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20 Cards in this Set
- Front
- Back
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Which pelvic masses would be considered benign? |
Myomatous uterus Functional cysts of the ovaries Benign solid ovarian tumours Infectious masses |
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How would a myomatous uterus be diagnosed? |
Hx: may be asymptomatic, discomfort, ache, heavy feeling bladder and bowel, increased blood loss during menstruation, dysmenorrhoea, chronic lower abdominal pain and dyspareunia O/E: Abdomen - distension, lower abdominal/pelvic masses Pelvis - cervix displaced, uterus enlarged, mobile masses |
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How is a myomatous uterus managed? |
Expectant if: not growing fast and asymptomaric uterus <16 weeks pregnant and diagnosis uncertain patient refuses surgery and s premenopausal Medical - NSAIDs - pain and bleeding Iron supplements - anaemia GnRH-analogues - shrink myomas Surgical - Hysterectomy, myomectomy or uterine artery embolism |
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What are the indications for surgery on a myomatous uterus? |
excessive menstrual blood loss, anaemia, rapidly growing masses, pain, distention, bowel symptoms, urinary retension |
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How do we diagnose functional cysts of the ovaries? |
- pain in iliac fossa - menstrual disturbances - palpable mass: cystic, non-tender, <6cm, freely movable, unilateral (on transvaginal ultrasound) - young patient with a normal serum Ca125 level |
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In what population do you expect to find functional cysts of the ovaries? |
Women of reproductive age, not using hormonal contraception, who menstruate |
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How are functional ovarian cysts treated? |
Expectant - cyst usually resolves spontaneously in 2-3 months Medical - Combined oral contraceptive/ medroxy progesterone - supresses ovulation and shrinks the cyst Surgical - Laparoscopy or open laparotomy |
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How do we diagnose benign solid ovarian tumours? |
Solid adnexal mass Final diagnosis made on histology |
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How are benign solid ovarian tumours treated? |
Always regarded as malignant until proven otherwise and urgently referred for surgery |
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How are infectious masses diagnosed? |
Hx: young, reproductive age, previous pelvic infection, chronic lower abdominal pain, frequent vaginal discharge O/E: bimanual - mass fixed to uterus, not well circumscribed and immobile, semicyst |
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How are infectious masses treated? |
Expectant - risk analysis and second opinion Medical - treat as acute PID, antibiotics, if mass still present surgery is indicated |
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How is vulvar cancer dianosed? |
Inspection & biopsy |
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How is vulvar cancer treated? |
Surgery - remove the tumour and regional lymph nodes Radiation |
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How can ovarian cancer present? |
Pelvic masses or ascites, dyspepsia, other GIT symptoms, non-specific abdominal complaints, cachexis
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How is ovarian cancer diagnosed? |
Bloods - kidney and liver functions FBC Tumour markers (Ca 125) |
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How is ovarian cancer treated? |
Surgery - removal of all visible tumours Chemotherapy |
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How is endometrial cancer diagnosed? |
Clinical assessment Endometrial ultrasound Cervical cytology Endometrial biopsy |
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How is endometrial cancer treated? |
Hysterectomy Lymph node dissection Radiotherapy |
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How would a patient with cervical cancer present? |
Abdominal bleeding, discharge or contact bleeding |
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How is cervical cancer diagnosed? |
Speculum and papsmear - send for cytology and histology Look for: granulomatous lesions, large condylomata acuminata |
