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#DAY4_OBSTETRICS/GYNECOLOGY > Cervix, Uterus, Ovaries, Vagina > Flashcards

Cervix, Uterus, Ovaries, Vagina Flashcards

1
Q

When to start pap smear

A

Within 3 years of onset of sexual activity At 21 years old

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2
Q

How often does a woman need to undergo pap smear?

A
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3
Q

When to discontinue pap smear?

A

65-70 years old provided that negative for 3 consecutive years No abnormal results for the past 10 years, no new sexual partner Post hysterectomy

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4
Q

Management of CIN 1 biopsy result

A
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5
Q

Evaluation for squamous cell abnormalities in Pap smear

A

Colposcopy

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6
Q

Management of CIN 2,3 biopsy result

A

Colposcopy, excision or ablation of transformation zone

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7
Q

2nd most common cancer among women

A

Cervical

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8
Q

Necessary cause of cervical cancer

A

HPV

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9
Q

Most common type of cervical cancer

A

Squamous cell CA

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10
Q

Squamous cell CA of the cervix arises from what structure

A

Ectocervix

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11
Q

Most common symptom in cervical cancer

A

Vaginal bleeding

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12
Q

Cervical cancer stage where lower 1/3 of the vagina is affected

A

Stage 3

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13
Q

Cervical cancer stage where it extends beyond the cervix but not pelvic wall or lower third of vagina

A

Stage 2

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14
Q

Cervical cancer stage where there is bladder or rectal invasion

A

Stage 4

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15
Q

First line combination chemotherapy for cervical cancer

A

Cisplatin Paclitaxel

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16
Q

Single agent chemotherapy for cervical cancer

A

Cisplatin

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17
Q

Treatment for stage 1 cervical cancer if not desirous of pregnancy

A

Hysterectomy

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18
Q

Treatment of cervical cancer from stage 2 onwards

A

Chemotherapy

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19
Q

MANAGEMENT FOR PREMENOPAUSAL WOMEN: Hyperplasia WITH atypia

A
  • If desirous of pregnancy
  1. Continuous MPA 10-20mg OD x 3 months
  2. Megestrol acetate 40-200mg OD
  3. DMPA 150mg every 3 months
  4. LNG-IUS for 1-5 years
  • Do UTS & sample endometrium after 3 mos:
    • Normal: decrease MPA 10mg OD x 14 days for 12 more months
    • Persistent: increase MPA to 40-100mg daily for 3 months, OR shift to Megestrol acetate 40mg 2-4x a day for 3 months then repeat biopsy, if persistent: EH +/- BSO
  • No desire for pregnancy: EH +/- BSO
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20
Q

MANAGEMENT FOR PREMENOPAUSAL WOMEN: Hyperplasia WITHOUT atypia

A
  • For simple hyperplasia: OCP x 6 cycles
  • MPA 10-20 mg OD x 14 days
  • Do UTS & sample endometrium after 3 mos:
    • Normal: MPA, 5mg x 10days/month for 12 months
    • Persistent: increase dose 40-100mg daily for 3 months, then repeat biopsy
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21
Q

MANAGEMENT FOR POSTMENOPAUSAL WOMEN: Endometrial Hyperplasia WITHOUT atypia

A
  • If desirous for uterine preservation, of if poor surgical risk, same as in premenopausal
  • If not desirous of uterine preservation, EHBSO
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22
Q

Treatment for endometrial hyperplasia with atypia for postmenopausal

A

EHBSO

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23
Q

Most common type of endometrial CA

A

Adenocarcinoma

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24
Q

Stage of endometrial cancer reaching the cervix

A

Stage 2

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25
Q

Stage of endometrial cancer outside the uterus

A

Stage 3

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26
Q

Stage of endometrial cancer reaching the bladder

A

Stage 4

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27
Q

Treatment for endometrial cancer

A

EHBSO Chemotherapy if stage 3

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28
Q

Most popular theory for endometriosis

A

Retrograde menstruation

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29
Q

Classic symptoms of endometriosis

A

Cyclic pelvic pain and infertility

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30
Q

Classic PE finding in endometriosis

A

Fixed retroverted uterus with scarring and tenderness posteriorly

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31
Q

Definitive treatment for endometriosis

A

Hysterectomy

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32
Q

Medical treatment for endometriosis to induce pseudomenopause

A

Danazol-atrophic changes to implants GnRH agonists like leuprolide OCP, NSAID Aromatase inhibitors like letrozole

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33
Q

Size of the ovaries that may suggest malignancy

A

>8cm

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34
Q

Most common cause of simple cystic adnexal mass in the reproductive age

A

Functional cyst

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35
Q

Most common cause of complex adnexal mass

A

Benign cystic teratoma

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36
Q

Most common cause of pelvic mass

A

Pregnancy

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37
Q

This type of ovarian cyst can rupture and cause intraperitoneal bleeding

A

Corpus luteum cyst

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38
Q

This ovarian cyst can cause adnexal torsion and massive bleeding

A

Theca lutein cyst

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39
Q

Halban triad in a corpus luteum cyst

A

Spotting with delayed menses Unilateral pelvic pain Small, tender adnexal mass

40
Q

Functional ovarian cyst that is usually more than 10cm in size, due to prolonged stimulation by HCG, honeycomb appearance and tends to be bilateral

A

Theca lutein

41
Q

Most frequent ovarian epithelial tumor

A

Serous cystadenoma

42
Q

Transitional cell tumor that has similar lining to the urinary bladder Coffee bean appearing nucleus

A

Brenner tumor

43
Q

Most common neoplasm in prepubertal female

A

Benign cystic teratoma

44
Q

Most common benign solid tumor of the ovary Whorled pattern on cross section

45
Q

Triad of: Ovarian fibroma Ascites Hydrothorax

A

Meig syndrome

46
Q

Tumor markers for epithelial ovarian tumors

A

CA 125, CEA

47
Q

Tumor markers for germ cell ovarian tumors

A

AFP LDH HCG

48
Q

Tumor markers for sex cord ovarian tumors

A

Estrogen Testosterone

49
Q

Stage of ovarian cancer where it spread to the fallopian tube

50
Q

Stage of ovarian cancer where it spread to the pelvis

51
Q

Stage of ovarian cancer where it spread to the peritoneal surface

52
Q

Epithelial ovarian tumor that is associated with DES exposure

A

Clear cell

53
Q

These are cells in clear cell ovarian tumor where the cells contain abundant glycogen

A

Hobnail cells

54
Q

Chemotherapy for epithelial ovarian cancer

A

Paclitaxel + carboplatin

55
Q

Most common ovarian malignancy in women <30 years old

A

Germ cell tumor

56
Q

Tumor marker for dysgerminoma

57
Q

Tumor marker for endodermal sinus/ yolk sac tumor

58
Q

Schiller Duval bodies

A

Yolk sac tumor

59
Q

Tumor marker for immature teratoma

60
Q

Chemotherapy for germ cell and sex cord tumors

A

BEC VAC Bleomycin Etoposide Cisplatin Vincristine Actinomycin Cyclophosphamide

61
Q

Call Exner bodies

A

Granulosa cell tumor

62
Q

Nipple projections in dermoids

A

Tubercle of rokitansky

63
Q

Ovarian tumor that Presents as virilization

A

Sertoli leydig

64
Q

Ovarian tumor with numerous hyaline droplets

65
Q

Presence of thyroid tissue in the ovary

A

Struma ovarii

66
Q

Analogous to seminoma in males

A

Dysgerminoma

67
Q

Ovarian tumor that presents as vaginal bleeding in adults

A

Granulosa theca cell tumor

68
Q

Most common MALIGNANT tumor in patients less than 30 years old

A

Dysgerminoma

69
Q

Eosinophilic bodies surrounded by granulosa cells ovarian tumor

A

Granulosa theca tumor

70
Q

Epithelial vulvar lesions that result from reactive changes to chronic scratching and rubbing

A

Lichen simplex chronicus

71
Q

Multiple shiny flat purple papiles usually on inner aspect of the labia minora, vagina and vestibule Atrophic inflammatory condition usually seen in postmenopausal

A

Lichen planus

72
Q

Histology: Liquefaction degeneration at the basal layer Well defined band like infiltrate below the basal layer

A

Lichen planus

73
Q

Most common tumor found in the vulva

A

Epidermal inclusion cyst

74
Q

Benign cyst in the vulva due to occlusion of apocrine sweat glands

A

Hidradenitis suppurativa

75
Q

Obstruction cyst in the vulva at 4 and 8 o clock position, usually asymptomatic

A

Bartholin duct cyst

76
Q

Bartholin duct cysts must be biopsied in women this age to rule out carcinoma

A

40 years old

77
Q

Treatment for recurrent bartholin duct cyst

A

Marsupialization

78
Q

Paraurethral gland cyst is also called

A

Skene’s gland cyst

79
Q

Dysontogenic cyst that is a remnant of the mesonsphric duct, most commonly found in the anterolateral aspect of the upper part of the vagina

A

Gartner’s duct cyst

80
Q

Most common benign solid tumor of the vulva

81
Q

Permanent epithelialized sac like projection in the anterior bahinal wall

A

Urethral diverticulum

82
Q

3 Ds of urethral diverticulum

A

Dysuria Dyspareunia Dribbling of urine

83
Q

Hyperplastic dystrophy of the vulva where there is elongation and widening of the rete ridges which may be confluent White, firm, cartilaginous lesions with hyperkeratotic changes

A

Squamous cell hyperplasia of the vulva

84
Q

Treatment for vulvar squamous cell hyperplasia

A

Topical steroids

85
Q

Rare intraepitheloal disorder in the vulva that is associated with adenocarcinoma Reddish eczematoid appearance

A

Paget disease of the vulva

86
Q

Most contagious of all STIs

A

Pediculosis Phthrius pubis

87
Q

Caused by pox virus Flesh colored dome shaped papules with umbilicated center

A

Molluscum contagiosum

88
Q

Treatment for chancroid

89
Q

Treatment for lymphogranuloma venereum

90
Q

Treatment for donovanosis

A

Doxycycline 100 mg BID

91
Q

Most common organisms involved in PID

A

Chlamydia trachomatis Neisseria gonorrhea

92
Q

Complication of PID where there are numerous adhesions

A

Fitz-Hugh-Curtis

93
Q

Treatment for Acute PID

A

Ceftriaxone 250mg IM single dose Plus doxycycline 100mg PO BID x 14 days Metronidazole 500mg PO BID x 14 days

94
Q

Anti retro viral therapy for pregnant women

A

Tenofovir Lamivudine Efavirenz

95
Q

CERVICAL CYTOLOGY

  • Most common squamous abnormality
  • Few cells may show features associated with squamous intraepithelial lesions, but there are few of these cells present or the changes are not consistent with a more precise diagnosis
96
Q

Management of cervical cytologic abnormalities

#DAY4_OBSTETRICS/GYNECOLOGY (22 decks)

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