Female Path part 2 Flashcards
Suppresses GnRH, FSH/LH & lowers Gonadotropin levels to inhibit ovulation
Progestin implant/ injection
Combined OCP
prevent pregnancy by thickening cervical mucus, which prevents sperm from accessing the uterus.
Still get period
The progestin-only pill (due to low dosage/potency) and levonorgestrel intrauterine device (IUD)
releases copper ions that elicit an inflammatory reaction in the uterus that is toxic to sperm and prevents fertilization.
copper IUD
Sensory Perenial region
External urethral and anal sphincters
Pudendal n
S2-S4
Pudendal n
Sensory suprapubic
iliohypogastric n
Sensory of scrotum/ Labia Majora and upper medial thigh
Genitofemoral n
Important landmarks for a ___ nerve block include the ischial spines and sacrospinous ligament.
pudendal
Injury from abdominal retractors during laparotomy can lead to labial/scrotal anesthesia.
Genitofemoral nerve
courses along the anterior surface of the psoas muscle.
Injury during closure of suprapubic skin incisions (cesarean section) can result in burning pain and paresthesias.
iliohypogastric nerve
Injury during hip surgery can impair hip extension.
inferior gluteal nerve (gluteus maximus)
The uterine arteries, the major blood supply to the uterus, are branches of the ____ arteries.
internal iliac
Bilateral ligation of the internal iliac arteries should stop ___ blood flow and post-partum hemorrhage
uterine
A midline episiotomy is a vertical incision from the posterior vaginal opening to the perineal body. It transects the
Perineal body
Ovulation is then induced by administration of human chorionic gonadotropin, which mimics the ___ surge.
LH
Menotropin (human menopausal gonadotrophin) therapy mimics ___ and triggers the formation of a dominant ovarian follicle.
FSH
Following ovulation, the granulosa and theca cells of the ovarian follicle luteinize to form the ____; this secretes relatively high levels of progesterone
corpus luteum
stimulates the endometrium to transform from proliferative to secretory to become a hospitable environment for implantation.
Progesterone
Primary lymph node drainage of Uterus
External iliac
Primary lymph node drainage of the Vagina
Proximal: internal iliac
Distal: inguinofemoral
Primary lymph node drainage of Cervix
Internal iliac
Primary lymph node drainage of Vulva
Inguinofemoral
Primary lymph node drainage of
Paraaortic
The discharge is grayish-white and fishy smelling.
Gardnerella Vaginalis
amide odor with KOH wet mount
Gardnerella Vaginalis
squamous epithelial cells with adherent bacteria
Gardnerella Vaginalis
clue cells
Treatment is with metronidazole or clindamycin
Gardnerella Vaginalis
Bacterial Vaginosis
A wet mount shows leukocytes and pear-shaped organisms (flagellated trophozoites).
Trichomoniasis Vaginalis
Presents with vulvovaginal erythema and frothy, yellow-green vaginal discharge; patients with cervicitis classically have a cervix with punctate hemorrhage (ie, strawberry cervix).
Trichomoniasis Vaginalis
A third-generation cephalosporin will treat the gonococcal infection, and further treatment with _____ is required to treat the chlamydia
azithromycin or doxycycline
HPV is a _____, NON-enveloped DNA virus that has a predilection for squamous epithelium of the skin and vagina/cervix.
double-stranded
A koilocyte is an immature squamous cell with dense, irregularly (dusky) staining cytoplasm and perinuclear clearing, resulting in a halo.
HPV
pseudohyphae of budding yeast on a Pap smear.
Candida Albicans (normal flora)
Common triggers for Candida vaginitis include the following:
Antibiotic use High estrogen levels (eg, pregnancy) Systemic corticosteroid therapy \_\_\_\_\_\_\_ Any other cause of immunosuppression, including HIV
Uncontrolled diabetes mellitus
Antibiotic use is the most common cause of Candida vaginitis due to reduction of the ____ population, which facilitates Candida overgrowth.
gram + lactobacilli
Elevated pH of vaginal secretions (>4.5) is associated with (2)
Bacterial vaginosis
Trichomonas vaginitis
Diagnosis is made via wet mount microscopy, which typically reveals pseudohyphae with budding yeastand true hyphae.
Candida Albicans
Treatment of vulvovaginal candidiasis is with
Fluconazole
Anatomic or functional ____ is almost always necessary for the development of acute pyelonephritis.
vesicoureteral reflux
E-Coli (UPEC) cause Cystitis (dysuria) via
Ascending infection
P-pili
_____ are pathognomonic for acute pyelonephritis when accompanied by symptoms of acute UTI.
white blood cell casts
Sterile pyuria (WBCs, but no bacteria) can be seen with nongonococcal urethritis caused by ____.
Chlamydia
Ureaplasma
Use wet mount SALINE microscopy to diagnose
Trichomonas vaginalis
motile protozoa
It can cause disulfiram-like effects (eg, abdominal cramps, nausea, headache) when combined with alcohol due to acetaldehyde accumulation.
Metronidazole
How to treat Trichomonas vaginalis
Metronidazole
must treat partner as well
is caused by weakened pelvic floor muscle support that often occurs due to chronically increased intraabdominal pressure (eg, obesity, chronic cough, prior pregnancies).
Stress urinary incontinence (intermittent, involuntary leakage of urine)
Red-inflamed friable cervix with purulent discharge
Asymptomatic, or presents with post-coital bleeding.
detected by pelvic examination and nucleic acid amplification testing (NAT).
Gonoccal Cervicitis
chalmydia can cause it too
Bacterial vaginosis (BV) is most commonly caused by an overgrowth of the facultative________ Gardnerella vaginalis and loss of normal lactobacilli flora.
anaerobic,gram-variable rod
Rotation of the ovary around the ___ ligament results in ovarian torsion.
Presents with sudden-onset unilateral pelvic pain and nausea and sometimes vomiting and fever
infundibulopelvic (IP) ligament
suspensory ligament of the ovary
The ____ ligaments connect the posterior aspect of the uterus to the anterior portion of the sacrum.
These ligaments hold the uterus in an anteverted or retroverted position; loss of this support contributes to uterine PROLAPSE into the vagina.
uterosacral
Teenager with ammenorhea Examination shows fully developed secondary sexual characteristics. Pelvic ultrasound shows a shortened vaginal canal with a rudimentary uterus.
Mullerian Agenesis
