GYN Flashcards
primary amenorrhea
no menses by age 16
secondary amenorrhea
menses cease after establishment
PAP results - Bethesda classification of dysplasia
CIN 1
HPV or mild dysplasia
PAP results - Bethesda classification of dysplasia
CIN 2
moderate dysplasia
PAP results - Bethesda classification of dysplasia
CIN 3
severe dysplasia
PAP results - Bethesda classification of dysplasia
CIS
carcinoma in situ
Refer for cervical dysplasia when?
no later than CIN 2
When to start PAP testing?
age 21
Woman age 21 - 29
frequency and type of PAP testing
every 3 years
cytology only
Woman 30 - 65
frequency and type of PAP testing
every 3 years if cytology
OR
every 5 years if cytology and HPV testing
When to stop PAP screening?
age 65 - 70 depending on overall health and risk factors
What are the 3 major causes of vaginitis?
trich
BV
cadidiasis
What are the signs and symptoms of trich?
malodorous, frothy yellowish-green discharge
pruritis / itching
vag erythema
“strawberry patches” on cervix and vagina
dysparunia
dysuria
What is the microscopic test for trich?
SALINE prep
see motile trichomonads
What is the treatment for trich?
metronidazole (Flagyl) – an antibiotic despite -azole suffix
What are the signs and symptoms of BV?
watery, gray, “fishy” discharge
vaginal spotting
What is the microscopic test for BV?
SALINE prep
see clue cells
what are clue cells -
epithelial cells with poorly defined borders
What is the treatment for BV?
metronidazole (Flagyl) – an antibiotic despite -azole suffix
OR
clindamycin (Cleocin)
What are the signs and symptoms of vaginal candidiasis?
thick, white, curd like discharge
vulvovaginal erythema
pruritis
What are the microscopic findings of vaginal candidiasis?
KOH prep
shows psuedohyphae
looks like “spaghetti and meatballs”
What is the treatment for vaginal candidiasis?
miconazole (Mono-stat)
terconazole
butaconazole
–> these ARE antifungals with -azole suffix
Metronidazole vs miconazole – which is the ABT?
metronidazole
What does PID look like?
flu symptoms
+
GYN
What are the signs and symptoms of PID?
fever chills nausea / vomiting vaginal discharge dysuria dysparunia
Physical exam findings in PID?
adnexal tenderness
abdominal tenderness
fever > 38 C
Treatment of PID for most
class: fluoroquinalone
ofloxacin
OR
levofloxicin +/- metronidazole (Flagyl)
Treatment of PID for more refractory disease
class: cephalosporin + tetracycline + other stuff
cefoxitin + probenecid + doxy +/- metronidazole (Flagyl)
OR
ceftriaxone + doxy +/- metronidazole (Flagyl)
What is the effect of probenecid?
slows renal excretion rate of ABT making regimen more effective
What is the usual cause of abnormal uterine bleeding?
endocrine dysfunction
Somatic symptoms of PMS/PDD have to do with what?
physical symptoms
Management of PMS/PDD most supported in the literature?
caffeine restriction
