ICSM Year 5 Gynaecology Flashcards Preview

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Flashcards in ICSM Year 5 Gynaecology Deck (402)
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1

What is Asherman's syndrome?

Presence of intrauterine adhesions that may partially/ completely occlude the uterine cavity

2

Recall 3 risk factors for Asherman's syndrome

Endometrial resection
Dilation and curettage (for miscarriage)
Endometriosis

3

Recall 3 symptoms of Asherman's syndrome

Amenorrhoea, subfertility, cyclical abdo pain

4

Recall what investigations should be done in suspected Asherman's

Saline hysterosonography (HSG), TVUSS

5

What would be seen on TVUSS in Asherman's syndrome?

Sub-endothelial linear striations + 'boggy' uterus

6

How is Asherman's syndrome managed?

Initially: Hysteroscopic adhesionolysis + post-op copper IUD
Next: PO oestrogens and reasses cavity

7

Recall some complications of Asherman's

Infertility, miscarriage, oligomenorrhoea

8

What is atrophic vaginitis?

Vaginal irritation caused by thinning of the vaginal epithelium

9

What is the cause of atrophic vaginitis?

Reduction in circulating oestrogen ie. Post-menopause

10

Give 3 signs of atrophic vaginitis

Irritation, dyspareunia, discharge (may be bloody)

11

How does atrophic vaginitis appear O/E?

Pale, thin vaginal walls with loss of rugal folds, cracks or fissures

12

What investigations would you order in suspected atrophic vaginitis?

1. Clinical examination
2. Swabs for potential infection
3. Biopsy for potential malignancy/ ulcers

13

How is atrophic vaginitis managed?

1. Systemic HRT
2. If bleeding on intercourse --> water based moisturisers and lubricants

14

What 8 things should be checked for when doing a history for gynaecological infections?

Discharge (smell, consistency, colour, volume), Blood
Pain
Urinary symptoms
Itch
FLAWS
Pregnancy status
Sexual history

15

What investigations should be done in a suspected gynaecological infection?

pH, swabs (double or triple) and blood tests (for HIV/ syphilis)

16

What is the normal pH for the lateral wall of the vagina?

3.5-4.5 (due to lactobacilii in vagina)

17

What is a low vaginal pH indicative of?

Candida

18

What is a raised vaginal pH indicative of?

Contamination, BV or TV

19

Describe the method of 'double swab'?

1. Endocervical swab - tests for gonorrhoea and chlamydia
2. High vaginal swab, "charcoal swab" - fungal and bacterial (BV, TV, candida, GBS)

20

Describe the method of 'triple swab'?

1. Endocervical (for chlamydia)
2. Endocervical charcoal swab (for gonorrhoea)
3. High vaginal charcoal swab (for fungal/ bacterial infection)

21

What type of testing is done on the endocervical swab?

NAAT (nucleic acid amplification testing) for chlamydia/ gonorrhoea

22

What type of testing is done on the high vaginal swab?

MCandS

23

How does gonorrhoea appear under the microscope?

Gram neg diplococci

24

What is the most common cause of abnormal discharge?

BV

25

How does discharge appear in BV?

Thin and watery, grey/ white - FISHY SMELLING ODOUR

26

What are the symptoms of BV?

Just the discharge

27

What is the cause of BV?

Overgrowth of anaerobic bacteria

28

What is the most commonly implicated microbe in BV?

Gardinella vaginalis

29

What is required for BV diagnosis?

Clinical diagnosis + microscopy, can show high pH

30

What would be shown on microscopy in BV?

Clue cells - vaginal epithelium cells coated with lots of bacilli