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OB/GYN > Blueprints gyn > Flashcards

Blueprints gyn Flashcards

1
Q

most common enzyme deficiency, causes labial fusion

A

21 hydroxylase deficiency leading to congenital adrenal hyperplasia

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2
Q

sx of CAH, 21 hydroxylase deficiency

A

ambiguous genitalia, hyperandrogenism with salt wasting, hypotension, hyperkalemia, hypoglycemia

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3
Q

tx of CAH, 21 hydroxylase deficency

A

cortisol, decreases ACTH

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4
Q

cause of primary amenorrhea and pelvic pain, physical exam shows no vaginal lumen, a tense bulging mass, increasing lower abdominal girth

A

imperforate hymen

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5
Q

cause of primary amenorrhea and pelvic pain, blind puch and short vagina

A

transverse vaginal septum

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6
Q

tx of transverse vaginal septum

A

surgical correction

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7
Q

tx of imperforate hymen

A

surgical correction

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8
Q

mayer kokitansky kuster hauster - what it is, physical exam, tx

A

aka vaginal agenesis

absence of vagina and absence of cervix, uterus, fallopian tubes

exam: normal ext genitalia, normal secondary sexual characteristics, normal ovarian
tx: creating a neovagina

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9
Q

lichen sclerosis - common population, CA risk, phys exam, sx, tx

A

population: postmenopausal women

CA risk: 5-15%

phys exam: symmetric white, thinned skin on labia, perineum, shrinkage and agglutination of labia minora

sx: asymptomatic
tx: steroids

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10
Q

squamous cell hyperplasia - phys exam, sx, tx

A

phys exam: thickening of vulvar skin from edema, raised white lesion on labia majora and clit

sx: chronic pruritis and thickened skin
tx: medium potency steroids

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11
Q

lichen planus - phys exam, sx, tx

A

phys exam: multiple shiny, flat, purple papules on inner aspect of labia minora, vagina

sx: pruritus with mild inflammation to severe erosion
tx: vaginal hydrocortisone, surgical excision or vaginal dilators

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12
Q

lichen simplex chronicus - phys exam, sx, tx

A

phys exam: thickened white epithelium, slight scaling

sx: vulvar pruritis
tx: medium potency topical steroids

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13
Q

vulvar psoriasis - phys exam, sx, tx

A

phys exam: red moist lesions, sometimes scaly

sx: asymptomatic or pruritis
tx: ultraviolet light or steroids

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14
Q

vaginal adenosis

A

phys exam: palpable red glandular spots and patches in the upper third of the vagina on ant wall

sx: none
tx: serial exams

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15
Q

most common tumor on vulva

A

epidermal inclusion cysts

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16
Q

fox fordyce disease

A

occlusion of apocrine sweat glands, absceses

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17
Q

gartner duct cyst

A

remnants of mesonephric ducts of wolffian system, anterior lateral aspects of vagina

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18
Q

bartholin cyst in women over age 40…

A

should be biopsied to rule out bartholin’s gland carcinoma

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19
Q

most common uterine anomalies not related to drugs

A

septate uterus, malfusion of paramesonephric ducts

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20
Q

uterine fibroids - cause, sx, outcome/tx

A

cause: proliferations of smooth muscle cells of myometrium, common in women of childbearing age
- monoclonal, hormonally responsive to estrogen and progesterone

sx: asymptomatic, heavy or irregular bleeidng, reproductive problems, mass effect, abnormal uterine bleeding (most common sx)

tx: medical: progesterone, GnRH agonists
surgical: uterine artery embolization, myomectomy (recurrence), hysterectomy (definitive treatment)

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21
Q

most common DES anomaly in uterus

A

t shaped uterus

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22
Q

most common fibroid location

A

intramural fibroids heavy or prolonged bleeding

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23
Q

continuous endogenous or exogenous strogen and abnormal uterine bleeding leads to…

A

endometrial hyperplasia

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24
Q

risk factors for endometrial hyperplasia

A

unopposed estrogen exposure

obesity
nulliparity
late menopause
exogenous estrogen use without progesterone

anovulation
PCOS
estrogen tumors
HTN
DM
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25
Q

tx of endometrial hyperplasia

A

biopsies, 90-95% accuracy rate

progestin therapy, surgically for atupical complex hyperplasia

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26
Q

most common cyst in ovaries

A

functional cyst, follicular cysts

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27
Q

risk factor for functional cyst

A

smoking

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28
Q

sx for functional cyst

A

waxing and waning pain and nausea - torsed ovary from cyst

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29
Q

palpable ovary r adnexal mass in permenarchal o rpostmenopausal patient suggests…

A

ovarian neoplasm

tx: ex lap

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30
Q

most common sites for endometriosis

A

ovary, pelvic peritoneum

31
Q

incidence of endometriosis percent and population

A

10-15%, women of reproductive age

32
Q

sx of endometriosis

A

chronic cyclic pelvic pain, infertility, dysmenorrhea, dyspareunia, abnormal bleeding

33
Q

risk factors for endometriosis

A

first degree relatives, autoimmune associated

34
Q

dx of endometriosis

A

direct visualization with laparoscopy or laparotomy

35
Q

tx of endometriosis

A

medical: NSAIDS, oral contraceptives, progestins - pseudopregnancy
- pseudomenopause with danazol, or GnRH agonists
- side effects - acne, oily skin, weight gain, edema, hirsuitism, voice deepening

surgical: laparoscopy and fulguration, conservative leaving uterus and ovaries
- definitive management is TAH and BSO

36
Q

adenomyosis - defn

A

extension of endometrial tissue into uterine myometrium

  • enlarges and becomes globular due to hypertrophy an dhyperplasia adjacent to ectopic endometrial tissue
  • not responsive to OCPs/ hormones
37
Q

incidence of adenomyosis

A

15%, women in 30s or 40s parous

38
Q

sx and phys exam of adenomyosis

A

asymptomatic, secondary dysmenorrhea, menorrhagia

phys exam: diffusely enlarged globular uterus

39
Q

adenomyosis - dx

A

MRI most accurate imaging tool

40
Q

adenomyosis - tx

A

definitive treatment is hysterectomy with endometrial biopsy to rule out concomitant hyperplasia or carcinoma before a hysterectomy

41
Q

most common cause of vulvitis

A

candidiasis

42
Q

screening for syphilis

A

VDRL and RPR

43
Q

tx of syphilis

A

penicillin G, desensitization

alt: tetracylcine, doxy, ceftriazone, azithromycin
neurosyph: PCN

44
Q

jarisch herzheimer reaction

A

acute febrile reaction accompanied by fever, chills, headache, myalgia, malaise, pharyngitis, rash

45
Q

dx for HSV

A

tzanck smear, viral cultures

46
Q

tx of HSV

A

primary infx: acyclovir, famciclyovir, valacyclovir

47
Q

tx of chancroid

A

ceftriaxone, azithromycin, cipro, erythromycin

48
Q

tx of LGV (chlamydia)

A

doxy or erythro

49
Q

dx of HPV

A

clinically, raised wart with papillomatous or spiked surface

50
Q

strains that cause cervical CA

A

16, 18 31

51
Q

strains that cause condyloma acuminata

A

6 and 11

52
Q

tx of HPV

A

removal

53
Q

tx of scabies and pediculosis

A

permethrin cream rinse

54
Q

bacterial vaginosis - cause, dx, and tx

A

gardnerella vaginalis, multiple sex partners, douching, cigarette smoking

dx: whiff test, presence of clue cells
tx: metronidazole or clinda

55
Q

dx of candidiasis

A

KOH preparation

56
Q

tx of candidiasis

A

azoles, nystatin

57
Q

sx of trichomonas

A

erythematous, punctate, epitheliail papillae or strawberry cervix

58
Q

tx of trichomonas

A

metronidazole

59
Q

cause of cervicitis

A

gonorrhea and chlamydia

60
Q

tx of gonorrhea

A

ceftriazone and tx for chlamydia with azithromycin or amox or doxy

61
Q

tx of chlamydia

A

azithromycin or amox or doxy and cetriaxone for tx of gonorrhea

62
Q

tx of endometritis

A

clinda IV and gent

63
Q

cause of endometritis

A

D&C/ D&E / IUD placement / c section

64
Q

incidence of PID is highest in which age groups

A

15-25 y/o

65
Q

sx of PID

A

CMT, uterine tenderness, adnexal tenderness with fever, mucopurulent discharge, WBC, elevated ESR, elevated CRP

66
Q

fitzhugh curtis syndrome

A

complication of PID where it causes a perihepatitis from ascending infection cuasing RUQ pain and tenderness with LFT elevation

67
Q

tx of PID

A

cefoxitin plus doxy inpatient

ceftriaxone with doxy outpatient

68
Q

diagnostic test for tuboovarian abscess

A

culdocentesis; ultrasound

69
Q

tx of TOA

A

amp, gent, clinda or metronidazole until fever goes down than PO abx

if resistant to abx then surgical intervention necessary

70
Q

TSS sx and cause

A

high fever, hypotension, rash, desquamation of palms and soles, GI problems, myaogias, increased BUN/ creatinine

  • caused by exotoxin TSST1 from staph aureus
71
Q

TSS tx

A

clinda plus vanc or linezolid - MRSA

clinda plus naf or oxa - MSSA

72
Q

dx of HIV

A

ELISA assay and confirmed with western blot

73
Q

tx of pregnant female with HIV

A

zidovudine administered during pregnancy and labor and to the newborn reduces risk

  • c section

OB/GYN (3 decks)

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