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GYN 2 Flashcards

1
Q

What is milky nipple discharge a sign of?

A

galactorrhea, can be normal, drug related, thyroid related, or due to prolactinoma

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2
Q

What is bloody nipple discharge a sign of?

A

intraductal papilloma

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3
Q

What is greenish/brown nipple discharge a sign of?

A

mammary duct ectasia

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4
Q

What is purulent nipple discharge a sign of?

A

acute mastitis

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5
Q

What is the most common “painful” breast mass for women less than 50?

A

fibrocystic changes

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6
Q

What is the most common breast mass?

A

fibroadenoma

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7
Q

Who is intraductal papilloma commonly found in?

A

perimenopausal and menopausal patients

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8
Q

What are the characteristics of mastitis?

A

sudden onset of fever, localized pain, and swelling

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9
Q

What is the most common cause of mastiti?

A

staphylococcus aureus

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10
Q

When do the most aggressive breast cancers occur?

A

less than 40 years old

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11
Q

When do most breast cancer cases occur?

A

greater than 50 years old

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12
Q

What gene is associated with nearly half of early-onset breast cancer?

A

BRCA 1

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13
Q

What are the 3 categories of breast cancer malignancies?

A

ductal, nipple, lobular

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14
Q

What is the most common breast cancer?

A

invasive ductal carcinoma

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15
Q

What is the most common organism to cause bacterial vaginosis?

A

gardnerella vaginalis

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16
Q

What is the color of the discharge of candidiasis?

A

thick, “cottage cheese” curdy, white

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17
Q

What is the pH of candidiasis?

A

<4.5

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18
Q

Is the amine odor with KOH of candidiasis positive or negative?

A

negative

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19
Q

What does the wet mount of candidiasis show?

A

WBC, spores, pseudohyphae

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20
Q

What is the color of the discharge of trichomoniasis?

A

frothy, green/yellow discharge

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21
Q

What is the pH of trichomoniasis?

A

> 5

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22
Q

Is the amine odor with KOH of trichomoniasis positive or negative?

A

positive

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23
Q

What does the wet mount of trichomoniasis show?

A

WBC, motile trichomonads

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24
Q

What does the cervix look like with trichomoniasis?

A

petechia or strawberry patches

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25
Q

What is the color of the discharge of bacterial vaginosis?

A

thin, white/grey discharge

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26
Q

What is the pH of bacterial vaginosis?

A

> 4.5

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27
Q

Is the amine odor with KOH of bacterial vaginosis positive or negative?

A

positive - “fishy smell”

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28
Q

What does the wet mount of bacterial vaginosis show?

A

few WBCs, clue cells

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29
Q

What is the most common complaint for someone with vulvar cancer?

A

vulvar pruritus

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30
Q

What is the tx for Bartholin abscess?

A

I and D followed by insertion of a word catheter and abx

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31
Q

What are some risk factors of breast cancer?

A
  • Age >50
  • 1st-degree relatives
  • Radiation exposure
32
Q

What is the name of the cancer that is located on the nipple?

A

Paget disease (ductal carcinoma in-situ)

33
Q

What does Paget disease present as?

A
  • Eczematous lesions

- orange peel appearance

34
Q

Almost all lobular (invasive lobular carcinoma) are what?

A
  • Estrogen receptor +

- Multifocal and bilateral

35
Q

What are the diagnostic studies used for breast cancer?

A
  • Mammogram
  • FNA
  • Core needle bx
  • Excisional bx: GOLD standard
36
Q

What is the tx for breast cancer?

A
  • Radical Mastectomy
  • Modified radial mastectomy
  • Lumpectomy
  • Chemotherapy
37
Q

Vulva cancer occurs at what age?

A

Postmenopausal women: 70-80 yo

38
Q

What is the MC cell that makes up vulva cancer?

A
  • SCC

- most develop through VIN

39
Q

Where is melanoma found in pts with vulva cancer?

A
  • Clitoris

- Labia minora

40
Q

Where does adenocarcinoma start?

A

Bartholin glands

41
Q

What are the characteristics of vulva cancer?

A

Red or white ulcerative or exophytic lesions

42
Q

Most lesions are located where in regards to vulva cancer?

A

posterior 2/3 of labia

43
Q

What are the dx and tx options for vulva cancer?

A
  • Dx: biopsy of multiple sites

- Tx: laser, excision, vulvectomy

44
Q

What is the age risk factor for vaginal cancer?

45
Q

What is the MC cell found in vaginal cancer and where is it MC’ly found?

A
  • Squamous cell - secondary to cervical or vulvar cancers

- upper 1/3 of vagina

46
Q

What is VAIN 1 classified as and how would you tx?

A

Basal epithelial

- monitor, no therapy

47
Q

What is VAIN 2 classified as and how would you tx?

A

2/3 vaginal epithelium

- topical chemo (5-FU cream)

48
Q

What is VAIN 3 classified as and how would you tx?

A

> 2/3 vaginal epithelium

- laser ablation, local excision, intracavitary radiation, topical chemo (5-FU) or partial/total vaginectomy

49
Q

What are the risk factors for cervical ca?

A
  • 1st intercourse < 18 yo
  • Multiple partners
  • Infrequent/ abnormal paps
50
Q

What are the HPV types responsible for cervical cancers? Of those which two are MC?

A

16, 18, 31, 45

- 16 and 18 are MC

51
Q

What is the pap test report for CIN 1?

A

Mild cervical dysplasia

52
Q

What is the pap test report for CIN 2?

A

Moderate to marked cervical dysplasia

53
Q

What is the pap test report for CIN 3?

A

Severe dysplasia to carcinoma in-situ

54
Q

What are the Dx test for cervical cancer?

A
  • Pap
  • HPV DNA
  • Colposcopy
55
Q

What are the Tx options for cervical cancer?

A
  • Cryo
  • Laser ablation
  • LEEP
  • Cold knife conization
56
Q

What would you expect to find on an exam in a pt with fibrocystic breasts?

A
  • Lumpy, thick, firm
  • Not able to feel clear margins
  • Able to move tissue.
57
Q

What may a pt present with if they have fibrocystic breasts?

A
  • Non-bloody, green, or brown nipple discharge.
  • Fluctuance in size
  • Rapid appearance or disappearance of lesions
58
Q

What are the Dx for fibrocystic breasts?

A
  • Bx: diagnosis often rest on this pathology
  • US
  • mammo: not indicated <30
59
Q

What is the tx for fibrocystic breasts?

A
  • Reassurance- NO potential for malignancy
  • limit caffeine consumption
  • BC pills
60
Q

Fibroadenoma is MC’ly found in who?

A

Younger women

- if found in older women they are calcified

61
Q

What is the cause of Fibroadenoma?

A
  • Hormonal response: estrogen sensitive
  • Changes in size with pregnancy
  • Regresses w/ menopause
62
Q

What are come clinical findings of an Fibroadenoma?

A
  • Round, firm, discrete, relatively movable

- Non-tender: 1-5cm mass

63
Q

What are the dx test for Fibroadenoma?

A
  • US: well-defined mass with benign features

- Core Needle Biopsy: confirm dx

64
Q

What are some clinical finding in a pt with Intraductal papilloma?

A
  • Bloody, serous, or turbid nipple discharge

- May stain bra

65
Q

What is the Dx for intraductal papilloma?

A
  • Mammogram &/or Ultrasound

- Ductography: identify intraductal filling defect

66
Q

What is the Tx for intraductal papilloma?

A

Excision of involved duct

67
Q

Galactorrhea is a milky d/c that occurs in who?

A

In women who aren’t pregnant or breast feeding

68
Q

What are the causes of Galactorrhea?

A
  • Physiologic
  • Neoplastic
  • Hypothalamic- Pituitary
  • Medications (SSRIs, TCAs)
69
Q

What are the dx test for Galactorrhea?

A
  • Serum pregnancy test
  • Prolactin level
  • Renal function test
  • TSH
  • Official visual field test
  • MRI
70
Q

What is the tx for Galactorrhea?

A

Treat underlying cause

71
Q

When should you suspect an abscess in a pt with mastitis?

A

If sxs cont. after starting pt on antibiotics

72
Q

If pt has mastitis and abscess is present what may you note on PE?

A

Fluctuant mass with palpation

73
Q

What is the the tx for BV?

A
  • Metronidazole

- Clindamycin

74
Q

What are the risk factors for candidiasis?

A
  • DM
  • Obesity
  • Pregnancy
  • Immunosuppressed
  • Oral contraceptives or corticosteroids
  • Broad spec antibiotics
75
Q

What is the tx for candidiasis?

A
  • “azoles “: topical, suppository, or oral
76
Q

What is Trichomonas associated with?

A
  • PID
  • Endometriosis
  • Infertility
  • Ectopic Pregnancy
  • Premature birth
77
Q

What is the tx for Trichomonas?

A
  • Metronidazole
  • Tinidozole
  • Treat sexual partners
  • Undergo other STI testing

OBGYN (5 decks)

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