Brainscape's Knowledge GenomeTM

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


See full index

PANRE > GYN > Flashcards

GYN Flashcards

1
Q

ovarian cysts

A

in postmenopausal women–> consider malignancy

bening: common in reproductive age
- many resolve on own

most common type is functional ( follicular test),
- resolve in 60 days

dx: sonogram
management: observation 30-60 days
- follicular or theca lutein- surgical evaluation is present

nonfunctional: endometraiona ( chocolate cyst)– surgery

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

PCOS

A

1 cause of androgen excess ad hirsutism

  • bilat cysts
  • presentation: hirsutism, infertility
  • women with regular periods in young years and in 20s periods are very

sonogram/labs: string of pearls, oyster ovaries
elevated androgen, high FSH, LH, lipid abnormality , insulin resistant

tx: OCPs, DepoProvers, weight loss

if wants pregnancy:climid with metformin

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

ovarian cysts- neoplastic masses

A

bening neoplastic process
- serous cyst adenoma- -uniloular, most common

  • bening cystic teratoma- mobile on long pedicles ( have teeth and hair)
    mangement: surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ovarian cancer

A

2nd gyn malignancy
- mean age 69

RF: BRCA 1 gene, fix, nulliparity, late menopause, caucuasian/ asian, diet high in sat fat

screenin: biannual pelvic exam
- sonogram not done for routine screening

tumor types: epilethial

s/s: early - most asymptomatic
later: abd distenction, pain, early satiety, urinary frequency, change in bowel habits

exam: fixed, bilat nodualr pelvic mass, abd distenion, ascities, sister mary joseph’s nodule in the umbilicus
dx: sonogram, biopsy

tumor markers: CA 125 and CEA

tx: TAH/ SBO

chemo -IV or IP

-rad tx

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

Pap smear screening

A

who gets tested:

women under 21 should be tested regardless of sexual initiation
- 21-29- every 3 years
30-65- Pap and HPV every 5 years or Pap one every 3 years

over 65–> previous normal Paps- no testing

h/o pre-cancer- Paps 20 years after that dx

check for statement of adequacy: most have endocervical cells,

if adequate:
negative, atypical squamous cells, low grade spumous, or high grade , or cancer

management:
ASCUS- repeat 4-6 months, if second is same do colposcopy

ASC-H, LSIL, HSIL-colposccopy/ bx/ HPV testing

treat histology not pap results

CIN1- repeat in 6- 12 months
HPV DNA testing

CIN1 or C1N3- cryotherapy
cold knife conization, or LEEP

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

cervical cancer

A

3rd most common

RF: early sex, too man sex partner, HPV, smoking
16, 18, 31, 33

squamous cell

s/sx: post-coital bleeding

exam: cervix if friable
dx: pap and bx

tx TAH
Stage 3/ 4 chemo and rad tx

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

cytocele/ retocele/ uterine prolapse

A

common after menopause

  • cystocele- prolapse of bladder into ant wall of vagina
  • retocel- herniation of rectum into post wall

uterine prolapse- prolapse vaginal canal

sx: vaginal fullness or pressure, feeling of incomplete voiding/ defecation

tx: topical estrogen therapy ( cystocele)
- pessary
- kegel exercises
- surgcial repair

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

mastitis

A
  • occurs inf breastfeeding women
  • caused by nipple trauma
  • s. aureus

sx: unlit, erytheamt, tenderness
- fever/ child

tx: dicloxacilin, cefalexin, erythro
- continue breast feeding on affected side

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

breast abscess

A

farther along mastitis

  • localized mass
  • f/c

management: I and D
IV abx- vancomycin
stop breastfeeding
pump and dump

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

fibrocystic breast

A
  • sxs: painful cystic billet breast pain, size of cyst fluctuate during menstrual cycle

exam; bilat cysts that vary in size
sonogram- fluid filled cysts

tx: conservation, reduce caffeine, increase vitamin e, tamoxifen, or bromocritpin

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

fibroadenoma

A
  • AA, 20 years of puberty
  • painless and unlit
  • mobile

s/s: painless uniat lump

dx: sonogram- smooth, uniform, solid, FNA ( no fluid)
-watched,
large- surgery

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

breast cancer

A

most common cause in women, 2nd MC cause of cancer

RF: BRCA 1 and 2

  • prolonged use of unopposed estrogen
  • early menarche, late menopause, late first pregnancy, nulliparty, over 40
  • high fat diet
  • obesity
  • hyperplasia with fibrocystic breast
mammogram screening: 
If average risk: 
start at 40 
40-40--> every 1-2 years
> 50-- every year

Genetic RF: 25-35
not accurate
consider MRI

tumor types 80% infiltrating ductal

  • painless, stony hard unlit mass
  • infiltrating lobular- 10%
  • inflammatory- 2%
  • Paget’s dz- 1% ( rash on her breast and tried anti-fungal cream)

sx: painless mass in URQ, nipple d/x, erosion.

dx: 90% seen on exam
u/s
mammogram
FNA
open bx

surgery: 1 cm

hormone therapy-HR positive( tamoxifen and AI)

Zometa to dec fx

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

menopause

A

mean age 51
-low estrogen

changes: cessation of sense, hot flashes, dec vaginal lubrication, depression, mood swings

late changes: CAD

  • everything dries up and falls down

FHS> 30 diagnostic

tx: HRT-contervial
used for hot flashes and dryness

CI: liver dz, thrombosis, CA of breast or endometrial

alternative tx:
hot flashes- depo vera, SSRI, yoga, acupuncture

osteopsosi: calc with vitamin d

vaginal dryness

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

vaginitis

A 
candida: 
RF: HIV, DM, abx
s/sx:  thick white 
10% KOH pseudonyme
tx: diflucan po or single dose or azole cream

bacterial vaginosis
-smells bad, d/c worse after menses, scant/ sticky, clue cells,
flagyl 500 mg bid X 7 days
-think about cost

trichomonas - sexual awtiviy, copious d/c, green/ yellow frothy ( strawberry cervix), protozoa, flagyl 2 g po X 1 dose

flagyl- avoid ETOH and sun

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

chlamydia

A

most common of STI

RF: sex

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

gonorrhea

A
  • vaginal itching or penile itching
  • cervical motion tenderness
  • dissementiated infection
  • cause of septic arthritis ( wrist, elbows, knee, ankles)
  • macular papular leions on hands and feet

tx: zithromax X 1 dose
or ceftrixome

tx partners

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

HPV

A

most common STI in women

  • subtype 6 and 11 are being
    16, 18, 31, 33- cause cervical cancer

-cauliflower -like warts on external genitalia, anus, cervical

dx: HPV DNA testing, clinical on PAP
tx: small lesions
-podophyllin, imiquimod
large lesions: cryotherapy or surgery

prevention gardais vaccine
girls and boys 9-26
16, 18,

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

pelvic inflame dz

A
  • bacteria starts in uterus and works its way up bilat
    pathogens: chlamydia- dos common, gonorrhea,

RF: age 20, prior PID, prior douche

sx: bilat pelvic pain, back pain down the legs

exam: mucopurlent cervical d/c
- cervical motion tenderness

dx: cervcial cx
- elevatd WBC
- sonogram

d/d: ectopic, appendicitis, pyelonephritis

tx: inpatient- pelvic access, fever above 102, pregnancy, unreliable pt
outpatient: ceftriazone IM single dose +doxcycyline po X 14 days

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

contraception

A

NPF- tracking a women menstrual cycle,
avoid sex 48 hours before and after this time
- check Basal body temp and monitor cervical mucous
failure rate: 25%

barrier methods “
condoms- protects gains STI, diaphragm ( bladder irritation), cervical cap
, spermicides

advantage: low SE profile, low cost

hormonal method
estrogen and progesterone - 3 weeks and 1 week off ( get periods

monphasic- dose is stay

-advantage- in monogamous relationship

OrthoEva- path changed once a week X 3 weeks
failure rate 1%

Nuva Ring-
leave in for 3 weeks and then come out for menses

  • estrogen suppress FSH so follicle won’t mature
  • no ovulation
  • mucous is thicker

benefits: dec endometrial can, ovarian cyst, dysmneoorhea, fiber breast

CI: pregnancy, H/o: dat, breast/ endometrial cancer, melanoma, abn liver function tests

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

progesterone only

A
  • taken daily
  • take same time every day
  • good breastfeeding
  • women > 40
Depo Provea- IM every 3 months
- return of ovulation up to 18 months
( good for teenagers)
SE: weight gain, mood changes, 
only use for 2 years
calcium loss

SQ Rods: left 3-5 years
cannot take oral
ovulation start promptly after removal

SE: scarring

  • MOA: ovulation interrupted

CI: breast ca and liver tumors

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

IUD

A 
replace every 5-10 years
-wire in winning of future
-multi-parous women
- smokers > 35 y/o 
CI: pregnancy, uterine bleeding, acute gyn infection,

complications: uterine perforation,

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

sterilization

A

tubal is most common

vasectomy is reliable

23
Q

infertility

A

not able to conceive w/in 12 months of unprotected sex
primary- no prior pregnancy
secondary- after previous pregnancy

causes: an-ovulation- most common
- tubal dz
- male factor
- unexplained

an ovulation
- PCOS, high prolactin, hypothalamic-pit dysfunction, hypothyroidism

dx: menstrual diary, literal phase day 21
management: bromocriptine to dx hyperpolactinemia, climid to stimulate ovulation, metformin to increase ovulation and pregnancy

24
Q

infertility- tubal dz

A

-cause: scarring/ adhesions
PID, endometriosis, h/x rupture appendix

dx: hysterosalpinogram
lapro

management: surgery/ lysis of adhesions

25
Q

infertility-male factors

A

abnormal semen analysis

cause: increase scrotal temp, smoking, excessive ETOH, varicocele
dx: semen analysis

tx: tx etiology
-IUI
doner insemination

26
Q

General approach to infertility

A
  • phase 1-
  • detailed h/o and type of coitus, ovulation tracking, semen analysis, TSH, prolatic, LH

Phase 2:

  • hystersalpinogram
  • lapro
  • IVF if no cause
27
Q

fetus/ infant nomenclature

A

abortion: 42 weeks

twins counts as 1 pregnancy

28
Q

presumption manifestations of prengnay

A 
amenorrhea
n/v
quickening ( fetal movement)
nulliparas 18-20 weeks
multipara: 14-16 weeks

urinary frequency, nocturia, infection

signs; chadwicks signs- bluish discoloration of vagina and cervix

skin change: melasma/ chloasma ( dark patches on face)
-linea nigra

probable manifestation

  • positive pregnancy test
  • hagar’ sign -softenging b/w fundus and cervica

uterine growth-
12 weeks-symphisi pubis
20 weeks - at umbilicus
after 20 weeks- 1 cm

positive manifestations
fetal heart tones
-u/s examination of fetus

labs:
cholesterol increase > 200

BUN/ cr decrease

29
Q

prenatal labs

A

abc, blood type, vdrly, hep b, rubella,

every visit- check maternal weight, BP, fundal height, fetal size , urine dipstick for protein,glucose, ketones

30
Q

screening tests

A

1st visit- dating sonogram -discuss screening tests

10-13 weeks-nuchal translucency

15-18 weeks- alpha-fetal protein/ quadruple screen

18-22 weeks- anatomical sonogram

24-28 weeks: glucose challenge test

28 weeks- Rhogam if woman is RH negative

32 weeks- repeat abc, VDRL, chlamydia, gonorrhea, Grp B strep

31
Q

trisomy 21

A

1st trimester- PAPP-A- low
free beta hCG- high

2nd trimester-
AFP -low
inhibin A

nuchal translucency screenin test

10- 13 weeks

10-13 weeks- CVS, not risky
15-20 - amniocentesis

32
Q

weight gain/ nutrition

A

20-35 pounds

  • intake 300 kc/per day
  • avoid ETOH, smoking, drugs, unpasteurized foot, deli meat, farm salmon
33
Q

stages of labor

A

stage 1- onset of labor to full dilated ( 10 cm )

second stage: fully dilated to birth of infant

3rd stage; - delivery of infant to delivery of placenta

34
Q

causes of slowed labor

A 
pelvic floors- inadequate pelvis, failure to descent, 
contraction factors ( tx picot )

aides:
episiotomy- incision to widen vulvar orifice

forceps
vacuum- suction cup on stop of baby’s head
- do first before C-seciton

induction of labor:
considered when prolgoned pregnancy
- DM, pre-eclmapia

CI: cephalospelic dispropriotn, placenta previa, uterine scar, traverse lie

35
Q

inducing labor

A

meds: early- prostaglandin gel, given vaginally to ripen the service

some dilation and effacement- Piton - causes uterine contraction, given IV

36
Q

antepartum testing

A

NST- non-stress test

  • reactive test
  • 2 acceleration in 20 minutes, up 15 beast from baseline- positive test is GOOD

Contraction stress test:
given pitocin and watch monitor
-if late decellerations- BAD

vibroacoustin stiumuatlion:
auditory source to wake up the baby
-

biophysical profile- watch sonogram for 20 minutes

  • check breathing, gross body movements, fetal tone, amniotic fluid index
37
Q

monitor during labor

A

120-160 normal fetal HR
- if consistent decceleration- could be fetal distress

external fetal monitor
internal fetal monitor- dilated and ruptured

if non-reassuring FHR
- stop piton, scalp PH

38
Q

induced abortion

A

medical ( up to 7-9 weeks)

suction curetage

39
Q

spontaneous abortion

A

-pregnancy ends befor 20 weeks gestation

more than 80% of abortions

RF: parity, increase with material/ paternal age

60% -caused by chromosomal abn
endocrine, infection, ETOH, caffeine

40
Q

clarifications of spontaneous abortion

A

all except for missed have vaginal bleeding

threatned- women w/ vaginal bleeding and pregnant,

inevitable- POC have not passed

incomplete vaginal bleeding, partial pass of POC

habitual abortion 2-3 ore more abortions
check genetic, endocrine labs

41
Q

incompetent cervix

A

-cervical weakness causing passive, painless cervical dilation

results in 1st or 2nd trimester abortion or pre-term labor

management:
cerclage- cervical suture in 1st trimester to provide support to weak cervix

42
Q

ectopic pregnancy

A

-embryo is somewhere besides uterine cavity
most common in tube

cause: salpingitis ( PID)

sxs: pain, vaginal bleeding, amenorrhea
( women with positive pregnancy test now having slight vaginal bleeding with pain)

unruptured- more pain
ruptured- pain better, hypotension, tachycardia

lab: B-HCG or serum positive
sonogram: absence of IU gestational sac

tx: methotrexate
- serum b-hcg
stable, compliant
has to comply

surgical: salpingostomy,

43
Q

gestational trophoblastic dz

A

hydatiform mole- grape like vesicle on sonogram, no egg/ fetus

presentaiotn: positive pregnancy test, vag bleeding, pre-ecamplisa , hyperemesis
studies: b-hcg titer higher than gestation age
sonogram: sack of grapes on snows town pattern

44
Q

pre-term labor

A

20-36 weeks

triad- preterm pregnancy, uterine contractions ( 3 in 20 minutes), dilation/ effacement

RF: infection, Group B strep, cocaine, heavy cig smoking

sx: contraction, vag bleeding

labs: fetal fibronectiven testing
positive
negative lower risk

cervical length - if 2 cm at 20 weeks

if both abn 50/50 go into labor

management:
observe for 30-60 minutes and hydrate her

then abx to tx subclinical infection

bethamethsaone to help w/ fetal lungs
tocolytics- increase labor

45
Q

premature rupture of membranes

A
  • most common dx leading to NICU admission
Risks: 
vaginal/ cervical infection 
-cervical incompetence
- multiple pregnancy
- cig smoking

sxs: gush of fluid from vagina
- every time she cough or strains–> feels a squirt

signs: sterile speculum exam, pooling, nitrazine paper, ferning test, visual leakage

treatment:
34 weeks for lung mature- bethamethsone
> 35 weeks - induce
under 34- immature lungs - keep baby in mom, check NST, CBC, bed rest until she is 35 weeks then deliver

46
Q

maternal RH isoimmuniation

A

mom produces ab again foreign red blood cells antigen in maternal circulation

  • risk is present only if mom is RH negative and dad id RH + and baby is RH +

tx: Rhogam
- 28 weeks protective
-

47
Q

multiple gestation

A
  • more severe s/sx of pregnancy
  • high risk
complications: 
spontaneous abortion
- pre-eclampsia 
-increas of death for fetus,
-cord prolapse
- incr risk for placenta separation
48
Q

gestational diabetes

A

DM during pregnancy

RF: AA, hispanic, indian

correlation with pre-eclampsia, traumatic birth

fetal risK : macrosomia, prematurity, still birth,
delayed fetal lung maturity

24-28 week- GCT

  • non fasting 50 g glucose load
  • check maternal glucose after 1 hour
  • if > 140 mg/ dl move to GTT

GTT- fasting testing
take blood and then given 100 gm oral glucose at 1, 2, and 3 hours
- 2 abn values

fasting: 95

don’t use h A1c during DM

A1: diet controlled
A2: insulin

tx: diet and exercise
finger stick X qid
keep BS

49
Q

HTN in pregnant

A

chronic HTN-
HTN before 20 weeks before gestation

140/ 90- 179/109
- no end organ damage

check monthly sonogram- to make sure baby growing
-stat weekly NST and biophysical profile

serial BP and urine protein
medication 150/100
methoadopa

50
Q

preeclampsia/ eclampsia

A
  • proteinuria, edema, HTN

eclampsia- above pause seizures

after 20 weeks and moslty near term

  • can occur up to 2 weeks post part
    No incr risk for HTHn later in life

** most common risk factor is nulliparity
multiple gestation
DM
chronic HTN

complications: ecclmpia
, renal failure, HELP, DIC

prevention: 1 gm calcium daily

mild and severe classification

mild tx: BP high,
proteinuria, and no other sx –>

tx: deliver baby
before 37 weeks–: bed rest and check BP and urine dips
- if not reliable–> admit them and deliver at 37 weeks

severe: BP higher 160-180/ 100, ++ proteinuria, and have sxs ( HA, blurred vision, RUQ pain, elevated creatinine)

tx: hospitalize , ICU
given betamethasome
over 34 weeks --> induced
not stable--> immediate C-section  
mag sulfate- to dec seizures
hydralazien and labetolol
51
Q

placental abruption

A

placenta becomes detached from side of uterine

most common cause of 3rd trimester bleeding

RF: HTH, cocaine, cig smoking, trauma

external form: blood drains through the cervix
- more common, less serious

concealed- hemorrhage is confined
- less common, more serious

sx: abd pain ( searing)
fetal distress

labs/test: clinical, sonogram, H/H, PT/PTT

tx:
if large and fetal distress- emergency C-seciton

if small- watchful waiting

complications: fetal demise, maternal hemorrhage, maternal DIC and death

52
Q

placenta previa

A

placenta over the cervical os

  • may be partial or complete

RF: advanced mat age, multiple gestation, previous previa, scarred endometrium

sx: painless, bright red bleeding
may have contractions
( no prenatal care, easily seen on sonogram)

signs: sonogram , no vaginal exam
tx: if little spotting- bed rest

if full gush of blood- delivered C-section

complications: embolism, prematurity, hypoxia

53
Q

post part hemorrhage

A

uterine atony
- uterus continues to contact after baby born

RF: later is short or long or infection

findings: soft uterus
tx: piton and uterine manage

Genital laceration
- suture it

Retained placenta-
see on the placenta missing or go in do manual exploration

54
Q

endometritis

A

infection in the endometrium

ruptured membrane > 24 hours

2-3 days post part

fever , uterine tenderness

labs: elevated WBC
UA

tx: clindamycin and gentamicin

PANRE (27 decks)

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