2/20/13 Flashcards
What is thought to be the cause of variable decelerations in the fetal heart rate?
umbilical cord compression, low amniotic fluid, or fetal hypoxia
What is the first step in case of a non-reassuring fetal heart rate, such as variable decelerations?
maternal administration of O2 and change of position
What is the first-line of treatment for premenopausal pts w/ endometrial hyperplasia (simple or complex) without atypia?
cyclic progestins and repeat biopsy in 3-6 mos
What is the proper treatment for women with complex, atypical endometrial hyperplasia who do do not wish to have any more children?
hysterectomy
What is the appropriate Tx for women w/ complex atypical endometrial hyperplasia who wish to preserve fertility or are poor surgical candidates?
cyclic progestins an repeat biopsy in 3-6 mos
What are the histological types of endometrial hyperplasia and the rates of progression to uterine cancer?
simple: 1%, complex: 5%, simple atypical: 10%, complex atypical: 29%
What is the “gold standard” for evaluating cervical incompetence?
transvaginal US
What is the most common cause of mucopurulent cervicitis?
Chlamydia trachomatis
What should you suspect in most cases of bilateral nipple discharge in a woman who has not recently had a child?
prolactinoma
What are the 3 “red flags” for nipple discharge (cancer)?
unilateral, guiac positive, breast lump
Kalla\man’s syndrome consists of a congenital absence of _______ secretion associated with _______.
GnRH; anosmia
What are the 3 D’s of endometriosis?
dyspareunia, dysmenorrhea, and dyschezia
What is the definitive diagnostic procedure for endometriosis?
laparoscopy
What are the 3 main categories of managament/treatment for endometriosis?
hormonal, analgesic, surgical
What are 3 hormonal treatments for endometriosis?
OCPs, leuprolide (GnRH agonist), and danazol (modified testosterone)
Green, frothy, foul-smelling vaginal discharge is most likely caused by?
Trichomonas
What is the Tx for vaginal trichomoniasis?
oral metronidazole for pt and partner
What condition causes porcelain-white, polygonal macules and patches on the vulvae w/ an atrophic “cigarette paper” quality? (Mostly affects postmenopausal women.)
Lichen sclerosus et atrophicus
What is a non-malignant but serious potential consequence of lichen sclerosus et atrophicus?
scarring of the labia majora and clitorus can lessen the size of the vaginal introitus
What is the malignant possibility with lichen sclerosus et atrophicus?
SCC
What procedure should be considered to rule to rule out squamous cell carcinoma in pts w/ lichen sclerosus et atrophicus?
punch biopsy
What is thought to be the etiology of the chronic inflammation of the anogenital region in lichen sclerosus et atrophicus?
autoimmune
What is the first-line Tx for lichen sclerosus et atrophicus?
topical corticosteroids
