GYN Flashcards
Amsel Criteria
pH over 4.5, clue cells, positive whiff test, thin gray discharge
Which diagnosis? Polygonal ivory papules of vulvar and perianal areas, waxy sheen on labia minora and clitoris, hypopigmentation; progresses to fissures/erosions, mucosal edema, and surface vascular changes
Lichen sclerosis
Which diagnosis? Itching, pruritis, contact bleeding, pain, dyspareunia, lacy reticular pattern of labia and perineum, possible scarring or erosions
Lichen planus
Which diagnosis? Severe vulvar pruritis (can be worse at night), thick/enlarged labia possibly with edema, associated with chronic scratching/rubbing
Lichen simplex chronicus
Which vulvar infection necessitates treatment of sexual partner as well?
Trichomoniasis
Which diagnosis? Severe pain on vestibular touch and attempted vaginal entry, including tenderness to pressure
Vestibulodynia
Most prevalent STI in the US
HSV
Which diagnosis? Firm, small umbilicated dome-shaped papules on vulva
Molluscum Contagiosum
Management of tuba-ovarian abscess
Abx
Which diagnosis? Perihepatitis caused by purulent tubal discharge ascending to the RUQ
Fitz-Hugh-Curtis Syndrome
Which diagnosis? Soft painful ulcer on vulva
Chancroid
Which diagnosis? “School of fish” appearance on gram stain
Chancroid
Which diagnosis? Pink/skin-colored lesions that range from papular to exophytic; pruritis and bleeding possible
Condyloma accumniata (HPV)
Which diagnosis? painless papule or shallow ulcer/erosion followed by development of inguinal buboes and groove sign
Lymphogranuloma venereum (chlamydia trachomatis)
Which diagnosis? Large beefy-red painless ulcerations, “Donovan bodies” on microscopy
Granuloma Inguinale/Klebsiella granulomatis
Which diagnosis? Pain/fullness/heaviness of variable intensity and duration, worse premenstrually and during pregnancy, aggravated by standing, fatigue, and coitus
Pelvic congestion syndrome
Which diagnosis? Cyclical mastalgia worst before menstruation, engorged breasts, possibly serous or green discharge
Fibrocystic breast changes
Which diagnosis? serosanguineous nipple discharge in absence of breast mass
Intraductal papilloma
Which diagnosis? red, edematous, tender indurated breast in a non-lactating female
Inflammatory breast cancer
Delayed puberty definition
No secondary sex characteristics at age 14
Which diagnosis/tx? Premature menses before breast and hair development
McCune-Albright Syndrome (Continuous GnRH therapy)
Which diagnosis/tx? Premature adrenarche, may have ambiguous genitalia at birth
CAH (steroid replacement)
Which diagnosis? Absent uterus, normal secondary sex characteristics
Mullerian Agenesis
Which diagnosis/tx? Absent uterus, normal breast development, axillary/pubic hair absent
Androgen Insensitivity Syndrome (46,XY), Gonadectomy
Most common cause of amenorrhea
Pregnancy
FSH:LH ratio in premature ovarian failure
Greater than 1.0
Which diagnosis/tx? Intrauterine synechiae or adhesions result from trauma to the basal layer of the endometrium, may result in amenorrhea
Asherman Syndrome (Operative hysteroscopy w/IUD placement)
PCOS hormone ratio
Elevated LH:FSH ratio
PCOS increases risk for ____ cancer
endometrial
Which diagnosis/tx? Hirsutism, amenorrhea, acanthosis nigricans
PCOS/OCPs
Labs for Hirsutism (7)
FSH, LH, DHEA-S, Testosterone, 17-hydroxyprogesterone, PRL, TSH
Which diagnosis? most common in women 20-40, rapid onset hirsutism and virilizing signs (acne, amenorrhea, clitoral hypertrophy, deepening of voice)
Sertoli-Leydig Cell tumor
PALM-COEIN
Polyp, Adenomyosis, Leiomyoma, Malignancy, Coagulopathy, Ovulatory Dysfunction, Endometrial Dysfunction, Iatrogenic, Not Classified
Workup for heavy menses
Pregnancy test, Pelvic US, Endometrial biopsy
Most common cause of post-menopausal uterine bleeding
Atrophic endometrium
Ddx for dysmenorrhea (5)
Adenomyosis, Leiomyomas, Endometriosis, PID, Primary
Management of Adenomyosis (4)
GnRH agonists, Endometrial Ablation, IUD, Hysterectomy
Management of Endometriosis (5)
NSAIDs, OCPs, GnRH agonists, Danazol, Laparoscopy
Causes of Infertility (5)
Ovarian Factor, Uterine Factor, Tubal Factor, Male Factor, Peritoneal Factor
Diagnostic test for tubal disease
HSG
Demographic at highest risk for GTD
Asian
Which diagnosis? Vaginal bleeding, uterine size greater than dates (25-50% of cases)
Molar pregnancy
Management of Molar Pregnancy (3)
Suction curettage, Follow hCG levels, screen for metastasis (CT CAP/MRI Brain)
Diagnosis of choriocarcinoma
hCG level
Leading cause of injury-related death in pregnant women
Homicide
Which diagnosis? Tissue paper, crinkled skin with fragile, thinned, and atrophic appearance
Lichen sclerosis
Which diagnosis? White plaque-like lesions, poorly defined erythema
Paget Disease
Treatment of leiomyomas (5)
Contraceptives, GnRH agonists, Myomectomy, Hysterectomy, Uterine Artery Embolization
Most common cause of hysterectomy
Leiomyomas
Most common gynecologic malignancy
Endometrial Cancer
Screening for endometrial cancer metastasis
CXR
Which diagnosis? Uniloculated ovarian cyst, without evidence of blood, soft tissue, or excrescences in a women of child-bearing age
Functional Ovarian Cyst
Most common ovarian epithelial tumor
Serous cystadenoma
Most common category of malignant ovarian tumors
Epithelial
Most common ovarian tumor in all ages
Dermoid cyst/Benign cystic teratoma (most common in reproductive years
Granuloma cell tumors may cause _____.
Endometrial hyperplasia