4.1 pt 2 Flashcards
1
Q
main cause of candida infections
A
Candida albicans
2
Q
what color will vaginal discharge be in vulvovaginal candidiasis
A
white, thick curd-like
3
Q
what will you see on KOH smear for candidiasis
A
budding yeast and pseudohyphae
4
Q
ovarian cysts are also called
A
adnexal masses
5
Q
during what age are ovarian cysts most commonly found
A
reproductive age
6
Q
most common symptom of ovarian cysts
A
pelvic pain/pressure
7
Q
when should you do surgery for ovarian cyst
A
if greater than 10 cm
8
Q
implantation of endometrial tissue outside of the uterus
A
endometriosis
9
Q
when do symptoms of endometriosis usually improve
A
during pregnancy and after menopause
10
Q
most common site for endometriosis
A
ovaries
11
Q
biggest risk factor for endometriosis
A
prolonged estrogen exposure
nulliparity
12
Q
classic triad of endometriosis
A
cyclic premenstrual pelvic pain
dysmenorrhea
dyspareunia
13
Q
initial imaging of choice for endometriosis
A
pelvic ultrasound
14
Q
definitive diagnosis for endometriosis
A
laparoscopy with biopsy
15
Q
endometriosis involving the ovaries large enough to be considered a tumor, usually filled with old blood appearing chocolate-covered
A
chocolate cyst/endometrioma
16
Q
when do symptoms occur for PMS
A
luteal phase (1-2 weeks before menses)
17
Q
when are symptoms of PMS relieved
A
within 2-3 days of onset of menses
18
Q
benign uterine smooth muscle tumor
A
uterine fibroids
19
Q
growth of uterine fibroids depends on what hormone
A
estrogen
20
Q
2 risk factors for uterine fibroids
A
> 35
African American (5x more likely)
21
Q
most uterine fibroids are asymptomatic, but if they are symptomatic, what is the most common symptom
A
abnormal uterine bleeding
22
Q
will uterine fibroid be tender or non-tender on exam? symmetric or asymmetric?
A
non-tender asymmetric mobile mass
23
Q
what will you see on transvaginal ultrasound for uterine fibroids
A
focal heterogenic hypo echoic mass or masses with shadowing
24
Q
if small and asymptomatic, do you need treatment for uterine fibroids?
A
no just observation
25
surgical treatment of choice for women who wish to preserve fertility with uterine fibroid
myomectomy
26
definitive treatment for uterine fibroids
hysterectomy
27
most common benign gynecologic tumor
uterine fibroids/leiomyomas
28
most common type of uterine fibroid
intramural (in the wall of the uterus)
29
are cystic ovaries bilateral in PCOS
yes
30
what do people with PCOS have resistance to
insulin
31
what hormone do people with PCOS have too much of
androgen
32
describe menstruation for someone w PCOS
amenorrhea
or
oligomenorrhea
33
can PCOS cause infertility
yes it can
34
what stimulates excess ovarian androgen production in PCOS
increased LH
35
what causes insulin-resistant hyperinsulinism
functional ovarian hyperandrogenism
36
what is a symptom of increased androgen
hirsutism
37
Bc people with PCOS have insulin resistance, they have increased risk of developing
type 2 DM
obesity
HTN
38
what skin condition may you see in someone with PCOS
acanthosis nigricans
39
what type of criteria do you use for diagnosis of PCOS
Rotterdam criteria
40
how much of Rotterdam criteria must be met to be diagnosed with PCOS
2 of 3
41
3 Rotterdam criteria to be diagnosed with PCOS
hyperandrogegism (lab or clinical signs)
ovulatory dysfunction (amenorrhea or oligomenorrhea)
cystic ovaries on US
42
what will the LH:FSH ratio be in PCOS
great than or equal to 3:1
43
What will you see on pelvic ultrasound for PCOS
bilateral enlarged ovaries and multiple ovarian cysts with a "string of pearls" appearance
44
first line treatment for PCOS
lifestyle changes
45
mainstay of treatment for PCOS
combination oral contraceptives
46
Anti-androgenic agent for PCOS
Spironolactone
47
3rd most common gynecologic cancer
cervical cancer
48
most common type of cervical cancer
squamous cell carcinoma (90%)
49
what is a cofactor in squamous cell carcinoma
smoking
50
most common symptom in cervical cancer
postcoital bleeding
51
how to diagnose cervical cancer
colposcopy with biopsy
52
what is performed after a positive Pap smear to determine the extent and depth of invasion of the cancer
Cervical biopsy and endocervical curettage or ionization
53
preferred treatment for carcinoma in situ
excision
54
what cancer has the highest mortality of all the gynecologic cancers
ovarian cancer
55
most common type of ovarian cancer
epithelial cell cancer (>90%)
56
What is the biggest environmental risk to getting ovarian cancer
increased number of ovulatory cycles
57
someone with increased number of ovulatory cycles
nulliparity
infertility
> 50
early menarche
late menopause
58
genetic risk factors for developing ovarian cancer
BRCA1
BRCA2
Peutz-Jeghers
Turner's syndrome
Lynch syndrome
59
What decreases your risk of getting ovarian cancer
combination oral contraception
decreased number of ovulatory cycles
60
when does ovarian cancer typically become symptomatic
typically late in the disease course
61
most common symptoms for ovarian cancer
increasing abdominal girth
weight loss
back or abdominal pain
early satiety
62
What will you see on PE for ovarian cancer
palpable abdominal or ovarian mass (solid, fixed, irregular)
ascites
pleural effusion
63
initial test of choice for ovarian cancer
pelvic ultrasound
64
what can be used to monitor progress of ovarian cancer
Serum CA-125
65
What bacteria causes toxic shock syndrome
staphylococcus aureus
66
clinical illness characterized by rapid onset of fever, rash, hypotension, and multi organ system involvement
toxic shock syndrome
67
what type of toxins are produced by staphylococcus aureus
exotoxins
68
50% of menstrual causes of toxic shock syndrome
tampon use
69
non menstrual causes of toxic shock syndrome
surgical and postpartum wound infections
burns
contraceptive sponge use
70
what type of conjunctivitis do we commonly see in toxic shock syndrome
nonpurulent conjunctivitis
71
how does multi systemic involvement manifest in toxic shock syndrome
hypotension
72
is detection of staphylococcus aureus required for diagnosis of toxic shock syndrome
NO
73
another common organism that can cause toxic shock syndrome
group A strep
74
what indicates renal failure in toxic shock syndrome
creatinine great that or equal to 2 mg/dL
75
what indicates coagulopathy in TSS
platelets less than or equal to 100,000/mm
76
what will you see on the skin of someone with TSS
erythroderma --- resembles sunburn
77
does erythroderma include the palms and soles in TSS
YES
78
what happens to erythroderma after 1-2 weeks in TSS
desquamation
79
most common cause of UTI/cystitis
E. coli (>80%)
80
what will you see on urinalysis for UTI/cystitis
pyuria (>10 WBCs/hpf)
81
definitive diagnosis for UTI/cystitis
urine culture
82
clean catch or first catch for UTI
clean catch
83
having what in your urine usually indicates you have a UTI?
nitrites
84
an inflammatory mass involving the Fallopian tube, ovary, and occasionally the adjacent pelvic organs (bowel, bladder)
tubo-ovarian abscess
85
what age of patients are most commonly affected by tube-ovarian abscess
reproductive age
86
risk factors for tube-ovarian abscess (same as for PID)
multiple sex partners
age between 15-25
prior history of PID
87
what is a common complication of PID
tubo-ovarian abscess
88
classic presentation of tubo-ovarian abscess
acute lower abdominal pain
fever
chills
vaginal discharge
89
patients with a ruptured TOA typically present with
acute abdominal pain
signs of sepsis
90
first line for diagnosing TOA
ultrasound
91
capacity to have a live birth
fecundity
92
probability of achieving a pregnancy in a single menstrual cycle
fecundability
93
permanent state of infertility
sterility
94
after how many months of regular, unprotected sexual intercourse is someone considered to be infertile
12 mos
95
most common cause of infertility
failure to ovulate
96
what is the female athlete triad
eating disorders
amenorrhea
bone disorders (osteoporosis)
97
in female athlete triad, what hormone is deficient
estrogen
98
islands of ectopic endometrial tissue within the myometrium
uterine adenomyosis
99
between what ages does uterine adenomyosis commonly present
35-50
100
common clinical manifestations of uterine adenomyosis
chronic pelvic pain
dysmenorrhea
menorrhagia (heavy/prolonged)
101
on physical exam, will the uterus be symmetrically or asymmetrically enlarged in uterine adenomyosis
symmetrically enlarged
102
will the uterus be boggy or hard in uterine adenomyosis
boggy
103
will the uterus be mobile or not in someone with uterine adenomyosis
mobile
104
Overall, describe what you will see on PE in someone with uterine adenomyosis
symmetrically enlarged
soft/boggy
mobile uterus
105
first line for diagnosis of uterine adenomyosis
transvaginal ultrasound
106
more accurate and useful tool for diagnosing uterine adenomyosis if transvaginal ultrasound isn't helpful
MRI
107
conservative treatment of uterine adenomyosis
IUD (hormonal)
108
definitive treatment for uterine adenomyosis
total abdominal hysterectomy
109
most common gynecologic malignancy in US
endometrial cancer
110
what is the most common type of endometrial cancer
adenocarcinoma
111
who does endometrial cancer mainly affect
post menopausal women
112
risk factors for endometrial cancer
increased estrogen exposure
PCOS
Tamoxifen
113
What protects against ovarian and endometrial cancer
combination oral contraceptives
114
clinical manifestations of endometrial cancer
abnormal uterine bleeding
postmenopausal bleeding
115
Definitive diagnosis of endometrial cancer
endometrial biopsy
116
what STIs are reportable in every state
syphilis
congenital syphilis
gonorrhea
chlamydia
chancroid
HIV
117
within how many days must all STIs be reported
2 weeks
118
within how many days must HIV be reported
7 days
119
expedited partner therapy can be used for which STIs
chlamydia
gonorrhea
120
all sexual partners within how many days can use the expedited partner therapy
60 days
