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Women'sHealth > Gyn conditions > Flashcards

Gyn conditions Flashcards

1
Q

What is normal post-void residual volume?

A

50-60 cc

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2
Q

What defines overflow incontinence?

A

Post-void residual volume of >300 cc

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3
Q

How do you measure urethral hypermobility?

A

straining Q-tip angle >30 degrees from horizontal

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4
Q

What is “urethral bulking”?

A

artificially inflates the submucosa of the bladder neck to treat intrinsic sphincteric deficiency

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5
Q

What is the MOA of tolterodine?

A

bladder selective muscarinic antagonist

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6
Q

Who should NOT use tolterodine?

A

contraindicated in pts with narrow-angle glaucoma

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7
Q

What medications can be used for detrusor overactivity?

A

beta-3 adrenergic receptor agonists (Mirabegron)

antimuscarinic (Tolterodine)

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8
Q

Who should NOT use Mirabegron?

A

contraindicated in pts with HTN, end-stage renal dz, liver dz

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9
Q

Cystoceles are repaired by fixing defects in what fascia?

A

pubocervical fascia - reattach to the sidewall

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10
Q

Rectoceles are repaired by fixing defects in what fascia?

A

rectovaginal fascia

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11
Q

What is colpocleisis and what is it used for?

A

closure of the vagina

used to treat vaginal prolapse

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12
Q

What is the best treatment for PCOS?

A

OCPs - treats both hirsutism and irregular menses

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13
Q

What size polyp indicates polypectomy versus observation?

A

> 1.5 cm

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14
Q

What is the mechanism for increased androgen production in PCOS?

A

increased LH production –> increased stim of theca cells –> increased androgen production

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15
Q

What is the recommended Ca intake for postmenopausal women?

A

1200 mg

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16
Q

Ovaries stop producing ___ after menopause.

A

estrogen

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17
Q

Menopausal ovaries continue to produce what?

A

androgens

which then can be converted into estrogen in the periphery

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18
Q

Combination HRT increases risk of __ cancer and decreases risk of ___ cancer.

A

1 - breast

2 - colon

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19
Q

How does HRT affect lipid panel?

A

increases HDL and decreases LDL

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20
Q

What T-score on DEXA indicates osteopenia?

A

-1 to -2.5

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21
Q

What T-score on DEXA indicates osteoporosis?

A

less than -2.5

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22
Q

What type of carcinoma accounts for 90% of vulvar cancers?

A

squamous cell

23
Q

What increases the risk for squamous cell carcinoma?

A

smoking
HPV infection
lichen sclerosus

24
Q

How does verrucous carcinoma of the vulva present?

A

cauliflower-like lesion

25
Q

What is TCA used to treat?

A

genitl warts

26
Q

What is the best treatment choice for VIN 2?

A

laser treatment

27
Q

How is Paget’s disease of the vulva described?

A

fiery red mottled background with whitish hyperkeratotic areas

28
Q

What are risk factors for vulvar cancer?

A

HPV exposure, smoking, vulvar dystrophy (lichen sclerosis), immunocompromised

29
Q

What are risk factors for cervical cancer?

A

HPV exposure, early-onset sexual activity, multiple sexual partners, immunosuppression, smoking, low socioeconomic status, lack of regular pap tests

30
Q

What are high and low risk` strains of HPV?

A

high - 16 and 18

low - 6 and 11

31
Q

What is a white plaque on the cervix called?

A

leukoplakia - biopsy!!

32
Q

When should women stop receiving cervical cancer screening?

A

65 yo if no h/o moderate or severe dysplasia and three negative pap tests in a row or two negative co-tests within the past 10 years

33
Q

What are medical treatment options for bleeding due to leiomyomas?

A

GnRH agonists, OCPs, NSAIDs

34
Q

What is the optimal time period recommended for GnRH agonist treatment?

A

short! 3-6 months

typically used prior to surgical procedure

35
Q

What are risk factors for endometrial carcinoma?

A

nulliparity, obesity, late menopause, HTN, unopposed E

36
Q

What are the top 5 cancers in women?

A

Breast > lung > colon > uterine > thyroid

Gyn: uterine > ovary > cervix > vulva > vaginal

37
Q

Granulosa cell tumors secrete what hormone?

A

estrogen

38
Q

What is the most common cause of post-menopausal bleeding?

A

atrophy - either vagina or endometrium

but be concerned for endometrial cancer

39
Q

What are risk factors for ovarian cancer?

A

nulliparity, fhx, early menarche, late menopause, white race, increasing age

40
Q

What type of contraception appears to provide protection against ovarian cancer?

A

OCPs - cause anovulation

41
Q

In women <30 yo, what is the most common ovarian neoplasm?

A

germ cell tumors

42
Q

In women > 30 yo, what is the most common ovarian neoplasm?

A

epithelial cell tumors

43
Q

Intermenstrual spotting + abdominal pain + vomiting + slightly elevated transaminase levels

A

perihepatitis from PID

44
Q

Primary ovarian insufficiency refers to menopause before ___

A

age 40

45
Q

What is Uterine synechiae?

A

Asherman syndrome

46
Q

How does obesity affect ovulation?

A

increased insulin resistance and hyperglycemia –> decreased sex hormone-binding globulin –> elevated androgen –> aromatized in adipose tissue to estrone –> suppression of LH surge and ovulation

47
Q

What is the MOA of tamoxifen?

A

estrogen receptor antagonist at the breast

agonist in the uterus

48
Q

How does tamoxifen affect bone density?

A

estrogen-like activity at the bone –> strengthens the bone density

49
Q

How does Raloxifene affect the uterus?

A

estrogen ANTAGonist effect

50
Q

What are adverse effects of raloxifene?

A

VTE

51
Q

What is the diagnostic test for vulvar lichen sclerosis?

A

Vuvlar punch biopsy

52
Q

What do atypical glandular cells on pap test indicate?

A

could be either cervical or endometrial adenocarcinoma - have to evaluate endometrium

53
Q

In a patient with adenomyosis, is the uterus symmetric or irregularly shaped?

A

symmetric!

Women'sHealth (12 decks)

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