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Fiser's ABSITE Review > Chapter 40 - Gynecology > Flashcards

Chapter 40 - Gynecology Flashcards

1
Q

What does the round ligament do?

A

Allows for anteversion of the uterus

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2
Q

What does the broad ligament contain?

A

Uterine vessels

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3
Q

What does the infundibular ligament contain?

A

Ovarian artery, nerve, vein

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4
Q

What does the cardinal ligament do?

A

Holds cervix and fun box

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5
Q

When can you see pregnancy on ultrasound?

A

Six weeks

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6
Q

With what beta hCG is a fetal pole seen?

A

6000

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7
Q

At what hCG is a gestational sac seen?

A

1500

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8
Q

What is a missed abortion?

A

First trimester bleeding, closed os positive second ultrasound, no heartbeat

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9
Q

What is a threatened abortion?

A

First trimester bleeding, positive heartbeat

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10
Q

What is a incomplete abortion

A

Tissue protrudes through os

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11
Q

What is an ectopic pregnancy?

A

Acute abdominal pain; positive beta hCG, negative ultrasound for sac; missed period, Vaginal bleeding, hypotension

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12
Q

What are risk factors for ectopic pregnancy?

A

Previous tubal manipulation, PID, previous ectopic pregnancy. Shock and hemorrhage can occur from the ectopic pregnancy

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13
Q

What are the symptoms of endometriosis and how is it diagnosed?

A

Dysmenorrhea, infertility, despareuinia Laparoscopy shows blue mass

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14
Q

What are the symptoms of pelvic inflammatory disease?

A

Pain, nausea, vomiting, fever, vaginal discharge. Most commonly occurs in the first half of the menstrual cycle
Risk factors include whoring it up
Cervical motion tenderness, cervical cultures, Gram stain

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15
Q

What is mittelschmerz?

A

Rupture of graafian follicle. Causes pain that can be confused with appendicitis. Occurs 14 days after first day of menses

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16
Q

What is the number one type of vaginal cancer?

A

Squamous cell carcinoma. DES can cause clear cell carcinoma

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17
Q

What is botryoides?

A

Rhabdomyosarcoma of the vagina that occurs in young girls

Xrt

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18
Q

What are risk factors for vulvar cancer?

A

Old, fat, nulliparous
TX: less than 2 cm wide local excision and ipsilateral inguinal node dissection. Greater than 2 cm vulvectomy with bilateral inguinal dissection, postop XRT

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19
Q

What is the leading cause of gynecologic death?

A

Ovarian cancer. Decreased risk with OCP’s and bilateral tubal ligation. Increased risk with nulliparity, late menopause, early monarchy

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20
Q

What are the types of ovarian cancer?

A

Teratoma, granulosa theca, Sertoli leydig storms ovarii, choriocarcinoma, mucinous, serous papillary

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21
Q

What type of ovarian cancer has the worse prognosis?

A

Clear-cell

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22
Q

What stage ovarian cancer is bilateral ovaries?

A

One

23
Q

What is the most common initial site of regional spread of ovarian cancer?

A

The other ovary

24
Q

What is the treatment for ovarian carcinoma?

A

Total abdominal hysterectomy and bilateral oophorectomy for all stages. Pelvic and a para aortic lymph node dissection. Omentectomy, four quadrant washes

25
Q

What is the chemotherapy for ovarian cancer?

A

Cisplatin and paclitaxel

26
Q

What is the stomach cancer that has metastasized to ovary? What is shown on pathology?

A

Krukenberg tumor. Pathology shows signet rings

27
Q

What is meige’s syndrome?

A

Pelvic ovarian fibroma that causes ascites and hydrothorax

28
Q

What is the most common malignant tumor in female genital tract?

A

Endometrial cancer

29
Q

What are the risk factors for endometrial cancer?

A

Nulliparity, late first pregnancy, obesity, tamoxifen, unopposed estrogen

30
Q

What is vaginal bleeding in postmenopausal woman until proven otherwise?

A

Endometrial cancer

31
Q

What subtypes of endometrial carcinoma have worse prognosis?

A

Serous and papillary

32
Q

What nodes does cervical cancer go to first?

A

Obturator nodes

33
Q

What types of HPV are associated with cervical cancer?

A

16 and 18

34
Q

What is the most common type of cervical cancer?

A

Squamous cell

35
Q

How do you cervical carcinoma?

A

Stage 1 and 2A-total abdominal hysterectomy. Stages 2-4 xrt

36
Q

Where the stages of cervical cancer?

A

One cervix
Two upper two thirds of vagina
Three pelvis, sidewall, lower one third of vagina, hydronephrosis
Four bladder and rectum

37
Q

What do you do with ovarian cysts in a post menopausal patient

A

If septated, has increased vascular flow on Doppler, has solid components, or has papillary projections-oophorectomy with intraoperative frozen sections; TAH if ovarian CA

38
Q

What do you do with ovarian cyst in a premenopausal patient?

A

If septated, has increased vascular flow on Doppler, has solid components, or has papillary projections-oophorectomy with intraoperative frozen sections

39
Q

What do you do with an incidental ovarian mass at the time of laparotomy for another procedure?

A

Postmenopausal-oophorectomy, frozen section, TAH and BSL if ovarian CA
Premenopausal patient-complicated

40
Q

What do you do with abnormal uterine bleeding in a patient under 40?

A

Usually from anovulation. Treat with Medroxyprogesterone. If leiomyomas-GnRH

41
Q

What do you do with abnormal uterine bleeding in a patient older than 40?

A

Usually from cancer or menopause-need biopsy

42
Q

What are contraindications to estrogen therapy

A

Endometrial cancer, active thromboembolic disease, Undiagnosed vaginal bleeding, breast cancer

43
Q

What can a uterine endometrial polyp present as?

A

Progressively heavier menses

44
Q

What is caused by uterine fibroids?

A

Recurrent abortions, infertility, bleeding

Under hormonal influence.

45
Q

What is the most common vaginal tumor?

A

Invasion from surrounding or distant structure

46
Q

Appendicitis with pregnancy causes what?

A

Increased risk of premature labor and fetal mortality

47
Q

What is a hydatidiform mole?

A

Malignancy risk with partial mole; complete mole is of paternal origin. Treat with methotrexate

48
Q

What do you get with toxic shock syndrome?

A

Fever, erythema, diffuse desquamation, nausea, vomiting. Associated with highly absorbent tampons (gag).

49
Q

What do you do with ovarian torsion?

A

Remove torsion and check for viability

50
Q

What do you do with adnexal torsion with vascular necrosis?

A

Adnexectomy

51
Q

What do you do with ruptured tubo-ovarian abscess?

A

Drainage

52
Q

How do you diagnose ovarian vein thrombosis?

A

CT scan. Treat with heparin

53
Q

What do you do with postpartum pelvic thrombophlebitis?

A

Heparin and antibiotics

Fiser's ABSITE Review (50 decks)

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