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Women's Health > DM 1 > Flashcards

DM 1 Flashcards

1
Q

indications for gnRH

A
  1. differentiate causes of hypogonadism

2. evaluate disorders of puberty

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2
Q

indications for FSH

A
  1. diagnose menopause (test of choice)

2. other menstrual irregularities

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3
Q

what type of collection is needed for FSH – 24h or single specimen?

A

24 hour (levels fluctuate during the day)

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4
Q

indications for LH

A

predicts ovulation, evaluate infertility

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5
Q

indications for progesterone

A

monitor ovulation induction, ectopic pregnancy evaluation, eval infertility, monitor placenta in high risk pregnancies

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6
Q

indications for estrogen

A

index of fetal well-being, evaluate sexual maturity/infertility/menopausal status, tumor marker,

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7
Q

indications for AMH

A

predict ovarian response to stimulation, determine ovarian reserve

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8
Q

indications for testosterone

A

evaluate ambiguous sex characteristics, precocious puberty, virilizing disorders

note: free testosterone is follow up for normal total T

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9
Q

progesterone withdrawal test indication

A

evaluate hypothalamic-pituitary-gonadal axis; secondary amenorrhea, etc

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10
Q

prolactin indications

A

investigate amenorrhea, evaluate cause of galactorrhea, monitor pituitary tumors, eval hypo-pituitary disorders

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11
Q

hCG indications

A

pregnancy

also eval ectopic, monitor after abortion, tumor marker

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12
Q

which is more sensitive: serum or urine hcG?

A

serum

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13
Q

what population is vaginal cancer suggested for?

A

s/p hysterectomy w h/o CIN (cervical intraepithelial neoplasia) 2, 3

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14
Q

what are low-risk HPV strains associated with?

A

condylomata genital warts and low-grade cervical changes (mild dysplasia)

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15
Q

what are high-risk HPV strains (in terms of #s) and what are they associated w?

A

6,11,16,18 + more

associated with intraepithelia neoplasia and are more likely to progress to severe lesions and cervical cancer

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16
Q

what is the length of HPV DNA screening intervals for pts 30-65?

A

5 years

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17
Q

where do you take the specimen source for PAP

A

squamocolumnar junction around the cervical os in nulliparous women

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18
Q

Bethesda system is used for reporting what?

A

cervical and vaginal cytologic diagnoses

19
Q

does the colposcopy evaluate the endocervix and ectocervix?

A

no - not the endocervix

20
Q

what is a contraindication for colposcopy?

A

menses

21
Q

indications for endocervical curettage

A
  1. suspected glandular lesions
  2. unsatisfactory colposcopy
  3. normal appearing ectocervix on colposcopy but pap indicates abnormal cytology
22
Q

contraindications for endocervical curettage

A
  1. pregnacy

2. acute cervicitis

23
Q

indications for direct conization

A
  1. colposcopy and endocervical curettage do not explain problem
  2. entire transformation zone is not seen
  3. lesion extends up in the cervical canal beyond colposcopic visualization
24
Q

indications of colposcopy

A
  1. eval of abnormal pap tests
  2. allows for biopsy of suspicious areas
  3. f/u of previously treated individuals
25
Q

indications for endometrial biopsy (8)

A

r/o endometrial cancer when:

  1. post-menopausal bleeding
  2. AUB ages 45-menopause (intermenstral, frequent, heavy) or <45 if obese, persistent bleeding, etc
  3. premenopausal women who are anovulatory with prolonged amenorrhea
  4. atypical glandular cells on Pap (also needs colposcopy)
  5. benign endometrial cell on pap if woman >40 and AUB
  6. surveillance of women w known endometrial hyperplasia
  7. eval of abnormal imaging
26
Q

contraindications of endometrial biopsy (3ish)

A
  1. pregnancy
  2. pelvic infection (treat 1st)
  3. refer: bleeding diathesis, cervical stenosis, cervical cancer
27
Q

MC side effect of endometrial biopsy

A

cramping

28
Q

do you need abx ppx for endometrial biopsy?

A

nope

29
Q

indications for D and C (3)

A
  1. irregular or heavy menstrual bleeding
  2. post menopausal bleeding (when EB is not adequate)
  3. incomplete or induced abortions
30
Q

what STI(s) is NAAT typically used for?

what are acceptable specimens?

A

primarily used for gonorrhea & chlamydia

cervical
vaginal
urine

31
Q

what STIs can you test for using serum?

A

HIV
syphilis
herpes
hepatitis

32
Q

what STIs are tested for with a vaginal wet prep

A

trich
bv
yeast

33
Q

is a wet prep vaginal or cervical?

A

vaginal

34
Q

testing for vulvovaginal candidiasis?

what will you see?

A

wet prep + KOH
budding yeast, mycelial tangles of yeast pseudohyphae
pH is normal (4-4.5)

35
Q

testing for BV? what will you see

A

wet prep + KOH

clue cells (fried egg with pepper appearance) and fishy odor

pH typically > 4.5

36
Q

2 main testing options for HSV I & II

A
  1. viral culture

2. PCR (molecular techniques)

37
Q

when is herpes serology IgG useful? (3)

A
  1. determining whether a pt has been previously exposed to type I and II
  2. distinguishing between type I and II
  3. determine susceptibility of a sexual partner of a pt w documented HSV infection
38
Q

indications for syphilis testing

A
  1. painless ulcer
  2. diffuse, symmetrical, macular or papular rash on trunk and extremities (palms and soles esp)
  3. neuro symptoms
39
Q

syphilis serology testing uses what kind of testing?

A

immunologic Ab tests:

  1. nontreponemal (detects Abs to reagin)
  2. treponemal (detects Abs against specific treponemal antigens)
40
Q

what’s an important thing to remember about the two syphilis serology tests?

A

must use BOTH (one alone is insufficient for diagnosis)

41
Q

when is gonorrhea culture preferred?

A

for detection of rectal, oropharyngeal, conjunctival

42
Q

4 methods for HIV testing

what is preferred?

A
  1. ABs to the virus
  2. viral antigen
  3. viral RNA
  4. culture

4th generation combination HIV-1/HIV-2 antigen-antibody immunoassay

43
Q

gold standard testing for trichomonas

A

NAAT

Women's Health (3 decks)

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