Gynecology summary notes PDF

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Gynecology summary notes...

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When the cervix descends to the vaginal introitus it is defined as second degree prolapse of the

Procidentia means total or third degree prolapse of the uterus

If the cervix descends to the vaginal introitus, the prolapse is defined as second Total prolapse means that degree. The term procidentia is applied to where the cervix and the body of the the body of the uterus and uterus and the vagina walls protrude through the introitus. The word actually the vaginal walls protrude means ‘prolapse’ or ‘falling’ but is generally reserved for the description of total through the introitus or third-degree prolapse. (page 343-344)

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the tumor has extended to page 321 the lateral pelvic wall

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2.

Which statement is not correct?

Third degree prolapse means that the uterus protrudes through the introitus but the vaginal walls do not

3.

What are the criteria of stage III vaginal cancer?

intraepithelial

limited to the vaginal walls

involves the subvaginal tissue but has not extended to pelvic Wall

4.

Women with atypical hyperplasia of the endometrium have a risk of future endometrium carcinoma in:

0,1

0,25

0,5

0,7

dysmenorrhoea and heavy bleeding are common symptoms

MRI is the most sensitive technique for the diagnosis

levonorgestrel-releasing intrauterine system can relief symptoms

A, B, C are true

HIV infection

none of these above

page 267

can be both

cannot be classified

page 329

leiomyosarcoma

11.

True for adenomyosis:

What is the commonest cause of Chlamydia thrachomatis 15. HPV infection acute salpingitis? infection Serous papillary type of 16. Type I Type II mixed endometrial cancer is in Malignant mesenchymal tumour of endometrial stroma 17. Müllerian tumour the uterus except sacrcoma What's the definition of 5 or fewer menstrual periods 3 or fewer menstrual 19. oligomenorrhoea? over 12 month periods over 12 month What can you use for emergency 21. 1*750 mg levonorgestrel 2*750 mg levonorgestrel contraception? There is a high incidence Suppresses the normal build of irregular scanty 30. Which is not true for Mirena? up of the endometrium bleeding in the first 3 months after Treatment of polycystic ovary cyproterone acetate with 32. weight loss syndrome, except oestrogen What thickness of endometrium 34. represents a very low risk in postmenopausal women? The principal features of sexual (find the wrong answer)

36. dysfunction in men are:

Common complications of ovarian 41. tumours Most common pathogens of PID: 42. (find the wrong answer) 43.

Follicular ovarian cysts contain:

44.

Recent caesarean rate in Hungary?

47.

True for polycystic ovary syndrome, except

51.

True for vaginal hysterectomy

clear cell tu. of uterus

page 330

none of the above

page 245

2*500 mg dienogest

3*1000 mg norgestrel

page 300

There is a higher risk of ectopic pregnancy

Causes reduction in menstrual blood loss

page 294

bilateral laparoscopic adnexectomy

laparoscopic ovarian drilling

page 249

>10mm

When the endometrium is measured at less than 3 mm, significant endometrial pathology is very unlikely. An endometrial thickness of less than 5 mm on transvaginal ultrasound in a postmenopausal woman indicates a very low risk of endometrial cancer. (page 329) The principal features of sexual dysfunction in men are: (page 315) too many previous sexual • failure to achieve erection partners • problems with ejaculation • loss of libido.

>9mm

failure to achieve erection

problems with ejaculation

loss of libido

ascites

torsion of ovarian pedicle

hemorrhage into the tumour

Clostridium perfringens

Streptococcus pneumoniae

Chlamydia trachomatis

Neisseria gonorrhoeae mixed (solid and fliud) structure

blood

clear fluid

decomponated blood

10%

20%

30%

hyperovulation

uterovesical and can be done when malignant rectovaginal peritoneum uterine disease is suspected are opened

type 2 diabetes is common

>15mm

A, B, C are true

40%

normal FSH level

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page 238

7 or fewer menstrual periods over 12 month

>5mm

increased level of androstenedione

Women with atypical hyperplasia have an up to 50% chance of concurrent carcinoma and 30% chance of future progression to carcinoma (page 329)

page 239 pelvic inflammatory disease (PID), primary infection by Chlamydia trachomatis or Neisseria gonorrhoeae (or both) (page 310-311) The cysts rarely exceed 4 cm in diameter, the walls consisting of layers of granulosa cells and the contents of clear fluid, which is rich in sex steroids. (page 332) http://www.who.int/healthsystems/topics/financing/healthreport/30Csectioncosts.pdf Oestrogen and FSH levels are normal, and as a result there is an increase in the LH: FSH ratio. About 10% of women with PCOS have type 2 diabetes. The principal androgens raised in PCOS and produced by the ovary include testosterone and androstenedione. (page 247-248)

uterine arteries are not ligated

big fibroid is not a relatíve contraindication for the page 245 operation

10%

none of the above is true page 369

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To obtain informed consent for a surgical procedure, it is never 52. required to give information about

complications occurring less often than … Risk of malignant change to 54. leiomyosarcoma in an uterine fibroid is: Which type of the surgical repairs 56. can be recommended for uterovaginal prolapse? 60.

Treatment of the endometrial polyps?

Loss of libido can caused by: (find the wrong answer) Clinical presentation of the acute 66. ectopic pregnancy, 64.

69.

70.

Data of Perinatal Mortality Rates

Which is not true for the insertion of intrauterine devices?

What belongs to previous 73. gynecological history, EXCEPT What are the most common 75. symptoms of vulvar 76.

Choose the correct statement!

What symptoms can endometrial polyps cause, EXCEPT?

0,1%

0.3-0.8%

fascial repairs

spontaneously resolve pain on intercourse Uterine bleeding collected annually The optimal time for insertion is in the first half of the menstrual cycle

1%

3.2-3.8%

graft augmented repairs

7.2-7.8%

A+B

10.2-10.8%

conservative treatment

dilatation and curettage

hysteroscopy

menopause

inserted IUD

fear of pregnancy

Amenorrhoea

Dysuria

Lower abdominal pain

includes the number of includes the number of stillbirth during deaths in the first week of pregnancy life With postpartum Should be inserted in the women, the optimal time second half of the for insertion is 4-6 weeks menstrual cycle after delivery

B, C

all

miscarriage

ectopic pregnancy

page 225

raised lesion

vulvar ulcus

all of the three

page 318

B+C

page 343

page 235

An urethrocele is the An urethrocele is the result of A cystocele is the result of damage to level II support result of damage to level damage to level II support III (anterior) support

colicky

diabetes mellitus

obesity

polycystic ovary syndrome

A, B, C are true

The effect of Tamoxifen (used in hormone sensitive breast cancer to protect against metastases) on the risk of endometrial cancer is:

protective

indifferent

pro- cancer

is not known

vulva and vagina

endometrium

Fallopian tubes Commonest site for ectopic pregnancy is the ampullary region of the Fallopian tube

ovaries

Which is not true for ectopic pregnancies?

10% of pregnancies are ectopic

Most important cause of maternal death in early pregnancy

91.

Management of miscarriages, except:

Dilatation of the cervix

Laparoscopic surgery

Suction curettage

Examination of the karyotype of both parents and any fetal products

Ultrasound scan to assess ovarian morphology for PCOS and the uterine cavity

Examination of maternal blood for lupus anticoagulant and anticardiolipin antibodies on at least two occasions 6 weeks apart

infection

antisperm

abnormal mucus

all are correct

dilatation and evacuation

removal with suction curette

hysteroscopy

Investigation of recurrent miscarriage:

Poor cervical penetration by sperm may also caused by Method of surgical termination 96. during the first trimester of pregnancy:

95.

caesarean section

page

jennifer

page 328

The commonest infections of the genital tract are those that affect the vulva and jennifer vagina. (page 306)

Can be accurately diagnosed by a page 289 combination of ultrasound and hCG measurement

89.

94.

page 364

breast cancer

infertility

Lower genital infections affect

all are clinical presentations, except C. Page 283

pruritus

intermenstrual bleeding

84.

page 236 page 314

contraception

dyspareunia

81. patients

page 347 - 348

May result in vagal syncope page 295

The follownig factors can increase 80. the risk of endometrial hyperplasia/ carcinoma, except

78.

page 331

Prostaglandin analogue

All of above

page 281 Recurrent miscarriage should be investigated by examining the karyotype of both parents and, if possible any fetal products. Maternal blood should be examined for lupus anticoagulant and anticardiolipin antibodies on at least two occasions 6 weeks apart. An ultrasound scan should be arranged to assess ovarian morphology for PCOS and the uterine cavity. (page 282-283) page 286 page 315

jenny

gynecology

98. 100 .

The presence of a vaginal septum may result in....? Ureteric trauma may be caused during gynecologic surgery

postcoital bleeding causes discomfort by ligation, thermal injury, infection

both

none

page 245

by transection, crush injury, thermal injury

thermal injury, devascularisation

infection, massive bleeding, ligation

page 371

dyspareunia

103 .

What is the first line treatement of syphilis?

penicillin

ketoconazole

metronidazole

aciclovir

104 .

Which is not true for miscarriages?

Pregnancy loss before 24 weeks

Complicates 40% of pregnancies

Commonly associated with chromosome

Does not always require surgical treatment

Not a typical symptom of bacterial vaginosis

A typical thin homogenous vaginal discharge.

105 .

107 . 110 . 111 . 115 .

The symptom of dysuria The following methods can be used to diagnose or rule out endometrial cancer Risk factors associated with endometrial cancer except: Granulosa cell tumours may cause:

A fishy odour produced when 10% potassium A decrease of the vaginal hydroxide is added to the pH less then 4,35 discharge fever

vaginal discharge

lower back pain

page 361

endometrial biopsy witha Pipelle

hysteroscopy and endometrial biopsy

a,b,c

page 340

obesity

multiparity

diabetes

hypertension

page 339

precocious puberty

prolonged and excessive menstrual bleeding

postmenopausal bleeding

all of the above

page 345

Which is not true for pharmacologically active devices?

Reduce the likelihood of PID

119 .

Endometrial cancer in the UK is the … most common female cancer

first

second

121 .

Clinical features of hyperemesis, except:

Bradycardia and hypotension

130 .

What is the primary mode and way of spred in vulvar cancer?

lymphatic spred in the superficial and deep inguinal and femora

131 .

Which of the following does not play role in the prevention of pelvic organ prolapse?

132 .

Premature ovarian failure refers to a loss of function of the ovaries before age ….

Depress the uptake of thymidine into DNA

third

Impair glycogen storage in page 305 the endometrium

fourth

Alterations in electrolyte levels

avoiding a prolonged second stage of labour

avoiding premature delivery

avoiding premature bearing down during the second stage of labour

30 years

40 years MRSA screening is obligatory

50 years

Ketonuria

avoiding instrumental delivery

60 years

Preoperative antibiotic profilaxis:

Administered iv. before the start of the operation

136 .

The most common early symptom of endometrial cancer is:

pain

postmenopausal bleeding

dysmenorrhoea

weight loss

137 .

Intraoperative haemorrhage

the blood loss of more than 1000ml

massive haemorrhage is life threatening

can cause multiple organ failure

All

At the first consultation you have to check, EXCEPT? Management of the uterine fibroids, EXCEPT?

Not necessary

facial, body hair

pulse

gynecological

Wertheim-hysterectomy

simple hysterectomy

GnRH analouges

153 .

Dermoid cysts may cause:

precocious puberty

chemical peritonitis

hypothyreoidism

155 .

Causes of secondary amenorrhoea

Sheehan's syndrome

breastfeeding

Asherman's syndrome

157 .

Which hystological type of endometrial cancer has the best prognosis:

serous papillary

endometrioid

clear cell

162 .

Sign or symptom of chronic pelvic infection, except one:

chronic pelvic pain

deep-seated dysparenuria

acute unilateral inguinal stabbing pain

166 .

What type lesion is the equivalent of VIN-1 in the actual classification?

normal epithelium

severe fungal infection

condyloma

Complete mole is diploid with no female genetic material

168 .

Which statement is not true?

169 .

Women with Chlamydia infection should be given

Doxycylin or Azithromycin

170 .

During uroflowmetry:

Intraabdominal pressure is measured

171 .

Failure rates of combined pills?

175 .

What are the symptoms of the unrecognised gastrointestinal injury during gynecologic surgery?

180 .

One of the statements is wrong:

181 .

What percent of cervical cancer can be prevented through HPV vaccination?

185 .

In advanced metastatic endometrial cancer the therapy is

187 . 189 .

Preoperative blood investigation include: Rapid growth of fibroid with pain may indicate:

0,3-15/100 women years

The mortality rate of choriocarcinoma is very low

Metastases of choriocarcinoma most commonly appear in the lungs

rectal examination

Premature ovarian failure (POF) is usually defined as the cessation of ovarian function before the age of 40 and is characterized by amenorrhoea and raised gonadotrophin levels. (page 247)

yulia

page 329 Intraoperative haemorrhage is blood loss of more than 1000 mL or blood loss that requires blood transfusion. Massive haemorrhage is defined as acute loss of more than 25 % of the patient’s blood volume or a loss that requires a lifesaving intervention. More than 40 % blood loss is life threatening. (page 359)

yulia yulia

hypertension

A, B, C are ture

undergo torsion or rupture, when the release of sebaceous material causes an acute chemical peritonitis. (page334) Absence of menstruation for more than 6 months • Physiological causes – pregnancy, breastfeeding • Pathological causes – hypothalamic dysfunction, hyperprolactinaemia, polycystic ovarian syndrome (page263, 246-248)

prognosis depends on the stage of tumour and page 329 independent of hystologic type • chronic pelvic pain • chronic purulent vaginal discharge infertility • epimenorrhagia and dysmenorrhoea • deep-seated dyspareunia, or just • infertility. (page 312)

Women who have hypogonadal hypogonadism will menstruating regularly.

it is not known

about 70%

about 50%

about 10%

chemotherapy

radiotherapy

Full blood count

Urea

Electrolytes

All

menopause

thrombosis of ???

pregnancy

malignancy

198 .

True for hysteroscopy

allows visualisation of the ovaries

can be done only by using general anesthesia

you can visualize polyps in the endometrial cavity

199 .

Risk factors for acute compartment syndrome

prolonged surgical time

Leg holders

high BMI

yulia

sarah

pages 286-287

Hypogonadal hypogonadism can be acquiered after surgery or radiotherapy for pituitary tumour.

fibroids

yulia

Partial mole is a triploidy pregnancy

Hypogonadal hypogonadism can be congenital as in Kallman's syndrome.

endometrioma

yulia

yulia

Hypogonadal hypogonadism is associated with abnormally low or undetectable concentrations of LH and FSH.

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