NAME:

GYNAECOLOGY WITH FAMILY WELFARE:

01. PRE-MENSTRUAL SYMPTOMS:
MOA- Its due to estrogen excess/progesterone deficiency, increased carbohydrate intolerance in
luteal phase, vit.B6 deficiency, increased vasopressin, aldosterone, prolac n, prostaglandins
⮚ PAIN- headache, abdominal cramp ,backache
⮚ WATER RETENTION: breast pain, bloa ng, weight gain
⮚ BEHAVIOUR CHANGE: low performance, irritability, depression
⮚ AUTONOMIC: dizziness, nausea, vomi ng, hot flushes

02. POST COITAL TEST:

(SIMS TEST/HUHNER’S TEST)
● Couple advised to undergo intercourse in early morning, women presents herself in
clinic within 2 hours. Smear taken from posterior fornix- control, mucus aspirated from
cervical canal spread over slide.
● Normally, 10-50 mo le sperms seen in hPF, with progressive mo lity and not rotatory.
● Rotatory will be seen only if an spermal-an bodies are present. Cervical mucus
examined for quan ty, viscosity and fern test.

ADVANTAGES :(A) to study estrogen effect and ovula on, (B)capablility to allow sperm, (C)
presence of antbodies can be seen

03. SUBDERMAL IMPLANT- NORPLANT:

ADVANTAGES:
To reduce frequent visits, ensure even release of drug, reduce side effects
NORPLANT I- a single rod implant
NORPLANT II- 2 rods, each 70mg LNG, daily release: 50ug, contracep on for 3-5years.
MOA: suppress endometrium, 50% suppress ovula on
Precau ons: ll 7 days a er implant- BARRIER method followed, inserted on 1st day of cycle

04. CLASSIFICATION OF GESTATIONAL TROPHOBBLASTIC DISEASE:

● Benign hyda form mole- par al/complete
● Persistent trophoblas c disease
● Choriocarcinoma- non-metasta c/ metasta c

05. ERT(ESTROGEN REPLACEMENT THERAPY:

Dry vagina, senile vagini s, urethral symptoms in menopausal women
Oral contracep ves, DUB
C/I: breast ca, thromboembolism, liver/gall disease
Side effects: mastalgia, water reten on, endo / breast ca if not given along with progesterone
06. CA125:
 ⮚ CA-125 (cancer antigen 125, carcinoma antigen 125, or carbohydrate antigen 125)
also known as mucin 16 or MUC16 is a protein that in humans is encoded by
the MUC16 gene.
⮚ USES: a marker for ovarian cancer, tuberculosis. it may also be elevated in other
cancers, including endometrial cancer, fallopian tube cancer, breast
ca, endometriosis.

07. WHAT ARE ESTROGEN FREE PILLS:

(MINIPILL/PROGESTERONE ONLY PILL)
⮚ Taken within 5-7 days of menstrua on and taken at same me with leeway of 3 hours on
either side on fixed me each day.
⮚ ADVANTAGES:
⮚ Lacta ng women, >35years, focal migraine, intolerant to estrogen.

08. WHAT IS CRYPTOMENORRHOEA: (HEMATOCOLPOS/IMPERFORATE HYMEN)

⮚ An imperforate hymen causing hematocolpos
⮚ Clinically: coliky abd. Pain, secondary sexual character +, difficulty in micturi on,
reten on of urine due to compression, low temperature, malaise, pallor, primary
amenorrhoea
⮚ Examina on: suprapubic/hypogastric bulge, blue bulging membrane on separa on of
labia
⮚ Diagnosis- pelvic usg
⮚ Surgical treatment : cruciate incision under anesthesia.

09. TOXIC SHOCK SYNDROME:

⮚ TODD- first reported, TSS in vaginal tamponade during menstrua on/peurperium.
⮚ Due to staphylococcus aureus, b-hemoly c streptococci due to toxin release
⮚ Myalgia, fever,diffuse skin rash,vomit, diarrhea
⮚ LAB: leukocytosis, thrombocytopenia , elevated liver enz. And bilirubin.
⮚ Treatment: IVF, penicillin

10. CAUSES OF RETENTION OF URINE:

⮚ Acute: post op, Puerperal reten on, stenosis of urethra following surgery,
⮚ obstruc on: hematocolpos, retro gravid uterus about 14weeks gesta on, cervical
myoma, ovarian neoplasm, ca cervix/bladder/urethra
⮚ non gynaec- spinal cord lesions, tabes dorsalis

11. UTERINE ARTERY:

Arises from anterior trunk of internal iliac artery (please read anatomy clearly in page- 19 with
diagram)
Uterine artery emboliza on: first introduced to decrease vascularity in fibroids, approached
through percutaneous femoral catheter, using PVA, gel foam, or metal coils.
C/I: subserosal/pedunculated fibroids, infer lity.

12. CLUE CELLS:

 ⮚ Epithelial cells have fuzzy border to adhere bacteria- Gardrenella vaginalis and other
gram nega ve bacteria and decreased number of lactobacilli
⮚ Cytoplasm is granular

13. SONO SALPHINGOGRAPHY:

(SION TEST)
● For tubal patency
● Under USG, 200ml saline into uterine cavity is accomplished with foley catheter and
inflated to prevent leak from internal os. Fimbrial end seen for free fluid and pouch of
douglas is noted.
● USES: submucous fibroid polyp and intramural lesions, DUM to study endometrium,
asherman syndrome

14. C/I FOR HSG:

⮚ Post-ovulatory period
⮚ Presence of genital infec on
⮚ Suspected TB- genital
⮚ Sensi ve to Iodine

15. ORGANISM CAUSING PELVIC INFLAMMATORY DISEASE:

Chlamydia and Gonnococci are most important
Others: Mycoplasma, Tb, E.coli, viruses

16. CAUSES OF DYSPAREUNIA:

● Bartholin cyst/abscess, narrow introitus, trauma c stenosis following episiotomy,
cervici s, adenomyosis, acute/chronic salphingo-oophori s

17. HYSTEROSCOPY:
⮚ Performed in preovulatory phase
⮚ Diagnos c indica ons: study endocervical mucosal lining, congenital malforma on of
uterus, endometrial TB, asherman syndrome, missed IUCD, polyp, corneal tubal block
⮚ Therapeu c indica ons: uterine septum, embedded IUCD, DUB, tubal block, IVF.

18. ADVANTAGES OF HRT IN MENOPAUSE:

⮚ Prevents osteoporosis and cardioprotec ve
⮚ Vulvovagini s, senile vagini s, urethral symptoms

19. FALLOPIAN TUBE:

(Page- 11)

20. TRICHOMONAS VAGINALIS:

 ⮚ It is a PROTOZOAN, ac vely mo le, anaerobic, 4 anterior flagella
⮚ STD- strawberry vagina, froathy discharge, dysuria, frequency of urine
⮚ Wet mount slide- diagnos c
⮚ Metronidazole 200mg x 3 mes a day – 7 days for BOTH PARTNERS

21. MINILAP:
⮚ Opera on done through small suprapubic incision
⮚ Types: pomeroy, madlener, irving, Aldridge, corneal resec on , uchida method,
fimbrectomy

22. CLASSIFICATION OF U-V PROLAPSE:

(page- 332)

23. CLASSIFICATION OF DYSMENORRHOEA:

⮚ spasmodic: more in 1st and 2nd day of menstrua on
⮚ conges ve: pelvic discomfort and pain few days before menses begin, seen in PID, pelvic
endometriosis and fibroids

24. INDICATIONS OF ENDOMETRIAL BIOPSY:

o Endometrial hyperplasia, endometrial ca,
o endometriosis, emdometri s

25. C/I OF IUCD:

⮚ Suspected pregnancy,
⮚ PID, presence of fibroid,
⮚ severe anemia, heart disease,
⮚ previous ectopic
26. LIGAMENTUS SUPPORT OF UTERUS:
(Picture a ached)

27. PRE-REQUISITE OF MYOMECTOMY:

⮚ Hemoglobin should be restored
⮚ Autotransfusion arranged
⮚ In infer lity, others causes should be ruled put
⮚ Signature for hysterectomy
⮚ Endometrial ca to be r/o by D/C
⮚ Done in preovulatory cycle only
28. DIAGNOSIS OF GENITOURINARY FISTULA:
 ⮚ Descending pyelography
⮚ Cystoscopy with indigo carmine excre on test
⮚ Methylene blue- 3 swab test

29. CAUSES OF PRIMARY AMENORRHOEA:

● Imperforate hymen
● Transverse vaginal septum
● Absent vagina
● Others: turner’s, hyperprolac emia, hypogonadotropic hypogonadism

30. COMPLICATIONS OF VAGINAL HYSTERECTOMY:

⮚ Dyspareunia, chronic pelvic pain due to adhesions, vault prolapse, residual ovarian
syndrome
⮚ Complica ons of abdominal hysterectomy: primary/secondary hemorrhage, trauma to
bladder/bowel, sepsis, anesthesia complica ons, thrombosis,pulmonary embolism,
chronic abdominal pain.

31. BARTHOLINITIS:
⮚ Infected with gonococci/other organism
⮚ Painful vulval swelling, purulent discharge, painful and inflamed
⮚ Pus- incision and drainage and sent for culture.
⮚ Treated with an bio cs

32. FEMSHIELD: FEMALE CONDOM

● Loose fi ng 15-17cm, barrier method, polyurethane lubricated
● Has polyurethane ring at closed end of sheath- anchoring device
● Covers en re vagina , cervix as well as external genitalia
● Advantage: coital dependant, doesn’t spill off, strong than condom, puerperal period
● Failure rate: 5-15/100 woman years, 2-3 dollars/piece

33. POST COITAL CONTRACEPTION:

● 2 tablets of 100ug EE2+ 1mg of nor ethisterine taken within 72hours, followed by 2
tablets 12hours later
● Ethinysestradiol 1mg daily for 5days within 72hours of exposure
● 0.75mg LNG within 72hours and another a er 12hours
● Mifepristone 10mg, single dose
● Centchroman 2tablets(60mg) twice in 24hours within 24 hours of intercourse
● Copper T within 5 days can prevent implanta on of fer lized ovum

34. METROPATHICA HEMORRHAGICA:

● Special form of DUB SEEN IN 40-45YEARS, CONTINOUS PAINLESS VAGINAL BLEEDING,
SOMETIMES AT STARTING OF MENSES OR, PRECEDED BY 6-8WEEKS OF AMENORRHOEA.
● Uterus bulky, endometrium shows- thick, polypoidal and thin slender polypi project in to
uterine cavity, showing cys c endometrial hyperplasia
● SWISS CHEESE pa ern, cork screw glands are absent.
35. LEFORTS REPAIR FOR UV PROLAPSE:
36. OVARIAN HYPERSTIMULATION SYNDROME:
● Iatrogenic complica on in luteal phase/early pregnancy, life threatening
● Seen in induc on of ovula on in infer lity- FSH/LH therapy, pulsa le GnRH therapy
● MOA: vascular permeability leading to shi from intravascular to extravascular space,
leading to ascites, hydrothorax.
● Preven on: HCG withheld if >20 follicles seen in USG and E2 levels to 3000pg/ml,
albumin 5% infusion in 500ml RL

37. CHRONIC CERVICITIS:

● Due to infec on during abor on or child birth, instrumenta on .
● Mucous membrane is rugose, not exfoliated and cervical gland are racemose.
● Treatment –diathermy, cautery, cryosurgery, laser therapy, Coniza on opera on.

38. USES OF ESTROGEN:

⮚ Uretheral syndrome
⮚ senile vagini s
⮚ oral contreacep ve
⮚ DUB, intersex – turner syndrome.

39. PROGESTROGEN ROLE IN HRT:

⮚ Prevent endometrial hyperplasia and cancer, improve bone mineral density , prevent
breast cancer , if oestrogen is contraindicated.

40. D/D FOR ACUTE SALPHINGITIS:

⮚ Acute ectopic pregnancy splenic rupture , perforated appendix , acute pancrea s,
rupture corpus luteum hematoma.

41. MANAGEMENT OF POST PILL AMENORRHOEA:

⮚ It is due to hypothalamic dysfunc on .
⮚ Diagnosis is made if menses do not resume a er 6 months of stopping the pill .
⮚ Treatment-EE2 0.05mg daily for 21 days , for a few cycle.

42. BENEFITS OF COMBINED PILLS:

⮚ Effec vely controls fer lity, prevents anemia by reducing flow, lower incidence of benign
breast neoplasia, incidence of PID reduced, reduced incidence of ectopic, protect against
rheumatoid arthri s.

43. ETIOLOGY OF ENDOMETRIOSIS:

⮚ Implanta on theory
⮚ Coelomic metaplasia theory
⮚ Meta sta c theory
 ⮚ Hormonal influence
⮚ Immunological factor.

44. D/D FOR POST MENOPAUSAL BLEEDING:

⮚ Cervical erosion , polyp, CA malinancy.
⮚ TB, endometrial CA.
⮚ Ovarian tumour, vulva-trauma , hypertension , blood dyscariasis.

45. EMERGENCY CONTRACEPTION:

(Already discussed)

46. PAP SMEAR:

⮚ Screening for cervical cancer-surface biopsy or exfolia ve cytology.
⮚ All women >35 years, should be obtained prior to vaginal examina on.
⮚ Cusco speculum is used squamo-columnar junc on is scraped with ayre’s –spatula
and put in to 95% ethyl alcohol and ether and grading is done.

47. CLINICAL SIGNIFICANCE OF POUCH OF DOUGLAS:

⮚ Site of pelvic abscess and ovarian metastasis , endometriosis with adhesion to
rectum.
48. HSG IN TB:
⮚ A rigid non peristal c pipe like- lead pipe appearance , beading ,calcifica on of the
tube , cornual block , tobacco pouch and dilated distal end of tube .
⮚ In proven case of Tb HSG is contra indicated.

49. INDICATIONS OF PER RECTAL IN GYNAEC:

⮚ Pathology in pouch of douglas.
⮚ In parametri s and endometriosis – uterosacral ligament are thickened and nodular.
⮚ CA cervix .
⮚ Fissure, fistula in ANO, polyp, piles.
⮚ Pelvic hematocoele.

50. DIAGNOSIS OF PCOD:

⮚ Increased LH:FSH ra o, greater than 3:1
⮚ Sonography with enlarged ovary with mul ple cys c follicle
⮚ Laporascopy – bilateral enlarged ovaries with thick tunica albugina with mul ple
cys c follicle.

51. GYNAECOLOGICAL CAUSES OF LOW BACK ACHE:

⮚ Hemato colpos, hemato metra, abdomen TB, ovarian torsion, malignancy, PID,
MI elschmerz.

52. DIAGNOSTIC LAP COMPLICATIONS:

 ⮚ Cardio pulmonary arrest and gas embolism , hemorrhage , cautery burn, sepsis,
injury to bowel and bladder.

53. MEDICAL MANAGEMENT OF ENDOMETRIOSIS:

⮚ Oesterogen dependent
⮚ Oral contraceptle-norethisterone 5-20mg daily, medroxy progesterone 50mg IM
weekly
⮚ Mirena IUCD
⮚ Danezol 200-800mg daily
⮚ GnRH, aromatase inhibitor-anastrozole/letrozole.

54. PSEUDOMYXOMA PERITONEII- CAUSES AND PREVENTION:

⮚ Peritoneal cavity filled with coagulated mucinous material adherent to omentum
and intes ne.
⮚ Seen in mucinous cyst adenoma overy, mucocoele of appendix , CA large intes ne.
⮚ Mesothelium is converted into high columnar cell .
⮚ Preven on : remove appendix with mucinous ovarian tumour.

55. LIST THE HORMONE PRODUCING TUMORS:

⮚ Dysgerminoma: B-HCG
⮚ Germ cell tumour-HCG , alpha feto protein , alkaline phophatase.

56. IMPERFORATE HYMEN:

(discussed already- hematocolpos/cryptomenorrhoea)

57. MONILIAL VAGINITIS:

⮚ Fungal infec on – candida / monilia
⮚ Risk – immune suppression ,HIV, steroid, OCP ,DM, obesity.
⮚ Pruri s, dysuria, curdy discharge.
⮚ 10% KOH solu on , culture on sabouraud agar .
⮚ Single dose of fluconazole 150mg, topical an fungal.

58. TUBAL PATENCY TESTS:( all are very important- short notes)
⮚ HSG
⮚ Laparoscopic chromotuba on
⮚ Sonosalphingography
⮚ Hysteroscopy and falloscopy
⮚ Ampullary and fimbrial salphingoscopy
59. FOLLOW UP OF MOLAR PREGNANCY:
⮚ Follow up for 2years
⮚ Normally the test becomes nega ve in 6-8 weeks, pa ent is called at weekly interval.
⮚ Once the test is nega ve , pa ent followed up monthly and 3 monthly in the first
year and 6 monthly in the second year.
⮚ Pelvic examina on to rule out vulval /vaginal mets and uterine size recorded
 ⮚ x-ray chest and pelvic USG
⮚ pregnancy avoided atleast one year.

60. FRACTIONAL CURETTAGE:

61. CULDOCENTESIS:
⮚ Aspira on of pouch of douglas
⮚ Seen in pelvic hematocoele

62. HYPER PROLACTINEMIA:

⮚ Due to enlargement of pituitary gland or due to pituitary tumour
⮚ Prolac on level >100 ng/ml
⮚ Causes primary amenorrhoea Is treated with bromocrip ne 1.25mg at bed me for
7 days, increment of 1.25 mg per week is recommended un l spontaneous ovula on
occurs.

63. INDICATIONS OF EXPECTANT MANAGEMENT OF UNRUPTURED ECTOPIC PREGNANCY:

⮚ Gesta onal sac <2cm
⮚ HCG level not high 2000 mIU/ml
⮚ Haemo peritoneum<50ml

64. OVARIAN REMANANT SYNDROME:

● Follows hysterectomy in 1.4% due to ovarian adhesions to vaginal vault
● Cyclical pain, deep dyspareunia
● Require oophorectomy.

65. TODAY:
● Mushroom shaped polyurethane disposable sponge, has loop for its easy removal
● Placed high up in vagina with concave side covering cervix., used once
● Act as mechanical barrier and prevent entry of sperm, spermicidal agent +
● Failure rate: 9-30/100 woman years
● Complica on: TSS

66. DECUBITUS ULCER:

⮚ Kera niza on and pigmenta on of vaginal mucosa as well as ulcera on of the prolapsed
ssue are caused by fric on, conges on and circulatory changes in dependent part of
the prolapse.
⮚ The reduc on of the prolapse into the vagina and daily packing heals the ulcer in a week
or two.
 ⮚ The decubitus ulcer needs to be differen ated from cancer of the cervix. Apart from
cytology and biopsy, the other dis nguishing features are that the decubitus ulcer shows
a clean edge and heals on reposi on and vaginal packing.
⮚ Rarely carcinoma develops over the decubitus ulcer and when a ring pessary is le in
situ for a long period.

67. TRIPHASIC PILLS:

⮚ 30ug EE2 + 50ugLNG –first 6 days
⮚ 40ugEE2 + 75ugLNG-next 5 days
⮚ 30ugEE2 + 125ugLNG-next 10 days, followed by one medica on free week.
⮚ No adverse effect of carbohydrate and lipid metabolism, so used in diabe c and no risk
of MI.

68. COMPLICATION OF OVARIAN CYST:

o Rupture
o Torsion
o Infec on
o Malignant change-Meig’s syndrome

69. CEA:
⮚ CEA measurement is mainly used as a tumor marker to monitor colorectal
carcinoma treatment. CEA levels may also be raised in gastric
carcinoma, pancreatic carcinoma, lung carcinoma, breast carcinoma,
and medullary thyroid carcinoma, as well as some non-neoplastic conditions
like ulcerative colitis, pancreatitis, cirrhosis, COPD, Crohn's disease,
hypothyroidism as well as in smokers.

70. MEIG’S SYNDROME:

⮚ Meigs' syndrome, is the triad of ascites, pleural effusion and benign ovarian
tumor (fibroma,Brenner tumour and occasionally granulosa cell tumour)
⮚ It resolves after the resection of the tumor. Because the trans diaphragmatic
lymphatic channels are larger in diameter on the right, the pleural effusion is
classically on the right side.

71. MISSED IUCD:

⮚ Tail of IUCD is not seen through os.
⮚ Causes- uterus enlarged through pregnancy, thread curled inside os , perfora on,
expelled.
⮚ Diagnosis –plain x-ray /pelvic USG, with uterine sound
72. INJECTABLE CONTRACEPTIVES:
⮚ DMPA25-50mg with oestradiol 5mg monthly or DMPA 150mg three monthly .
⮚ Injec on should be started within a month of delivery in a non-lacta ng and third month
in lacta ng women as ovula on is delayed upto 10 weeks.
⮚ Advantage:
 ⮚ No worry of missing pill , PID, ectopic are low , can be given in sickle cell, coital
independent .
⮚ Disadvantage:
⮚ Do not prevent STD/HIV , c/I in breast cancer.

73. SENILE VAGINITIS:

⮚ MOA: Oestrogen deficiency, the vaginal epithelium becomes thin and atrophic, the
glycogen content and acidity of the vagina are lowered.
⮚ Prolonged lacta on or premature menopause, women who have undergone
oophorectomy.
⮚ Dry vagina, dyspareunia and a purulent, o en slightly blood nged, discharge are
evident.
⮚ The vagina is inflamed and tender and the mucosa is excoriated.
⮚ Urinary symtoms of frequency and dysuria are common.
⮚ TREATMENT:
⮚ Ethinyloestradiol 0.01 mg daily for 3 weeks should suffice.
⮚ Pessary containing oestrogen.

74. COLPOSCOPY:
⮚ Integrated with screening program for CA CERVIX.
⮚ No vaginal examina on should be done prior to colposcopy to avoid denuding
epithelium to yield fasle posi ve result.
⮚ Indica on abnormal pap smear , abnormal areas of vagina , vulval area, laser and cone
biopsy for CIN LESION.

75. PRE-COCIOUS PUBERTY:

⮚ Secondary sexual character before age of 8 and menstrua on before 10.
⮚ CAUSES-cons tu onal due to pre mature HPO axis .
⮚ Pituitary tumour, encephali s, McCune-albright syndrome , ovarian femizining tumour,
adrenal tumour , hypo thyroidism.
⮚ Inves ga on-CT/MRI, TFT, x-ray bone age.

76. RUBIN’S CANULA:

⮚ Used in HSG.
⮚ The dye is ins lled into the uterine cavity , the cone prevent retro grade spilling into
vagina .
⮚ 50% iodine with 6%poly vinyl alcohol in water is used as a medium.

77. 2ND TRIMESTER MTP:

⮚ Surgical-dilata on and evacua on , aspirotomy .
⮚ Medical-extra ovular ins lla on of ethacridine lactate (emecredil) ,
⮚ intracervical PGE2 (cerviprime),
⮚ oral mifepristone 200mg followed by 36-48 hours later 600ug misoprostol followed by
400mg of vaginal misoprostol every 3 hourly,
 ⮚ prostaglandin F2alpha.
⮚ Combined- emecredil +PG, PG + laminariatent , emecredil + oxytocin.

78. PELVIC HEMATOCELE:

⮚ Blood collects in the pouch of douglas to form hematocele.
⮚ It forms an irregular mass of clot and blood and bulges forward displacing the cervix
against the bladder neck and leading to reten on of urine.

79. BROMOCRIPTINE:
⮚ Synthe c ergot deriva ve , powerful dopamine agonist.
⮚ NOA-suppress prolac n , induces menstrua on , ovula on and promotes pregnancy.
⮚ C/I- hypertension , cardiovascular disease.
⮚ ADR- nausea ,vomit, hypotension, headache.

80. RED DEGENERATION:

⮚ Complica on of uterine myoma during pregnancy, tense and tender , abdomen pain ,
fever.
⮚ Purple red colour . fishy odour due to thrombosis of small vessel, diffusion of blood
pigment.
⮚ Leucocytosis, raised ESR,USG is diagnosis.

81. PUBERTY MENORRHAGIA:

⮚ Immature development of hypothalamus-pitutary-ovary causing an ovula on due to
unopposed oestrogen causing endometrial hyperplasia.
⮚ Other causes hypothyroid coagula on disorder, genital TB liver disease.
⮚ Menorrhagia start on menarche.
⮚ Inves ga on – Hb, clo ng factor,TFT , D&C.
⮚ IV premarin 25mg 6-8 hourly, oestrogen 21 days and progesterone for 10 days for 3-6
cycle.

82. MIFEPRISTONE:
⮚ RU 486
⮚ MOA: block progesterone ac on at target organ, glucocor coid and androgen receptor.
⮚ Indica on-MTP up to 49 days . ripening of cervix ,missed abor on ,ectopic pregnancy,
cushing syndrome, postcoital contracep on

83. SARCOMATOUS DEGENERATION:

⮚ Extremely rare , not more than 0.5%.
⮚ Intramural and submucosal tumour have higher potency.
⮚ Seen in post menopausal , sudden increase in size , yellow gray and hemorrhagic.
⮚ Non encapsulated.

84. MENSTRUAL REGULATION:

⮚ First trimester MTP.
⮚ Aspira on of content of uterine cavity by a plas c cannula (karman’s).
 ⮚ Carried out within 42 days, out pa ent clinic .
⮚ Failure to evacuate is due to too early pregnancy, ectopic pregnancy, bicornuate uterus.
⮚ Complica on-safe occasionally cervical lacera on, hemorrhage, con nua on of
pregnancy.

85. MODE OF DEATH IN CA CERVIX:

 - Dr.Yogesh Subramanian
Reg.No: 107015

All the best !!!!