Podcast
Questions and Answers
What percentage of CIN-3 cases will likely regress spontaneously?
What percentage of CIN-3 cases will likely regress spontaneously?
What is the most common type of cervical cancer?
What is the most common type of cervical cancer?
Which procedure is considered the best treatment for a biopsy-proven CIN-3?
Which procedure is considered the best treatment for a biopsy-proven CIN-3?
What is the primary cause of cervical cancer?
What is the primary cause of cervical cancer?
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What is considered a major symptom of cervical cancer?
What is considered a major symptom of cervical cancer?
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What is the criterion for diagnosing polycystic ovarian disease (PCOD) that involves the presence of anovulation?
What is the criterion for diagnosing polycystic ovarian disease (PCOD) that involves the presence of anovulation?
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What defines the structure of the cervix in nulliparous women?
What defines the structure of the cervix in nulliparous women?
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How many follicles are required in either ovary for a diagnosis of PCOS based on ultrasound criteria?
How many follicles are required in either ovary for a diagnosis of PCOS based on ultrasound criteria?
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Which hormone's elevated levels are typically associated with hirsutism in PCOS patients?
Which hormone's elevated levels are typically associated with hirsutism in PCOS patients?
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What is the typical LH to FSH ratio found in women with PCOS?
What is the typical LH to FSH ratio found in women with PCOS?
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Study Notes
Menstrual Cycle & Ovulation Tests
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Cervix:
- Nulliparous women: 3.5-4 cm
- Multiparous women: Varying size
- Uterus (Nulliparous): 7-8 cm
- Uterus (Multiparous): 8-10 cm
- Short cervix: <2.5 cm
- Fallopian Tube length: 7-12 cm
- Vagina (Anterior fornix): 7 cm
- Vagina (Posterior fornix): 9 cm
- Corpus: Body of the uterus
- Epithelium (Fallopian tube): Ciliated columnar epithelium
- Epithelium (Uterus): Ciliated columnar epithelium
- Early part of cervix (Anatomical Internal OS): Ciliated columnar epithelium
Importance of the Epithelium
- Cervix (Internal OS): Columnar epithelium
- Cervix (Transformation zone): Squamous epithelium
- Vagina: Squamous epithelium
- Epithelium importance in context of reproduction: Involved with hormonal changes and uterine lining
Ovary
- Size: 3x3.5x2.5 cm
- Volume: 3x3.5x2.5 x 5/9
- Follicle: One dominant follicle forms every month
- Ovarian follicles (Typical): 6-7 per month
- Primordial follicles: 1000-10000 per month
- Antral follicles 6-7/month
Important Information
- Post-delivery uterus size: Never comes back to pre-pregnant size.
Medical Disorders in Pregnancy
- Hypertension: BP >140/90 mmHg after 20 weeks of gestation
- Pre-eclampsia: Gestational hypertension with proteinuria
- Eclampsia: Pre-eclampsia plus tonic-clonic convulsions
- Chronic Hypertension: Pre-existing hypertension in early pregnancy
Ovarian Tumors
- Ages: 6-7th decade
- Causes: Related to ovarian surface scars, early menarche, late menopause, infertility treatment, familial predisposition to cancers (breast, endometrial, ovarian)
CA Cervix
- Screening: Pap smear is the most cost-effective method. Visual inspection under acetic acid (VIA) is also effective.
- Dysplasia classification (using Ayre's): <1/3rd abnormal = CIN-1, >1/3rd to 2/3rd abnormal = CIN-2, and >2/3rd cells abnormal = CIN-3/Cis.
- Significance of CIN-1: Can progress to CIN-3 in 5 years.
Endometrial Biopsy
- Effects of progesterone: seen through detailed examination.
- Luteal phase defect: Observed as lags of >2 days from expected changes
PCOS
- Diagnostic criteria: Rotterdam criteria (2003) involve anovulation and hyperandrogenism, along with ultrasound features.
- Characteristics: Multiple small follicles (2-6mm) in each ovary. Thick stroma. Increased ovarian volume (>10ml).
Infertility and Pregnancy Loss
- Primary Amenorrhea: Absence of menstruation ever.
- Secondary Amenorrhea: Absence of menstruation for at least three consecutive cycles.
- Causes of primary amenorrhea: Issues with the uterus, hormonal imbalances, or medical conditions.
Important tests in Pregnancy
- Maternal Syndrome: Poor placentation, maternal syndrome
- Fetal: The villi should have good blood flow, otherwise it could cause HELLP syndrome.
Medical Disorders in Pregnancy
- Chronic Hypertension: Pre-existing high blood pressure. Features of hypertension, including proteinuria and low platelets.
- Pre-Eclampsia: High blood pressure with proteinuria in pregnancy.
- Eclampsia: Pre-eclampsia plus convulsions.
- HELLP syndrome: Hemolysis, elevated liver enzymes, and low platelets.
- GDM: Gestational diabetes mellitus (High glucose during pregnancy)
Types of Bleeding in Pregnancy
- Postpartum hemorrhage (PPH): Blood loss > 500ml after vaginal delivery and > 1000ml after Cesarean section
- Abruptio placentae: Premature separation of the placenta from the uterus. Painful bleeding, uterine tenderness. - Mechanism: Uterine wall is contracted, thus putting pressure on the blood vessels.
- Placenta previa: Placenta covers the cervical os. Painless bleeding, often only noticed during the later stages of pregnancy (third trimester), in which case intervention is more likely.
- Causes of PPH: Abnormal Tone (uterine atony), Trauma, Thrombin, Tissue (retained bits)
Abortion
- Threatened abortion:Closed cervical os. Treated with rest, medication to maintain progesterone levels.
- Inevitable abortion:A dilated cervix; treatment involves evacuation.
- Incomplete Abortion:Partial passage of products of conception; treatment is to complete the abortion.
- Complete abortion:Passage of all products; no further treatment needed.
- Missed abortion:Dead fetus without discharge or bleeding; treatment is evacuation.
- **Causes:**Chromosomal defects, uterine abnormalities, infection, trauma.
Other Complications
- Ectopic Pregnancy: Fertilized egg implants outside the uterus, most commonly in the fallopian tube.
- Molar Pregnancy: Abnormal placental growth with no fetus.
- Uterine prolapse: Descent of the uterus into the vagina.
- Fibroids: Benign tumors of the uterus.
- Adenomyosis: endometrial tissue penetrating the uterine walls
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Description
Test your knowledge on cervical cancer, including its stages, symptoms, and treatment options. This quiz covers important information such as the regression rates of CIN-3 cases and the most common type of cervical cancer. Enhance your understanding of cervical health with these essential questions.
