Brainscape's Knowledge GenomeTM

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


See full index

Women's Health > Gyn Disorders > Flashcards

Gyn Disorders Flashcards

1
Q

____ is the MC gyn malignancy in the US and is MC in what age population?

A

Endometrial Cancer

-peaks at 50-60 years (POST-menopausal)

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

Endometrial cancer is an ______ - dependent cancer and the risk for getting it increases with _____ exposure.

A

Estrogen

*increased estrogen exposure associated with nulliparity, chronic anovulation, PCOS, obesity, estrogen replacement therapy, late menopause, Tamoxifen, HTN, DM

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

_____ is definitive dx of endometrial cancer.

A

Endometrial bx (Adenocarcinoma is MC- 80%)

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

Treatment options for endometrial cancer by stage…

A

Stage I: Hysterectomy (TAH +/- BSO) +/- post-op radiation tx

Stage II/III: TAH-BSO + LN excision +/- post-op radiation therapy

Stage IV: Advance–> Chemo

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

_____ is MC site of endometriosis.

A

Ovaries

*Endometriomas= Chocolate cysts

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

A big RF for endometriosis is _____. Its onset is usually before the age of ____.

A

Nulliparity

-onset before 35 y/o

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

This classic triad is associated w/ what diagnosis?

  1. Cyclic premenstrual pelvic pain
  2. Dysmenorrhea
  3. Dyspareunia

(+/- Dyschezia)

A

Endometriosis

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

The definitive diagnostic tool of endometriosis is _____.

A

Laparoscopy w/ bx

*PE usually normal with fixed, tender adnexal masses

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

Treatment ladder for Endometriosis:

A
  1. Combined OCPs (ovulation suppression) + NSAIDs
  2. Progesterone, Lupron (GnRH analog causes pituitary FSH/LH suppression), Danazol (testosterone–> induces pseudomenopause and suppresses FSH and LH)
  3. Conservative Laparoscopy w/ Ablation (if fertility is desired)
  4. TAH-BSO (if no desire to conceive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2 main types of functional ovarian cysts are ____ & _____.

A

Follicular and Corpus Luteul

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

Most patients presenting with this dx are asymptomatic however some may have unilateral RLQ or LLQ pain. There may also be a mobile, palpable adnexal mass. These usually spontaneously resolve.

A

Functional Ovarian Cyst

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

Functional ovarian cysts are diagnosed by ____.

A

Pelvic US

  • Follicular= smooth, thin-walled unilocular
  • Luteal= complex, thicker-walled with peripheral vascularity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mainstay of treatment for functional ovarian cysts is ____.

A

Supportive care: rest, NSAIDs, repeat US after 6 weeks

  • Most cysts <8cm usually spontaneously resolve
  • IF >8cm, persistent, or found post-menopause then +/- laparoscopy or laparotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Common RFs for ovarian cancer include:

A

Family history, increased number of ovarian cycles (infertility, nulliparity, >50 years at menopause), BRCA1 /BRCA2

*Protective factors= OCPs, high parity, or TAH

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

Ovarian cancer usually presents between ___ and ___ years of age.

A

40-60

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

_____ node= METS to the umbilical lymph node.

A

Sister Mary Joseph’s Node

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

Definitive dx tool for ovarian cancer is:

A

Biopsy (90% epithelial)

*Transvaginal US is a useful screening tool

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

What lab value is taken to monitor treatment progress of ovarian cancer?

A

CA-125

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

_____ is the MC benign ovarian cyst.

?? unsure of this

A

Dermoid Cystic Teratoma

*Management= removal due to potential risk of torsion or malignant transformation

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

What endocrine syndrome is characterized by the following triad:

  1. Amenorrhea
  2. Obesity
  3. Hirsutism
A

PCOS

*Due to insulin resistance= increased risk of HTN, DM, and atherosclerosis

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

What lab values are affected in patients with PCOS?

A
  • Increased testosterone

- LH:FSH ratio > 3:1 (normal 1.5:1)

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

What is the trademark US finding in a patient with PCOS?

A

String of pearls= bilateral enlarged ovaries with peripheral cysts

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

Mainstay of treatment for PCOS is _____.

A

Combined OCPs (normalizes bleeding)

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

_____ is an anti-androgenic agent for hirsutism.

A

Spironolactone- blocks T receptors

Teratogenic–> must be used with OCPs!!

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

____ in patients with abnormal LH:FSH ratios may improve menstrual frequency by reducing insulin.

A

Metformin

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

Long utero-ovarian ligaments predisposes what age group to ovarian torsion?

A

Prepubertal girls

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

Benign uterus smooth muscle tumors are known as _____.

A

Leiomyomas (Fibroids)

28
Q

If a suspected growth continues to enlarge after menopause it is likely not a fibroid as fibroids are related to ESTROGEN production!

A

FYI

29
Q

A 35 year old African American patient presents with a large, irregular hard palpable mass in the pelvis during bimanual exam. She complains of menorrhagia. What is her most likely diagnosis?

A

Leiomyoma- fibroid!

30
Q

Treatment options for leiomyomas…

A
  • Observation
  • Inhibit estrogen: LUPRON (causes GnRH inhibition when given continuously)- it shrinks the uterus temporarily until menopause. Usually used near menopause or pre-op
  • Progestins: cause endometrial atrophy
  • Surgical: Hysterectomy, Myomectomy Endometrial ablation, Artery embolization
31
Q

Islands of endometrial tissue within the myometrium are known as ____. It causes a DIFFUSELY enlarged uterus.

A

Adenomyosis

32
Q

A patient comes in with progressively worsening menorrhagia, dysmenorrhea, and a TENDER, SYMMETRICALLY “BOGGY” UTERUS on PE. Her most likely dx is ____.

A

Adenomyosis

33
Q

The only effective therapy for adenomyosis is ____.

A

TAH

34
Q

Pap Smear cervical cytology results and recommendations

A

SEE STUDY GUIDE!!

35
Q

Post coital bleeding/spotting is the most common sx of what diagnosis?

A

Cervical carcinoma

*Avg age of dx is 45 years

36
Q

Cervical cancer treatment based on stage:

A

Stage 0 (CIS): Local treatment- excision (LEEP, Cold Knife Colonization), ablation, TAH-BSO

Stage I-IIA (Microinvasion): Surgery (conization, TAH-BSO, XRT) +/- Chemo

Stage IIB-IVA (Locally advanced): XRT + Chemo

Stage IVB or Recurrent (Metastatic): Palliative XRT +/- Chemo

37
Q

HPV vaccination given between 11-26 (Gardasil and Gardasil 9)

A

If <15 y/o then 2 doses at least 6 mos apart

If >15 y/o then 3 doses usually at day 0, 2 mos, and 6 mos

38
Q

MC cause of cervicitis is _____.

A

Chlamydia

39
Q

Patient presents with increased urinary frequency, dysuria, abdominal pain, and post coital bleeding. What should be on the differential?

A

Chlamydia

40
Q

How is chlamydia diagnosed?

A

Nucleic Acid Amplification–> PCR more specific and sensitive though

-Cultures and DNA probe as well

41
Q

How is gonorrhea diagnosed?

A

Nucleic Acid Amplification–> PCR more specific and sensitive though

-Cultures and DNA probe as well

42
Q

Patient presents with ulcerated vulvar lesion. She also complains of a low-grade fever for the last week. What should be on the differential?

A

Herpes Simplex

43
Q

How is herpes diagnosed?

A

Viral culture & PCR

-See enlarged, multi-nucleated cells with ground-glass cytoplasm and nuclei containing inclusion bodies

44
Q

Patient presents with a flat, pedunculated flesh-colored growth (“cauliflower-like” lesion) with post-coital bleeding. What should be on the differential?

A

HPV (Cervicitis)

45
Q

Patient presents with a painful genital ulcer with some foul smelling discharge. Painful inguinal LAD also present. What is the most likely diagnosis and treatment?

A

Dx- Chancroid

Tx- Azithromycin 1g x 1 dose

46
Q

Patient presents with PAINLESS genital lesion with softening and tender, unilateral inguinal LAD. What is a possible dx and treatment?

A

Dx- Lymphogranuloma Venereum

Tx- Doxycycline 100mg PO BID x 21 days

47
Q

Rectal exposure can result in proctocolitis in patients with LGV. Can have mucoid and/or hemorrhagic rectal discharge and pain.

A

This can lead to chronic, colorectal fistulas and strictures, which can involve the entire sigmoid :(

48
Q

The presence of LGV is strongly associated with what other diagnosis?

A

HIV

-Positive HIV in 75% of cases

49
Q

Patient presents with painless ulcer with raised, indurated edges. Diffuse, bilateral maculopapular lesions on the palms and soles are noted. Also, multiple wart-like lesions near the ulcer are noted. What should be on the differential for this patient?

A

Syphilis

50
Q

How is syphilis diagnosed?

A
  • darkfield microscopy: allows for direct visualization of the spirochete (used in patients with chancre or condylomata lata)
  • RPR: titer; non-specific and must be confirmed by treponemal testing (FTA)
51
Q

What is the treatment for syphilis?

A

Penicillin G (even in PCN allergic)

*May have Jarisch-Herxheimer Rxn: acute febrile response due to rapid lysis of many spirochetes, assoc with myalgias and HAs

**ALL patients must be reexamined clinically and serologically at 6 & 12 months after tx

***ALL patients w/ syphilis should be tested for HIV

52
Q

Cervical motion tenderness associated with PID is known as a ______ sign.

A

Chandelier

53
Q

19 year old patient presents w/ lower abd tenderness, fever, purulent cervical discharge and CMT. She states that she does not use protection and has multiple sexual partners. What should be on your differential?

A

PID- most commonly gonorrhea and/or chlamydia

54
Q

Hepatic fibrosis/scarring and peritoneal involvement related to PID is known as ______ Syndrome.

A

Fitz-Hugh Curtis

(RUQ pain due to perihepatitis which may radiate to the right shoulder)

*Violin strings on anterior surface of liver

55
Q

How is PID treated?

A

Outpatient: Doxy 100mg BID x 14 days + Rocephin 250mg IM x 1

Inpatient: IV Doxy + 2nd Gen Cephalosporin (Cefoxitin or Cefotetan)

56
Q

Vaginal and vulvar pruritus with red/white ulcerative, crusted lesions on exam is associated with what cancer diagnosis?

A

Vulvar

*Treatment- surgical excision, radiation therapy, chemotherapy

57
Q

Patient presents with some vaginal itching and states that she notices a strange “fishy” odor, especially after sex. She also states that she has noticed a greyish, white discharge. What is at the top of your differential?

A

BV

58
Q

What do you see on a microscopic evaluation of BV sample?

A

Clue cells

59
Q

How do you treat BV?

A

Flagyl x 7 days (gel or PO)

60
Q

Patient presents with vulvar itching, redness, and pain with intercourse. She also states she has a greenish discharge. What may be near the top of your differentials?

A

Trichomoniasis

61
Q

What is a common finding on speculum examination of a patient with Trich?

A

Strawberry cervix (cervical petechiae)

62
Q

What is found on microscopic examination of a Trich specimen?

A

Mobile protozoa on wet mount

63
Q

How is Trich treated?

A

Flagyl 2g x 1 dose OR
Flagyl 500mg BID oral x 7 days

*MUST treat partner too!!

64
Q

Patient presents with vaginal burning and itching. She also notes dysuria and dyspareunia. She says a few days ago she noted a thick, curd-like/cottage cheese discharge. What is at the top of your differential list?

A

Candida- Yeast Infxn

65
Q

What is seen on a microscopic examination of a yeast specimen?

A

HYPHAE, YEAST

66
Q

How is Candida treated?

A

Fluconazole PO X 1 dose or

Intravaginal antifungals

Women's Health (8 decks)

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