4 - Annual Exams, Menopause, Gynecologic Problems

Question 1

What is the mainstay of medical treatment for endometriosis (after surgery has been done)?

Answer 1

• lower ovarian estradiol secretion with progestins or OCPs

Question 2

What is the cause of longitudinal vaginal septum?

Answer 2

• incomplete fusion laterally of mullerian ducts

Question 3

what is the most common STI causing acute vulvitis?

Answer 3

• trichomoniasis

Question 4

Ectopic pregnancies most commonly are located where?

Answer 4

within the fallopian tube

Question 5

How is candida vaginitis diagnosed?

Answer 5

wet prep

Question 6

Endometriosis is dependent on what hormone?

Answer 6

• estrogen

Question 7

Endometrial glands and stroma found within the myometrium of uterus is called what?

Answer 7

• Adenomyosis

Question 8

A white, lacy, fernlike pattern of the genital mucosa is consistent with what?

Answer 8

• lichen planus

Question 9

What is the most common cause of vaginal discharge in reproductive age women?

Answer 9

bacterial vaginosis

Question 10

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?

Answer 10

• primary dysmenorrhea

Question 11

Lesions of procelain-white papules and plaques often with areas of ecchymosis or purpura are findings consistent with this diagnosis.

Answer 11

lichen sclerosis

Question 12

What is the most common indication for HRT?

Answer 12

moderate to severe vasomotor symptoms

Question 13

How is endometriosis diagnosed and treated?

Answer 13

• surgically via laparoscopy

Question 14

This is a chronic eczematous disease resulting in scaling and lichenified plaque and an intense and unrelenting itch.

Answer 14

lichen simplex chronicus

Question 15

what defines an acute vs chronic pelvic pain?

Answer 15

acute = < 6 months
chronic = > 6 months

Question 16

What is the primary etiology of dysmenorrhea?

Answer 16

• excess prostaglandin production at menstruation

Question 17

At what age should pap testing begin for screening for cervical cancer?

Answer 17

21

• if normal, do every 3 years until 30

Question 18

Unopposed estrogen increases the risk of what 2 types of cancer?

Answer 18

endometrial cancer

breast cancer

Question 19

“Cottage-cheese” like vaginal discharge is consistent with what type of vaginitis?

Answer 19

candidal vaginitis

Question 20

When should mammogram testing begin?

Answer 20

age 40 unless high risk

Question 21

What is the most common ovarian tumor in 2nd and 3rd decade of life?

Answer 21

mature cystic teratoma (dermoid cyst)

Question 22

What is first line treatment for dysmenorrhea?

Answer 22

• NSAIDs

Question 23

When should colonoscopy exams start?

Answer 23

45

Question 24

What is the lifetime risk of breast cancer?

Answer 24

12%

Question 25

What are the 2 most common cancers in women?

Answer 25

1. skin cancer | 2. breast cancer

Question 26

How is menopause defined?

Answer 26

absence of menses for 1 year

Question 27

Pathologic diagnoses of endometriosis requires 2 of the following 4 factors.

Answer 27

- endometrial epithelium - endometrial glands - endometrial stroma - hemosiderin-laden macrophages

Question 28

What is the medical treatment for anovulation d/t POS?

Answer 28

letrozole (aromatase inhibitor)

Question 29

What is the leading cause of mortality in the first trimester?

Answer 29

ectopic pregnancy

Question 30

Ultrasound can detect intrauterine pregnancy within ____ weeks of LMP.

Answer 30

5 weeks

Question 31

What is the most common obstructive anomaly?

Answer 31

imperforate hymen

Question 32

Longitudinal vaginal septum is commonly seen with this uterine anomaly (75% of the time).

Answer 32

- uterine didelphys

Question 33

What is the best treatment for vulvovaginal atrophy and vasomotor symptoms?

Answer 33

- hormone replacement therapy (HRT)

Question 34

Breast exams should be done how frequently between the ages of 25-39 compared to after 40?

Answer 34

- 25-39 yo = 1-3 yrs | - 40+ yo = every year

Question 35

When should adolescents start seeing a gynecologist?

Answer 35

13-15 yo

Question 36

How is osteoporosis prevented?

Answer 36

- calcium and vitamin D intake - avoid excess sodas - high impact exercise

Question 37

How is ectopic pregnancy medically terminated?

Answer 37

methotrexate

Question 38

Acute genital pruritus is most commonly a symptom of what condition?

Answer 38

- vulvovaginitis

Question 39

How is infertility defined? (2)

Answer 39

- 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

Question 40

A positive Whiff test is consistent with what diagnosis?

Answer 40

- bacterial vaginosis

Question 41

What is the difference between stress vs urgency incontinence?

Answer 41

- stress = leakage with increases in intra-abdominal pressure - urgency = leakage with a sense of urinary urgency

Question 42

What medication is used for ovulation stimulation in the treatment of infertility?

Answer 42

- clomiphene citrate

Question 43

This is an auto-inflammatory disease that causes groin and axillary lesions. More commonly seen in obese patients.

Answer 43

- Hidradenitis suppurative

Question 44

What is the gold standard treatment for adenomyosis?

Answer 44

- Hysterectomy

Question 45

What BDM value defines osteoporosis?

Answer 45

< 2.5 from mean of young adult reference population

Question 46

How is bacterial vaginosis medically treated? (2 options)

Answer 46

- metronidazole | - clindamycin

Question 47

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

Answer 47

d. greater parity, longer lactation | * also regular exercise decreases risk

Question 48

What is the most common ovarian tumor found in childhood and adolescence?

Answer 48

germ cell tumors

Question 49

How is lichen sclerosis treated?

Answer 49

- clobetesol (temovate) | * high potency steroid

Question 50

Why is it important to take a family history with endometriosis?

Answer 50

- if a first degree relative has it, it increases the risk by 10 fold

Question 51

DEXA scan should start at what age?

Answer 51

65 unless high risk

Question 52

Hemi-obstructed vagina is almost always seen with this renal anomaly.

Answer 52

- ipsilateral renal agenesis