Brainscape's Knowledge GenomeTM

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


See full index

OB Gyn Shelf - Gyn > Gyn > Flashcards

Gyn Flashcards

1
Q

Clinical signs of menopause

A

Sweating, hot flashes, absent or irregular menses, insomnia, headaches

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

Menopause and hyperthyroidism can have similar sx. What levels should you check?

A

FSH and TSH

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

Steroid tx does not have proven benefit after?

A

34 weeks gestation; limited benefit between 24-34 weeks

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

How many hours needed for steroids to have benefit?

A

24-48 hours

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

Genital warts aka. Present where? And morphology?

A

Condyloma acuminata. Small pink teardrop clusters in internal/external vagina or anogenital area.

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

Condyloma acuminata caused by?

A

HPV infection

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

Tx of condyloma acuminata?

A

Small lesions can be treated with trichloroacetic acid or podophyllin. Large lesions are treated with excision or fulgruation (electric current).

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

Condyloma lata caused by?

A

Syphillis. Part of secondary syphillis. Flat, velvety lesions

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

Lichen sclerosus, lichen planus presentation?

A

Lichen sclerosus in older women - white, thin, wrinkled skin over the labia. Typically affects older women, causes anogenital discomfort - causes pruritis, dyspareunia, dysuria, painful defecation. Lichen planus - middle aged women, can be hyperkeratotic, papulosquamous, or erosive.

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

Daugthers of women who used diethylstillbestrol (DES) are at increased risk for?

A

40x risk of clear cell adenocarcinoma of the vagina and cervix. Many of these women have cervical or uterine malformations (hooded cervix, T-shaped uterus, small uterine cavity, vaginal septae) as well as difficulty conceiving and maintaing pregnancy (ectopics, pre-term)

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

Risk factors for endometrial adenocarcinoma?

A

Prolonged exposure to estrogen stimulation (obesity, early menarche, late menopause, chronic tamoxifen use)

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

Benefits and risks of estrogen-progestin contraception

A

risks 1) VTE 2) HTN 3) hepatic adenoma 4) rare risk of stroke and MI. Benefits: reduce risk of endometrial and ovarian cancer

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

Menorrhagia

A

Heavy or prolonged menstruation typically lasting longer than 7 days or exceeding 80ml.

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

Young patients have irregular/heavy bleeding because?

A

Their HPA is not well developed and don’t produce FSH LH in the right ratios and up to 90% of cycles after menarche can be anovulatory. The endometrium responds to baseline estrogen which is why a lining builds and then sloughs off.

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

Fibroids aka

A

Uterine leiomyomata

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

Adenomyosis is?

A

Endometrium within the myometrum

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

Endometriosis?

A

Presence of normal endometrial mucosa (glands and stroma) in locations other than the uterine cavity

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

Tx for primary dysmenorrhea

A

NSAIDS . Inhibits prostaglandin synthetase which decreases prostaglandin production (prostaglandind released from uterus to cause contractions causes the pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the different common causes of secondary dysmenorrhea

A

1) uterine leimyomata 2) endometriosis 3) adenomyosis 4) pelvic infection

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

Pelvic exam for atrophic vaginitis

A

Pale, smooth and dry vaginal epithelium, scarce pubic hair, loss of fat pad in the labia

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

Tx for atrophic vaginitis

A

Initial tx for mild: lubricants, moisturizers. Moderate to severe: local low-dose vaginal estrogen replacement

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

Typical sx of atrophic vaginitis

A

Dyspareunia, dysuria, increased urinary frequency, pruritis, vaginal dryness

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

Stressful lives, excessive exersice dieting can cause

A

Hypogonadotropic hypogondadism

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

Laparascopy is both diagnostic and therapeutic. Allows

A

Visualization, ablation, excision,

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

Dx endometriosis when/with

A

When tx of suspected endometriosis with NSAIDs has failed. Tx/Dx with laparascopy

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

Risk factors for endometriosis

A

Nulliparity, early menarche, short menstrual cycles, menstrual flow obstruction

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

Risk factors for breast cancer

A

Nulliparity, postive family hx, genetic mutations (BRCA and p53), early menarche, late menopause, prolonged HRT

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

Risk factors for endometrial carcinoma?

A

Advancing age, unopposed estrogen or prolonged use of tamoxifen, obesity, nulliparty, anovulatory conditions

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

Pathogenesis of endometriosis

A

Ectopic endometrial tissue forms on or beneath pelvic mucosal or serosal surfaces, cyclic hyperplasia and degeneration occur in response to female sex hormones, chronic hemorrhaging leads to formation of fibrotic pelvic adhesions.

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

Presentation of endometriosis

A

Dysmenorrhea, dyspareunia, pelvic pain, infertility. Can have chronic pelvic pain

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

Exam for lichen sclerosus

A

Porcelain white atrophy with “cigarette paper” quality. Do biopsy to rule out vulvar SCC

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

Lichen sclerosus et atrophicus is considered

A

Premalignant, can lead to vulvar squamous cell carcinoma

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

1st line therapy for lichen sclerosus et atrophicus?

A

high potency topical steroids

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

Risperidone MOA, side effects

A

dopamine antagonist, also acts on serotonin receptors. Inhibits dopamine, causes galactorrhea, amenorrhea

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

Raloxifene? Most important side effect?

A

Selective estrogen receptor modulalator. Mixed agonsit/antagonist. In breast and vaginal tissue it is antagonist whereas in bone tissue it is agonist. Decreases breast cancer risk. One of the first line Tx for osteoporosis though less effective than bisphosohnates and estrongen. Increased risk for VTE

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

PCOS also known as

A

Stein levanthal syndrome

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

How does clompihene citrate work

A

Estrogen analog that improves GnRH release and FSH release thereby improving chances of ovulation.

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

Ovulation can be induced in patients with PCOS with

A

Clomiphene citrate and metformin

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

Difference between genital ulcers seen in chancroids and herpes genitalis differ from syphillis in that

A

Both are painful while syphillis is not painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

presentation of primary syphillis

A

infection, then 2-3 weeks later, development of small painless papule => ulcerates, forms a chancre with punched-out base and raised indurated margins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Chancroid

A

Ulcer with deep purulent base, and painful lymphadenopathy

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

Genital herpes presentation

A

Multiple vesicles following prodrome of burning and pruritis. Within days, vesicles become painful ulcers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Dx of primary syphillis is best made via

A

spirochete ID on dark field microscopy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Nontrepenomal serologic tests and trepenomal serologic tests

A

RPR, VDRL, FTA-ABS . In primary syphillis may not have yet formed antibodies against syphillis, therefore, can’t detect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What’s going on with ovaries in Turner Syndrome?

A

Ovarian dysgenesis => low estrogen => high FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Adenomyosis a/w

A

multiparous women >40, early menarche, short menstrual periods, prior uterine surgery, preterm birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Definitve dx of adenomyosis is made?

A

surgical pathology after hysteroectomy

48
Q

Adenomysosis clinical presentation

A

dysmenorrhea, pelvic pain, heavy menses, bulky, globular/tender uterus (around 10 weeks size)

49
Q

Midcyle pelvic pain aka

A

mittelchmerz

50
Q

Serum inhibin B is used to measure

A

ovulatory reserve

51
Q

Risk factors for osteoporosis

A

Advanced age, Caucasian/Asian ethnicity, cigarette smoking, alcohol consumption, thin body, steroid use, menopause, malnutrition, family hx

52
Q

Tx / instructions for patients with trichomonas

A

Tx patient and sexual partner with metronidazole or tinidazole. No need to test partner but should treat, partner always has it, they can be asympomatic, it is cheap to treat. No sex till both are treated

53
Q

Changes in cervical mucus during menstrual cycle

A

Thick, opaque and acidic in follicular phase. Thin, abundant, clear, extends 6cm in ovulatory phase, back to being thick in the luteal phase

54
Q

Hallmarks of endometriosis

A

the 3Ds - dyspareunia, dysmenorrhea, dyschezia

55
Q

Precocious puberty defined as puberty before the ages of

A

8 for girls or 9 for boys

56
Q

Precocious puberty can be due to

A

Central (early activation of HPA axis) - will have high levels of FSH/LH or peripheral reasons (excess adrenal or gonadal production of hormones). Wil lhave low levels of FSH/Lh. Example of peripheral precociosu puberty is CAH.

57
Q

Two main types of vaginal cancer

A

Squamous cell and clear cell adenocarcinoma

58
Q

Clinical features of vaginal cancer

A

Malodorous discharge, postmenopausal or post coital vaginal bleeding; irregular mass/plaque or ulcer on vagina

59
Q

Typical location of squamous cell cancer of vagina and clear cell adenocarcinoma of vagina

A

1) upper 1/3rd of posterior vagina wall 2) upper 1/3 or anterior vagina wall.

60
Q

Risk factors for scc vaginal cancer and clear cell adenocarcinoma

A

1) history of hpv 16 or 18, hx of cervical dysplasia/cancer, cigs 2) in utero exposure to DES

61
Q

Aromatase deficiency. Pathophysiology and presentation?

A

Rare genetic disorder resulting in lack or poor functioning of enzyme that converts androgens to estrogen. In utero> masculization of mother that resolves after delivery. In the child=> high levels of gestational androgens leading to normal internal genitalia but ambiguous external genitalia. clitoromegaly when excess androgens are present in utero. later in life => delayed puberty, osteoporosis, undetectable circulating estrogen, high concentration of gonadotropins and polycstic ovaries. (high FSH/LH)

62
Q

Most common CAH

A

21 hydroxylase deficiency. Estrogen synthesized, internal genitalia normal

63
Q

Mccune albright syndrome

A

Café au lait spots, polyostotic fibrous dysplasia, autonomous endocrine hyperfunction. Most common endocrine feature = gonadotropin independent precocious puberty.

64
Q

Kallman’s syndrome

A

Hypogonadotropic hypogonadism with anosmia.

65
Q

Treatment for stress incontinence

A

Kegel exercises and then urethopexy (restoration of urethovesical angle)

66
Q

uretheral hypermobility can be diagnosed by?

A

Inserting cotton swab into urethral orifice and demonstrating angle > 30 degrees upon increase in intra-abdominal pressure

67
Q

Treatment for chlymadia

A

1 dose azithromycin or 7 day course of doxyclycine

68
Q

Treatment for gonorrhea

A

Ceftriaxone

69
Q

Endometrial hyperplasia classification and tx

A

Endometrial hyperplasia gets categorized as simple (mildly crowded and cystically dilated) or complex (more crowded and disorganized) and without atypia or with atypia. Hyperplasia without atypia ( hysterectomy

70
Q

Candida vaginitis tx

A

Oral fluconazole (over intravaginal agents) due to comfort. Pseudohyphae seen in wet-mount prep. Cttage cheese discharge, vaginal inflammation. No need to treat partner. Ph = 3.8-4.5

71
Q

PID diagnosis criteria

A

Fever >38, leukocytosis, elevated ESR, purulent cervical discharge, adnexal tenderness, CMT, lower abdominal tenderness

72
Q

Most common cause of infertility in women

A

PID

73
Q

Tx for PID

A

If high fever, failure to respond to antibiotics, N/V, pregnancy => inpatient hospitalization and wide spectrum abx. Regimens: cefoxitin or cefotetan/doxycycline, clinda/gentamycin. No not delay abx tx until ucx results come out.

74
Q

PID can lead to

A

tubo-ovarian abscess, abscess rupture, pelvic peritonitis, and sepsis

75
Q

Diagnosis of primary ovarian failure

A

FSH elevation in the setting of >3 months of amenorrhea in a woman under 40

76
Q

Causes of premature ovarian failure

A

Chemotherapy, radiation, autoimmune ovarian failure, Turney’s syndrome, fragile X syndrome.

77
Q

What are athe FSH and LH levels like in premature ovarian failure

A

no folicular development -> no estrogen => elevated FSH AND LH. FSH elevated more because of slwoer clearance from the system

78
Q

Patients with secondary amenorrhea should get

A

FSH, prolactin and pregnancy test

79
Q

Women with excessive exercise, low caloric intake have amenorrhea due to

A

Decreased LH and GnRH

80
Q

Syncytiotrophoblast

A

Outer layer of the trophoblasts. Epithelial covering of the embryonic placental villi which invades the wall of the uterus

81
Q

Role of HCG in pregnancy

A

HCG secreted by the syncytiotrophoblasts to preserver the CL during pregnancy, so that it can continue to secrete progesteerone until the placenta starts making its own progesterone and takes over. Production of hCG starts around 8 days after fertilization and the levels of hcG doubles every 48 hours

82
Q

Alpha unit of hCG is common with

A

TSH, FSH, LH. Beta unit is specific to hCG and is the basis of home pregnancy tests.

83
Q

Morning after pill is what?

A

Levonorgestrol, Works by delaying ovulation

84
Q

Abnormal uterine bleeding definition

A

Menstrual bleeding with abnormal duration, quality, or schedule

85
Q

Ovarian cyst rupture presentation

A

Mostly in young women of reproductive age, asymptomatic or develop sharp sudden onset unilateral pain esp after strenuous activity or sex. May have slight bleeding due to drop in hormones after ovarian cyst rupture. Pelvic u/s shows free fluid near the cyst

86
Q

Differential diagnosis for acute pelvic pain

A

1) Ovarian cyst rupture 2) ovarian torsion 3) ectopic pregnancy 4) mittelschmerz 5) ectopic

87
Q

Ovarian torsion presentation

A

Acute onset uniliateral abdominal pain, n/v, pelvic u/s with doppler shows enlarged ovary veins with decreased blood flow

88
Q

Initial workup for adnexal mass in postmenopausal woman

A

Trans vag u/s, CA 125 level. In post menopausal women, elevated CA125 has high sensitivity and specificity.

89
Q

Mgmt of asymptomatic women with adnexal mass

A

if U/S not concerning and CA125 low, observe patient with periodic U/S. if U/S concerning, or if CA125 elevated, refer to gyn onc

90
Q

Common STDS and tx

A

1) chlamydia trochamitis cervicitis (most common cause of cervicitis)-azithromycin 2) neisseria gonorrhea - ceftriaxone 3) herpex - acyclovir 4) trichomonoas vaginitis - metronidazole

91
Q

What testing is recommended to differentiate GC?

A

Nucleic acid ampflicfication testing

92
Q

Tx for Neisseria gonorrhea

A

Ceftriaxone + azithro or doxy. Second agent to cover cephalosporin resistant gonococci as well as concoitant chlamydia infection

93
Q

Most common cystic ovarian neoplasm

A

Serous cystadenomas, accounts for 30% of ovarian tumors. 25% are malignant, about half are bilateral. Do not produce androgens or estrogens.

94
Q

Presenting feature of serous cysteadenoma

A

Ovarian mass and abdominal pain

95
Q

Granulosa cell tumors. Epi, presenting feature

A

Fairly common. 10% of all solid malignant ovarian tumors. Tumor produces excess estrogen. Occur at any age but follow bimodal distrubition. If occuring young, will show as precocious puberty (breasts, hair, hyperplasia of uterus). If occuring post menopausal, wont have the tx menopausal sx like vaginal dryness.

96
Q

Dysgerminomas, epi and presentation

A

Arise in younger women, average incidence age 20. usually unilateral and undergo torsion. Tumor is neutral and does not secrete male or female sex hormone.

97
Q

Sertoli-Leydig cell tumors presentation

A

Produce testosterone, causes defeminazation followed by masculinization. Altered body contour, scanty breasts,

98
Q

Mature teratomas aka

A

Dermoid cysts. Don’t produce any hormones

99
Q

Examples of emergency contraceptions and efficacy

A

1) copper iud - causes inflammation, toxic to ova/sperm (99%) 2) levonorgestral pill - progestin, delays ovulation (85%) 3) ulipristal pill - anti-progestin, delays ovulation (>=85%) 4) OCPs (75%) - progestin, delays ovulation

100
Q

Abnormal uterine bleeding in adolescents typically due to

A

immature hypothalamus pituitary ovarian axis. Endometrium builds up during anovulatory cycles and if ovulation occurs, heavy menses ensue

101
Q

First line tx for AUB in adolescents

A

high dose estrogen, high dose OCPs, high does progestin, and if those are contraindicated transexemic acid (antifibrinolytic)

102
Q

Side effects of combined OCPs

A

Breast tenderness, amenorrhea, bloating, breakthrough bleeding, decreased risk for ovarian and endometrial cancer, increased risk for cervical cancer, VTE, hypertension, liver disorders, elevated triglycerides

103
Q

Amsel criteria for bacterial vaginosis

A

When 3 of 4 criteria are met, dx 1) positive whiff test 2) clue cells on wet mount (vaginal epithelial cells with adherent coccobacilli) 3) vaginal pH >4.5 4) thin, gray-white vaginal discharge. ITCHING AND BURNING ARE NOT USUAL. VAGINAL EPITHELIUM/CERVIX NOT INFLAMED

104
Q

Premature ovarian failure

A

amenorrhea>3 months, high gonadotropin levels, low estrogen in women

105
Q

Obesity is a common cause of amenorrhea

A

There is anovulation secondary to obesity. Ovaries still producing estrogen, but progesterone not being produced at normal post ovulation levels. Therefore, progesterone withdrawal menses at the end of the cycle do not occur

106
Q

Steroid acne presentation

A

monomorphous pink papules and absence of comedones. Distributed on face, arms, and extremities.

107
Q

Patients taking metronidazole should avoid?

A

Alcohol - be cautious against disulfiram like reaction - acetaldehyde accumulates in the blood stream. Flushing, N/V, hypotension.

108
Q

Cervical cancer screening guidelines

A

No screening under 21 unless immunocompromised, HIV+/SLE. 21-29: cytology every three years, 30-64: cytology every 3 years or cytology+hpv testing every 5 years. 65 and over: no screening if hx of negative screens and not at high risk for cervical cancern pts with hysterectomy/cervix removal: no screening is no hx of high grade precancerous lesions, cervical cancer, DES exposure

109
Q

Fibroids presentation

A

Irregular uterus, pregnancy difficulties, difficulty conceiving, mass issues (causes constipation, urinary frequency, pelvic pressure/pain), heavy menses with clots

110
Q

Tx of fibroids

A

observation if asymptomatic, hormonal contraception, embolization, surgery if symptomatic

111
Q

First line diagnostic work up for fibroids

A

U/S has high sensitivity for uterine fibroids and ovarian pathology.

112
Q

Most common cause of decreased fertility in women in their fourth decade who are still experiencing menstrual cycle

A

Decreased ovarian reserve

113
Q

Inferitility due to aging can be assessed by?

A

Using early follicular phase FSH level, clomiphene challenge test, inhibin B level

114
Q

In patient with primary amenorrhea and uterus, what should be done next?

A

FSH level. If FSH is high => karyotyping. If FSH is low => pituitary MRI

115
Q

Forms of effective contraception for breastfeeding moms

A

Barrier method, sterilization, IUD, progstin only contraceptives. Don’t give combined pills - may decrease production and get into the milk

116
Q

Most common pelvic tumor found in women

A

Fibroids

117
Q

Risks and benefits of tamoxifen

A

SERM. Antagnositic on breast and vaginal tissue but agonist on endometrium, increasing risk for endometrial cancer. Has overall mortality benefit, also decreases risk for osteoporosis by acting as a estrogen recept agonist on osteoclasts, inhibiting bone turnover.

OB Gyn Shelf - Gyn (1 decks)

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