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Clin med FINAL- sem 2 > Female reproductive disorders > Flashcards

Female reproductive disorders Flashcards

1
Q

Menorrhagia

A

Excessive flow and duration

Regular intervals

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2
Q

Metrorrhagia

A

Excessive flow and duration

Irregular intervals

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3
Q

Hypomenorrhea

A

Decreased flow

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4
Q

Polymenorrhea

A

Shortened interval <19-21 d

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5
Q

Oligomenorrhea

A

Lengthened interval >35 d

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6
Q

Menometrorrhagia

A

Irregular or excessive bleeding during menses and between menses

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7
Q

what is dilation and curettage? (D&C) What is it used for?

A
  • remove tissue from inside uterus
  • used to diagnose and treat certain conditions like heavy bleeding or to clear the uterine lining after a miscarriage or abortion
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8
Q

what is dysmenorrhea?

A

Pain associated with menses- 1-2 days up to everyday

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9
Q

what is the cause of dysmenorrhea?

A

Prostaglandin overactivity- leads to uterine contractions

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10
Q

dysmenorrhea signs and symptoms

A

mild discomfort to severe pain
N/V
fatigue
diarrhea

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11
Q

dysmenorrhea imaging

A

rule out bx

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12
Q

dysmenorrhea tx

A

Prostaglandin (NSAIDS)
Heat
Avoid- nicotine, alcohol, caffeine
Birth control- IUD or longer acting progesterone

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13
Q

leiomyoma

(uterine fibroid)- what is it?

A

Common benign uterine tumor

discrete (individual and separate), round and firm, enlarged uterine mass

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14
Q

leiomyoma

(uterine fibroid)- who is this common in?

A

older patients

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15
Q

leiomyoma

(uterine fibroid)- depend on _____?

A

estrogen to live

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16
Q

leiomyoma

(uterine fibroid)- signs and symptoms

A 
Bleeding= MC
Pain- outgrows blood supply and "dies" 
Dysmenorrhea
Pressure/fullness in pelvis
Infertility 
Anemia
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17
Q

leiomyoma

(uterine fibroid)- imaging

A 
Pelvic US
D&C
Saline hysteroscopy 
Hysterosalpingography 
Laparoscopy
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18
Q

leiomyoma

(uterine fibroid)- tx

A 
GnRH agonist to shrink
- Triptorelin 
- Goserelin
- Leuprolide 
Birth control
Myomectomy 
D&C
Transexamic acid 
Uterine arterial embolization or endometrial ablation 
Hysterectomy
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19
Q

endometriosis-

what is it?

A

endometrial tissue outside endometrial cavity

develops during menstrual cycle

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20
Q

endometriosis- risk factors

A

20-30
early menarche
longer duration of flow- short cycles
heavy bleeding during cycles

MORE menses

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21
Q

endometriosis- what helps?

A

exercise >4hrs/wk
higher parity
longer lactation period

DECREASES menses

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22
Q

endometriosis- signs and symptoms

A 
Infertility + 3Ds
- dysmenorrhea
- dyspareunia
- dyschezia 
Pain w uterine motion 
Tender adnexal masses
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23
Q

endometriosis- what are they called on ovaries?

A

chocolate cysts-

build up of blood due to menstrual cycle- erodes into underlying tissue and distorts organs w implants

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24
Q

endometriosis- early vs older

A

early- red petechial lesions
older- dark brown, blue or black filled w debris- powder burn lesions
- thickening and scarring
- adhesions

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25
Q

endometriosis- treatment

A 
NSAIDS
Remove large endometriomas 
Decrease menses
- oral contraceptives- progesterone
- progesterone therapy- depo Provera or Mirena
- danazol 
GnHR agonist
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26
Q

adenomyosis- what is it?

A

endometrial tissue within wall of uterus

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27
Q

adenomyosis- risk factors

A

Same as endometriosis- childbearing age

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28
Q

adenomyosis- signs and symptoms

A

severe dysmenorrhea
abdominal pressure and bloating
SYMMETRICAL enlarged uterus

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29
Q

adenomyosis- diagnosis

A

hysterectomy

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30
Q

adenomyosis- treatment

A 
Same as endometriosis 
NSAIDS
Remove large endometriomas 
Decrease menses
- oral contraceptives- progesterone
- progesterone therapy- depo Provera or Mirena
- danazol 
GnHR agonist
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31
Q

what is a cystocele?

A

prolapse of bladder anteriorly- towards vagina

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32
Q

what is it called when bladder and urethra prolapse together?

A

cystourethrocele

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33
Q

what is a rectocele?

A

prolapse of rectum or large bowel posteriorly

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34
Q

what is it called when the small bowel prolapses?

A

enterocele

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35
Q

pelvic organ prolapse- signs

A

feel bulge when patient coughs

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36
Q

Uterine prolapse- risk factors

A

menopause
any condition that increases intra-abdominal pressure
childbirth- vaginal delivery

can also occur if no childbirths

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37
Q

uterine prolapse- signs and symptoms

A 
relieved by lying down 
vaginal fullness 
low back pain 
falling out sensation 
etc.
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38
Q

abnormal uterine bleeding (AUB)- what should be considered if childbearing age?

A

Complication of pregnancy

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39
Q

abnormal uterine bleeding (AUB)- causes PALM and COEIN

A

P- polyps
A- adenomyosis
L- leiomyoma
M- malignancy and hyperplasia

C- coagulopathy 
O- ovarian dysfunction 
E- endometrial process
I- iatrogenic 
N- not yet classified
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40
Q

abnormal uterine bleeding (AUB)- what if everything else is excluded?

A

Dysfunctional uterine bleeding

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41
Q

abnormal uterine bleeding (AUB)- exams and imaging

A 
pelvic exam 
abdominal exam 
rectovaginal exam 
pap smear
hysteroscopy - bx= GOLD
transvaginal US- #1
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42
Q

abnormal uterine bleeding (AUB) - if you see endometrial cells in a postmenopausal W in a pap smear what should you be thinking?

A

endometrial cancer

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43
Q

abnormal uterine bleeding (AUB) - treatment

A

Progesterone- depo injections or IUD
Oral contraceptives
Endometrial ablation
Hysterectomy

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44
Q

postmenopausal bleeding- considered when?

A

post 12m of amenorrhea in middle aged W

45
Q

postmenopausal bleeding- FSH and estradiol values

A

FSH- >30mlU/mL

Estradiol- <20

46
Q

postmenopausal bleeding- most common cause

A

exogenous hormones

47
Q

polycystic ovary disease- stein leventhal syndrome- PCOS- what is it?

A

enlarged ovaries
thick sclerotic capsules and
abnormally high number of follices

48
Q

polycystic ovary disease- stein leventhal syndrome- PCOS- signs and symptoms

A

amenorrhea
infertility
hirsutism

49
Q

ovarian torsion- signs and symptoms

A

lower abdominal pain

blue ovary- decreased blood flow

50
Q

ovarian torsion- imaging

A

doppler US

51
Q

Dermoid cyst of the ovary- what do ovaries contain?

A

Pleniprotential cells- can develop into any type of organ

Can be benign or malignant

52
Q

What do tumors that contain hair, teeth and hair, etc. called?

A

Demoid cyst of the ovary

53
Q

lichen sclerosus- what is it?

A

MC non-neoplastic vulvular epithelial disorder

54
Q

lichen sclerosus- signs and symptoms

A

puritis

think and wrinkled- “cigarette paper”

55
Q

lichen sclerosus- treatment

A

antihistamines

high potency topical steroids

56
Q

lichen sclerosus, simplex chronicus and planus- diagnosis

A

bx- to confirm and rule out cancer

57
Q

lichen sclerosus increases risk of

A

squamous cell carcinoma of the vulvula

58
Q

lichen simplex chronicus- what is it?

A

benign epithelial thickening and hyperkeratosis resulting from chronic irritation- infection, chemical exposure, allergic causes

59
Q

lichen simplex chronicus- signs and symptoms

A

thickened- leathery appearance

pruritis- labia majora mc

60
Q

lichen simplex chronicus - treatment

A

antihistamines

medium potency steroid

61
Q

lichen planus- what is it?

A

Inflammatory autoimmune disorder

62
Q

lichen planus- signs and symptoms

A 
Mucous membranes- vulva and vagina- also oral 
Itching
burning
postcoital bleeding
dyspareunia
pain
Sharply marginated flat topped papules on skin 
Erosions and ulcerations
63
Q

lichen planus- treatment

A

topical hydrocortisone foam- more potent topical steroids

64
Q

Behcet’s syndrome- what is it associated with?

65
Q

Behcet’s syndrome- triad

A
  • Recurrent oral ulcers
  • Recurrent genital aphthae or ulcerations (painful)
  • Uveitis
66
Q

Behcet’s syndrome- treatment

A

topical and systemic corticosteroids

67
Q

Molluscum contagiosum- what is it? describe it

A

Benign epithelial poxvirus

- Pearly, dome shaped papules w dimpled center or bx

68
Q

Molluscum contagiosum- mc in?

A

young children

69
Q

Molluscum contagiosum- in adults is

A

sexually transmitted

70
Q

Molluscum contagiosum- treatment

A

Self
Cryotherapy curettage
Topical- imiquimod

71
Q

Bartholin duct cyst and abscess- cause

A

obstruction

72
Q

Bartholin duct- purpose

A

moisture vulva

73
Q

Bartholin duct cyst and abscess - signs and symptoms

A

fluctuant/unstable tender mass- palpable
pain, tenderness,
difficulty walking

74
Q

Bartholin duct cyst and abscess- treatment

A

Cyst- no abx
I&D
Cath placement
Marsupialization- wick gauze- drain fluid

75
Q

atrophic vaginitis- cause

A

diminished estrogen levels

76
Q

atrophic vaginitis - risk factors

A

post-menopausal
prepubertal
lactating

77
Q

atrophic vaginitis- signs and symptoms

A

pale
flat
white

78
Q

atrophic vaginitis- pH

79
Q

atrophic vaginitis- treatment

A 
estrogen- oral/systemic 
if contradictions- topical:
- premarin vaginal cream 
- estrace vaginal cream 
- vagifern tablets
80
Q

atrophic vaginitis- complications

A

infections and trauma due to thin vaginal epithelium

81
Q

Paget disease of the vulva- what type?

A

in situ adenocarcinoma in epithelium of vulva and perineal regions

82
Q

Paget disease of the vulva - signs and symptoms

A

pruritis
red crusty lesions
labia majora= MC
white coating- “cake icing”

83
Q

Paget disease of the vulva- diagnosis

84
Q

Paget disease of the vulva - treatment

85
Q

foreign bodies- causes what?

A

drying and microulcerations

86
Q

foreign bodies- signs and symptoms

A

malodorous vaginal discharge

spotting

87
Q

What should be evaluated in a menstruating W w sudden onset of febrile illness?

A

toxic shock syndrome

88
Q

toxic shock syndrome- cause

A

staph infections

89
Q

toxic shock syndrome- signs and symptoms

A

desquamation of palms and soles
hypotension
etc. like fever, sore throat

90
Q

toxic shock syndrome- treatment

A

irrigation of saline

b-lactamase resistance pen or vanco

91
Q

Malignant disease of the vagina- what is it?

A

Metastatic or vaginal involvement via direct extension from cervix

clear cell adenocarcinoma

92
Q

Malignant disease of the vagina - who are at risk?

A

DES daughters

93
Q

Malignant disease of the vagina - signs and symptoms

A

Asymptomatic
Painless bleeding- early
Late- pain, weight loss, swelling

94
Q

Malignant disease of the vagina- treatment

A

Surgery

RT, chemo

95
Q

Ectropion - what is it?

A

Eversion of columnar epithelium onto ectocervix

96
Q

Ectropion- signs and symptoms

A

Cervix= red, granular and inflamed

97
Q

Ectropion- what is it associated with?

A

pregnancy and puberty

98
Q

Nabothian cysts- signs and symptoms

A

Asymptomatic

Translucent-yellow mucous-filled cyst

99
Q

Cervicitis- signs and symptoms

A

Asymptomatic
Similar to vaginitis
Acute- cervical friability (sign of infection or inflammation)
Postcoital bleeding/spotting

100
Q

Cervicitis- labs

A

CBC- white count- nl or slightly elevated

101
Q

Cervicitis - complications

A

infertility
ectopic
chronic pelvic pain

102
Q

Cervical stenosis- at what level?

A

of internal os

103
Q

Cervical stenosis - causes

A

cone bx
LEEP
Ablative techniques for tx of dysplasia
tx of dysplasia

104
Q

Cervical stenosis- signs and symptoms

A

amenorrhea and pelvic pain

105
Q

Cervical stenosis- imaging

A

unable to pass sound or dilator through cervical opening

106
Q

Cervical stenosis- treatment

107
Q

Incompetent cervix- occurs when?

A

weak cervical tissue causes or contributes to premature birth of loss of an otherwise healthy pregnancy

108
Q

Incompetent cervix- causes/risk factors

A

Congenital
Cervical trauma
D&C
Hx of pre-term delivery

109
Q

Incompetent cervix- treatment

A

Cervical cerclage
Bed rest
Frequent US
Progesterone

Clin med FINAL- sem 2 (5 decks)

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