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Clinical Medicine LAB - Professor Sample > GYN 1 > Flashcards

GYN 1 Flashcards

1
Q

E2 aka ?

A

Estradiol

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2
Q

Normal Pap smear results ?

A

No atypical cells

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3
Q

Hysterogram own notes ?

A

Bicornuate uterus - impartial development

Septate uterus - sometimes the septet restricts fetal growth and leads to fetal demise

Asherman syndrome - adhesions , incompletely filling pockets

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4
Q

FSH / LH decreased ?

A

Pituitary failure

Hypothalamus failure

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5
Q

E3 decreased indicates ?

A

failing pregnancy

like : Fetal distress, Rh incompatibility, preeclampsia, anencephaly, fetal death

  • *not everyone gets tested
  • *
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6
Q

Schiller Test: ______ _______ is an aqueousiodinepreparation and is commonly used for the Schiller test.

A

Lugol’s solution

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7
Q

Dx tests: Ovarian torsion ?

A

US

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8
Q

E2 and GRH ratio ?

A

↓ E2 = ↑ GRH (hypothalamus)

  • *negative feedback to GnRH in hypo
  • *
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9
Q

What is the main screening for carvical CA ?

A

Pap smear

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10
Q

Hysterosalpingography (HSP) indications ?

A

Usually a work-up for infertility

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11
Q

Testosterone increased in females ?

A

Ovarian tumor

Adrenal tumor

PCOS

-hirsutism and acne = sxs. anovulatory cycles and get all these follicles floating around in the opvarys and they never get periods and they get infertility with it.

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12
Q

E3 Increases at _____ gestation and rises throughout _________

A

8 wks

pregnancy

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13
Q

What is a Laparoscopy ?

A

Allows direct visualization of the intraabdominal and pelvic organs.

**just LOOKing!

using tools to go in through puncture wounds but this is no procedure ( this is just looking)
endometriosis or fibroid on outside of uterus in the myometrium**

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14
Q

Ovarian Disorder examples ?

A

Ovarian Cysts
PCOS
Ovarian CA
Ovarian Torsion

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15
Q

Normal Testosterone in females ?

A

< 300 pg/ml

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16
Q

Pap Smear guidelines: Women age 21-65 ?

A

Pap tests no more than Q 3 years

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17
Q

D & C indications ?

A

DUB

Abnormal vaginal bleeding

Endometrial hyperplasia or carcinoma

Therapeutic:

  • Remove embedded IUD
  • DUB
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18
Q

E2 (Estradiol): premarin ?

A

methylestradiol - made from pregnant mare urine ( horse pee)

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19
Q

Uterine disorder examples ?

A 
Asherman Syndrome
Endometrial Ca
Endometriosis
Leiomyoma
Adenomyoma
PID
Toxic Shock Syndrome
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20
Q

What is the major circulating estrogen after menopause ?

A

E1 (Estrone)

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21
Q

Pap smear: What is the purpose of Bethesda System for Reporting Cervical and Vaginal Cytologic Diagnoses ?

A

Minimize discrepancy between reports on cervical cytologic findings ( across PAP smear results)

  • Adequacy ( of specimen)
  • General Categorization
  • Interpretation/Result
  • Ancillary tests

Box 7-1 Mosby’s p.744

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22
Q

Dx tests: Leiomyoma ?

A

US
Laparoscopy
Hysteroscopy
Hysterogram

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23
Q

Dx tests: PID ?

A

GC/ CT Swabs
US
Culdocentesis

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24
Q

Colposcopy findings: carcinoma in situ ?

A

Pink or red well-circumscribed punctate lesion

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25
Q

Dx tests: Bartholin cyst ?

A

culture

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26
Q

When is E2(Estradiol) elevated ?

A

Precocious puberty
early age

Ovarian tumor

Testicular tumor

Adrenal tumor

Pregnancy

Liver necrosis

Hyperthyroidism

**
adrenal tumor cause they increase sterols and then the hormones ( cortisol is related)

liver necrosis - nothing is being metabolized

hyperthyroidism - problems with hypothalamic pituitary access **

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27
Q

Mammogram: own notes ?

A

right is speculated and breast may be deformed here and mass may be pulling on tissue

MC in a breast are typically precursors to CA

right - smooth, uniform but suspicion enough for a bx

benign cysts you usually just leave it and no BX so you can get a US cause they are fluid filled

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28
Q

Cervical Ca usually starts with ?

A

HPV infection

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29
Q

Culdocentesis own notes ?

A

Pouch of Douglas - rectouterine pouch and this collects fluid in the area - infection to get a culture and for relief of sxs. and for a rupture ectopic and there is blood in there

2000 beta HCG - and they do a US and they see nothing and the woman has pain and is tachy - then they do a US and see ultrasound and see fluid here they can do this procedure and maybe see blood there

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30
Q

Gonadotropins own notes ?

A

FSH and LH go to the ovary and it secretes estrogen when then does the negative feedback

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31
Q

Dx tests: Ovarian cysts ?

A

US

Laparascopy

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32
Q

FSH in males aids in the development of ?

A

sertoli cells

which develop into sperm

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33
Q

Estradiol is produced where ?

A

ovary

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34
Q

LEEP aka ?

A

Loop Electrosurgical Excision Procedure

**the MC procedure done and it used electrosurgical loop and it cauterizes as it excises **

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35
Q

Cervical Biopsy what is it ?

A

Biopsy of the cervix to identify and treat premalignant cells and superficial malignancies

Bx that area away

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36
Q

What are the 3 major estrogens ?

A

E1
E2
E3

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37
Q

Estrogen’s order of potency ?

A

estriol < estrone < estradiol

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38
Q

Hysterosalpingography (HSG) own notes ?

A

this one shows the fallopian tubes

sapling shows fallopian tubes

**this procedure is kinda painful and can cause cramping

some women have an easier time getting pregnant after this exam**

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39
Q

Other cervical tests: Review ?

A

Chlamydia (NAAP is the most common test for G and C)

Gonorrhea

Wet Mount
BV ( clue cells = epithelial cells coating in bacteria and trichomonal - mobile flagellate )

KOH prep - viruses and it dissolves the epithelial cells

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40
Q

Dx tests: Endometrial CA ?

A

Pap smear
Endometrial bx
Hysteroscopy

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41
Q

When is a Colposcopy used ?

A

Used to evaluate patients that have an abnormal Pap with a grossly normal cervix

More thorough eval of an abnl Pap

more through evaluation

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42
Q

Estrogen and Progesterone own notes ?

A

if you are taking P then you are keeping the endometrium thin - cause is is a continous amount this is no surge to thicken it

taking steady P and E prevents the spike

E have an affect on the clotting mechanism so there is a risk of DVT and TE

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43
Q

What estrogen develops secondary sex characteristic in females ?

A

estradiol

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44
Q

Diagnostic tests: galactorrhea ?

A

Prolactin

MRI brain

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45
Q

Prolactin is used to evaluate: Galactorrhea ?

A

elevated with pituitary adenomas or cancers

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46
Q

What estrogen assess placental function ?

A

E3

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47
Q

Diagnostic tests: infertility ?

A

See Clin Med for work-up

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48
Q

What is a Pap smear ?

A

✪Mainstay screening exam for cervical CA

**you need a speculum and a spatula and an endocervical brush **

49
Q

Prolactin is used to evaluate: Sheehan syndrome ?

A

pituitary infarct- level will be decreased

  • caused from hemorrhage during birth anf you get decreased prolactin levels
  • postpartum amenorrhea
50
Q

Estrone is more potent than _______ but is less potent than _______.

A

estriol

estradiol

51
Q

Normal Testosterone in males ?

A

240-650 pg/ml

52
Q

Dx tests: Syphillis ?

A

Review (RPR, FTA-ABS)

53
Q

Abnormal Pap smear results ?

A

ASCUS - the least

LGSIL

HGSIL

Cervical Cancer (SCC)

Can also lend information on nonneoplastic findings and infectious organisms

  • *least amount of dysplasia to most
  • *
  • *CA is basically a an abnormal growth of cell in a different ways and lose the function of the tissue they are supposed to be
  • *
54
Q

Cervical Biopsy: punch ?

A

punch is good for depth of the lesion and for small smapling of a large dysplastic area ( see how deep it goes) or something that is suspicious

small tissue samples are taken from the cervix and examined for disease or other problems

55
Q

Laparoscopy results ?

A 
Abdominal adhesions
Ovarian tumor or cysts
Endometriosis
Ectopic pregnancy
Fibroids
Abscess
Cancer
Ascites
56
Q

What does menstruation interfere with Pap ?

A

endometrial cell
contaminate smear,

if you do get these cells and they are not menstruating then it could mean endometrial CA

57
Q

Dx tests: PCOS ?

A 
GTT
US
Serum androgen
LH/FSH ratio
Lipid panel
58
Q

Hysteroscopy own notes?

A

“looking inside the uterus “

59
Q

Dx tests: Ovarian CA ?

A 
BRCA gene 1
CA 125 marker
P53 tumor suppressor gene
US
Surgical bx
60
Q

E3 begin testing at ?

A

28 – 30 weeks

Get baseline then test daily / weekly

61
Q

Reflex HPV Testing: Low risk ?

A

HPV 6,11 ( gardasil protection)

42,43, and 44

62
Q

Dx tests: cervical dysplasia ?

A 
HPV
PAP
Cervical biopsy
Colposcopy
LEEP
63
Q

When would you want to do a urine culture instead of a swab culture ?

A

pediatric patients ( sexual assault or molestation) no pelvic exam on these patient

64
Q

Prolactin is used to evaluate ?

A

Galactorrhea - milky discharge for the nipples

Sheehan syndrome

65
Q

FSH in females aids in the development of ?

A

follicles in the ovary

66
Q

Estrogen testing evaluates what in females ?

A

Sexual maturity
Menstrual and fertility problems
Fetal-placental health
Estrogen producing tumors

67
Q

Cervical Biopsy: cone ?

A

a large area of tissue around the cervix is excised for examination

68
Q

Estrogen testing evaluates what in males ?

A

Gynecomastia

69
Q

Dx tests: ashermans syndrome ?

A

hysteroscopy

70
Q

What is the major estrogen during pregnancy ?

A

E3

71
Q

Pap Smear guidelines: Pap tests for women > 65 years old with hx of NL pap tests ?

A

None

** if the have a abnormal then yes test them, over 65 and getting cervial CA it is slim, low risk of contracting virus ( no sex) **

72
Q

Reflex HPV Testing: High risk ?

A

HPV 16,18, 31, 33,45, 52, 58 (gardasil protection)

35, 39, 51, 56, 59, 68

73
Q

Diagnostic tests: fibroadenoma ?

A

Breast US

74
Q

Septate Uterus ?

A

wedge of fibrous tissue dividing uterine cavity

75
Q

E3 aka ?

A

Estriol

76
Q

Pap Smear guidelines: Women age 30-65 ?

A

Q 5 years if pap with HPV testing

  • *HPV test is neg. then every 5 years
  • *
77
Q

E1 aka ?

A

Estrone

78
Q

High risk HPV is associated with ?

A

severe lesions and cervical cancer

79
Q

Testosterone decreased in males ?

A

Klinefelter syndrome (XXY)

Cryptochordism

Hypogonadism

Orchiectomy

Hepatic cirrhosis

**important to keep this on your differential for men with depression or loss of libido **

80
Q

E3 is produced in the ?

A

placenta

81
Q

Dx tests: TSS ?

A

US
CBC, CMP
GC/CT Swabs

82
Q

Reflex HPV Testing: involves what type of virus ?

A

DNA tumor virus

83
Q

What Interferes with Pap test results ?

A

Menstruation
Lubricating jelly
Infections
Delay in specimen transport

84
Q

Testosterone increased in males ?

A

Pinealoma
affects hypothalamus

Encephalitis

Testicular tumor

Hyperthryoidism

85
Q

Colposcopy findings: invasive CA ?

A

Disarray of blood vessels and mass effect

86
Q

When is E2(Estradiol) decreased ?

A 
Turner syndrome (XO)
wide neck, heart problems - COA

Hypopituitarism - decrease sex hormones

Primary and secondary hypogonadism

Menopause

Anorexia nervosa

**primary hypogonadism - ovarian failure ( happens with early menopause ( premature menopasuse)

secondary - anything else that cause hypogonadism - many had ovaries removed **

87
Q

Hysteroscopy indications ?

A

Abnormal Pap
-proliferation of endometrial cells

DUB

Postmenopausal bleeding
-endometrial CA then do a bx.

88
Q

Diagnostic tests: breast carcinoma ?

A

Mammogram
Breast US
Biopsy

89
Q

Colposcopy findings: own notes ?

A

coat the cervix with Acetic acid and if there is a dysplastic area it will light us

ASCUS / LGSIL - it will just have a sharply demarcated area ( just dyplasiea)

if it is CA punctate pink and dyplasitc area

90
Q

Hysterosalpingography (HSP) can also see ?

A

Uterine tumors

Adhesions

Developmental anomalies

Tubal obstruction (kinking, scarring)
-scarring maybe from PID which obstructs the egg from traveling
91
Q

Asherman’s syndrome ?

A

Adhesions ( band-like formations) crossing the lining of the Uterus

92
Q

E1 (Estrone) is secreted by ?

A

ovary

93
Q

Diagnostic tests: fibrocystic breast disease ?

A

Breast US

FNA

94
Q

LH in females forms the ?

A

corpus luteum

95
Q

FSH / LH increased ?

A

Gonadal failure
-trying to stimulate gonads to secrete

Precocious puberty

Pituitary adenoma

96
Q

What is a Dilation and Curettage (D&C) ?

A

Dilation of the cervix

Curettage of the endometrium

**use sounds to dilate the cervix using a large and larger sound

called a sound cause you are testing/measuring how deep the U is ( like when u are placing instruments you do not want to go to deep)

cervix has stretch receptors and no pain receptors - so this procedure does not help but they get cramping

Curettage is the scraping with a sharp rounded tool **

97
Q

LH in males is involved with ?

A

testosterone production (Leydig cells)

98
Q

What is prolactin ?

A

Hormone that is secreted by the anterior pituitary

Promotes lactation (feedback mechanism)

  • *Breast feeding release prolactin and oxytocin
  • *
99
Q

Hyster = ?

A

uterus

100
Q

Low risk HPV is associated with ?

A

genital warts and low grade dysplasia

101
Q

Dx tests: Condylomata acuminata ?

A

biopsy

102
Q

Pap Smear guidelines: Pap tests for women < 21 years old ?

A

None

  • *regardless of sexual activity
  • *
103
Q

Dx tests: cervicitis ?

A

CT/ GC
Trichomonas
BV

104
Q

Schiller Test is based on ?

A

the principle that normal mature squamous epithelium of the cervix contains glycogen, which combines withiodineto produce a deep mahogany-brown color.

105
Q

What is a Colposcopy ?

A

Macroscopic examination of the vagina and the cervix

**looking for areas of dysplasia **

106
Q

Dx tests: Adenomyoma ?

A

US

Endometrial bx

107
Q

Pap Smear guidelines:HPV testing in women < 30 years old ?

A

None

  • *some women test positive and then clear the virus
  • *
108
Q

ASCUS ?

A

Atypical squamous cells of undetermined significance - does not mean CA ( few cells that are atypical and they dont know what it means)

109
Q

Schiller Test: __________ constitutes a positive Schiller test.

A

Nonstaining

**if it does not turn brown it is abnormal cells **

**abnormal cells stay llgiith , no matter what you put on them **

110
Q

Hormones own notes

A

they all start as sterols

androgen into estrogens? what enzyme ?

men who do steroid get breast cause the estrodiol conversion ( most potent and most common)

T and converted to estradiol ( too commons was to covert it and that is why it is most common)

some tumors feed on estrogen so give a aromatase inhibitor to patient with breast CA to stop the production of E to starve the tumor

111
Q

E2 (Estradiol) own notes ?

A

most potent and prevalent

give to patients with post menopausal issues
osteoporosis
hot flashes
vaginal atrophy - it thickens walls

E2 increase right before the spike of LH

FSH stimulate the follicle and the ovary starts to make the follicle and secret the follicle within the ovary and the E2 during this cycle is starting to rise and when E2 spikes it causes the LH to spike which is the major hormone for the development of the corpus leuteum and cause ovulation. corpus hemorrhagiousum.

the eggs is then releases and trasv=fered to the uterus and the CH turing to the CL and CL releases hormones P and E that are responsible for thickening endmetrium(P) if there is no implantation the P drops off and the endometrium drops off and this is menstariton

E2 linked to reduction binge eating in mood , depression, bone density, atherosclerotic lesions ( only thing that it is linked to that is unhealthy is breast CA)

112
Q

LGSIL & HGSIL ?

A

low or high grade squamous intrahepathelail leasion - there is dysplasia and precursor to CA there ( comes before a formal dx. of cervial CA)

  • *LGSIL or HGSIL then they usually run a reflex test after
  • *
113
Q

FSH/ LH acts on the ?

A

ovaries or testes

114
Q

Reflex HPV Testing: virus pathology ?

A

HPV DNA incorporates itself into the cervical cell genome activating oncogenes and suppressing the cell immune response

115
Q

E3 can be tested in the ?

A

plasma / urine

116
Q

Dx tests: vaginal neoplasm ?

A

biopsy

117
Q

Colposcopy findings: Dysplasia ?

A

White, sharply demarcated after acetic acid

118
Q

Dx tests: Endometriosis ?

A

US

Laparoscopy

119
Q

Bicornuate Uterus ?

A

incomplete uniting of uterus

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