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GPA mini case > GPA - Amenorrhea, vaginal discharge, bleeding, dyspareunia > Flashcards

GPA - Amenorrhea, vaginal discharge, bleeding, dyspareunia Flashcards

1
Q

DDX - Amenorrhea40F, morning nausea, vomiting, fatigue, polyuria
Lase menses 6 weeks prior
tender breasts
Rhythem birth control

A

Pregnancy
PID
UTI
hyperprolactemia

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2
Q 
Workup - Amenorrhea
40F, morning nausea, vomiting, fatigue, polyuria
Lase menses 6 weeks prior
tender breasts
Rhythem birth control
A 
Urine HGC
UA- Culture
CBC
CMP, electrolytes
Prolactin, TSH
Papsmear - cultures, HIV
VDLR/RPR : syph
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3
Q 
DDX - Amenorrhea
35YO f
Galacgtorrhea
visual field defects
Headaches x 6 weeks
A 
Prolactinoma
Pregnancy
Thyroid disease
Pituitory tumor 
Premature ovariian failure
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4
Q 
WOrkup - Amenorrhea
35YO f
Galacgtorrhea
visual field defects
Headaches x 6 weeks
A 
Urine Hgc
Prolactin
TSH
MRI - Brain (not moveing
LH and FSH
Pelvic and breast exam (whats doing weird stuff)
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5
Q

DDX - Amenorrhea
46yo F x 6 months
hot flashes, night sweats, emotional lability
dyspareunia

A

Premenopause
Pregnancy
Pituitary tumor
Thyroid disease (hot)

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6
Q

Workup - Amenorrhea
46yo F x 6 months
hot flashes, night sweats, emotional lability
dyspareunia

A 
Urine HGC
TSH
LH, FSH, TSH, Prolactin
CBC
MRI
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7
Q

DDX - Amenorrhea
35yo, cold intolerance
course hair, wt loss, fatigue,
Abruptio placentae, followed by hypovolemic shock and failure of lactation 2 years ago

A 
Sheehan syndrom
Pituitory tumor
Thyroid diesease
Asheman syndrom
premature ovarian syndrome
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8
Q

Workup - Amenorrhea
35yo, cold intolerance
course hair, wt loss, fatigue,
Abruptio placentae, followed by hypovolemic shock and failure of lactation 2 years ago

A 
Uring HGC
TSH
Pelvic exam
CBC
LH, FSH, Prolactin (the menses hormones)
ACTH
MRI-brain
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9
Q

DDX - Amenorrhea
29yo x 6 months
palpitations, dizziness, lost fiance in car accident

A

Depression
Thyroid disease
Anxiety induced amenorrhea

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10
Q

Workup - Amenorrhea
29yo x 6 months
palpitations, dizziness, lost fiance in car accident

A 
Urine HGC
TSH
Pelvic exam
LH, FSH, Prolactin
ACTH
Urine cortisol- stress)
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11
Q

DDX - vaginal bleeding

17 yo prolongues, excessive menstural bleeding, irregulary withing past 6 months

A 
Dysfunctional uterine bleeding
coagulation: vonwilebrands, hemophelia
Cervical cancer
Hypothyroidism
Diabetes mellitus
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12
Q

Workup - vaginal bleeding

17 yo prolongues, excessive menstural bleeding, irregulary withing past 6 months

A 
Pelvic exam: Pap, cultures 
Uring HGC
CBC, ESR : 
PTT, PT
Prolactin, LH/FSH
TSH
US - Pelvis (cancer)
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13
Q 
DDx: Vaginal bleeding 
61 yo obease F, profuse vag bleeing x 1 months
10 years menopausal,
Hx of HTN and DM
Nulliparous
A 
Endometrial cancer
Cervical cancer
Entometrial hyperplasia
Endometrial polyups
atrophic vaginitis
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14
Q 
Workup: Vaginal bleeding 
61 yo obease F, profuse vag bleeing x 1 months
10 years menopausal,
Hx of HTN and DM
Nulliparous
A 
Pelvic exam: pap, cultues
Pelvic ultrasound
CBC, ESR
Endometrial biopsy
Colposcopy
Hysteroscopy
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15
Q

DDX vaginal bleeding
45, 5 kits,
postcoital bleeding
smoker and takes OCP

A

Cervical cancer (smoker)
Cervical polyup (bleed when bumped)
Cervicitis
Trauma

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16
Q

Workup: vaginal bleeding
45, 5 kits,
postcoital bleeding
smoker and takes OCP

A

Pelvic exam: pap,

Colposcopy and biopsy

17
Q

DDX vaginal bleeding
28 yo F,
8 weeks pregnant, lower abd pain and vag bleeding

A

Spontaneous abortion
ectopic pregnancy
Molar pregnancy

18
Q

Workup vaginal bleeding
28 yo F,
8 weeks pregnant, lower abd pain and vag bleeding

A 
Pelvic exam
Urine hCG
US pelvis
CBC, PT, PTT
Quanitative serum hcg
19
Q

DDX vaginal bleeding
32 yo, sudden onset, left lowe abddomina pain
radiate to scapula and back, with vaginal bleeding
5 weeks since last menses
Hx of PID, unprotected intercourse

A

Ectopic pregnacy
PID
Ruptured ovarian cyst
ovarian torsion

20
Q

WOrkup : vaginal bleeding
32 yo, sudden onset, left lowe abddomina pain
radiate to scapula and back, with vaginal bleeding
5 weeks since last menses
Hx of PID, unprotected intercourse

A

Urine hCg + quanitative serum
Pelvic Exam, cultures
Pelvic ultrasound

21
Q

DDX - Vaginal discharge
28 yo, discharge
thin gray, white
foul smelling

A

Bacterial vaginosis : Thin grey white, odor
Vaginitis ; candidial: thick greay white, odorless
Vaginitis: trichomonal (green yellow, Fishy)
Cervisitis, Chylamidis Gonorrhea

22
Q

Workup- Vaginal discharge
28 yo, discharge
thin gray, white
foul smelling

A

Pelvic : wet mount, cultures
KOH: whiff test (trich)
PH

23
Q

DDX - Vaginal discharge
30 yo F,
thick white, cottage cheesey
odorless vag discharge

A 
Vaginitis: candidial (thick white, odoless)
Bacterial vaginosis (thin grey white, odor)
Vaginitis _ trich
24
Q

Workup - Vaginal discharge
30 yo F,
thick white, cottage cheesey
odorless vag discharge

A

Pelvic, wet mount, cultures
Koh: whiff test
Ph

25
Q

DDX - Vaginal discharge
35 yo F
Malodorus, profuse, frothy greenish vag discharge
Vaginal itching and discomfort

A

Trich
Candida
BV
GCCT

26
Q

DDX - Vaginal discharge
35 yo F
Malodorus, profuse, frothy greenish vag discharge
Vaginal itching and discomfort

A

Pelvic exam,
wet mount + cultures
Ph,
KOH

27
Q

DDX - Dyspareunia
54yo painful
Last Mensus 9 months ago
hot flashes

A

atrophic vaginitis
Endometriosis
Cervicitis
Depression

28
Q

DDX - Dyspareunia
54yo painful
Last Mensus 9 months ago
hot flashes

A

Pelvic exam
wet mount, KOH, cultures
US pelvis

29
Q

DDX - Dyspareunia
37 yo F
inability to conceive and dysmenorrhea

A

Endometriosis
Cerviscitis
PID

30
Q

Key physical exams for dyspareunia

A

vitals
abdominal
complete pelvic

31
Q

Key physical exams for vag discharge

A

Abdominal

complete pelvic

32
Q

Key physical exams for vag bleeding

A

vitals
abdominal
complete pelvic

GPA mini case (11 decks)

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