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Clin Med 2 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Irritative symptoms

A

Frequency
Nocturnia
Urgency
Urge incontinence

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2
Q

Obstructive symptoms

A 
Hesitancy
Weak stream
Small caliber stream
Intermittent urination
Straining to produce stream
Prolonged/ incomplete emptying
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3
Q

Varicocele general

A

Dilation of veins of pampiniform plexus

Left sided most common (if right need to work up for tumor or thrombus)

Bag of worms on exam

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4
Q

Varicocele associated with…

A

Infertility and testicular atrophy, but rarely discomfort

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5
Q

Spermatocele general

A

Retention cyst, holds cloudy fluid containing sperm

Above and posterior to the testes

US helpful

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6
Q

Hydrocele

A

Fluid collection in tunica vaginalis

Painless

Transilluminates

Infants- resolve
Adults- need surgery usually

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7
Q

Spontaneous decent rare after…

A

6-12 months

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8
Q

Cryptorchidism at higher risk of…

A

Testicular CA, 5x

Bilateral means infertility

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9
Q

Testicular cancer general

A

Most common solid tumor of young adult males, 15-35 years

Germ cell tumors

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10
Q

Testicular cancer presentation

A

Painless nodularity or enlargement
Dull ache or heaviness

10% asymptomatic
10% significant pain from hemorrhage
10% sx of metastatic d

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11
Q

Testicular torsion general

A

Usually prepubertal males

Two types: extra and intravaginal (more common)

Left testis more commonly affected

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12
Q

Intravaginal testicular torsion

A

Bell clapper deformity, malrotation within tunica vaginalis

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13
Q

Testicular torsion symptoms

A

Acute, severe pain, often during night or early am

Nausea/vomiting

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14
Q

Testicular torsion exam

A

Edema, induration or erythema

Tenderness

Elevated testes

Absent cremasteric reflex

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15
Q

De-torsion timing

A

<6 hours, 90% salvage
>12 hours, 50%
>24 hours, 10%

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16
Q

Torsion of testicular appendage

A

Remnant of mullerian and wolffian ducts, painful but no significant risk

Blue dot sign- paratesticular nodule on superior testicle is pathognomonic

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17
Q

Epididymitis

A

Usually infectious

Urethral discomfort
Scrotal swelling
Fever
Firm, tender epididymis

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18
Q

Orchitis

A

Testicular inflammation, usually infectious

Can see with UTI, prostatitis, mumps

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19
Q

Fournier’s gangrene

A

Necrotizing skin and soft tissue infection of scrotum and perineum

Preceded by scratching, shaving or mild insults

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20
Q

Fournier’s gangrene presentation

A

Abrupt onset of pain

Rapid spread to abdominal/gluteal muscles

Aggressive drainage/debridement and antibiotics needed

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21
Q

Hypospadias

A

Ventral opening of urethral meatus

Ventral curvature of penis

Genetic component with usually endocrine factor

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22
Q

Epispadias

A

Exposed or open dorsal urethra

Mild form of bladder exstrophy

Surgical care

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23
Q

Phimosis

A

Tightness of foreskin, prevents retraction of prepuce over glans

Usually resolves by 5 years

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24
Q

Paraphimosis

A

Foreskin trapped below glans

Leads to venous engorgement, ischmia, and even autoamputation

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25
Q

Balanitis

A

Inflammation or infection of glans

Candida in diabetes patients

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26
Q

Urethritis

A

Urethral inflammation

Usually STD, commonly chlamydia (1) or gonorrhea (2)

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27
Q

Signs/symptoms of urethritis

A

Dysuria

Pruritus, burning or discharge

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28
Q

Peyronie disease

A

Fibrotic disorder of tunica albuginea

Penile curvature and sexual dysfunction

5% of men over 50

Usually penile trauma

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29
Q

Acute cystitis

A

Acute infection of the bladder

Frequency/urgency/dysuria/suprapubic discomfort

Cloudy, malodorous urine or hematuria

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30
Q

Ph >7.5 suggests …

A

Urease production

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31
Q

Reflex to cx is helpful when…

A

Patient is sick, fails treatment, or has complicated disease

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32
Q

Daily abx help patients with how many UTI’s a year?

A

3+

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33
Q

Pyelonephritis

A

Upper UTI affecting renal pelvis and parenchyma

Usually ascending from cystitis

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34
Q

Presentation of pyelonephritis

A

Fever, shaking chills

May be septic

Flank pain/CVA tenderness

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35
Q

Acute bacterial prostatitis

A

Likely reflux of infected urine into prostatic ducts

Fever, perineal pain and irritative and/or obstructive sx

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36
Q

Exam in acute bacterial prostatitis

A

High fever

Warm, tender prostate

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37
Q

Chronic bacterial prostatitis

A

May evolve from acute

UA often normal

Diffficult to cure

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38
Q

Non bacterial prostatitis

A

Identical presentation to chronic prostatitis

Most common syndrome

Dx of exclusion

Rule out bladder cancer

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39
Q

Prostatodynia

A

Voiding and/or pelvic floor dysfunction in young to middle aged men

Mimics prostatitis but normal prostate

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40
Q

Interstitial cystitis

A

“Painful bladder syndrome”

Pain with bladder filling that is relieved with urination

Dx of exclusion

Females ~40

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41
Q

Interstitial cystitis workup

A

UA

Cystoscopy- fill bladder with saline and visualize with scope

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42
Q

Txt of interstitial cystitis

A

Amitriptyline

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43
Q

Unexplained hematuria…

A

In an older (esp male smoker) patient is bladder CA until proven otherwise

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44
Q

DIAPPERS

A 
Delirium 
Infection
Strophic urethritis or vaginitis
Pharmaceuticals
Psych factors
Excess urine output
Restricted mobility
Stool impaction
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45
Q

DIAPPERS is to assess..

A

Urinary incontinence

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46
Q

Urge incontinence

A

Uninhibited detrusor contraction leading to leakage

Leaking after sudden onset of intense urge to urinate

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47
Q

Stress incontinence

A

Common in older women

Instantaneous leakage of urine after stress or valsalva, usually only while away

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48
Q

Urethral obstruction

A

Common cause of male incontinence

Dribbling after voiding

Check post void residual!

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49
Q

Overflow incontinence

A

Uncommon

Underactive detrustor due to LMN dysfunction

Frequency, nocturia, frequent leakage of small amounts

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50
Q

BPH general

A

Most common benign tumor in men

50% genetics

Progressive urinary retention and other urinary sx

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51
Q

BPH on exam

A

Smooth, firm, elastic prostate

Need to do focused neuro exam

PSA can be tested

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52
Q

TURP

A

Transurethral resection of prostate

Risk of retrograde ejaculation in 75%, maybe ED

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53
Q

TULIP and TUNA

A

Laser or needle ablation of prostate

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54
Q

First line treatment for BPH

A

Medical therapy

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55
Q

Prostate cancer general

A

Most common non skin CA in men

> 40% of men over 50 have prostate cancer, it is slow growing and local

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56
Q

High risk groups for prostate CA

A

Black men
Family history
High dietary fat intake

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57
Q

Prostate cancer screening/diagnosis

A

PSA detects subclinical disease often

DRE shows induration

Voiding/obstructive symptoms

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58
Q

PSA levels that are concerning

A

4 is the cutoff for high

> 0.75 increase in PSA

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59
Q

Staging for prostate cancer

A

Gleason grading system

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60
Q

Kidney stones general

A

More common in men, 3rd and 4th decade

Warm, humid areas from dehydration

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61
Q

Kidney stone presentation

A 
Severe renal colic
Flank pain
CVA tenderness
Awaken from sleep
N/V
Pain shifts to lower abdomen

Writhing and can’t get comfortable, often hematuria

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62
Q

Stones what size can be passed spontaneously?

A

<5 mm

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63
Q

Most common stones?

A

Calcium oxalate

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64
Q

Struvite stones

A

Infection

Coffin lid crystals or staghorn calculi

Proteus, pseudomonas

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65
Q

First line kidney stone imaging

A

Spiral CT

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66
Q

Recurrence rate of kidney stones?

A

50% in 5 years if no medical management

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67
Q

Lifestyle modifications for kidney stones

A

Increase fluids, reduce salt

Pain meds and gentle fluids in acute episode

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68
Q

Ureteral stone treatments

A

Ureteroscopic stone extraction

Extracorporeal shock wave lithotripsy

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69
Q

Decreased libido with ED?

A

Androgen deficiency

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70
Q

Does patient have any normal erections, like during sleep/early am?

A

If yes, organic disease is unlikely

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71
Q

Ability to attain but not maintain an erection suggests…

A

Vascular issue

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72
Q

Medication trial for ED

A

Give PDE 5 and see if erection develops

If not, vasoactive injectable

If still none, vascular evaluation needed

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73
Q

ED treatment

A

Counseling for psych issues

Testosterone replacement therapy, PDE 5

Vasoactive therapy

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74
Q

Priapism general

A

Persistent erection of penis >4 hours

Ischemic (more common, emergency)

Nonischemic (rare, usually AV fistula)

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75
Q

Priapism common causes

A

Sickle cell disease (kids)

ED drugs (adults)

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76
Q

Priapism workup

A

Cavernosal blood gas analysis- black if ischemic, normal if non ischemic

Rule out heme abnormalities

US

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77
Q

Less that 4 hours traetment of priapism

A

Intervacernous phenylephrine to contract smooth muscle and decrease blood volume

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78
Q

More than 4 hours txt of priapism

A

Phenylephrine and aspiration

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79
Q

Male factors of infertility

A

Decreased sperm production or function

Obstruction of male GU tract

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80
Q

Male infertility workup

A

Semen analysis on 2 separate occasions (2-3 days of abstinence)

Usually 1.5-5 mL volume

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81
Q

Oligozoospermia

A

<15 M sperm/mL

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82
Q

Azoospermia

A

No sperm

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83
Q

Spermatogenesis takes…

A

70 days

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84
Q

Increased FSH and LH but decreased testosterone…

A

Primary testicular failure

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85
Q

Decreased FSH LH and testosterone…

A

Secondary testicular failure

Problem in hypothalamus or pituitary

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86
Q

Vulva

A

Area immediately external to vagina

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87
Q

Lichen sclerosis

A

Benign, chronic progressive derm condition with:

Marked inflammation
Epithelial thinning
Pruritus and pain

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88
Q

Lichen sclerosis referred to as…

A

Onion skin epithelium or cigarette paper skin

Loss of normal anatomical landmarks and stenosis of vaginal introitus

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89
Q

Lichen simplex chronicus

A

Itch that rashes

Develops after scratching/rubbing from irritant dermatitis

Repetitive trauma causing epidermal thickening, inflammatory cells, heightened sensitivity, more irritation

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90
Q

Lichen simplex chronicus signs/symptom

A

Vulvar pruritus or burning, relieved by scratching or rubbing

Reddened areas with hyperplasia or hyperpigmented plaques

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91
Q

Lichen planus general and symptoms

A

Inflammatory derm condition that is likely autoimmune

Chronic vulvar burning/pruritus
Insertional dyspareunia
Profuse vaginal discharge

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92
Q

Lichen planus signs

A

Whitish, lacy bands *wickham striae

Reddened ulceratedlesions

Patchy

Vaginal discharge with inflammatory cells

93
Q

Psoriasis

A

Itching, look for other lesions

Auspitz sign

UV light and steroids

94
Q

Seborrheic dermatitis

A

Chronic inflammation of sebaceous glands

Vulvar pruritus

Pale red to yellowish pink lesions with oily appearing or scaly crust

95
Q

Seborrheic dermatitis treatment

A

5% solution of. Aluminum acetate

96
Q

Bartholins gland cyst/abscess

A

Duct becomes obstructed and mucous acumulates causing a cyst

Becomes infected forming an abscess

97
Q

Bartholin’s abscess

A

Abscess is warm, tender, fluctuant, maybe lymphangitis

I&D, maybe antibiotics

98
Q

Vulvar vestibulitis

A

Inflammation of vestibular glands, between 4 and 8 o clock

Suspect in all patients with new onset insertional dyspareunia

99
Q

Vulvar vestibulitis exam

A

Light touch with cotton applicator recreates the pain

May see small reddened patchy areas

100
Q

Normal vaginal pH

A

4-4.5

101
Q

Physiological leukorrhea

A

White or transparent, thick or thin, mostly odorless

102
Q

If elevated vaginal ph, suggests…

A

BV or trich

103
Q

KOH

A

Whiff test

Helps visualize hyphae and budding yeast

104
Q

Bacterial vaginosis general

A

Most common cause of vaginal d/c in women of childbearing age

Overgrowth of vaginal anaerobes or other organisms

105
Q

Risk factors of BV

A

Sexual activity
Multiple/new sexual partner
Douching
Cigarette smoking

106
Q

Consequences of BV

A

Preterm delivery
Risk for STDs
Factor in developing precancerous cervical lesions

107
Q

BV presentation

A

50-75% asymptomatic

Vaginal discharge and odor, offwhite and thin
Odor is unpleasant and fishy

108
Q

Amstel criteria

A

For diagnosing BV

Homogenous, white d/c coating vaginal walls
Clue cells on microscopy
Vaginal pH >4.5
Positive whiff test

109
Q

Vulvovaginal candidiasis general

A

Vulvovaginal inflammation in presence of candida (usually albicans)

2nd most common cause of vaginitis

Recurrent (>4) think diabetes

110
Q

Vulvovaginal candidiasis clinically

A

Pruritus
Burning, soreness, irritation
Worse. During week prior to menses

Erythema and edema
Excoriation or fissures
White, thick and adherent and clumpy white discharge

111
Q

Trich general

A

Anaerobic protozoan parasite

From sexual contact

5-28 day incubation period

112
Q

Male trich symptoms

A

Itching, irritation
Burning after urination or ejaculation
Discharge
Dyspareunia

113
Q

Female trich symptoms

A

Itching, burning, redness, soreness
Frothy yellow green malodorous discharge
Dyspareunia

114
Q

70% asymptomatic in…

A

Trich

115
Q

PE for trich in female

A

Strawberry cervix

116
Q

Gonorrhea infection general

A

Gram negative diplococcus

Urethritis and cervicitis

2-8 day incubation

117
Q

Gonorrhea presentation

A

Pain, frequency and urgency

Purulent vaginal or urethral discharge

Imtermenstrual bleeding

Dyspareunia

Lower abdominal pain

118
Q

Diagnosing gonorrhea

A

Culture is the gold standard

NAAT from first morning urine

Gram stain of gram neg diplococci

119
Q

Chlamydia genearl

A

Intracellular parasites

7-21 incubation

Could be eye, GU tract, respiratory

120
Q

Chlamydia trachomatis general

A

Most common cause of sexually transmitted disease in US, leading cause of infertility in females

121
Q

Chlamydia presentation

A

Asymptomatic

Mucopurulent urethral or cervical discharge

Post coital and intermenstrual bleeding

Very similar to gonorrhea

122
Q

Swab site infection of NAAT for chlamydia

A

Women- vaginal swab

Men- first catch urine

123
Q

PID

A

Acute infection and inflammation of upper genital tract structures in women

124
Q

PID clinically

A

Fever
NV
Severe pain
Even sepsis

Lower abdominal pain, accentuated by motion, exercise or coitus

Vaginal discharge or irregular bleeding

125
Q

PID on exam

A

Lower abdominal tenderness
Rebound tenderness or decreased bowel sounds

CMT, vaginal discharge

126
Q

Complications of PID

A 
Ectopic pregnancy
Chronic pelvic pain
Infertility
TOA
Fits Hugh Curtis syndrome (violin strings, adhesions)
127
Q

Unintended pregnancy percentage?

A

45% in the US

128
Q

Lifespan of sperm in vaginal tract

A

No more than 5 days

129
Q

Lifespan of ovum after ovulation

A

24 hours

130
Q

Fertile window

A

5 days before ovulation to 24 hours after, so no more than 6 days per cycle

131
Q

Highest probability of pregnancy occurs…

A

2 days before ovulation

132
Q

Signs of ovulation with mucus

A

Abundant, clear stretchy vaginal secretions

Beginning of the fertile phase

133
Q

Signs of ovulation from temp

A

Temp elevation of .5-1

3 days of higher temps and 6 days of lower temps, indicated end of fertile phase

134
Q

Standard days method

A

Ideal for cycles between 26-32 days

Avoid unprotected intercourse from day 8-day 19 of cycle

135
Q

Cervical mucus or ovulation method

A 
Avoid unprotected sex:
During menses
Preovulatory days 
All days with mucus changes
Until 4 days past last day with secretions
136
Q

Twoday method

A

Avoid unprotected sex on all days with secretions and on the first day without

137
Q

Fertility after childbirth

A

Mean day of first ovulation ranges from 45-94 days, but can be as early as 25

*first ovulation occurs before first menses

138
Q

Abstinence until how many weeks post partum?

A

6

139
Q

What barrier contraceptives require prescription?

A

Diaphragm and cervical caps

140
Q

What condoms protect against HIV?

A

Only latex

141
Q

Spermicide

A

Nonoxynol-9

1 hour max effectiveness, insert 10-30 min prior to sex

142
Q

Diaphragm can be left in place for…

A

Up to 24 hours

143
Q

Cervical cap can be left in place up to…

A

48 hours

144
Q

Which barrier needs fitting?

A

The diaphragm

145
Q

Progestin releasing IUD

A

Thicken cervical mucus
Keeps endometrium thin
Inhibits sperm binding to egg
Inhibits ovulation partially

146
Q

Insertion of IUD’s

A

Best during menses

Proper technique is crucial, screen STI’s before

147
Q

Progestin implant

A

3 years of contraception

Can cause irregular bleeding

148
Q

Which sterilization procedure is better?

A

Vasectomy!

Cheaper, easier, more effective, more easily reversed, shorter recovery time

149
Q

Vasectomy follow up

A

Confirm sterility, 80% azoospermic after 3 months and 20 ejacultions

150
Q

Sterility failure

A

Mobile sperm present in 2 samples 1 month apart

151
Q

Which female sterilization is imediate?

A

Laparoscopic

152
Q

Hysteroscopy

A

Transcervical approach, placement of device into Fallopian tube lumen

153
Q

Breast development depends on…

A

Estrogen

154
Q

In pregnancy…

A

Increase in estrogen and progesterone from. Corpus luteum/placenta

155
Q

Estrogen suppresses…

A

Lactation

156
Q

Mastitis

A

Infection or inflammation of breast

Rupture of ducts

Often cracked skin around nipple from breastfeeding

157
Q

Fibrocystic breast changes

A

Most common lesion of breast

30-50 year old females

158
Q

Fibrocystic breast changes presentation

A

Asymptomatic

Painful, often premenstrual

Rapid fluctuations and multiple lesions are common

159
Q

Fibrocystic breast changes treatment/prevention

A

Avoid trauma

Supportive bra

HRT

Oil of evening primrose

Monthly post mentrual self exams because need to maintain suspicion of breast cancer

160
Q

Fibroadenoma

A

<35 years old

Asymptomatic, round rubbery discrete and movable, nontender

Clinical dx usually

161
Q

Phyllodes tumor

A

Looks like fibroadenoma, but rapidly enlarges

Can be cancer, needs to be excised

162
Q

Fat necrosis

A

May arise within lipoma

Rare, but tough to distinguish from cancer

Usually trauma

163
Q

Intraductal papilloma

A

Papillary cells grow out of a cyst wall into the lumen

Can harbor areas of ductal CA in situ

164
Q

Solitary intraductal papilloma

A

Excision!

165
Q

Multiple intraductal papilloma

A

Excision with or without hormone therapy

166
Q

Mammary duct ectasia

A

Distension of ductal structures with inflammation and fibrosis

Sticky discharge, infection common

Generally resolve, may need excision

167
Q

Plugged ducts

A

Common problem of lactation, firm and tender areas of the breast

Warm compresses, manual massage help

168
Q

Galactocele

A

Milk retention cyst usually due to obstructed duct

After end of breast feeding

Soft, cystic mass with milk aspirated

169
Q

Breast cancer epidemiology

A

Main cause of death in women 20-59

2nd most common cause of cancer death

170
Q

Breast cancer risk factors

A

75% of cases in women >50 years

Family hx important, 20% of cases

171
Q

Positive BRCA genes

A

50-85% risk of developing breast cancer if positive, and 15-40% risk of ovarian cancer

Increased risk of prostate cancer in men

172
Q

Clinical manifestations of breast cancer

A

Mass
Asymmetrical thickening
Nipple discharge
Skin/nipple changes

Noncyclic breast pain

173
Q

Breast cancer diagnosis

A

Pathologic analysis needed, core or fine needle aspiration/bx

Always image the other breast

174
Q

Mets from breast cancer

A

Lung
Liver
Bone

175
Q

Triple negative breast cancer

A

Poorer prognosis because no molecular targets to attack during treatment

176
Q

Paget’s dz

A

~1% of cases

Nipple changes with or without mass

Itching/burning, erosion or ulceration

Need to bx the bipple

177
Q

Inflammatory breast cancer

A

Most malignant but rare
Rapidly growing
Warmth, edema, erythema and maybe pain

Mets common

Chemo and XRT

178
Q

Breast cancer during lactation or pregnancy

A

Axillary mets common, 35% 5 year survival

Breast conserving surgery can be done while pregnant or lactating

179
Q

Male breast cancer

A

60 years

Hormonal and BRCA2 factors

Mets common at time of dx

180
Q

Hormone status of men’s breast cancer

A

Commonly ER+ in men

181
Q

Sentinel lymph node bx

A

Preservation of some axillary lymphatics

Radiotracer with dye injected near tumor, tracks to nodes to be excised

182
Q

Mammograms screening

A

All females 50-74

Discontinue at 70/75 or until 5-7 years life expectancy

Screen every 2 yeras

183
Q

Vulvar intraepithelial neoplasia

A

Mild dysplasia to carcinoma in situ, eventually tumor

~45 yeras old.

184
Q

Vulvar carcinoma

A

Average age of 65

185
Q

Cervical cancer is usually…

A

A squamous cell cancer

186
Q

HPV types with higher grade dysphasia

A

16, 18, 31

187
Q

Median age of cervical CA diagnosis

A

48

188
Q

Cervical cancer presentation

A

Postcoital spotting
Cervical ulceration
Blood/purulent discharge

189
Q

Age 21-29, Pap test every…

A

3 years

190
Q

> 30 Pap smear…

A

Every 5 years plus HPV testing

191
Q

Colposcopy and what solution to look at cervical cancer?

A

Acetic acid, dissolves mucus to cause aceto white areas

192
Q

Schiller test

A

Apply Lugol solution (iodine)

Normal squamous epithelium absorbs, non staining epithelium should be biopsied!

193
Q

Cervical cancer treatments that don’t preserve fertility

A

LEEP, conization of the cervix

194
Q

Fibroids

A

Most common benign tumor of female GU tract

Often several, abnormal or prolonged bleeding, pelvic pressure, infertility

Could be asymptomatic

195
Q

Endometrial cancer

A

Most common female pelvic cancer

Peak 50-70 years old

196
Q

Risk factor of endometrial cancer

A

Unopposed estrogen, promotes endometrial growth

197
Q

Ca 125 is helpful to predict..

A

Extrauterine spread

198
Q

Gestational trophoblastic disease labs and US

A

Markedly elevated hcG

Snowstorm appearance or honeycomb uterus

199
Q

Ovarian tumors

A

Usually benign

Asymptomatic unless larg or advanced

200
Q

Ovarian cancer weird findings

A

Bloating
Pelvic or abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (urgency, frequency)

201
Q

PMS risk factors

A

Obesity and smoking

202
Q

PMS first line traetment

A

NSAIDS

203
Q

PMDD

A

Recurrent depressive and anxiety symptoms enough to disrupt social and occupational function

204
Q

Gold standard treatment PMDD

A

SSRIs

205
Q

> 35, infertility is…

A

Inability after 6 months

206
Q

Fecundability

A

Achieve pregnancy in one menstrual cycle

207
Q

If mid luteal progesterone concentration is less than….

A

3, evaluation patient for causes of anovulation

208
Q

Laparoscopy is indicated in infertility workup if suspected…

A

Endometriosis or pelvic adhesions

209
Q

Primary vs secondary dysmenorrhea

A

Primary has pelvic pain without pathological physical findings, secondary has a pathology

210
Q

Primary dysmenorrhea etiology

A

Elevated prostaglandins, cramping and uterine ischemia

211
Q

Primary dysmenorrhea presentation

A

N/V, diarrhea, headache, fatigue

212
Q

Dysmenorrhea traetment

A

NSAIDs

213
Q

Chronic pelvic pain definition

A

At least 6 months of pain severe enough to cause functional disability

214
Q

Cornett sign

A

Sorts out muscular pain from visceral pain, having he patient do a crunch or straight leg raise to see if pain becomes worse

215
Q

Labs that everyone gets for abnormal uterine bleeding

A

HCG and CBC

216
Q

Uterosacral nodularity

A

Classic for endometriosis, but often not present

217
Q

Staging for endometriosis

A

Stage III and IV have adhesions, first two don’t

218
Q

Average menopausal age

A

50-52

219
Q

Primary amenorrhea definition

A

Never menstruated by 13 years without secondary sexual development

Age 15 no menses with secondary sexual development

220
Q

First thing to exclude in amenorrhea

A

Pregnancy

221
Q

Asherman’s syndrome

A

Scarring of the endometrium, most frequent anatomic cause of secondary amenorrhea

222
Q

Hirsuitism vs viriliztion

A

Hirsuitism is excess terminal hair in male distribution

Virilization is masculinization of a female because of increased testosterone

223
Q

Scale for virilization

A

Ferrima gallwey

224
Q

Most common cause of androgen excess in females

A

PCOS

225
Q

PCOS imaging

A

String of pearls

226
Q

Polymenorrhea

A

Frequent bleeding

227
Q

Menorrhagia

A

Prolonged or excessive bleeding at regular intervals

228
Q

Metrorrhagia

A

Bleeding between periods, irregular

229
Q

Menometorrhagia

A

Frequent bleeding that is excessive and irregular

Clin Med 2 (8 decks)

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