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Path 3 > Female genitalia/breasts > Flashcards

Female genitalia/breasts Flashcards

1
Q

Common malady; increased frequency w/ abx usage

Not always an STD (often an overgrowth of nromal flora or rxn to a product)

Most common infectious agents

A

Vulvovaginitis

  1. Candida albicans (most common cuase of vaginitis, esp after abx usage)
  2. Gardnerella vaginalis (overgrowth due to decreased lactobacillus, increased pH – CLUE CELLS)

[Screen/tx for STDs based on pt hx]

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2
Q

Ssx of candidia vaginal infxn?

A

itching, dryness, whitish d/c

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3
Q

Ssx of gardnerella (BV)?

A

burning snesation, fishy d/c, CLUE CELLS

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4
Q

Ascending lower genital infxn…

Cervicitis -> endometritis -> salpingitis

A

PID (associated w/ STDS)

Fallopian tubes are particularly vulnerable to develop tubo-ovarian abscess (leading to scarring and increased risk of infertility/ectopic pregancy)

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5
Q

Clincal features of PID?

A

sever abd pn, fever, nausea, (vag bleeding/dc may be present)

HALLMARK = cervical motion tenderness (CMT)

Tx = high dose broad spectrum abx (may be inpatient)

(once cervicitis beings, infxn is presumed to be at least as high as uterus)

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6
Q
  1. Menorrhagia
  2. Metrorrhagia
  3. Metromenorrhagia
  4. Dysmenorrhea
A
  1. profuse/heavy/prolonged bleeding
  2. irregularly timed menstrual bleeding
  3. irregular heavy menses
  4. painful menses
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7
Q

Two main causes of excessive/irregular bleeding?

A

Failure of ovulation and luteal phase

Contraception induced bleeding

(often temporary and self corects)

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8
Q

Aka fibroids

Benign tumor of uterine smooth appearing during reproductive years (more common in black females)

Large tumors can cause endometrial bleeding/dysmenorrhea

A

Leiomyomas

(compression of bladder/rectum = urinary ssx/constipation)

[tx = myomectomy/hysterectomy]

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9
Q

Rare cancer in myometrium

DOES NOT ARISE FROM LEIOMYOMA

A

leiomyosarcoma

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10
Q

Frequently causes infertility (but does not progress to CA)

Ectopic uterine lining

Tissue is still responsive to menstrual cycle

A

endometriosis

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11
Q

Endometriosis clinical features?

A

dysmenorrhea/pelvic pn

Urinary/bowel ssx w/ menses

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12
Q

Ovaries bilaterally enlarged

High LH, low FSH

Excessive androgen production (-> hirsutism)

Insulin dysfxn (obesity)

A

PCOS

(may be anovulatory/infertile OR present w/ oligomenorrhea)

Tx = complex mgmt of hormones

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13
Q

Implantation of fertilized ovum outside the uterus (embryo may grow to wk 12 then erode through fallopian wall)

increased risk w/ PID, tubal surgery

Ssx?

A

Ectopic pregnancy…

Ssx = pelvic pn, frank hemorrhage -> shock

**ALWAYS CHECK HCG in pts w/ pelvic pn

(US for ectopic location)

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14
Q

interruption of pregnancy before fetal viability

No identifiable cause …

Complete vs incomplete?

A

Spontaneous abortion

Complete = fetus/placenta fully expelled, normal menses resumes

Incomplete = some products of conception retained

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15
Q

Fetal demise?

Threatened?

A

Fetal death in utero, requiring surgical evacuation

Threatened = bleeding but cervix is NOT DILATED (pregnancy may/may not continue)

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16
Q

More common in first pregnancy

Triad of

HTN
Edema
Proteinuria

A

preeclampsia

tx = delivery (may need induction; most full recover)

17
Q

HTN
Edema
Proteinuria

+

sz or coma

A

eclampsia

(rarely seen)

tx = delivery (may need induction; most full recover)

18
Q

HPV is cause usually

Most are SCC

Warty, white patches (leukoplakia)

A

vulvar carcinoma (vulvar intraepithelial neoplasia)

usually in women > 60

(VAGINAL carcinoma is rarer, usually an extension of vulvar carcinoma)

19
Q

HPV is primary risk, others include

Early age of sexual intercourse
Multiple partners
Other STDs
Smokers

A

cervical carcinomas

20
Q

PAP screening has decreased cervical carcinoma incidence… ID early dysplacia…. if suspicious PAP results?

A

Colposcopy w/ biopsy.. .early lesions treated w/ easily w/ cryotherapy or loop exceision procedure

21
Q

Most common GYN CA

Primarily post menopausal women…

Risk factors?

A

Endometrial carcinoma…

Risk facotrs =

Estrogen supp or estrogen producing tumors
No pregnancies/early menarche w/ late menopause
Obesity/daibetes/HTN

22
Q

Endometrial carcinoma clinical features?

A

Abnormal uterine bleeindg

POST MENOPAUSAL BLEEDING IS CANCER UNTIL OTHERWISE PROVEN

23
Q

2nd most common GYN CA but MOST DEADLY

Most are epithelial tumors

Risk factors?

A

Ovarian CA

Nulliparous
High fat diet
Anovulation

(protective = multiparous, OCP)

24
Q

congenital absence of breatst

A

amastia

25
Q

Supernumerary nipples (w/o breast tissue/gland)

females or males (often misidentified as mole/birhtmark)

A

Polythelia

26
Q

Breast tiusse w/o nipple (usually found in axilla)

Often confused as breast cancer metastasis

A

Polymastia

27
Q

Incomplete emptying of milk from ducts, staph/strep enters into ducts

A

Acute mastitis

28
Q

Erythema/edema localized to breast quadrant

Markedly painful/tender (likely w/ breast engorgement)

What is it and tx?

A

Acute mastitis

Tx = continue/increase breast feeding (abx, warm compresses, clean nipple)

(Chronic mastitis = older/nonlactating women, need biopsy to r/o CA)

29
Q

Male breast enlargement

Risk factors?

A

In young males, triggered during puberty

Mature/older males risk factors...
Obesity
Alcoholic liver cirrhosis
Estrogen secreting tumors
Klinefelters
Meds (cimetidine/steroids)
30
Q

Tx of gynecomastia?

A

In infants/teens… self corrects

Mature males = look for CA

31
Q

Fibrotic/cystic changes from tissue overresponse to hormones/aging

PAIN, NODULARITY of breasts bilat or unilat

Ssx VARY DURING MENOPAUSE

Must differentiate from CA… how?

A

Fibrocystic change

US/mammogram reveal cysts/calcifications that appear similar to CA… biopsy establish diagnosis

No specific tx (support bra, NSAID, OCPs)

Fine needle aspiration is both diagnostic and therapeutic

32
Q

Most common BENIGN tumor of female breast

Post-puberty/young women (overresponse to increased estrogen)

Freely mobile/firm/rubbery (2-5 cm nodules)

Often vary in size w/ menstrual cycle/pregnancy

PAINLESS

A

Fibroadenoma

PAINLESS/found incidentally on self-exam which helps separate it from fibrocystic changes

33
Q

Fibroadenoma tx?

A

Eval w/ US/mammography

Biopsy

Self-exam/monitoring

34
Q

Breast CA lumps are typicallyhow big before palpable?

A

2-2.5 cm

35
Q

Most lumps are self detected

Mammographgy can detect how big of a tumor?

A

.5 cm

36
Q

Breast CA ssx?

A 
Lumps
Painless
Nipple dischage (spintaneous/unilateral = bad)
Pae d'orange
Retraction of skin/nipple
37
Q

Bilat nipple d/c, not assoc w/ CA?

A

galactorrhea (high prolactin levels from pit. adenoma)

38
Q

Breast CA risks?

A

Female > 35
Fam HX
Caucasiamn = higest risk

ESTROGEN EXPOSYRE (early menarche, late menopause)

postmenopausl estrogen supp increase risk

39
Q

Half of primary breast CA tumors located in which quadrant?

A

Upper lateral

(lymphatic drainage into axilla)

Mets -> lungs, liver, bones

Path 3 (7 decks)

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