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Obstetrics and Gynecology > General Gyne > Flashcards

General Gyne Flashcards

1
Q

What is the DSM IV Dx: Persistent or recurrent deficiency or absence or sexual fantasies and desire for sexual activity

A

Hypoactive Sexual desire disorder

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2
Q

What is the DSM IV Dx: Persistent or recurrent extreme aversion to or avoidance of all or almost all genital sexual contact with a sexual partner

A

Sexual aversion disorder

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3
Q

What is the DSM IV Dx: Persistent or recurrent delay in or absence of orgasm following sexual excitement phase

A

Orgasmic disorder

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4
Q

What is the DSM IV Dx: Persistent or recurrent genital pain associated with sexual intercourse

A

Dyspareunia

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5
Q

What is the DSM IV Dx:
Persistent or recurrent involuntary contraction of the perineal muscles surrounding the outer third of the vagina when vaginal pentration with penis, finger, tampon or speculum is attempted

A

Vaginismus

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6
Q

First line treatment for PMDD

A

SSRI

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7
Q

What is the diagnosis? Vaginal burning and pain, vaginal pH <4.5, pseudohyphae on wet mount

A

Vulvovaginal Candidiasis

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8
Q

How do you diagnose and treat recurrent vulvovaginal candidiasis?

A

4 or more episodes in 12 months
Tx: Induction and maintenance treatment.
Eg. Fluconazole 150mg PO 3 doses 72 hours apart THEN 150mg PO weekly x 6 months

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9
Q

What is the diagnosis and treatment? malodorous frothy voluminous discharge with wet mount showing motile parasite

A

Dx: Trichomonas (flagellated parasitic protozoan)

Tx: Metronidazole 500mg PO BID x 7 days or 2g PO x1, treat partner (not reportable disease in Canada)

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10
Q

What is the diagnosis and treatment? Vaginal pH > 4.5, Clue cells on wet mount, positive whiff test (amine odour with additional of KOH

A

Dx: Bacterial Vaginosis (overgrowth of vaginal flora, less lactobacilli)

Tx: Metronidazole 500mg PO BID x 1 week (or vaginal 0.75% x 5days), alternate Metronidazoel 2g PO x1 or clindamycin cream or PO x 7 days

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11
Q

When does hysterosalpingogram require antibiotics?

A

When tubes are dilated, give doxycycline

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12
Q

Most common strain of HSV causing genital herpes

A

HSV2

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13
Q

What is the rate of transmission of genital HSV to a partner while on suppressive therapy?

A

1%

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14
Q

Genital Warts in prepubertal child requires consideration of what?

A

Sexual abuse, no need to biopsy

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15
Q

Cervical cytology screening is considered what type of prevention?

A

Secondary prevention (looking for pre cancerous lesions)

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16
Q

What kind of prevention is the HPV Vaccine?

A

Primary Prevention - the best form of prevention for HPV

17
Q

HPV is implicated in what types of cancers?

A

cervical, vaginal, vulvar, anal, head and neck

18
Q

HPV is associated with what percentage of vulvar cancer and vaginal cancer ? Anal cancer? Head and neck cancer?

A

Vu/Va: 20-50%, Ano: 80-90%, H&N: 10-20%

19
Q

HPV is most common among young sexually active women, what percentage will clear the virus?

A

80%

20
Q

What proteins doe HPV use to be oncogenic?

A

E6 and E7 proteins interfere with normal cell regulatory functions

21
Q

When should an IUD be removed in PID?

A

after 72 hours if no clinical improvement

22
Q

Risk of PID post IUD placement in the first 90 days?

A

0.5%

23
Q

What are the Benefits of OCP?

A
  • Contraception
  • Regulation of menses
  • Treatment of the following:
    o dysmenorrhea
    o PMS
    o Menstrual headaches
    o Acne
    o Hirsutism
  • Long term benefits:
    o Reduced rates of endometrial, ovarian and colorectal cancer
24
Q

What is the risk of VTE with OCP?

A

Background risk 4-5/10 000 women years
(doubles)
OCP risk 8-10/10 000 women years

Pregnancy risk 29/10 000

Peripartum risk 300/10 000

25
Q

Treatment for Primary Dsymenorrhea

A

C - Heat pads, exercise
M - NSAIDS (Tylenol), COC (IUD, DMPA, Visanne)
S - for secondary causes (endo ablation, hysterectomy EM ablation + COC)
Other: TENS, accupuncture

26
Q

Adolescent Pregnancies are at higher risk for:

A

Maternal:
antepartum - depression, ?HTN, IPV, anaemia, substance use, etoh, STI, PPROM

intrapartum: SVD
Postpartum: unintended pregnancy, depression, low rate of breast feeding

Fetal:
antepartum - congenital anomaly, congenital infection (chlamydia), IUGR, PTL, PTN
Intrapartum - SB
Post partum - NND, children with lower education

27
Q

Most common US findings for Ovarian torsion and what are other US findings?

A
  1. Ovarian enlargement
  2. absence of doppler flow
    Others:
28
Q

When would you consider oopheropexy in the management of ovarian torsion?

A
  1. repeat torsion
  2. congenitally long ligament
  3. no obvious cause of torsion
29
Q

Classic findings in Turners 46 X

A
  • Short stature
  • Micrognathia
  • Epicanthal folds
  • High arched palate
  • Hearing loss
  • Webbed neck
  • Shield chest
  • Absent breast development
  • Wide spaced areolae
  • Cubitus valgus
  • Short 4th metacarpal
  • AI disorder
  • AI thyroiditis
  • Renal anomalies
  • Aortic coarctation
30
Q

Obstructive hemi vagina is associated with ?

A

ipsilateral renal agenesis (didelphys, obstructed hemivagina and ipsilateral renal anomaly = OHVIRA

31
Q

What are the most common additional anomalies seen with mullerian anomalies?

A

Renal, Spinal

32
Q

What mullerian anomaly has the best fertility outcomes?

A

Didelphis uterus

33
Q

What are the obstetrical complications associated with mullerian anomalies?

A

SA, RPL, PTL, PTB, IUGR, SGA, PPROM, Malposition, Fetal malformation (septum)

34
Q

Describe the phenotype for 46XY complete AIS

A

No uterus, testis present (intra-abdominal), no pubic or axillary hair, breasts present , short blind end vagina

35
Q

Describe the phenotype for 46 XX with Complete mullerian genesis (MRKH)

A

No uterus, short pouch vagina, no testis, ovaries present, normal breasts, axillary and pubic hair present

36
Q

What are the indications for EUA with a straddle injury?

A
  1. inability to void
  2. ongoing bleeding
  3. expanding hematoma
  4. suspicion of penetrating injury (need to inspect upper vagina)
  5. suspected anal sphincter injury

Obstetrics and Gynecology (5 decks)

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