Reproductive

Question 1

What is pelvic inflammatory disease – PID?

Answer 1

Bacterial infection of female upper genital tract – uterus, uterine tubes + ovaries

Spread up from vagina/cervix

Question 2

What is the cause of pelvic inflammatory disease?

Answer 2

One in four cases it’s a result of an STI - chlamydia/gonorrhoea

Can be from bacteria normally present in vagina E.G after childbirth or having an IUCD fitted

Affect sexually active woman aged 15 to 24

Question 3

What are the complications of a pelvic inflammatory disease?

Answer 3

Scarring/narrowing of uterine tubes which can lead to atopic pregnancy or infertility

Question 4

What is the incidence of infertility?

Answer 4

One and seven couples in the UK – 35 million people

Question 5

What are the three types of causes of infertility?

Answer 5

Functional anatomical or physiological

Question 6

What is polycystic ovary syndrome (PCOS)?

Answer 6

Ovaries that contain many cysts – two times more than normal

Cysts are no bigger than 8 mm – below surface of ovaries

Question 7

What are cysts in ovaries?

Answer 7

cysts are eggs – containing follicles – not develop properly – hormonal abnormalities 

Question 8

What is the incidence of PCO and PCOS?

Answer 8

PCO – very common – 20% of women

PCOS – very common – 5 to 10% of women

Question 9

What are the features of PCOS/PCOD?

Answer 9

Anovulation – resulting in irregular menstruation, amenhhroea

Excessive amounts or Effects of androgenic hormones resulting in acne and Hirsutism 

Insulin resistance

Ovaries are appearing polycystic on ultrasound is common but not an absolute requirement

symptoms and severity of the syndrome vary greatly among affected women

Question 10

What are the treatments of PCOS/PCOD?

Answer 10

A minor surgical procedure called laparoscopic ovarian drilling - LOD

Lifestyle changes – balanced diet

Drug treatment

Question 11

What are Anatomical variations?

Bicornate

Answer 11

Malformation of the uterus

Bicornate – two horns form at the top of the uterus

Question 12

What is the incidence of a bicornate?

Answer 12

0.1–0.5% of women

Question 13

Why are pregnancies considered high risk with bicornates?

Answer 13

Considered high risk and require extra monitoring because of association with poor reproduction potential e.g. stillbirth/malformation

Question 14

What are fibroids?

Answer 14

Uterine fibroid - leiomyoma - benign tumour from smooth muscle tissue - originates from smooth muscle layer of uterus

Question 15

What is the incidence of fibroids?

Answer 15

20 to 50% of women child bearing age

Question 16

What are the sizes of fibroids + how many are usually present?

Answer 16

Range in size – large 70%

Coin – melon

After multiple – if too many to count – diffuse uterine leiomyomatosis

Question 17

What are the two types of ovarian cysts?

Answer 17

Functional

Pathological

Question 18

What is a functional ovarian cyst?

Answer 18

Functional- Harmless; form as part of menstrual cycle; most common

Pathological; benign or malignant; dermoid - (mature cystic adenoma - under 40)
- cystadenoma over 40

Question 19

What is a dermoid ovarian cyst?

Answer 19

Ovarian teratoma tumour – could consist of different tissue types E.G fat, bone, hair;

Usually benign but may be removed due to size – up to 15 CM

Question 20

What is a cystadenoma ovarian cyst?

Answer 20

Develops from cells covering the outer part of Overy;

Some small other large – up to 30 cm;

Risk of rupture ovarian torsion – due to cyst blocking it’s blood supply

Question 21

What is cervical carcinoma?

Answer 21

Cervical carcinoma/cancer is a malignant neoplasm arising from cells originating in the cervix uteri

Question 22

Where may the cervical carcinoma metastasise?

Answer 22

Abdomen lungs or elsewhere

Question 23

What is the prognosis for cervical carcinoma?

Answer 23

100% survival rate diagnosed at stage one

30 to 40 years; rare under 25

Question 24

What are the two main types of carcinoma of the cervix?

Answer 24

Squamous cell – most common; develops from the skin like squamas cells that covers the cervix

Adenocarcinoma - Less common; develops from mucus producing glandular cells within cervical canal

Question 25

What is ovarian carcinoma?

Answer 25

Cancerous calls arising from cells in or around the ovary

Question 26

What is the incidence of ovarian carcinoma?

Answer 26

7100 UK diagnosis per year Rare under 40 Most common in postmenopausal women - Typically over the age of 50 Most are benign – only 1 to 5 masses in menustrating women cancerous; 1:2 post menopause Epithelial – Arises from cells that line/cover the ovaries – most common

Question 27

What is the prognosis of ovarian carcinoma?

Answer 27

Per prognosis Lacks any clear early detection or screening  Most cases are not diagnosed until we have reached advanced stages 60% of women presenting with this cancer has stage 3 or 4 and it has already spread beyond the ovaries

Question 28

What are the symptoms of a ovarian carcinoma?

Answer 28

Bloating Pelvic pain Difficulty eating Frequent urination

Question 29

Different types of trauma to the male reproductive system? And what may be the result?

Answer 29

Blunt trauma – 75% Penetrating Can result in a partial or complete ripping of the testicle loss of entire testicle or injury to vascular structures

Question 30

How does a penile fracture occur?

Answer 30

Occurs whilst select most commonly during sexual intercourse The tunica albuginea stretches - in trauma this is breached causing injury to the carvernosa corpora most severe cases the urethra and associated structures involved

Question 31

How does testicular torsion occur?

Answer 31

Occurs when the spermatic cord twists cutting off the testicles blood supply

Question 32

What increases the incidence of testicular torsion?

Answer 32

Congenital malformation known as bell clapper deformity – testes is inadequately affixed to the scrotum allowing it to move freely on its axis  L>R 13-17 year olds Rare over 30 Can affect babies, newborn + unborn Congenital

Question 33

What are the clinical signs of testicular torsion?

Answer 33

Sudden onset of scrotal pain Nausea and vomiting Infection and inflammation Young men plus adolescence Surgical emergency is urethritis or UTI are ruled out completely Reversible damage 6 hours after onset - diagnosis + treatment to reduce necrosis 

Question 34

What is a Hydrocele?

Answer 34

So this food collection with the layers of the tunica intima vaginalis surrounding the testicle/s Vary in size Normally painless and harmless Large can cause discomfort 

Question 35

Causes of a hydrocele?

Answer 35

Acquired or congenital Physical trauma Testicular carcinoma Epididymitis Testicular torsion Generally unknown

Question 36

What is a varicocele?

Answer 36

Collection of dilated blood vessels in the spermatic cord in the scrotum next to/above one or both testicles Like varicose veins Valves and veins malfunction; backflows of blood is not prevented which causes pooling and enlarges veins

Question 37

What is the incidence of Varicocele?

Answer 37

common 1:7 15–25 years Less common in the testicle Left over right

Question 38

What is a benign prostatic enlargement - hyperplasia – BPH

Answer 38

Enlargement of prostate Extremely common – considered normal part of aging

Question 39

What are the Symptoms of benign prostatic enlargement?

Answer 39

Urinary hesitancy Frequent urination UTI Urinary rentention

Question 40

What is the result of a benign prostatic enlargement?

Answer 40

Nodules Compress the urethra – partial or virtually complete urinary tract obstruction

Question 41

What is the incidence of a benign prostatic enlargement?

Answer 41

age 60. - 50% of a men age 90. –90% of men

Question 42

 How does prostate carcinoma develop?

Answer 42

Develops slowly – may not be aware of presents for many years Matasize via lymph 

Question 43

How is prostate carcinoma diagnosed?

Answer 43

PS symptoms Physical exam PSA Biopsy

Question 44

What are the symptoms of a prostate carcinoma?

Answer 44

First sign often bone mets

Question 45

What is the incidence of prostate carcinoma?

Answer 45

Most common cancer in men UK over 40,000 cases diagnosed every year Most common type – adenocarcinoma

Question 46

Testicular carcinoma incidence?

Answer 46

Affects main 15 to 49 One of the less common cancers Senimoma 30-40years Teratoma 20-30 years Imperfectly just said the testes have a 20 to 30% higher chance of developing carcinoma Excellent prognosis if not later stage due to metastases via lymph