Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PANCE > 6. Reproductive > Flashcards

6. Reproductive Flashcards

(67 cards)

Start Studying
1
Q

Basic PathoPhysiology of Mense cycles

A

Day 1-12

  • GnRH -> FSH, LH -> Estrogen
  • FSH increase cause follicle & egg matruation
  • LH stimulates the maturing follicle to produce estrogen to build endometrium (preparing pregenancy environment)

Ovulation 12-14

  • LH surge cause release egg

Day 14-28

  • Estrogen decrease and Progesterone increase

1st day of mensteration

  • fall of estrogen and progesteron cause lose of endometrium (shed tissue and bleed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Type of amenorrhea explain

  1. Amenorrhea
  2. Cryptomenorrhea
  3. Menorrhea
  4. Metrorrhea
  5. MenoMetrorrhagia
  6. Oligomenorrhea
  7. Polymenorrhagia
A
  1. not bleeding
  2. light bleeding
  3. Large bleeding
  4. Irregular bleeding
  5. Large irregular bleeding
  6. Prolonged cycle length >35 days
  7. Frequent cycle interval <21 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

US normal, normal pep, but irregular bleeding

Name/Etio/Dx/Tx

A

Name: DUB (dysfunctional uterine bleeding)

Etio: Anovulation(high estrogen), Ovulation

Dx: Diagnosis of exclusion

Tx

  1. OCP
  2. Progesterone
  3. Surgery
    • Hysterectomy (definitive)
    • Endometrial ablation (pt who wants keep productive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Diffuse pelvic pain right before or with the onset of menses

Name/Tx

A

Name: Dysmenorrhea

Tx: NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Physical, behavioral & mood change with cyclical occurence during luteal phase (1-2 weeks before mense)

Name/Other type/Tx/Workup differentiate

A

Name: Premenstural syndrome

Other type: Premenstrual dysphoric disorder (PMDD)

  • additional sx: Anger & irritabillity

Tx: SSRI, OCP

Workup: Hyper/hypothyroidism check (may mimic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Failure of mense before 15y or no second sex characteristic by 13y

Name

  1. Uterine present + breast absent=?
  2. Uterine absent + breast present=?
A

Name: Primary amenorrhea

  1. 2type
    • FSH, LH low - hypothalamus
    • FSH, LH high - Turner
  2. Mullerine, androgen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Not bleeding but no genetic issue

Possible 5 dz/Dx/Tx

A
  • MC cause pregnancy
  • Hypothalamus
    • Dx: low LH, FSH
    • Tx: Clomephen
  • Pituitary dysfunction
    • Dx: low FSH, LH, + Prolactin high
    • Tx: TSS
  • Ovarien failure
    • Dx: high FSH, LH + low estrogen
  • Uterine disorder
    • Dx: Pelvic US, hysteroscopy
    • Tx: estrogen tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

age of 50y women + has not bleeding for a year

+ hot flashes and mood change

Name/Risk/PE/Dx/Complication/Tx

Premanopause vs perimanopause Term?

A

Name: Menopause

Risk: 50-52y

PE: bone density low, Vaginal atropy

Dx: FSH (1st) -> FSH high LH high but estrogen low

Complication: Osteoporosis

Tx: HRT

  • Estrogen only
    • Benefit: good for sx
    • Risk: endometrial cancer, thromboembolism
    • Often use this for nonintact uterus
  • Estrogen + progesterone (best option often)
    • Benefit: protect against endometrial cancer
    • Often use this for intact uterus

Vaginal atrophy: estrogen cream

Premanopause - no sx

Perimanopause - estrogen drop and shows sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

leiomyoma vs adenomyosis

A

Leiomyoma

  • Benign smooth muscle tumor
  • MC AA
  • PE: Asymetric, firm, nontender mass
  • Dx: US
  • Tx: Observe + leuprolide (GnRH inhibitor)
    • Definitive: hysterectomy, myodectomy for preserve inferility

Adenomyosis

  • Ectopic endometrial hypetrophy within muscle layer of uterine
  • PE: Symetric, soft, tender mass
  • Dx: MRI
  • Tx: Total abdominal hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

infection post C-section + fever, tachycardia

Name/Pathogen/Tx

A

Name: Endometritis

Pathogen: GBS

Risk: C-section

Tx: Clinda + gentamycin

Prophylaxis: 1st gen cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

nulliparty + pelvic pain + painful intercourse

Name/Patho/Risk/Dx/Tx

A

Name: Endometriosis

Patho: ectopic endometrial tissue (MC ovaries)

Risk: Nulliparty, <35y

Dx: Laparoscopy w/ biopsy

Tx: OCP + NSAID, Danzol, leuprolide

  • Surgical
    • Keep fertility -> abalation
    • Not keep fertility -> total abdominal hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Precursor to endometrial cancer + Post menopausal bleeding

Name/Patho/Dx/Tx

A

Name: Endometrial hyperplasia

Patho: estrogen high by hyperplasia

Dx: Transvaginal US (1st) - endometrial stripe >4mm -> Endometrial bx (definitive)

Tx

  • Hyperplasia w/o atypia - progestin
  • Hyperplasia w/ atypia - hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Manopausal bleeding + hx of use estrogen

Name/Risk/Dx/Tx

A

Name: Endometrial Cancer

Risk: hx of use estrogen

Dx: Transvaginal US (1st) - endometrial stripe >4mm ->endometrial bx

Tx: Hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Uterine prolapse

3 type/Grade/Sx/PE/Tx

A

3 type

  • Cystocele: Posterior bladder herinating into Anterior vagina
  • Enterocele: Small bowel herniate into Upper vagina
  • Rectocele: sigmoid colon(rectum) herniate into Posterior distal vagina

Grade

  1. descent into upper 2/3 of the vagina
  2. cervix approaches introitus
  3. outside introitus
  4. entire uterus out

Sx: pevic or vaginal heaviness, fullness, falling out sensation

PE: Bulging mass when introabdominal pressure (valsalva)

Tx

  • Prophylactic - kegel exercise
  • Nonsurgical - pessaries
  • Surgical - hysterectomy (grade 4)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Unilateral RLQ or LLQ pain + otherwise normal

Name/Dx/Tx

A

Name: Functional ovarian cysts

Dx: Pelvic US

Tx: Supportive

  • Cyst <8cm - rest, NSAID
  • if 8cm< - laparoscopy or laparotomy
  • Repeat US after 6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Palpable overain mass + postmenopausal bleeding

Name/Risk/Dx/Tx/Protective factors

A

Name: Overian cancer

Risk: hx of fx, BRCA

Dx: Biopsy 90% Epithelial, CA 125 serum

Tx

  • TAH-BSO
  • Chemo + surgery

Protective factors: OCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Amenorrhea + Obesity + Hirsutism + hx of DM

Name/Dx/Tx

A

Name: PCOS (polycystic overian syndrome)

Dx: LH:FSH >3:1, Labs - testosterone

  • Pelvic US: string of Pearls

Tx: OCP (main)

  • Hirsutism: spironlactone
  • Infertility: clomiphene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cervical test result/bx - tx

A
  • Negative - Normal pap -> NO HPV test
  • ASC-US - if >25y
    • HPV test
      • neg -> 3y
      • POS -> colposcopy
  • ASC-H - Colposcopy
  • LSIL
    • 25-29 -> colposcopy
    • >30 - HPV test
      • Neg -> Pap 1y
      • POS -> colposcopy w/ bx
  • HSIL - Colposcopy

Biopsy result

  • CIN 1 - mild -> Observe or leep
  • CIN2,3 - Moderate(1/3 - 2/3 thick), severe -> leep or abalation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bleeding after sex, Non-menstrual bleeding

Name/Risk/Dx/Tx

A

Name: Cervical carcinoma

Risk: DES exposure (estrogen), HPV 16/18

  • MC Squamous

Dx: Colposcopy w/ bx

Tx: early - leep, abalation

  • Stage 1 - 2a - TAH-BSO
  • Stage 2a above - TAH-BSO + Chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HPV vaccination recommendation

Age/type of vaccine/schedule

A

HPV vaccination: 11-26y

  • Gardasil: HPV 6,11,16,18
  • Gardasil 9: 5 more then regular

Schedule

  • <15y 2 dose HPV 6month apart
  • >15y 3 dose 2,4month apart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cervical cancer screening

Age initiate/Discontinue/Recommendation pap

A

Age: 21

Discontinue: 65

Test

  • 21-29: Pap test
  • >30: Pap 3y HPV 5y
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Painless cervical dilation in 2nd trimester

Name/Risk/Tx

A

Name: Cervical insufficiency

Risk: DES exposure

Tx: cerclage + bed rest (may add 17 alpha-hydroxyprogesterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tender vulvar 4 or 8 o’clock

Name/Dx/Tx

A

Name: Bartholin cyst/abscess

Patho: bartholin duct obstruction

Sx

  • Tender - infected
  • Nontender - not infected

Dx: CBC, culture

Tx: I & D w/ abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

significant pruritus + red/white ulcerative

Name/Risk/Tx

A

Name: Vulvar cancer

Risk: 90% squamous (HPV 16,18,31)

Tx: Surgical remove + Chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Vagnial dryness, dyspareunia (painful sex) Name/Tx
Name: Vulvovaginal atrophy Tx: Vaginal estrogen cream
26
Unilateral breast pain Name/Risk/Tx
Name: Mastitis/breast abscess Pathogen: S. Aureus Sx * Unilateral - infected * Bilateral - congestive * Breast Abscess - induration with fluctuance Tx * Infected - dicloxacillin, **Continue breast pump** * Congestive - ice pack, tight-fitting bras * Breast abscess - I & D, discontinue breastfeeding from the affected breast
27
Cyst become bigger or smaller in size with menstrual hormonal change Name/Dx/Tx
Name: Fibrocystic breast disorder Dx: US(1st), FNA (straw-colored fluid) Tx: Most spontaneously
28
Smooth, well circumscribed Non tender freely mobile fixed mass + No change in size Name/Tx
Name: Fibroadenoma of the breast Tx: Observe
29
breast mass painless hard fixed + blood discharge from nipple (unilateral) Name/Risk/Type/PE/Dx/Tx
Name: Breast cancer Risk: BRCA, fx hx Type: ductal carcinoma MC PE: Itchy scaling rash on the nipple + Peau d'orange (peel of an orange looking) Dx: US (1st) -\> Mammogram, Biopsy (def) Tx: Lumpectomy (save breast), Mastectomy (remove breast) * Medication - tamoxifene, raloxifene
30
Mammogram 1. ACS screening recommendation 2. ACOG screening recommendation 3. USPSTF screening recommendation Clincal Breast exam recommendation When to start self breast exam?
Mammogram 1. 45-54y annually, 55 above q2y 2. 40 above annually 3. 50-74y q2y Breast Exam in clinic - q3y in women age 20-39, 40 above annually Self exam should start age of 20 monthly
31
abd tenderness + cervical motion tenderness + adnexal tenderness Name/Infection site/pathogen/Dx/Tx
Name: Pelvic inflammatory disease Infection site: upper reproductive region Pathogen: Gonorrhea & chlamydia Dx: Clinical, maybe used US for abscess Tx * Outpatient - doxy + ceftx * Inpatient - IV doxy + cefo
32
hx of tampon use + fever + skin macular rash + hypotension Name/Pathogen/Dx/Tx
Name: Toxic shock syndrome Pathogen: S. Aureus Dx: CBC Tx: Admission * Vanco + clinda + fluid replacement
33
Grey white fish rotten smell Name/Pathogen/Dx(results)/Tx/Prevention
Name: Bacterial vaginosis Pathogen: Gardnerella vaginallis Dx * PH 5\< * Fish smell * Wiff test POS with 10% KOH * Microscopic: clue cell Tx: Metronidazole Prevention: avoid douching, NO need tx partner
34
FROTHY yellow green discharge + strawberry cervix Name/Pathogen/Dx/Tx/Prevention
Name: Trichomoniasis Pathogen: Trichomonas vaginalis Dx * PH 5\< * Wiff test may POS * Wet Mount (Flagellated) Tx: Metronidazole 2g oral Prevention: Must tx partner
35
Thick curd like/cottage cheese like discharge Name/Pathogen/Dx/Tx
Name: Candida Pathogen: Candida albicans Dx * PH normal acidic (3.8-4.2) * Wiff test (neg) * Microscopic (hyphae, yeast) Tx: Fluconazole
36
Cauliflower like lesion (flesh colored growths) Name/Dx/Tx
Name: HPV infection Dx: whitening with 4% acetic acid Tx: Acetic acid, podofilox, imiquimod
37
1. which meds approve for PMDD? 2. Which meds last 3 years and S/E? 3. Which meds last 3 month and S/E 4. What is OCP S/E? 5. Safe OCP for lactation? 6. 5 year long OCP? 7. 10 year long OCP?
1. Progestin + estrogen 2. Implane, Osteoprosis 3. Depo shot, weight gain 4. Imgraine or smoker \>35 should avoid 5. Progestin only 6. Mirena 7. Paragard
38
Uncomplicated pregnancy Dx/PE/Timeline(fetal movement/pelvic US/heart tone)
Dx * Serum HCG - detect pregnancy 5 days after conception * Urine HCG - 14 days after conception PE * Uterus (soften) * Ladin - 6 weeks * Hegar - 6-8 weeks * Piskacek - 7-8 weeks * Cervix * Goodell - cervix soften * Chadwick - blue color cervix 8-12hr Timeline * Fetal heart tone - 10-12 weeks * Pelvic US - detect fetus 5-6 weeks * Fetal movement - 16-20 weeks
39
GPA and Fundal height measurement GPA classification/timeline for height explain
GPA * Gravida - # of pregnancy * Para - # birth * Abortus - # of loss Fundus height * 12 weeks - pubix symphysis * 20 weeks - at ubilicus * 38 weeks - below xiphoid process
40
Estimated date of delivery (EDD)
Naegele's rule * (1st day of last mense + 7 days) - 3month
41
First trimaster visit tests (1-12wks)
* Maternal blood screening test for down syndrome * HCG(high or low), PAPP-A(low), Nucal translucency (thick abnormal) * US * Feter heart tone - 10-12wks * heat beat check - 5-6 wks * Chorionic villus sampling (CVS) * age \>35 at risk option to test chromosomal abnormality
42
Second trimaster visit test (13-27 weeks)
* Triple screening test (15-20wks) * beta hCG high - down syndrome (trisomy 21) * Alpha fetoprotein high - Neural tube defect * everything low (trisomy 18) - usually die in 1st year of life * US * In 15-18 wks, Aminocentesis offered to check chromosomal abnormality (maternal 35y) * Gestational diabetes screening 24-28wks
43
Third trimaster visit test (28 wks - till birth)
* RhoGAM - 28 wks and within 72 hours after child birth * GBS screening to prevent endometritis 32-37 wks * Non stress test - 2 acceleration in 20 min, if no acceleration -\> contraction stress test - NO late deceleration (no problem), if late deceleration present -\> delivery
44
Failure to conceive after 1 year trial Name/RIsk/Dx/Tx
Name: Infertility Risk: Male (40%), Female (30%) Dx: check male sperm first and Hysterosalpingography Tx: Clomephene (induce ovulation), Intrauterine insemination * if fallopian tube defect - vitro ferilization
45
Unilateral pelvic pain + amennorrhea Name/Risk/MC site/Dx/Tx
Name: Ectopic pregnancy Risk: hx of abd surgery or tubal (due to adhesions) MC site: Fallopian tube MC Dx * Beta hCG - 2000\< or doubling in 24-48hrs * Transvaginal US - absence of sac Tx * MTX * lararoscopic salpingostoy (unstable) * RhoGAM if mother is RH negative
46
Abortion cases tx * NO POC expelled + Cervical close * some POC expelled + Cervical close * some POC expelled + Cervical open * NO POC shown + Cervical closed * NO POC expelled + Cervical close + fetal demise (death) * Some POC expelled + cervical tenderness + cervical closed
Basic Tx: D&E except for threatened * Threatened * Inevitable * Incomplete * Complete * Missed * Septic
47
Medical vs surgical
Medical * MTX * Misoprostol * Mifepristone Surgical * D & C - 4-12 wks * D & E - 12wks \<
48
No proteinuria + HTN + Pregnancy 20 wks Name/Tx
Name: Gestational HTN Tx: Hydralazine
49
ProteinUrea + HTN + Pregnancy Name/Complication/Tx
Name: Preclampsia Complication: HELLP syndrome Tx * 37wks\< - delivery NOW * 34wks\> - admission tx w/ mag sulfate + hydralazine
50
Seizure or coma + HTN + Pregnancy Name/type of seizure/Tx
Name: Eclampsia Type: Tonic-clonic 1,2 min -\> postictal state Tx: ABCD 1st, Mag sulfate + hydralazine or labetalol * Once stable - DELIVERY (life thretening)
51
HTN before 20 weeks pregnancy Name/Tx
Name: Chronic HTN Tx: Methyldopa
52
3rd trimaster + Painless bleeding (bright red) Name/Patho/Fetal HR/Dx/Tx
Name: Placenta previa Patho: abnormal place for placenta Fetal heart rate: Normal Dx: Pevic US Tx: hospotalization * tocolytic (mag sulfate) * if less than 34 wks give steriod for surfactant * once stable - delivery
53
3rd trimaster + severe sudden painful bleeding Name/Patho/Risk/fetal HR/Dx/Tx
Name: Abruptio placenta Patho: seperation of placenta from uterine wall Risk: HTN, Smoking Fetal HR: Brady Dx: Pelvic US Tx: Delivery NOW
54
Painless vagnial bleed + 3rd trimaster bleeding Name/Patho/Fetal HR/Dx/Tx
Name: VASA Previa Patho: fetal vessel traverse the fetal membrane over cervical os Fetal HR: Brady Dx: Pelvic US Tx: C-section NOW
55
Pregnancy + obesity + hx of DM Name/Risk/Dx/Tx
Name: Gestational DM Risk: Obesity, hx of DM, 4g over baby birth Dx 1. 50g glucose challenge at 24-28 wks * if \>140 after 1 hour -\> 3 hr test 2. 3 hour 100g glucose tolerence test (GTT) * Overnight fast and test in the morning * Fasting \>95, 1hr \>180, 2 hr \>155, 3 hr \>140 Tx: Insulin
56
Postpatum blues vs depression
Blue - do not think of harm baby 2-4 days onset * No need tx resolve in 10 days Depression - 2 wks - 2 month onset and THINK OF HARM BABY * May need antidepressant, may last 3-14 month
57
beta hCG more than 100,000 + Snowstorm shown in US Name/Dx/Tx
Name: Molar pregnancy Patho: Neoplasm growth due to abnormal placental development (Hidaform Mole) Dx: US, hCG Tx: Surgical uterine evacuation (Suction curettage) * MTX can be used if METS
58
Pregnancy + hepatosplenomegaly + jaundice Name/Patho/Dx/Tx
Name: RH allomunization Patho * 1st pregnancy (Mom RH-, Baby RH+) develop antibody * 2nd pregnancy (Mom RH-, Baby RH+) developed antibody from 1st pregnancy will cross to attack baby RBC Dx * Pt must be RH- abo and 2nd pregnancy Tx * given at 28 weeks * within 72 hrs of delivery * anytime bleeding during pregnancy * if bleed less than 12 weeks - 50 RoGAM * if bleed more than 12 weeks - 300 RoGAM
59
Severe emesis during pregnancy Name/Tx
Name: Motion sickness or HEG (hyperemesis Gravidarum) Tx * Fluid, electrolyte repletion * Pyridoxine (Vit B6) + Doxylamine
60
Stage of Labor explain Contraction but no Cervial dilation called?
* Stage 1 - dilation of cervix (10 cm) * Stage 2 - delivery of fetus * Stage 3 - delivery of placenta * Stage 4 - 1-2 hr after delivery and assessed for complication * Called as Braxton-hicks contraction
61
APGAR score category
* Appearance - pink * Pulse - 100\< * Grimace - pull away, sneeze, or cough * Activity - arm, leg flex and resists extension * Repiratory - strong, crying
62
Postpartum Physical difference 4 things
* Uterus - shrink in 2 days, decends back to 2 weeks, Normal size in 6 weeks * Lochia serosa - bleeding 4-10 days, Resolves 3-4 weeks * Breast - milk in 3-5 days * Mense - restart if no breast milk, usually restart in 6-8 weeks
63
loss of blood more than 500ml during delivery Name/Risk/Patho/PE/Dx/Tx
Name: Postpartum hemorrhage Risk: 500ml vaginal, 1000ml C-section Patho: Uterine atony (uterus unable to contact to stop bleeding) PE: soft boggy uterus Dx: CBC, type & cross Tx * Bimanual uterine massage * IV fluid + oxytocin
64
hx of smoking + sudden pooling of secretion in vagina (pregnacy) Name/Dx/Tx
Name: Premature rupture of membrane Risk: STD, SMOKING Dx * Nitrazine paper test - turn blue PH 6.5\< * Fern test - fern pattern crystalization Tx: Labor + monitor for infection
65
Any delivery before 37 wks Name/Dx/Tx
Name: Premature Labor Dx * Fern test - crystal * Nitrazine paper test - blue (ph 6.5\<) * Presence of FETAL FIBRONECTIN Tx * Beclomethasone (premature lung) * Tocolytic - It's Not My Time * Indomethacin * Nifedipine * Meg sulfate * Terbutaline * ABX for GBS infection (ampicilin + amox)
66
During delivery baby head is out but shoulder stuck at mother pubis Name/Tx
Name: Shoulder dystocia Tx * Nonmanipulation - McRobert maneuver (lift leg up and push w/ hand on mother suprapubis) **1stline** * Manipulation - Wood "Corkscrew" Maneuver (180 should rotation)
67
Induction of labor medication
* Oxytocin IV - 1cm dilation with some effacement * Prostaglandin gel - unfavorable cervice

PANCE (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions