4 - Annual Exams, Menopause, Gynecologic Problems Flashcards
What is the mainstay of medical treatment for endometriosis (after surgery has been done)?
- lower ovarian estradiol secretion with progestins or OCPs
What is the cause of longitudinal vaginal septum?
- incomplete fusion laterally of mullerian ducts
what is the most common STI causing acute vulvitis?
- trichomoniasis
Ectopic pregnancies most commonly are located where?
within the fallopian tube
How is candida vaginitis diagnosed?
wet prep
Endometriosis is dependent on what hormone?
- estrogen
Endometrial glands and stroma found within the myometrium of uterus is called what?
- Adenomyosis
A white, lacy, fernlike pattern of the genital mucosa is consistent with what?
- lichen planus
What is the most common cause of vaginal discharge in reproductive age women?
bacterial vaginosis
A patient presents with menstrual cramps that began with menses. She notes the pain was worse in the first day of menses but has been getting better. She also complains of headaches and nausea. What condition do you think she has?
- primary dysmenorrhea
Lesions of procelain-white papules and plaques often with areas of ecchymosis or purpura are findings consistent with this diagnosis.
lichen sclerosis
What is the most common indication for HRT?
moderate to severe vasomotor symptoms
How is endometriosis diagnosed and treated?
- surgically via laparoscopy
This is a chronic eczematous disease resulting in scaling and lichenified plaque and an intense and unrelenting itch.
lichen simplex chronicus
what defines an acute vs chronic pelvic pain?
acute = < 6 months chronic = > 6 months
What is the primary etiology of dysmenorrhea?
- excess prostaglandin production at menstruation
At what age should pap testing begin for screening for cervical cancer?
21
- if normal, do every 3 years until 30
Unopposed estrogen increases the risk of what 2 types of cancer?
endometrial cancer
breast cancer
“Cottage-cheese” like vaginal discharge is consistent with what type of vaginitis?
candidal vaginitis
When should mammogram testing begin?
age 40 unless high risk
What is the most common ovarian tumor in 2nd and 3rd decade of life?
mature cystic teratoma (dermoid cyst)
What is first line treatment for dysmenorrhea?
- NSAIDs
When should colonoscopy exams start?
45
What is the lifetime risk of breast cancer?
12%
What are the 2 most common cancers in women?
- skin cancer
2. breast cancer
How is menopause defined?
absence of menses for 1 year
Pathologic diagnoses of endometriosis requires 2 of the following 4 factors.
- endometrial epithelium
- endometrial glands
- endometrial stroma
- hemosiderin-laden macrophages
What is the medical treatment for anovulation d/t POS?
letrozole (aromatase inhibitor)
What is the leading cause of mortality in the first trimester?
ectopic pregnancy
Ultrasound can detect intrauterine pregnancy within ____ weeks of LMP.
5 weeks
What is the most common obstructive anomaly?
imperforate hymen
Longitudinal vaginal septum is commonly seen with this uterine anomaly (75% of the time).
- uterine didelphys
What is the best treatment for vulvovaginal atrophy and vasomotor symptoms?
- hormone replacement therapy (HRT)
Breast exams should be done how frequently between the ages of 25-39 compared to after 40?
- 25-39 yo = 1-3 yrs
- 40+ yo = every year
When should adolescents start seeing a gynecologist?
13-15 yo
How is osteoporosis prevented?
- calcium and vitamin D intake
- avoid excess sodas
- high impact exercise
How is ectopic pregnancy medically terminated?
methotrexate
Acute genital pruritus is most commonly a symptom of what condition?
- vulvovaginitis
How is infertility defined? (2)
- failure to achieve pregnancy within 12 months of unprotected intercourse in women < 35
- failure to achieve pregnancy within 6 months of unprotected intercourse in women > 35
A positive Whiff test is consistent with what diagnosis?
- bacterial vaginosis
What is the difference between stress vs urgency incontinence?
- stress = leakage with increases in intra-abdominal pressure
- urgency = leakage with a sense of urinary urgency
What medication is used for ovulation stimulation in the treatment of infertility?
- clomiphene citrate
This is an auto-inflammatory disease that causes groin and axillary lesions. More commonly seen in obese patients.
- Hidradenitis suppurative
What is the gold standard treatment for adenomyosis?
- Hysterectomy
What BDM value defines osteoporosis?
< 2.5 from mean of young adult reference population
How is bacterial vaginosis medically treated? (2 options)
- metronidazole
- clindamycin
Which of the following decreases the risk of endometriosis?
a. early menarche (<11)
b. shorter cycles (<27 d)
c. heavy, prolonged cycles
d. greater parity, longer lactation
d. greater parity, longer lactation
* also regular exercise decreases risk
What is the most common ovarian tumor found in childhood and adolescence?
germ cell tumors
How is lichen sclerosis treated?
- clobetesol (temovate)
* high potency steroid
Why is it important to take a family history with endometriosis?
- if a first degree relative has it, it increases the risk by 10 fold
DEXA scan should start at what age?
65 unless high risk
Hemi-obstructed vagina is almost always seen with this renal anomaly.
- ipsilateral renal agenesis
