Gynaecology — Flashcards

Flashcard 81: If ectopic pregnancy is _____ then medical (methotrexate) management is indicated

Answer: not significantly painful

Flashcard 82: What is the likely diagnosis in a woman that presents with fever, lower abdominal pain, and purulent cervical discharge? Physical exam reveals cervical motion tenderness. _____

Answer: Pelvic inflammatory disease

Flashcard 83: COCP _____ the chance of ovarian cancer

Answer: ↓

Flashcard 84: Patients with suspected pelvic inflammatory disease should be tested for _____ & Neisseria gonorrhoeae with a vaginal/cervical swab (NAAT)

Answer: Chlamydia trachomatis

Flashcard 85: What is the initial investigation of choice for a suspected ovarian mass/cancer?\n_____

Answer: Ultrasonography (USG)

Flashcard 86: The mutations _____ or BRCA2 increase the risk of ovarian cancer

Answer: BRCA1

Flashcard 87: What is the next investigation for suspected ovarian cancer if CA-125 levels are found to be elevated?

Answer: An ultrasound of the abdomen and pelvis is the next step to visualize the adnexa and assess for features of malignancy.

Flashcard 88: The definitive investigation for the diagnosis and staging of ovarian cancer is _____.

Answer: exploratory laparotomy

Flashcard 89: What gynaecological disorder is a risk factor for ectopic pregnancy? _____

Answer: Endometriosis

Flashcard 90: What is the initial investigation for ectopic pregnancy? _____

Answer: Urine pregnancy test

Extra: Diagnostic algorithm for Ectopic Pregnancy: 1. **Initial/Best screening test:** Urine Pregnancy Test (UPT). If negative, ectopic is highly unlikely. 2. **Next step/Investigation of choice:** Transvaginal Ultrasound (TVS). 3. **Gold standard:** Laparoscopy (usually reserved for treatment or hemodynamically unstable patients). 4. **Bio-chemical marker:** Serial serum beta-hCG (failure to double in 48 hours).