterior fornix)
Fixed retroverted uterus
Pain on examination

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22
Q

Miscarriage risk factors

A

Previous miscarriage
Smoking/alcohol
Advanced maternal age
Phospholipid syndrome

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23
Q

Causes of recurrent miscarriage

A

Anti phospholipid syndrome - causes placental insufficiency
Uterine abnormality/bicornuate uterus
Ashermans syndrome

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24
Q

Cervical cancer risk factors

A

Hiv
Smoking
Many sexual partners
High parity
Combined oral contraceptive pill

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25
Which HPV causes cervical cancer
16/18
26
Prolapse risk factors
Obesity Chronic Constipation Multiple vaginal delivery COPD
27
Types of prolapse
Cystocele Rectocele Uterine prolapse Vault prolapse
28
Fitz Hugh Curtis syndrome cause + finding
Prolonged chlamydia infection violin string adhesions between liver and peritoneum
29
What thyroid hormone abnormality is molar pregnancy
High T3/T4 Low TSH
30
A 65-year-old woman presents with vulval itching and white, shiny plaques on the vulva. On examination, the lesions are atrophic and involve the perianal area. what condition an what first-line treatment?
lichen sclerosis - white shiny plaques topical clobetasol propionate/dermovate
31
Which of the types of twin configuration is most common in twin-twin transfusion syndrome?
Monochorionic diamniotic twins
32
where is a ruptured ectopic most likely to occur
isthmus of fallopian tube
33
what is the recurrence rate after 1 ectopic pregnancy
18.5%
34
Most common site of ectopic
ampulla of fallopian tube
35
Criteria for 2 week wait breast referral with ages
Over 30 with unexplained lump Over 50 with nipple discharge or retraction
36
Which serum marker for breast cancer
CA15-3
37
how long post pregnancy should a woman wait for cervical cancer screening
3 months
38
A 55-year-old female patient presents to her GP complaining of breast pain and a new hard lump. She mentioned she recently injured her breasts on a door. Her past medical history includes diabetes and hypertension, and she has a BMI of 34. What is the most likely diagnosis?
fat necrosis
39
What cancer marker is used for ovarian cancer
Ca125
40
What blood test results indicates menopause
High fsh
41
What is the order of movements of the fetus during delivery
Flextion, internal rotation, extension, external rotation
42
A 22 year old woman attends the Emergency Department with pain and tenderness of the left breast for 48 hours. She is breastfeeding. She has a swollen right breast with a 5 cm mass which is red and tender and several tender enlarged nodes under the arm. She has a fever of 38ºC, pulse of 78 bpm and BP of 120/80 mmHg. what condition
breast abbcess
43
what occurs in primary syphilis
small papule and painless enlarged lymph nodes - lasts 2-6 weeks
44
small papule and painless enlarged lymph nodes - lasts 2-6 weeks what
primary symphilis
45
what occurs in secondary syphilis
4-8 weeks after primary lesion macularpapular rash - not itchy fever, headache and lymphadenopathy rarely
46
4-8 weeks after primary painless red papule macularpapular rash - not itchy fever, headache and lymphadenopathy rarely what
secondary syphilis
47
complications of syphilis
neurosyphilis cardiosyphilis - aortitis
48
IUGR diagnostic
Abdominal circumference/estimated foetal weight less than the 10th centile for gestation oligohydramnios, abnormal UA Doppler, poor interval growth velocity, EFW <3rd centile
49
chlamydia treatment
doxycycline 100mg twice a day for 7 days CI - breast feeding/pregnant Azithromycin 1g stat then 500mg once a day for 2 days
50
Thrush treatment
Oral fluconazole If preggers - Clotrimazole intravaginal pessary
51
Bacterial vaginosis presentation
Thin grey discharge Fishy
52
Bacterial vaginosis treatment
Oral metronidazole Vaginal clindamycin cream
53
Hot flushes treatment
Hrt Fluoxetine ssri
54
Stress incontinence medication
Duloxitine
55
Strength of pelvic muscle contraction score
Oxford score 5 - strong 0 - nothing
56
First line investigation stress incontinence
Urine dipstick and bladder diary
57
5 treatment for stress incontinence
Weight loss Stopping smoking/asthma control Pelvic floor excersice - 3 months Duloxitine Surgery
58
Overactive bladder treatment
Bladder retraining Solifenacin (anticholinergic) Mirabegron (beta 3 agonist) Botox injections Sacral nerve stimulation IN THIS ORDER
59
Most common infertility cause
30% Male factor 25% ovulatory factor
60
Preconception advice
400 micrograms folic acid (high risk 5mg) Vitamin D Healthy diet/excersice Normal weight
61
Complication of hormonal fertility treatment
Ovarian hyper stimulation syndrome
62
Ovarian hyper stimulation syndrome
Abdo pain Vomiting Recent IVF Large ovary size Ascites Hypo-osmolarity Thromboembolism
63
IUGR risk factors
Booking BMI Smoking Previous IUGR/Pre eclampsia
64
investigations for 3rd trimester foetus
ultrasound foetal growth measurments/amniotic fluid measurement doppler umbilical artery waveform cardiotocography
65
2 medications for premature babies
steroids - lung maturation magnesium sulfate - neuroprotection
66
cause of raised urea/creatinine in ovarian cancer
renal tract obstruction or dehydration leading to loss of third space fluid
67
cause of anaemia in cancer
presence of cancer/anaemia of chronic disease
68
what investigations in ovarian cancer
ultrasound abdo pelvis CT chest abdo pelvis CA125
69
Pcos diagnostic criteria
Rotterdam 2/3 Oligomenorrhea Polycystic overies Hyperandrogenism
70
3 blood tests in Pcos
Testosterone FSH TSH
71
Treatment for hormonal acne
Combined Oral contraceptive pill Antibiotics Azelaic acid
72
Black skin in armpits/neck/groin Name and what condition
Acanthosis Nigricans Insulin resistance
73
Downs syndrome signs
Short stature Short neck Single Palmer crease Sandel toe gap Flat occiput Prominent epicanthic folds
74
Antenatal chromosome testing
Combined test - 11-14 weeks Quadruple test - 15-20
75
Gestational diabetes complications
Macrosomia Shoulder dystocia Pre-term birth Neonatal hypoglycemia
76
Most common breast cancer
Invasive ductal carcinoma of no special type
77
What is used to asses risk of 5 year recurrence of breast cancer
Nottingham prognostic index
78
Fibroadenoma presentation + pathophysiology
Firm, rubbery, painless, mobile lump. Benign tumour of epithelial breast duct tissue
79
When operation on fibroadenoma
Over 3cm - rare
80
If one relative with breast cancer, what indicates referral
Bilateral Under 40 Male
81
Prophylactic BRCA surgery
Bilateral mastectomy with bilateral oophorectomy
82
Breast screening age
50 to 70 every 3 years
83
Differential for nipple discharge
Physiological Galactorrhoea Mammary duct ectasia Carcinoma
84
Green nipple discharge What and who
Mammary duct ectasia - dilation of large breast duct Post menopausal women
85
What medication causes gynaecomastia
Spironalactone (most common) Antipsychotics Digoxin
86
Causes of gynaecomastia
Kallmans/Klinefelter s syndrome Mumps/testicular failure Testicular cancer
87
Blood tests gynaecomastia
TFT U+E FSH LH PROLACTIN testosterone
88
Medication for gynaecomastia
Tamoxifen (selective oestrogen receptor modulator)

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