Benign disorders

Question 1

Cervical polyps

Answer 1

Soft, friable red/purple growths
usually endocervical
asymptomatic, or irregular and postcoital bleeding

Question 2

Endometrial polyps

Answer 2

Overgrowth of endometrial glands and stroma
asymptomatic, or abnormal bleeding
May interfere with pregnancy

Question 3

Nabothian Cyst

Answer 3

Translucent or grayish-white cyst on cervical surface
caused by squamous epithelium growing over columnar cells and blocking mucus secretions
asymptomatic, no treatment necessary

Question 4

Leiomyomas (fibroids)

Answer 4

Benign smooth muscle tumor of uterus

Hard, painless, frequently multiple nodules firmly attached to fundus

Question 5

How to treat fibroids

Answer 5

Small and asymptomatic-no tx
Large and desires pregnancy-do myomectomy (shave lining of uterus)
If no desire for fertility, do hysterectomy
GnRH agonist for 3 months preoperatively or for perimenopausal woman (to shrink uterus)
Uterine artery embolization

Question 6

ovarian cysts

Answer 6

Follicular or corpus luteum
normal in reproductive age women
thin-walled and clear, occasional internal hemorrhage
usually asymptomatic
may rupture and cause pain

Question 7

Vulvodynia

Answer 7

Chronic vulvar pain lasting at least 3 months with no noted pathology
Constant or episodic, triggered by exercise, sanitary pads, sexual intercourse

Question 8

urge incontinence

Answer 8

Immediate need to void/involuntary loss
Frequent nocturia
Feeling of urination out of proportion to intake of coffee, tea, or alcohol

Question 9

Stress Incontinence

Answer 9

Leakage upon sneezing, coughing, or lifting

Frequent urination to avoid accidents

Question 10

Incontinence medication

Answer 10

Ditropan (oxybutynin Chloride)
Antispasmodic effect bladder smooth muscle
Detrol (Tolterodine tartrate)
Detrusor muscle selective - improve bladder capacity/compliance

Question 11

Endometriosis

adenomyosis:

Answer 11

Presence of endometrium in a location other than the uterine cavity

presence of endometrial tissue within the uterine myometrium

Question 12

PE findings for endometriosis

Answer 12

Fixed, retroverted uterus
scarring and tenderness of cul-de-sac
nodularity of uterosacral ligaments
enlarged, tender adnexa

Question 13

treatment of endometriosis

Answer 13

Surgery-to remove implants, or TAH/BSO(removal of ovaries and fallopian tubes)
provera- oral or IM, to induce amenorrhea
oral contraceptives-anovulation
danazol-causes amenorrhea and endometrial atrophy
GnRH agonists: leuprolide, nafarelin, goserelin