Female Reproductive System & Breast Flashcards
Most common histologic subtype of ovarian cancer
Epithelial ovarian carcinoma
Epithelial ovarian carcinoma
- Clinical presentation
- Laboratory findings
- Ultrasound findings
- Management
Polycystic ovarian syndrome
- Clinical features
- Pathophysiology
- Comorbities
- Treatment options
High risk family history for breast cancer
Two 1st degree relatives with breast cancer, including one before age 50
Three or more 1st of 2nd degree relatives with breast cancer
1st or 2nd degree relative with breast & ovarian cancer
1st degree relative with bilateral breast cancer
Breast cancer in a male relative
Ashkenazi Jewish women with any 1st of 2nd degree relatives with breast or ovarian cancer
US Preventative Services Tast Force recommendations for breast cancer screening
- Definitely beneficial - recommended
Cervical cancer screening guidelines
- HIV
- Immunosuppressed (SLE, organ transplant)
- Age < 21
- Age 21-29
- Age 30-65
- Age >= 65
Bartholin gland abscess
Pain with walking, sitting, and sexual intercourse
Tender, fluctuan mass in the medial aspect of the labium majus at 4 or 8 o’clock
Incision and drainage
Chlamydia trachomatis
Dysuria
Sterile pyruria
Non-monogamous sexual contacts
Benefits and risk of combined estrogen-progestin contraceptives
- Benefits
- Risks
Lichen sclerosis
Causes intense pruritus and white atrophic plaques involving the vulvar and sometimes perianal skin but not the vagina
Punch biopsy confirms the diagnosis and rules out vulvar squamous cell carcinoma
Scaping for potassium hydroxide test
Performed when dermal candidiasis is suspected
Wet mount microscopy
Used to evaluate bacterial vaginosis, trichomoniasis, or vaginal candidiasis
Atrophic vaginitis versus lichen sclerosis
- Clinical features
- Treatment
Pharyngitis, fever, lower abdominal pain in a sexually active patient
Gonococcal pharyngitis with associated pelvic inflammatory disease
High grade squamous intraepithelial lesion on pap
Require evaluation with immediate colposcopy
Can be treated with immediate loop excision in non-pregnant women
Genitourinary syndrome of menopause
- Symptoms
- Physical Exam
- Treatment
Differential diagnosis of vaginitis
- Diagnosis
- Examination
- Laboratory findings
- Treatment
Workup of palpable breast mass
Inflammatory breast cancer
Causes of urinary incontinence in elderly
- Genitourinary
- Neurologic
- Potentially reversible
Medications that cause urinary incontinence
Alpha-adrenergic antagonists (urethral relaxation)
Anticholinergics, opiates, calcium channel blockers (urinary overflow)
Diuretics (excess urine production)
Disorders of sexual development
(Diagnosis, cause, breast development, reproductive organs, axillary and pubic hair, karyotype)
- Complete androgen insensitivity syndrome
- Mullerian agenesis
- Transverse vaginal septum
- Turner syndrome
Genital development
Anatomy of genital development (male and female)
Emergency contraception options
- Method
- Mechanism
- Time after intercourse (hours)
- Efficacy
Misoprostol: prostaglandin analog used with mifepristone in the medical abortion mechanism. It works by stimulating uterine contractions. It has no effect on pregnancy prevention.
PMS/PMDD
- Clinical features (occurring during luteal phase)
- Evaluation
- Treatment
Evaluation of primary amenorrhea
Role of hCG in pregnancy
Preservation of the corpus luteum in early pregnancy
Begins to be secreted 8 days after fertilization
Peaks at 6-8 weeks
Differential diagnosis of Dysmenorrhea
- Diagnosis
- Clinical features
Endometriosis (classic triad)
Dysmenorrhea
Dysparunia
Infertility
Causes of abdnormal menstrual bleeding
- Diagnosis
- Clinical features
Pelvic endometriosis
Adenomyosis
Benign breast disease (Diagnosis, clinical features)
- Breast cyst
- Fibrocystic changes
- Fibroadenoma
- Fat necrosis
Fat necrosis can mimic breast cancer bc it commonly presents as a fixed mass with skin or nipple retraction and gives the appearance of calcifications on mammagrophy.
Ultrasound can demonstrate a hyperechoic mass, which often correlates with a benign etiology.
Biopsy of fat necrosis is diagnostic and shows fat globules and foamy histiocytes
Vaginal Cancer
- Type
- Epidemiology
- Risk factors
- Location of cancer
- Clinical features
- Diagnosis
Dimpling of the skin strongly suggests inflammatory breast cancer
Endometriosis
- Pathogenesis
- Physical examination
- Diagnosis
- Treatment
Noncyclic pain can be exacerbated by exercise
Endometrioma may be the only exam finding with a homogeneous cystic appearance on ultrasound
Ovarian torsion
- Risk factors
- Clinical presentation
- Ultrasound
- Treatment
Ovarian torsion versus appendicitis (or tubo-ovarian abscess)
An infectious etiology would be accompanied by fever and leukocytosis
Acute abdominal/pelvic pain in women
- Diagnosis
- Clinical presentation
- Ultrasound findings
Characteristics of ulcerative sexually transmitted diseases (Disease, Causative agent, Features of primary lesion, Initial Lesion Painful?)
- Chancroid
- Genital herpes
- Granuloma inguinale
- Syphilis
- Lymphogranuloma venereum
Syphilis - diagnostic serology
- Nontreponemal
- Treponemal
Management of CIN3
Pelvic inflammatory disease
- Symptoms
- Physical examination
3. Treatment
- Complications
Cervicitis can cause intermenstrual spotting.
Can be complicated by perihepatitis (Fitz-Hugh-Curtis disease), producing right upper quadrant pain
Sjogren’s syndrome
Autoimmune disorder caused by inflammatio of exocrine glands
Can cause generalized dryness of mucous membranes, including vaginal dryness
SS is associated with a significant risk for non-Hodgkin lymphoma
Vaginismus
Dyspareunia due to muscle spasm that prevents vaginal penetration
Indication for hormone replacement therapy
Treatment of vasomotor symptoms (e.g., hot flashes) in women < 60 who have undergone menopause within the past 10 years.
Contraindications to HRT: History of CAD, thromboembolism, TIA/stroke, breast cancer, endometrial cancer
First line treatment for women with symptomatic hot flashes
Weight loss
Indications for hospitalization for pelvic inflammatory disease
Regimens for hospitalized patients include IV cefoxitin or cefotetan plus oral doxycycline, or parenteral (IV) clindamycin plus gentamycin.
Outpatient regimen for PID: IM ceftriaxone + oral doxycycline.
Selective estrogen receptor modulators
- Drugs
- Mechanism of action
- Indications
- Adverse effects
