OBGYN

Question 1

what is histology of ectocervix

Answer 1

stratified squamous

Question 2

what is histology of endocervix

Answer 2

columnar (glandular)

Question 3

what is histology of transition zone

Answer 3

squamo-columnar junction

Question 4

what is does the normal menstrual cycle composed of

Answer 4

Normal Menstrual Cycle:
Cycle length usually 28 days
Between 21-35days

Day 1-14 = follicular phase (↑ FSH & oestrogen)

Day 14 – 28 = luteal phase (↑ LH & progesterone)

Ovulation occurs 24-36hours post LH surge

Question 5

tx for DUB

Answer 5

1st line = mirena IUS

2nd line = cOCP, POP

non-hormonal = tranexamic acid

Question 6

what is a normal vaginal flora

Answer 6

lactobacillis

Question 7

buzzword = itchy, white, curd-like

Answer 7

candida

Question 8

buzzword = Fishy, watery discharge, clue cells on microscopy, increased pH

Answer 8

bacterial vaginosis

Question 9

Most common, asymptomatic or urethritis (M), discharge (F)

Answer 9

chlamydia

Question 10

Gram positive diplococci (kidney bean shaped)

Answer 10

gonorrhoea

Question 11

Painful genital ulcer

Answer 11

herpes

Question 12

what causes genital warts

Answer 12

HPV 6 and 11

Question 13

buzzword = Musty smelling, frothy discharge, strawberry cervix

Answer 13

trichomonas

Question 14

Ix for chlamydia and gonorrhoea

Answer 14

FEMALE 1st line = Endocervical swab

MALE 1st line = first pass urine for PCR/NAAY

Question 15

Ix for syphilis

Answer 15

Screening = ELISA

Specific = TPPA

Monitoring = VDRL

Question 16

Ix for herpes

Answer 16

swab ulcer for PCR

Question 17

Ix for tricomonas

Answer 17

high vaginal swab

Question 18

Mx of candida

Answer 18

topical clotrimazole/oral fluconazole

Question 19

MX of chlamydia and gonorrhoea

Answer 19

C = PO Doxy

G = IM ceftriaxone

Question 20

what is post-menopausal bleeding most suggestive of

Answer 20

endometrial cancer

Question 21

Menorrhagia/dysmenorrhoea + bulky uterus =

Answer 21

fibroid

Question 22

Abdo distension, “clothes don’t fit”, SOB =

Answer 22

ovarian tumour

Question 23

adenoma + ascites + pleural effusion =

Answer 23

meig’s syndrome

Question 24

cOCP + increased discharge =

Answer 24

ectropion

Question 25

Contact bleeding/dyspareunia =

Answer 25

cervical cancer

Question 26

Fat, acne, oligomenorrhoea =

Answer 26

PCOS

Question 27

what is the tumour markers for = ovarian, bowel, pancreas, breast

Answer 27

CA125 - ovarian CEA – bowel CA19-9 – pancreas CA15-3 - breast

Question 28

how is CIN 2 and 3 treated

Answer 28

LLETZ | - large loop excision of transition zone

Question 29

what investigation should be offered to a woman with symptoms suggest of cervical cancer

Answer 29

colposcopy [not smear as that is screening not diagnostic]

Question 30

what is the cervical screening program

Answer 30

A smear test is offered to all women between the ages of 25-64 years 25-49 years: 3-yearly screening 50-64 years: 5-yearly screening

Question 31

what are risk factors for cervical cancer

Answer 31

Smoking Increased no. of sexual partners & younger age HPV 16 & 18

Question 32

risk factors for endometrial cancer

Answer 32

Exposure to oestrogen - HRT - Tamoxifen - PCOS & Lynch syndrome (HNPCC) - Increased BMI (increased aromatase)

Question 33

Ix for endometrial cancer

Answer 33

1st line = TVUSS [shows increased endometrial thickness]

Question 34

Tx for endometrial cancer

Answer 34

Hysterectomy + bilateral salpingo-oophrectomy chemo/radiotherapy if required

Question 35

Tx for adenomyosis

Answer 35

hysterectomy

Question 36

Tx for PCOS

Answer 36

1st line = Weight loss, metformin 2nd line = No pregnancy: cOCP – dianette 3rd line = Pregnancy – clomifene +/- metformin 4th line = Hirsutism – eflornithine cream/ laser treatment

Question 37

Bartholins cyst v abscess?

Answer 37

Bartholin’s cyst – typically soft, fluctuant and non-tender | Bartholin’s abscess – typically tense and hard, with surrounding cellulitis

Question 38

cause and Sx of overactive/urge incontinence

Answer 38

Urgency, frequency, nocturia – detrusor over-activity

Question 39

Tx for urge incontinence

Answer 39

bladder diary bladder training Oxybutinin [s.e. increase risk of falls in elderly]

Question 40

Tx for stress incontinence

Answer 40

pelvic floor training | duloxetine [SNRI]

Question 41

Ix only done in stress incontinence

Answer 41

urodynamic studies

Question 42

Tx for vault prolapse

Answer 42

sacrospinous fixation

Question 43

Tx for Incident cystocele picked up on cervical screening

Answer 43

pelvic floor exercises

Question 44

Tx for elderly woman with prolapse and multiple co-morbidities

Answer 44

pessary

Question 45

surgical treatment for bartholin's abscess

Answer 45

marsupialization

Question 46

OGTT results for people without diabetes

Answer 46

fasting value before test = < 6 at 2 hours = < 7.8

Question 47

OGTT results for people with impaired glucose tolerance

Answer 47

fasting value before test = 6 - 7 at 2 hours = 7.9 - 11

Question 48

OGTT results for people with diabetes

Answer 48

fasting value before test = > 7 at 2 hours = > 11

Question 49

diagnostic criteria for diabetes

Answer 49

If the patient is symptomatic: fasting glucose greater than or equal to 7.0 mmol/l random glucose greater than or equal to 11.1 mmol/l (or after 75g oral glucose tolerance test)

Question 50

what is the screening for gestational diabetes

Answer 50

women who've previously had gestational diabetes a OGTT should be performed after booking (8-12weeks) and at 24-28 weeks if the first test is normal. women with any of the other risk factors should be offered an OGTT at 24-28 weeks

Question 51

diagnostic criteria for gestational diabetes

Answer 51

fasting glucose is >= 5.6 mmol/l | 2-hour glucose is >= 7.8 mmol/l