Brainscape's Knowledge GenomeTM

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


See full index

CPD 2 > Gyn 2 Quiz > Flashcards

Gyn 2 Quiz Flashcards

1
Q

What 3 conditions constitute primary amenorrhea?

A

lack of menarche at age of 16, >2 years after onset of puberty or no signs of puberty by age 14

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

Define secondary amenorrhea.

A

menses cease >3-6 and the woman is not pg, lactating or menopausal

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

What are the most common cause of anovulatory amenorrhea?

A

functional causes (endocrine or genetic)

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

What is generally occurring with ovulatory amenorrhea?

A

anatomical genital abnormality with normal hormonal function

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

Give 3 examples of acquired uterine abnormalities causing ovulatory amenorrhea?

A

asherman’s syndrom
endometrial tb
obstructive fibroids and polyps
yes

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

Give 3 examples of congenital genital abnormalities that may result in ovulatory amenorrhea?

A

cervical stenosis
imperforate hymen
transverse vaginal septum

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

Give 4 examples of hypothalamic dysfunction that may result in anovulatory amenorrhea?

A

anorexia nervosa
excessive exercise
hypothalamic chronic anovulation
chronic undernutrition

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

Give 2 examples of pitutary dysfunction that may result in anovulatory amenorrhea?

A

galactorrhea (hyperprolactinemia)

benign pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 potential disorders involving ovarian failure/dysfunction that may result in anovulatory amenorrhea?

A

autoimmune d/o
chemo
viral infection

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

What are 3 potential disorders involving endocrine dysfunction that may result in anovulatory amenorrhea?

A

PCOS
Cushing’s Syndrome
Hyper/hypothyroidism

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

What are some signs during hx taking that might suggest hypothalamic anovulation?

A

change in weight
dietary deficiencies
excessive exercise
environmental stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What, in hx, might make you think Asherman’s?

A

Hx of D&C or uterine surgery

meds that might cause virilism or galactorrhea

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

What are some hx signs of endocrine d/o?

A

thyroid sxs
virilization: hirsutism, temporal balding, deepening voice
sxs of estrogen deficiency: hot flashes, vag dryness
obesity in hirsute women (PCOS)

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

What are 4 PEs you would want to do with amenorrhea?

A

vitals
thyroid
breast exam (looking for nipple d/c)
pelvic (looking for structural abnormalities)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some red flags for amenorrhea?

A

delayed puberty
virilization
visual field defects (prolactinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the top three labs to run when someone presents with amenorrhea?

A

pregnancy test
thyroid study
Prolactin (increase may indicate pituitary tumor)

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

What are the most common causes of primary amenorrhea?

A

physiological delay of puberty

functional hypothalamic chronic anovulation

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

Name 5 common causes of secondary amenorrhea?

A 
pregnancy
PCOS
Obesity
Thyroid dys.
hypothalamic dys.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If your pt. is taking drugs that affect dopamine, what might be the possible cause of her amenorrhea?

A

hyperporlactinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If your pt. is taking hormones and/or is on drugs that affect the balance of estrogenic/androgenic effects, what might be the possible cause of her amenorrhea? You may also see signs of virilization with this.

A

drug-induced virilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If someone has high BMI (>30) and virilization, what might be the cause of her amenorrhea?

A

PCOS

Estrogen excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If someone has low BMI (<18.5) and has risk factors such as a chronic d/o, dieting or an eating d/o, what might be the cause of her amenorrhea?

A

functional hypothalamic anovulation secondary to eating d/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If your pt is of short stature and has a webbed neck, primary amenorrhea and widely spaced nipples, what might you consider as the cause?

A

turner’s syndrome (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Your pt has warm, moist skin, tachycardia and a tremor, what might you be thinking is the cause of her amenorrhea?

A

hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Your pt. has course, thick skin, loss of eyebrow hair, bradycardia, delayed DRTs, weight gain and constipation along with her amenorrhea. what might be the cause?

A

hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pt. present with acne and signs of virilization along with amenorrhea. What might be the cause?

A

Androgen excess due to PCOS, an androgen secreting tumor, cushing’s syndrome, adrenal virilism or drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

You notice striae, moon face, tuncal obesity and thin extremities in your pt. with amenorrhea. What might be the cause?

A

Cushing’s Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Your patient has acanthosis nigricans, amenorrhea, virilization and obesity. What might be the cause?

A

PCOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

You notice vitiligo or hyperpigmentation of the palm as well as orthostatic hypotension in your patient with amenorrhea. What does this pattern suggest?

A

Addison’s dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A patient has amenorrhea and sxs of estrogen deficiency (hot flashes, night sweats, etc) and has risk factors such as oophorectomy, chemo or pelvic irradiation. What might be going on?

A

premature ovarian failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A young woman comes in with primary amenorrhea, hirsuitism and virilism. What are some possibilities for the cause?

A

androgen excess due to hermaphroditism, an androgen-secreting tumor, adrenal virilism, gonadal dysgenesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A woman comes in with primary amenorrhea, enlarged ovaries, hirsuitism and virilism. What are some possibilities for the cause?

A

androgen excess due to 17-hydroxylase deficiency
PCOS
androgen-secreting ovarian tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A pt. has amenorrhea, galactorrhea, nocturnal ha and visual field defects. What might be the cause.

A

hyperprolactinemia

pituitary tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A baby has fused labia and clitoral enlargement at birth. What might be the cause?

A

androgen exposure during the 1st trimester

drug-induced virilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common population to get DUS?

A

women >45 or in puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What percentage of cases of DUS are anovulatory?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the classic presentation of DUS?

A

polymenorrhea
menorrhagia
metrorrhagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the difference in presentation between anovulatory DUB and ovulatory DUB?

A

anovulatory tends to occur at unpredictable times and not related to the menstrual cycle
ovulatory tends to cause excessive bleeding during menstrual cycle and has signs of ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are some things you want to r/o with DUB in your hx/PE/Dx?

A 
pregnancy
anemia
coagulation d/o
thyroid problems
structural abnormalities
hormone imbalance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

In which patients would you want to r/o hyperplasia with EMB?

A 
women >35
obese
PCOS
DM
HTN
endometrial thickness >4mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When would you run a GC/CT in the case of DUB?

A

if PID endometritis or cervicitis is suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the pattern and quality of pain with dysmenorrhea?

A

occurs with or before menses by 1-3 days
peaks 24 hours after onset of menses
subsides in 2-3 days
sharp or cramping, throbbing or dull, constant ache

43
Q

Where does the pain of dysmenorrhea radiate and what are some concomitant sxs?

A

radiates to the legs

HA, N/D, constipation, LBP, urinary frequency

44
Q

When does primary dysmenorrhea usually begin?

A

in adolescence

45
Q

When does secondary dysmenorrhea usually begin?

A

in adulthood

46
Q

What is the difference in cause for primary vs secondary dysmenorrhea?

A

primary is not due to underlying gyn structural d/o.
(increased uterine contractions, passage of tissue through os, narrow os, lack of exercise)
secondary is usually due to underlying pelvic AbN (endometriosis, fibroids, adenomyosis)

47
Q

What are some good questions to ask to differentiate btw primary and secondary dysmenorrhea?

A 
age of onset
nature and severity
factors that relieve/worsen
degree of disruption of daily life
presence of pelvic pain unrelated to menses
effects of contraceptive on pain
48
Q

red flags: dysmenorrhea

A

new/sudden onset of pain
unremitting pain
fever
vaginal d/c

49
Q

What are the first tests to do for dysmenorrhea? And what if those come out inconclusive?

A

Pg, TVUS, culture
then, SIS or HSG
then, MRI
if all of above inconclusive….hysteroscopy

50
Q

What is the pattern of PMDD?

A

sever PMS sxs occurring only during the 2nd half of cycle and ending with onset of menses or shorty after

51
Q

What are some key sx features of PMDD?

A

suicidal thoughts
decreased interest in daily activities
sxs are severe enough to interfere with daily activities

52
Q

How do you Dx PMS or PMDD?

A

clinically
PMS: 2-3 month PMS diary
PMDD: diary for at least 2 cycles
Must have: feelings of sadness/hopelessness, anxiety, emotional liability with frequent tearfulness, irritability/anger, loss of interest in daily activities

53
Q

DDX: PMDD

A

thyroid disease
other hormonal d/o’s
affective d/o’s

54
Q

What is the underlying issue with PCOS?

A

the woman’s inability to process insulin in the liver and muscles due to probable genetic susceptibility that causes hyperinsulinemia

55
Q

When do sxs start with PCOS?

A

menarche and worsen with time

56
Q

What is the classic PCOS presentation?

A 
irregular menses
hirsutism, acne, temporal balding
acanthosis nigricans
obesity
m/b enlarged ovaries/cystic ovaries
57
Q

What are some serious sequelae if PCOS goes untreated?

A 
CVD
DM
metabolic syndrome
endometrial carcinoma
m/b breast CA
58
Q

What does PCOS look like on TVUS?

A

string of pearls: multiple follicles 2-9mm on periphery of ovary

59
Q

What is require for DX of PCOS?

A

2 of 3:
ovulatory dysfunction = menstrual irregularity
clinical/biochemical evidence of hyperandrogenism
more than 10 follicles per ovary on TVUS

60
Q

What two tests would you do to r/o Cushing’s Syndrome and adrenal virilism when you suspect PCOS?

A

serum cortisol

fasting serum 17-hydroxyprogesterone

61
Q

What are some etiologies of premature ovarian failure?

A

AI
chemo
cigarette smoking

62
Q

Sxs: premature ovarian failure

A

amenorrhea/irregular bleeding

sx of estrogen deficiency

63
Q

Which tests are diagnostic for premature ovarian failure?

A

serum FSH, estradiol (if FSH is >20)

64
Q

What is considered premature menopause? Give 3 reasons why this might occur

A

before the age of 40

high altitude, smoking, undernutrition

65
Q

What is the hallmark of perimenopause?

A

changes in bleeding patterns with menses usually beginning in 40s

66
Q

Ssx: menopause

A 
hot flashes/sweating
vaginal dryness
neuropsychiatric changes
night sweats
light-headedness, palpitations, numbness, tingling
atrophic changes
GI disturbances
lack of libido
67
Q

What are 3 health problems associated with menopause?

A

osteoporosis
CVD
breast CA

68
Q

What are three risk factors for osteoporosis?

A

smoking
sedentary lifestyle
wt. less than 127lbs. or BMI<21

69
Q

What is the classic presentation of vaginitis?

A

abnormal vaginal d/c
irritation
pruritis
erythema

70
Q

What makes d/c AbN?

A

offensive odor
prutitis
burning/pain
copious

71
Q

What does d/c look like when cancerous?

A

watery, bloody or both

72
Q

3 causes of vaginitis in young girls

A

chemicals
foreign bodies
infection

73
Q

what is the main cause of vaginitis in reproductive age women?

A

infection

74
Q

When is inflammatory or atrophic vaginitis most common?

A

in menopausal women

75
Q

What do you want to know, specifically, when a woman comes in with vaginits?

A

Antibx use
immunosuppressive d/os
hx of fistulas
sexual practices and hx

76
Q

What 4 PEs should you do for vaginitis?

A

palpate inguinal LNs
external genital exam
bimanual
vaginal pH

77
Q

red flags: vaginitis

A

trichomonal vaginitis in children

fecal d/c (fistula)

78
Q

What else could cause sxs that look like vaginitis? Name 4

A

UTI
allergy/irritation
derm dz
paget’s dz

79
Q

Risk factors for BV. Name 5

A 
IUD
Low vit. D
poor nutrition
douching
no condom use
anal sex before vaginal sex
spermicides
smoking
80
Q

What are the hallmark sxs of BV?

A

fishy odor to d/c
profuse, thin white gray d/c that coats tissue
pruritis and irritation

81
Q

What is uncommon with BV?

A

erythema and edema

82
Q

What are the dx criteria for BV?

A

gray d/c
pH >4.5
fishy odor
clue cells

83
Q

Do WBCs go up with BV?

A

no

84
Q

Risk factors for candida.

A 
antibx use
pregnancy
constrictive undergarments
UD
DM
85
Q

What is the d/c like with candida?

A

thick, white, cottage-cheese like
adheres to vaginal wall
pH<4.5

86
Q

When do sxs often increase with candida?

A

a week before menses

87
Q

How do you dx atrophic/inflammatory vaginitis?

A

ph>6
wet prep: increased WBCs, decrease lactobacillus, parabasal cells
m/b increased cocci

88
Q

What are the sxs of atrophic/inflammatory vaginitis?

A

clear or purulent d/c
dyspareunia, dysuria, irritation
itching, erythema, burning, minor bleeding
thin dry mucosa

89
Q

What is the d/c like with trich?

A

copious yellow/green and frothy!

90
Q

What might the walls and surface of the cervix look like with trich?

A

strawberry/punctate red

91
Q

how does one dx trich?

A

pH: >5.5

wet prep: increased WBCs, flagellated trichomod

92
Q

What are the sxs of cytolytic vaginosis?

A 
burning, pruritis
rawness
vulvovaginitis
dyspareunia
erythematous and excoriated tissue
93
Q

Dx of cytolytic vaginosis

A

pH normal or <3.5

wet prep: small amount of WBCs, increased rods, false/atypical clue cells

94
Q

What are the two most common causes of PID?

A 
Neisseria Gonorrhea (GC)
Chlamydia trachomatis
95
Q

What is the most common cause of PID in women >35?

A

overgrowth of anaerobic/aerobic bacteria in vagina that ascend

96
Q

What are common risk factors for PID in adolescents?

A

with older sexual partners
hx of child protective sercives involvement
hx of attempted suicide (wah???)

97
Q

Of gonorrhea and chalmydia, which causes more severe PID sxs?

A

gonorrhea

98
Q

Sxs: PID

A 
low ab pain that radiates to the back
fever
d/c
AUB
onset during or after menses
dysuria
N/V
99
Q

What will you find on PE with PID?

A 
inguinal LAD, tender
fever 101 or greater
increased pulse rate
speculum: red cervix, easily friable
mucopurulent d/c, yellow/green from os
CMT, guarding/rebound tenderness, enlarged skene's glands, uterine and adenexal tenderness
100
Q

how would you confirm/negate PID?

A

wet prep: >10 WBCs/hpf
CBC: elevated WBCs
ESR: increased >15mm/hr
If all negative, not likely PID

101
Q

What are the main complications of PID (know these fo’ reals)?

A

Tubal scarring and adhesions: chronic pelvic pain, menstrual irregularities, infertility and increased risk for ectopic pg

102
Q

3 DDx for PID

A

endometriosis
appendicitis
ectopic pg

103
Q

What does the d/c of gonorrhea look like?

A

yellow/green mucopurulent

104
Q

What is the pattern of labs associated with gonorrhea?

A

inc. pH
inc. WBCs
inc. ESR
positive culture, of course.

CPD 2 (5 decks)

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