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OB/GYN > Cervix, Uterus, and Ovaries > Flashcards

Cervix, Uterus, and Ovaries Flashcards

1
Q

cervicitis with foamy, greenish discharge and strawberry cervix

A

caused by trichomoniasis

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2
Q

cervicitis with thin, gray discharge with fish smell

A

caused by bacterial vaginosis

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3
Q

cervicities with thick, creamy discharge

A

caused by neisseria gonorrhea

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4
Q

cervicitis with purulent pus like discharge

A

caused by chlamydia trachomatis

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5
Q

cervicitis with white/curd like discharge

A

candidiasis

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6
Q

patient presents with post coital bleeding, dysmenorrhea, dyspareunia, lower abdominal pain, back pain, urgency, frequency, dysuria, puriritis, and vulvular pain. Also has leukorrhea. What is in ddx?

A

cervicitis. ask about discharge if acute condition

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7
Q

problem with cervicitis is it is often asymptomatic. if left untreated, can potentially lead to..

A

PID, chronic pelvic pain, infertility, and ectopic pregnancy

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8
Q

atypical cells of undetermined significance

A

ASCUS cells- abnormal, but not enough to call dysplasia

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9
Q

CIN II of cervical dysplasia

A

abnormal cells in half thickness of cervix lining

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10
Q

CIN III of cervical dysplasia

A

abnormal cells in entire thickness of cervix lining, but has not spread below to surface layer

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11
Q

in what treatments of cervical dysplasia can depth of tx be controlled/not controlled?

A

controlled in laser tx, not controlled in cryotherapy

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12
Q

result of cryotherapy tx in cervical dysplasia

A

damaged cells will shed in heavy watery discharge for 1 month

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13
Q

which tx of cervical dysplasia has lowest recurrence rate?

A

hysterectomy

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14
Q

tx of cervical dysplasia

A

cryotherapy, laser, cone biopsy, LEEP, hysterectomy

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15
Q

F/U of cervical dysplasia

A

CIN I- cytology at 6 months and 12 months OR HPV DNA testing at 12 months. CIN II and III- cytology or colposcopy at 4-6 months x 2 years

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16
Q

cell type affected in cervical cancer

A

squamous cell- 85%. adenocarcinoma on the rise

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17
Q

how to differentiate cervicitis with cervical cancer via symptoms. both may have post coital bleeding, but

A

cervicities- pruritic, cervical cancer- non pruritic

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18
Q

dx of cervical cancer

A

papsmear- vaginal cytology, cervical biopsy or endocervical curettage or conization

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19
Q

prevention of cervical cancer

A

gardasil quadravalent (6/11/16/18) or cervix bivalent HPV vaccine (16/18)

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20
Q

patient presents with heavy, irregular vaginal bleeding and pelvic pressure and pain. US shows fibroid tumor causing enlarged uterus. What other tests to do you?

A

suspect leiomyoma- pregnany test, U/A, Hgb levels,

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21
Q

tx for leiomyoma

A

symptomatic- intermittent ocp or progestrin,, myomectomy, hysterectomy

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22
Q

if preggo with leimyoma, and fibroid tumor greater than 3 cm,

A

increased risk of preterm labor, placental abruption, pelvin pain, and c-section

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23
Q

when do leiomyoma grow and atrophy?

A

responsive to hormones- so rapid growth in estrogen phases (enlarges with menstrual cycle) and atrophies during menopause

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24
Q

leiomyoma tumor made of of…

A

CT and smooth muscle

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25
Q

noncancerous uterine thickening

A

adenomyoma

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26
Q

heavy bleeding and severe cramping with menstrual periods. dx?

A

maybe its menorrhagia or leiomyoma. do surgical excision- if endometrial tissue in thick uterine lining, consider adenomyoma

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27
Q

tx for adenomyoma

A

lupron or synarel, surgery good when confined to isolated area in muscle wall.

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28
Q

dx of adenomyoma

A

surgical excision- only proven way to truly diagnose

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29
Q

first line imaging test for females with abnormal uterine bleeding

A

transvaginal US

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30
Q

sx of cervical or uterine polyps

A

postcoital bleeding, intermenstrual bleeding, heavy periods, metrorrhagia, leukorrhea

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31
Q

how to diagnose cervical/uterine polyps

A

transvaginal US, microscopic examination, sonohysterography, hysteroscopy

32
Q

most cervical/uterine polyps originate from

A

endocervix

33
Q

tx of cervical/uterine polyps

A

excise/cut, leave in place and monitor, laser tx

34
Q

number 1 symptom in endometrial cancer

A

endometrial cancer

35
Q

most common diagnosed gynecological malignancy is united states

A

endometrial cancer

36
Q

female 60 years old with abnormal bleeding including post menopausal, pelvic pain and discomfort

A

suspect endometrial cancer. do biopsy

37
Q

strongest predictor of survival in endometrial cancer

A

stage 1 depth of myometrial invasion

38
Q

majority of endometrial cancers are what kind of cancers?

A

primary- adenocarcinoma

39
Q

endometrial cancer tx

A

total hysterectomy and bilateral salpingo-oophorectomy

40
Q

ovarian cancer- benign or malignant?

A

most benign, but when malignant, leading cause of death for reproductive tract

41
Q

abdominal pain and bloating, pelvin pain/pressure. no abnormal bleeding. what cancer would you suspect?

A

ovarian cancer

42
Q

markers in ovarian cancer

A

CA-125 helps distinguish between benign and malignant, hCG, lactate dehydrogenase, alpha fetoprotein

43
Q

ovarian cancer diagnosis

A

pelvic US and exam, markers, transvaginal US in high risk females

44
Q

you diagnose malignant ovarian cancer. what are tx options

A

total hysterectomy and bilateral salphingo-oopherectomy and lymphadenopathy plus post op chemo

45
Q

benign ovarian cancer tx

A

remove tumor, unilateral oopherectomy may be done

46
Q

patient presents with dyspepsia, bloating, bowel/bladder pressure, dyspareunia, severe acne, deep voice, hirsutism. how to diagnose?

A

suspect benign ovarian neoplasm- do a pelvic exam. transvaginal US to determine architecture of mass. CBC for WBC to r/o PID. beta-hCG check. UA, serum estrogens and androgens if PCOS workup, CA-125 if post menopausal to differentiate benign vs. malignant pelvic pass, alpha fetoprotein

47
Q

patient presents with painful, tender mass on bimanual exam. Pelvic US shows smooth, thin walled, unilocular cyst less than 10 cm. OCP’s will help prevent these from reoccuring. suspect..

A

follicular cyst

48
Q

US shows complex, grossly yellow, rough edged cyst in ovary

A

corpus luteum cysst

49
Q

which cyst can present like appendicitis

A

corpus luteum cyst

50
Q

labs in theca lutein cyst

A

chorionic gonadotropin elevated, US or PE reveal bilateral, clear straw colored fluid

51
Q

ectocervix vs. endocervix covered by …

A

ecto-stratified squamous epithelium. endo - columnar epithelium (mucous secreting)

52
Q

is endo or ectocervix hormone sensitive?

A

ectocervix

53
Q

ectocervix extends from…

A

squamocolumnar junction to vaginal fornices

54
Q

classifications of leiomyoma

A

intramural, intraligamentous, cervical, parasitic, submucous, subserous

55
Q

first line imaging study of choice for evaluation of women with abnormal uterine bleeding

A

transvaginal ultrasound

56
Q

soft red pedunculated protrusion from the cervical canal at external os, intermenstrual or postcoital bleeding, post douching, post menopause bleeding. . In age 25, nulliparous. previously on tamoxifen.

A

endometrial polyps (cervical or uterine polyp)

57
Q

how to diagnose endometrial polyp

A

transvaginal ultrasound, sonohysterography, hysterectomy

58
Q

most common diagnosed gynecologic malignancy in U.S.

A

endometrial cancer

59
Q

to confirm diagnosis of endometrial cancer-

A

endometrial tissue biopsy

60
Q

distinguish between type I and II endometrial cancer

A

I- estrogen dependent. Most of the cases. favorable prognosis. low grade nuclear atypia. II- estrogen INdependent- spontaneous, less well differentiated, worse prognosis than Type I

61
Q

most common type of endometrial carcinoma

A

adenocarcinoma

62
Q

approx 10% of endometrial cancers=

A

serous carcinomas

63
Q

endometrial cancer tx

A

TAH-bso, radiation for metastatic disease

64
Q

strongest predictor of survival in endometrial cancer

A

stage I depth of myometrial invasion

65
Q

leading cause of death for reproductive tract cancer

A

ovarian malignant tumors

66
Q

BRCA1 gene mutation. chance of ovarian cancer?

A

39% lifetime risk

67
Q

malignant ovarian tumor in premenopausal vs. postmenopausal-

A

25% postmenopause, 10% premenopause

68
Q

abnormal bleeding in ovarian cancer?

A

NO. vague GI symptoms, pelvic pressure and pain

69
Q

Is CA-125 used for screening in ovarian cancer?

A

No

70
Q

CA-125 sensitivity and specificity

A

distinguishes between benign and malignatn pelvic masses. is sensitive, but not very specific (also may be elevated in endometriosis)

71
Q

imaging in ovarian cancer

A

transvaginal ultrasound for high risk women

72
Q

benign ovarian neoplasm tx

A

tumor removal/unilateral oophorectomy

73
Q

malignant ovarian cancer tx

A

complete surgical staging plus abdominal hysterecomy and BSO with omenetomy and selective lymphadenectomy

74
Q

2 types of funcitonal ovarian cysts

A

follicular and corpus luteum

75
Q

most common functional cyst

A

follicular cyst

76
Q

what medication increases risk of ovarian cyst formation?

A

tamoxifen

77
Q

cystectomy/wedge resection for cyst indicated when:

A

premenopausal cysts more than 5 cm that persist more than 12 weeks, when mass is solid, mass is greater than 10 cm, postemenopausal cyst

OB/GYN (10 decks)

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