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Obs and gynae passmed Flashcards

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1
Q

HNPCC/Lynch syndrome is a risk factor for which type of cancer?

A

Endometrial cancer

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2
Q

Complications of endometrioma?

A

Can rupture and cause intense pain

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3
Q

Drug of choice for medical management of ectopic pregnancy

A

Methotrexate

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4
Q

“snow storm” appearance on ultrasound

A

Hydatiform mole

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5
Q

How should you manage miscarriage if there is evidence of infection or increased risk of haemorrhage?

A

Surgical management

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6
Q

Criteria for diagnosing bacterial vaginosis

A

pH >4.5
Thin, white homogenous discharge
Clue cells on microscopy
Positive whiff test (addition of potassium hydroxide results in fishy odour)

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7
Q

Treatment of trichomonas vaginalis?

A

Metronidazole

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8
Q

Treatment of gonorrhoea?

A

IM ceftriaxone + oral azithromycin

azithromycin works synergistically but also treats chlamydia

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9
Q

Causes of vaginal discharge?

A

Physiological
Candida (thrush)
Trichomonas vaginalis
Bacterial vaginosis

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10
Q

Best imaging technique for adenomyosis

A

MRI pelvis

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11
Q

Diagnosis of PCOS requires which three features?

A

Polycystic ovaries
Oligomenorrhoea or amenorrhoea
Hirsutism

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12
Q

What test might you need to perform during pregnancy in women with PCOS?

A

Women with PCOS should be offered an oral glucose tolerance test as they are at a higher risk of developing type 2 diabetes

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13
Q

Sudden onset unilateral pelvic pain precipitated by intercourse or strenuous activity

A

Ruptured ovarian cyst

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14
Q

What class of drug is oxybutynin?

A

Anti-muscarinic

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15
Q

How should you manage simple endometrial hyperplasia?

A

Manage with high dose progestogens with repeat sampling in 3-4 months

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16
Q

What should you do if endometrial thickness is >4mm

A

Take a biopsy

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17
Q

If your smear comes back as mild dyskariosis, what should you do?

A

The sample should be tested for high risk HPV subtypes

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18
Q

Which type of ovarian tumour could cause atypical hyperplasia of the endometrium?

A

Granulosa cell tumour

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19
Q

Most common type of ovarian cancer

A

Serous carcinoma

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20
Q

Most common type of ovarian cyst

A

Follicular cyst

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21
Q

Torsion is more likely with this type of tumour than with other ovarian tumours

A

Dermoid cyst

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22
Q

This type of ovarian tumour could rupture and cause pseudomyxoma peritonei

A

Mucinous cystadenoma

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23
Q

Treatment of ovarian cancer?

A

Surgery +/- chemotherapy

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24
Q

Why should you avoid oxybutynin in old/frail people?

A

Should not use oxybutynin in old people due to increased risk of falls, safer options include solifenacin and tolteridone

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25
Most common cause of recurrent first trimester spontaneous miscarriage?
Antiphospholipid syndrome
26
Whirlpool sign on ultrasound
Ovarian torsion | -you might see free pelvic fluid also
27
Which type of HPV are most likely to cause cervical cancer?
HPV 16 & 18
28
First line treatment for menorrhagia
IUS (mirena)
29
Is mefenamic acid an NSAID?
Yes
30
Is tranexamic acid an NSAID?
no
31
Name two antimuscarinics which can be used in urge incontinence?
Oxybutynin, tolteridone
32
What should you do if you find a simple cyst in a young person?
Ultrasound and then repeat ultrasound in 12 weeks - if cyst is still there then consider referral
33
How often should HIV patients be screened?
Annually - they are at an increased risk of cervical cancer
34
What is Sheehan's syndrome?
When the pituitary doesn't really work following ischaemia necrosis due to blood loss and hypovolaemic shock following birth
35
What is premature ovarian failure?
The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40
36
What might increase survival and decrease recurrence in cervical cancer?
Platinum based chemotherapy
37
What might be used to treat haemorrhage in cervical cancer?
Radiotherapy might be used for haemorrhage
38
Treatment of early stage cervical cancer in post-menopausal women
Simple hysterectomy
39
How does metformin work in PCOS?
Increases peripheral insulin sensitivity - most patients with PCOS have a degree of insulin resistance, which in turn can lead to complicated changes in the hypothalamic-pituitary ovarian axis
40
How might vulval carcinomas present?
They are commonly ulcerated and can present on the labium majora
41
Individuals with BRCA1 mutation are at an increased risk of which type of cancers?
Breast and ovarian
42
When would you see cervical excitation?
Pelvic inflammatory disease and ectopic pregnancy | i think also endometriosis
43
What might present with pain during sexual intercourse?
PID | Endometriosis
44
Gold standard investigation for patients with suspected endometriosis?
Laparoscopy
45
Most common cause of post coital bleeding
Cervical ectropion
46
What medication can be used prior to fibroid surgery?
Can give GnRH agonist before surgery e.g. leuprolide
47
When should you offer test of cure?
Offer at 6 months (do cervical screening and HPV test of cure)
48
Which non-hormonal methods may help vasomotor symptoms in menopause?
SSRIs (e.g. fluoxetine) and venlaxafine Clonidine (but side effects) A progestogen (e.g. norethisterone)
49
Clonidine side effects
Dry mouth, dizziness, nausea
50
PCOS increases risk of which type of cancer?
Endometrial cancer
51
How do GnRH agonists help in fibroids?
They effectively turn off the ovaries, which causes the fibroids to shrink = easier to remove surgically If patient wants to retain fertility, you should do myomectomy
52
How big must a uterine fibroid be until you have to stop using the IUS?
You can use IUS until the uterine fibroid is 3cm
53
Where is an ectopic pregnancy most likely to occur?
The ampulla of the fallopian tube
54
What stage of endometrial cancer do most patients present with?
Most patients present with stage 1 cancer - can be treated with surgery
55
Most common complication of termination of pregnancy
Infection (occurs in up to 10% of patients)
56
How might cervical ectropion present?
With vaginal discharge and post-coital bleeding
57
Treatment of thrush in pregnant women
Clotrimazole pessary | -oral fluconazole cannot be used as risk of congenital abnormalities
58
Can you use fluconazole in pregnancy for treatment of thush?
No - risk of congenital abnormalities. Use clotrimazole pessary instead
59
Cervical cancer and smoking
Somking increases risk of cervical cancer by two times
60
Cervical cancer and parity
Risk of cervical cancer increases with parity
61
First line treatment for period pain
NSAIDs e.g. ibuprofen
62
Causes of primary amenorrhoea
Turner's syndrome Testicular feminisation Congenital adrenal hyperplasia Congenital malformations of the genital tract
63
What is Asherman's syndrome
Intrauterine adhesions (can occur after D&C)
64
What should you do if you are pregnant and get your letter about cervical screening?
Get your smear done after you have had your baby, but need to wait at last 12 weeks until after you have given birth
65
Most common complication of myomectomy?
Adhesions
66
How would you diagnose vesicovaginal fistula?
Urinary dye studies
67
If you are uncertain which type of incontinence someone has, and bladder diaries are inconclusive, what investigation should you perform?
Urodynamic studies | i remember a lecturer telling us these were quite horrid because it is uncomfortable and embarrassing for the woman
68
This is the most common type of epithelial cell tumour
Serous cystadenoma

Obs and Gynae (8 decks)

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