Lesson 2 Flashcards
(21 cards)
What is Fractional Curettage (FC)?
Done in: OT.
Anesthesia: GA (under general anaesthesia).
Procedure: Endocervical curettage.
Endometrial curettage.
Advantage: Diagnosis generalised endometrial pathology.
Disadvantage: Not good for localised pathology.
Note: Single best Ix → Fractional curettage.
What is the purpose of HYSTEROSCOPY?
Used for localised pathology.
What is metropathia hemorrhagica?
M/C: Perimenopausal female.
Pathology: Anovulatory cycles.
Amenorrhea - x 2-3 months.
Treatment: Tranexamic acid.
→ ОСР.
› Oral.
→ Progesterone.
> Mirena.
> HmB (Heavy menstrual bleeding).
What are the HPE findings for metropathia hemorrhagica?
Swiss cheese pattern.
Proliferative endometrium.
Equivalent to cystic glandular hyperplasia.
Risk of malignancy: 1%.
MX: TOC: Progesterone.
> Oral.
- Mirena.
Endometrial hyperplasia without atypia
Risk of malignancy: 1-3%
Next step: Progesterone downregulation of estrogen receptors, Endometrial atrophy. - Mirena > Oral: medroxy progesterone acetate continuous > Cyclical
≥ 10 days for a protective effect.
No contraceptive benefit.
Repeat biopsy at 3-6 months.
Endometrial hyperplasia with atypia
Risk of malignancy: 8-30%
Next step: FC + hysteroscopy.
Management: Best: TAH (Total abdominal hysterectomy → uterus + cervix). Patient refuses TAH: Progesterone (megestrol).
Failure/continued bleeding: Hysterectomy.
Indications for FC + Hysteroscopy
EB: EH + Atypia
El report: Insufficient sample.
Incase of cervical stenosis.
EB: EH w/o atypia, failure of medical mx
What is the cause of endometrial hyperplasia?
Testrogen (Hyperestrogenic state)
No example sentence provided.
How is endometrial hyperplasia classified?
AUB - m
No example sentence provided.
What are the investigations for endometrial hyperplasia?
Ist Ix (After r/o pregnancy): TVS I ET, Suspect EH TaKe, EB.
No example sentence provided.
What is the gold standard investigation for endometrial hyperplasia?
Fractional curettage + Hysteroscopy
No example sentence provided.
Where is endometrial sampling done?
OPD
What are the indications for endometrial sampling in reproductive age (<40 years) women?
C/o AuB + Risk factors of Ca Endometrium: PCOS, DM, HTN, Tamoxiten. ET ≥ 1amm. Auß unresponsive to medical mx (Tranexamic acid, OCP, progesterone).
No example sentence provided.
What are the indications for endometrial sampling in perimenopausal women?
EB Irrespective of USG findings
No example sentence provided.
What are the indications for endometrial sampling in menopausal women?
ET ≥ 4mm on TVS. Pap smear: AGCUS (Atypical glandular cells of undetermined significance).
No example sentence provided.
What are the karyotype for females?
46(xx) / 44+ XX
mnemonics: SEED
What are the karyotype for males?
46(XY) / 44 + XY
What is the best method for sex determination?
Karyotyping
What is the most common method for sex determination?
Assessment of external genitalia.
Drawback: Not applicable in ambiguous genitalia
What are the external genitalia in females?
Labia majora, Labia minora, Clitoris, Bartholin glands/Greater vestibular gland, Paraurethral/Skene gland
What are the external genitalia in males?
Scrotum, Penile urethra, Penis, Bulbourethral/coupers gland
