Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 CK > Gyn > Flashcards

Gyn Flashcards

1
Q

22 yo F asymptomatic small, fluid filled, round, simple, painless mobile 3cm. Next step in management?

A
  1. Beta HCG first. 2. US (need to always r/o ectopic pregnancy) 3. Observe. For large Ovarian Cyst can be removed laparoscopically.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

31 yo has sudden discomfort and pain in the left lower abdommen which has got progressively worse. Pt has a negative beta HCG. Management? Dx?

A

Unilateral pain with a negative beta can be Ovarian Torsion. Do beta then confirm with US (need to always r/o ectopic pregnancy) to see adnexal mass. Do Cystectomy if ovary is still viable. Do unilateral Oophorectomy if ovary is necrotic from this twisting of the vessels that lead to ischemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

No symptoms + Mucopurulent Discharge Dx? Diagnosis? Rx?

A

Cervicitis. Swab and culture for chlamydia and gonnorrhea on pelvic exam. Treat: 1 Dose Azithromycin and 1 Dose Ceftriaxone. If pt presents with Gonorrhea you can automatically treat for chlaymydia but not vice versa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Severe Abdominal pain, N/V, pt has negative lipstick sign (looks septic), Guarding, Rebound, Rigidity. CT shows bilateral adnexal masses. Dx? Rx?

A

Tubo-ovarian abscess 2/2 previous PID infection. IV Clindamycin + Gentamicin (to target the anaerobes + gram negatives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the 5 characteristics that distinguish a complete mole from a incomplete mole.

A

Complete mole: 1. Empty egg 2. All father 3. 46 xx diploidy 4. Fetus absent 5. Cancer prone
Incomplete mole: 1. Normal egg 2. Mom and dad 3. 69xxy triploidy 4. Fetus present but non-viable 5. Less chance of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Filipino/Taiwan, 14 weeks gestation and uterus extends all the way to the umbilicus. Passing vesicles/grapes. Has NV no fetal heart tones are heard and pt has high BP and protein Dx? Management?

A
  1. US: Complete mole: Snowstorm/Incomplete(fetus present) 2. Pre-op beta, CXR (Metastasis to lungs) 3. Suction D & C n Send to Path. 4. Ask if Benign? Serial betas weekly until they go down and OCPs for 1 yr 100 percent cure OR Malignant? Good metastasis? (Lung n pelvis) 1 chemo agent. Bad? (Brain n Liver) multiple Chemo agents.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common sexual dysfunction in males? N females?

A

Females is sexual desire. For males it’s premature ejaculation 2nd is erectile dysfunction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 3 causes of endometrial hyperplasia? Management?

A

Obesity/DM, Old age, Tamoxifen (Too much Estrogen). Hyperplasia with no atypia Rx with Cyclic Progestin (provera). Hyperplasia with atypia (TAH-BSO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference btw trichomonas and garndenells vaginalis infections?

A

They both elevate the ph but trichonomas is associated with itching while gardnella is not.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the difference btw trichomonas and gardinellas vaginalis infections?

A

They both elevate the ph but trichonomas is associated with itching while gardnella is not.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

7 yo girl Hispanic Obese girl develops secondary sex characteristics with high FSH and LH levels. Dx? Management? What if she developed isolate pubic hair?

A

Central Precocious Puberty (high FSH and LH). Next step in management is MRI and CT to r/o Tumor!!!! Give GnRH agonist. (To prevent Closure of the epiphyseal plates.) Isolated Thelarche 2/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

7 yo girl Hispanic Obese girl develops secondary sex characteristics with high FSH and LH levels. Dx? Next step in management?

A

Central Precocious Puberty (high FSH and LH). Next step in management is MRI and CT to r/o Tumor!!!! Give GnRH agonist. (To prevent Closure of the epiphyseal plates.) Isolated Thelarche 2/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

18 yo XX female presents with Primary Amenorrhea, Sexual infantilism, Cliteromegaly. Normal internal Genitalia (Vagina and Uterus Present). Low estrogen level and high FSH and LH levels. Dx?

A

Aromatase Deficiency. High levels of testosterone but no conversion to estrogen due to lack of Aromatase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The difference btw transvaginal and transabdominal when diagnosing ectopic pregnancy.

A

Transabdominal only diagnosis when HCG is >6500. Transvaginal can diagnose when it’s greater than 1500.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Low MSAFP, low Estriol, Elevated HCG and Elevated Inhibin A is indicative of what? Low MSAFP, low Estriol, Low hCG and Low Inhibin A is indicative of what?

A
  1. Down syndrome 22 two up two down. 2. Edward syndrome. 18 and everything under.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of ASC-US and LSIL age 21-24? Management of ASC-H and HSIL on pap smear age 21-24.

A
  1. Repeat pat in 12 months. If negative pap 2x then do routine screening. 2. Colpo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symmetrically enlarge uterus with menorrhagia and dysmenorrhea in a 40 yo pt. dx? Management?

A

Adenomyosis. Uterine fibroids present with irregular enlarged uterus. First step in management: For women above 35 it is mandatory to perform an endometrial curettage to rule out endometrial cancer. Hysterectomy for severe symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of ASC-US in >25 year olds.

A

HPV testing: If positive do colpo if negative then repeat pap and hpv test 3x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of pap in < 21 yrs? 21-29? 30-65? > 65?

A
  1. No testing 2. Pap every 3 years 3. Pap every 3 years or HPV testing + pap every 5 years 4. No testing if negative prior screens.
20
Q

56 yo female presents with complaints of insomnia, vaginal dryness, and lack of menses for 13 months. Dx? Test? Rx?

A

Menopause (average age 51) Rule Hyperthyroidism first. Clinical diagnosis. Can check FSH/LH levels. Rx: HRT - may increase risk of breast and endometrial cancer.

20
Q

Pelvic pain around ovulation. Day 12.

A

Midcycle pain (mittlermz)

21
Q

Pain before period and then release after period ends. Dx?

A

Pelvic Congestion Syndrome.

23
Q

Abnormal bleeding without evidence of underlying cause. Give the definition of each: 1. Oligomenorrhea 2. Polymenorrhea 3. Menorrhagia 4. Menometorrhagia.

A
  1. Long periods 2. Alot of periods 3. Excessive flow/bleeding 4. Irregular Bleeding btw periods 5. Excessive and irregular uterine bleeding
24
Q

Causes of Secondary Dysmenorrhea? Next step in Management?

A

Endometriosis, Adenomyosis, Polyps, Cancer, Adhesions (Asherman Syndrome), PID, STD, PCOS. Beta HCG to r/o pregnancy then confirm with US. CBC to r/o Infection or Neoplasm, UA to r/o UTI, G and C swab to r/o PIDs/STDs

25
Q

Rx for Batholin Cyst or Abscess.

A

I and D. Test for chlyamida. Abx only if cellulitis is present.

26
Q

Treatment for AUB: 1. VERY HEAVY Ovulatory Bleeding? 2. Medium Ovulatory Bleeding? 3. Anovulatory Bleeding? 4. vWF 5. If medical management fails?

A
  1. IV Estrogen 2. NSAIDs and OCPs 3. Cyclic Progestins (MPA) 4. Desmopressin 5. Hysteroscopy + Biopsy if lesions are present then Ablation or Hysterectomy.
27
Q

Management of PCOS for a pt who wants to conceive? For one who does not.

A

Diet, Weight loss, Exercise and Statin for everyone, Metformin. Clomiphen citrate for those who want to conceive. OCP for those who dont.

27
Q

Causes of precocious puberty? Management?

A

Can be Central (Premature activation of HPA, causing increase GnRH or Peripheral (GnRH independent due to adrenal tumor, CAH, McAlbright Syndrome)
Rx: Leuprolide GnRH agonist of Central. Glucoccorticoids for CAH, Resection for Adrenal Tumor.

28
Q

Causes of precocious puberty? Most common cause? How does it lead to isolated thelarche or adrenarche? Management and why this management?

A

Can be Central (Premature activation of HPA (Obesity can activate this), causing increase GnRH or Peripheral (GnRH independent due to Obesity, Adrenal tumor, CAH, McAlbright Syndrome.) Most common cause is Obesity. Adipocytes can cause activation of HPA (Increase bone and breast growth and acne) or activation of the ovaries (only breast growth) or adrenal glands (only pubic hair and acne.)
Rx: Leuprolide GnRH Continous agonist of Central. Glucoccorticoids for CAH, Resection for Adrenal Tumor.

29
Q

Hx of cyst. Sudden onset of lower abdominal pain at midcycle, fevers, chills, and vginal discharge. Often follows strenous physical activity or sex. Dx?

A

Ruptured Ovarian Cyst.

30
Q

Ovarian enlargement from mutiple cysts with fluid shifts out of the intravascular space that results in Asicites and hypovolumeia. Dx?

A

Ovarian Hyperstimulation Syndrome.

31
Q

Ovarian enlargement from multiple cysts with fluid shifts out of the intravascular space that results in Ascities and Hypovulemia Dx?

A

Ovarian Hyperstimulation Syndrome.

32
Q

25 yo c/o chronic pelvic and low sacral back pain for several months. Pain is worse premenstrually. NSAIDs have not improved pain. Monogamous with bf. No fever or No Discharge. There is pain in the posterior vaginal fornix and pain upon uterine motion. Urine pregnancy test is negative. CBC is normal. US is normal. Dx? Best initial test? Most Accurate test? Rx?

A

Endometriosis. Best initial is US. Most Accurate is Laproscopy. 1. Provera/OCPs (induce pseudo pregnancy to allow the endometrium to become atrophic and not grow.) 2. Danzol or Leuprolide (Induce Pseudomenauosae) 3. Laproscopy + cauterization (destroys the endometrias and increases fertility. 4. TAH-BSO in older patients for severe symptoms.

33
Q

Most likely cause of infertilty in a women < 30? >30?

A

PID. Endometriosis.

34
Q

Workup for a couple with infertility ( >12 months unprotected with no pregancy) ?

A
  1. Semen Anaylsis 2. Document ovulation with hysterospalgogram (check for Ectopic, PID, Previous D&C, FIbroids) 3. Laproscopy increase pts has endometriosis then can lysis lesions to improve fertility.
35
Q

What medication can you use if a pt is hypoestrogenic and cant use climophine citrate?

A
  1. Human menaupausal gonadotropin ( Has FSH and LH)
36
Q
  1. Cause of Biltateral NONbloody nipple discharge? 2. Cause of Unilateral bloody nipple discharge?
A
  1. OCPs, Antipsychotics ( D2 antanogist -> increase in prolactin), Hypothyroidism 2. Cancer.
37
Q
  1. What is the management of Fribrocystic diseae in women >35 yrs? 2. Fibroadenoma?
A

In absence of fat necrosis and bilateral masses never go wrong with doing a Core Biopsy >35 years. 1. Fluid Aspiration + Mammogram. 2. Baseline Mammogram if mass is small AND women is PRE-Menaupausal then no need for Biopsy. A phyllodes tumor can present as a Fibroadenoma in a POST-menaupausal woman.

38
Q

Primary amenorrhea, + breast (estrogen present) and Uterus, normal height and weight. Dx?

A

Imperforate Hymen.

39
Q

Primary amenorrhea, +breast (estrogen present), - uterus, +pubic and axillary hair (androgen present). Dx?

A

Mullerian Agenesis.

40
Q

Primary amenorrhea, + breast (estrogen), -uterus, - pubic and axilary hair (no androgen). Dx?

A

Androgen insensitivity ( XY and look like females, Receptors do not respond to Testerone so they develop breast by default and no male characteristics.

41
Q

Primary amenorrhea, -breast (no estrogen), + uterus, Increased FSH levels. Dx?

A

Gonadal Dysgenesis. Most likely Turner Syndrome (45, X)

42
Q

Primary Amenorrhea, - breast (no estrogen), + uterus, decreased FSH levels. AND Anosmia. Dx?

A

Hypothalamic- Pituitary failure Kallman Syndrome (Ansomia), radiation, stress, exercise, anorexia. Low GnRG so Low FSH.

43
Q

Work of Secondary Amenorrhea?

A
  1. Beta HCG -> if negative -> TSH and Prolactin -> if negative -> Progesterone Challenge Test -> Withdrawal bleeding -> Anovulation is the diagnosis and treat with MPA (Cyclic Progesterones), or OCPs. If NO Withdrawal bleeding -> Estrogen Progesterone Challenge test -> Withdrawal bleeding -> Check FSH -> High -> Ovarian failure (Premature Ovarian failure or Karyotype 45, X Turners.) If low -> HPA failure (Get MRI to check for tumor.) If NO withdrawal bleeding -> Asherman Syndrome (perform HSG, then lyse lesions.)
44
Q

Name the diagnosis in women

A
  1. Fibrocystic disease - FNA + US 2. Fibroadenoma (Estrogen dependent) - FNA + US 3. Fat necrosis.

Step 2 CK (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions