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Level Two > Female Reproductive System and Breast > Flashcards

Female Reproductive System and Breast Flashcards

1
Q

Heavy menstrual bleeding with DYSMENORRHEA and chronic pelvic pain with SYMMETRICALLY enlarged uterus that is boggy and tender and MOBILE.

A

adenomyosis

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2
Q

Heavy menstrual bleeding without chronic pelvic pain with IRREGULARLY enlarged uterus.

A

leiomyomata uteri (fibroids)

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3
Q

Heavy menstrual bleeding with DYSMENORRHEA and chronic pelvic pain but NONTENDER, IMMOBILE uterus.

A

endometriosis

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4
Q

tx of chlamydia and neisseria gonorrhea

A 
chlamydia = azithro
neisseria = ceftriaxone
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5
Q

BASE of labia majora - cyst at 4 or 8 o’clock position = dx?

A

bartholin duct cyst

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6
Q

Upper anterior vagina lesion that doesn’t involve the vulva = dx?

A

Gartner duct cyst

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7
Q

induce ovulation in PCOS how?

A

clomiphene citrate (selective estrogen receptor blockade at hypothalamus, so GnRH pulsatile release continues to normalize LH for ovulation surge (and FSH)

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8
Q

describe TSH, T4 and T3, and free T4 changes during pregnancy

A

TSH decreases
T3/T4 normal
Free T4 incrases

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9
Q

Beta-hCG stim what thyroid hormone in first trimester?

A

total t4

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10
Q

severe onset ul lowe abd pain following sex or strenuous activity.
u/s shows free fluid

A

ruptured ovarian cyst

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11
Q

severe onset ul lower abd pain, N/V. ul tender andexal mass palpated.
u/s shows enlarged ovary with decr blood flow

A

ovarian torsion

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12
Q

LEEP does what?

A

removes cervical transformation zone

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13
Q

endometrial bx indications BY AGE: -45yo or greater

A
  • ANY abn uterine bleeding or postmenpausal bleeding
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14
Q

endometrial bx indications BY AGE:

-less than 45yo

A
  • abn uterine bleeding PLUS
  • unopposed estrogen (OBESITY, anovulation)
  • failed medical mgmt
  • lynch syndrome (HNP colorectal cancer)
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15
Q

endometrial bx indications BY AGE:

-35y or older with:

A

ATYPICAL GLANDULAR CELLS ON P AP bc it can be dt either cervical or endometrial adenocarcinoma.

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16
Q

pharyngitis and PID presentation - think what bug?

A

neisseria

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17
Q

endometrial hyperplasia in postmeno (ie. from androgens) lead to what type of endometrial carcinoma?

A

Androgens

= Adenocarinoma

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18
Q

In a stable owman with suspected ectopic: beta hcg <1500. what next?

A

repeat in 2 days.

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19
Q

in a stable owman with suspected ectopic: beta hcg >1500. what next?

A

repeat in 2 days AND TVu/s

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20
Q 
Primary amenorrhea (>15yo w/o menarche): 
(1) uterus present --> what next?
A

uterus present –> FSH

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21
Q 
Primary amenorrhea (>15yo w/o menarche): 
(1) uterus absent --> what next?
A

uterus absent –> karyotype

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22
Q

FSH and LH and TSH and PRL differences in:

  • primary ovarian failure
  • Turners
  • functional hypothalamic amenorrhea
A
  • POF: FSH and LH high, TSH and prl normal
  • Turner = high FSH and LH
  • FHA = decr FSH and LH, nml prl and TSH
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23
Q

what lesion involves the vulva, perianal skin, but spares the vaginal? assoc with autoimmune (DM1, thyroid)

A

lichen sclerosis

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24
Q

symmetric breast fullness/tenderness 3-5d post delivery = ?

A

engorgement

25
Q

if fetal mvmts decrease… first test.

MCC if that test is nonreactive?

A

do a NST.

MCC of nonreactive is fetal sleep

26
Q

if NST is nonreactive, then do what?

A

vibroacoustic stim

27
Q

first line tx for postpartum hemorrhage

A

first line is oxytocin and bimanual massage.

28
Q

four vax CI in pregn

A

VZV, live flu, MMR, HPV

29
Q

accels during delivery + fetal tachycardia (baseline >160bpm) + maternal fever (>100.4) + uterin etenderness/discharge/leukocytosis –> ?

A

chorioamnionitis

30
Q

accels during delivery + SINUSOIDAL tracings.

A

fetal anemia

31
Q

AE of oxytocin:

A

SEIZURES DUE TO hyponatremia. hypotension, uterine tachysystole (abn frequent contractions >5 in 10min).

32
Q

variable decels with <50% of contractions - next step

A

this is well tolerated by the fetus and just tx

with maternal position readjustment

33
Q

at ten weeks gestation, what test can be offered to mom with high risk pregnancies?

A

cell free DNA testing

34
Q

presents as a low abd/back pain, high freq/low amplitude cxns, firm TENDER uterus –> ?

A

placenta abruption

35
Q

two RF for placental abruption

A

smoking and preeclampsia

36
Q

encephalopathy, nystagmus, gait ataxia - caused by deficiency in what. what can cause this deficiency?

A

thiamin/B1

alcoholism or hyperemesis gravidarum

37
Q
  1. short cervix with hx of preterm labor? do what?

2. shrot cervix w/o hx?

A
  1. progesterone
    injections + TVUS for cervical length (Prog matinatins uterine quiescence)
  2. TVUS + CL
38
Q

3 first line anti-HTN drugs in preg

A

Hydralazine (vasodilator), nifedipine, labetalol

39
Q

Hx factors that lead to significant redution in ovarian cancer risk:

A

BSO and OCPs

40
Q

Solid masse, thick septations, ascites. involves ovary, fallopian, PERITONEUM. sx: bloating, pain, early satieyt, abd distension (ASCITES). Dx?

A

epithelial ovarian carcinoma

41
Q

Dx? is complex multilocular mass involving tube and overy on u/s.

A

Tubo-ovarian abscess

42
Q

What is (ectopic implantation of endometrial glabd on ovary surface show on u/s as homogenous cyst with internal echoes (ground glass).

A

endometriosis

43
Q

RF for cerivcal cancer:

A

tobacco, HPV 16, 18

44
Q

RF for ovarian cancer

A

FHx, endometriosis

45
Q

Decr ovarian cancer risk

A

delayed menarche and early menopause

46
Q

RF for endometrial cancer =

A

chronic anovulation, obesity (unopposed estrogen).

47
Q

Decr endometrial cancer risk with:

A

progesteron (p-only IUD, OCP) dt differentiation of endometrial cells and prevention of hyperplasia.

48
Q

progesterone wihtdrawal should cause?

A

mensturation if no menses, then the problem is with ESTROGEN - not endough for endometrial proliferation/build up. Low estrogen predisposes to osteo.

49
Q

type of ovarian cyst assoc with: high beta-hCG levels (molar preg orin pregnancy) and RESOLVE after levels decline. Appear as multiseptated bilateral cystic masses on ultrasound.

A

theca lutein

50
Q

type of ovarian cyst:occur in first half of menstrual cycle and asx

A

Follicular cysts

51
Q

type of ovarian cyst: is B9 in PREMENOP AUSAL. Ultrasound shows hyperchoic nodules and calcifications. Most asx, but can include pelvic pain or pressure. High associated with OVARIAN TORSION.

A

dermoid ovarian cyst (mature cystic teratoma)

52
Q

SERMs - MOA and names (2)

A

A: tamoxifen and raloxifene. they INHIBIT ESTROGEN binding. (***Tamoxife inhibits @ breast; AGONIST in uterus and bone).

53
Q

what are indiations to both SERMs

A

A: tamoxifen - adjuvant breast cancer tx. Raloxifene for post meno osteoporosis.

54
Q

Adverse effects of both SERMS

A

tamoxifen = endometrial hyperplasia and carcinoma (dt unopposed estrogen). Both - hto flash an VTE.

55
Q

Lichen sclerosus v. atrophic vagintis - presentation and treatment?

A

A: Atrophic vaginitis is itchiness, VAGINAL DRYNESS, dyspareunia. Tx with topical ESTROGEN.

Lichen sclerosus has cigarette-tissue like skin changes, loss of normal anatomical markers. Vulvar itching, thinning. VAGINA UNAFFECTED. Tx with topical CS.

56
Q

acute pancreatits etiology: elevated alk phos, high BMI, ALT>150

A

gallstone pancreatitis

57
Q

what classifies arrest of active labor?

A

A: when no cervical change for four or more hours despite adequate contractions (200 or more MVUs in 10min) or 6+ hours with inadequate cxns.

58
Q

What do you do next if arrest of active labor?

A

A: Cesarean delivery.

59
Q

when do you give oxytoci in labor?

A

A: Protracted (slow) labor – with INADEQUATE cxns.

Level Two (15 decks)

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