Gyn General Flashcards
Tanner stage breast development
1) none
2) breast bud
3) further enlargement of areola and breasts with NO seperation of contours
4) 2nd mound of areola and papilla
5) areola recessed to general contour of breast -adult
Postmenopausal bleeding
First differential diagnosis
Endometrial cancer
Stages of puberty
Thelarche: breast
Pubarche: pubic hair
Growth spurt
Menarche
What is adenomyosis
Ectopic endometrial glands and stroma located within the myometrium of the uterine wall
Symptom and diagnosis of adenomyosis
Symptom: enlarged symmetric tender uterus in absence of pregnancy. Uterus is soft. 2ndary dysmenorrhea, and menorrhagia
Diagnosis: MR or usg: cystic area found within myometrial wall
Imperforate hymen
Primary amenorrhea associated with cyclic abdominal pain, swelling and urinaey retention
Treatment: resecting Hymen
Diagnosis: clinical, should do usg or mri
Positions of uterus in majority of females
Anteverted
Which ligaments are responsible for uterine support
Cardinal and uterosacra
Normal blood loss during menstruation
25-80ml
PMS
Physiological (breast tenderness, bloating, headache, swelling of extremities) and emotional (depression, anxiety, mood swings, angry) disturbance that occur 1-2 weeks prior to menses and last until a few days after the onset of menses
3 cycles one somatic and one affective symptom
What pelvic pathologies can you detect with usg?
- Evaluate intrauterine and ectopic pregnancy
- Asses masses in pelvis
- determine endometrial thickness and fibroids
- Monitor follicles during assisted reproductions
- assess endometrial lining in postmenopausal women
What pelvic pathologies can you detect with sonohysterography (SHG)
Saline infusion + usg AUB Uncertain endometrial findings on usg Infertility (tubal patency) Fibroids and polyps Need to check for STI BEFORE
Hysterosalpingography (HSG)
What pelvic pathologies can you detect
Dye + x-Ray
Evaluations of size shape configuration of uterus, congenital abnormalities, tubal patency, obstruction
IMFERTILITY
What is the most common cause of amenorrhea
Functional hypothalamic amenorrhea (Toronto)
Lecture
Primary: gonadal dysfunction
Secondary: chronic anovulation
Prolactinoma symptoms:
Galactorrhea
Visual changes
Headache
Radical hysterectomy
Uterus
Cervix
Upper 1/3-1/2 vagina
Entire parametric
Uterine artery ligated at its origin from int, iliac artery
Uterosacral ligament at its most distal attachment (rectum)
Indication for radical hysterectomy
Cervical cancer stage:1A2, 1B1
Modified radical hysterectomy (type2) or simple hysterectomy type 1) treatment of
Cervical cancer up to stage 1B1
Uterus Cervix Proximal 1/3 parametria Uterine artery ligated medial to ureter Midpoint of uterosacral ligament Upper 1-2 cm of vagina
TAH/BSO
TAH: Uterus Cervix Uterine artery ligated at uterus BSO: Fallopian tube Ovary
What pelvic pathologies can you detect with hysteroacopy
Diagnostic:
AUB
DUB
Infertility
Therapeutic
Removal of uterine polyps, fibroids, adhesion, septa, endometrial ablation
Treatment of what with endometrial ablation?
AUB
Risk factors for toxic shock syndrome
Tampons
Cervical caps or sponge, diaphragm
Wound infection
Post-partum infection
Clinical feature is TSS and treatment
High fever, soar throat, headache, diarrhoea, eruthroderma, MOF, refractory hypotension, exfoliation of palmar and plantar surface 1-2 w after onset of illness
Remove foreign body/necrotic tissue
Cloxacillin
Ovarian tumor marker
Epithelial cell tumor
Ca 125
Ovarian tumor marker
Granulosa cell
Inhibin
Ovarian tumor marker
Sertoli leydig cell
Androgens
Ovarian tumor marker
Immature teratoma
None
Ovarian tumor marker
Dysgerminoma (germ cell)
LDH
Yolk sac
Ovarian tumor marker
AFP
Choriocarcinoma
B-hcg
Ovarian tumor marker
Embryonal cell
AFP + b hcg
