GYN Miscellaneous

Question 1

What occurs with Ovarian Torsion?

Answer 1

Rotation of the ovary around the infundibulopelvic ligament

Question 2

How will Ovarian Torsion present? Physical exam finding?

Answer 2

SUDDEN onset unilateral pelvic pain + N/V
Exam: Adnexal tenderness

Question 3

What should you do if you suspect Ovarian Torsion?

Answer 3

Surgical emergency

Question 4

How will Ovarian Torsion present?

Answer 4

SUDDEN onset unilateral pelvic pain + N/V and adnexal tenderness

Question 5

What is Mittelschmerz?

Answer 5

Pelvic pain with ovulation

Question 6

When will Mittelschmerz occur?

Answer 6

Day 14 – 2 weeks after period

Question 7

Pelvic organ prolapse includes what things?

Answer 7

Cystocele
Rectocele
Uterine prolapse

Question 8

What are some possible signs of a Cystocele?

Answer 8

Urinary incontinence/retention
Feeling of incomplete emptying
– able to pee if they stick fingers in vagina

Question 9

What are some possible signs of a Rectocele?

Answer 9

Fecal incontinence/constipation
– able to poop if they stick fingers in vagina

Question 10

What are some treatment options for pelvic organ prolapse? (3)

Answer 10

Pelvic floor strengthening
Pessary placement
Surgeries

Question 11

Postmenopausal women are at an increased risk for recurrent UTIs due to atrophy. What are 3 treatment options?

Answer 11

Estrogen cream
Post-coital antibiotics
Daily antibiotics

Question 12

What causes Stress Urinary incontinence?

Answer 12

Laxity of pelvic floor muscles

Question 13

How will Stress Urinary Incontinence present?

Answer 13

Urine leakage with sneezing, coughing, laughing, lifting

Question 14

What causes Urge Urinary Incontinence?

Answer 14

Detrusor muscle hyperactivity

Question 15

How will Urge Urinary Incontinence present?

Answer 15

Unexpected urge to void randomly

Question 16

How will Overflow Urinary Incontinence present?

Answer 16

Urine leakage with high post-void residual volume

Question 17

How will a Vesicovaginal Fistula present?

Answer 17

Constant leakage of fluid from vagina – pee

Question 18

What may you see on vaginal exam with a Vesicovaginal Fistula?

Answer 18

Area of red raised granulation tissue on vaginal wall

Question 19

What test can detect a Vesicovaginal Fistula?

Answer 19

Bladder dye test

Question 20

What is Pseudocyesis?

Answer 20

False belief you are pregnant + pregnancy symptoms

Question 21

What is the pathophysiology of Polycystic Ovarian Syndrome?

Answer 21

• HIGH levels of Estrogen that results in elevated LH and NO LH surge = Anovulation
• HIGH Testosterone –> Male features
• Polycystic ovaries

Question 22

How will PCOS present?

Answer 22

• Anovulation and menstrual irregularities
• Acne, hirsutism, male pattern baldness
• Obesity
• Infertility

Question 23

If a PCOS patient is NOT trying to conceive, what is the treatment?

Answer 23

OCPs +/- Metformin

Question 24

If a PCOS patient is trying to conceive, what is the treament?

Answer 24

Clomiphene/Letrozole to induce ovulation

Question 25

If a patient is struggling with obesity, menstrual irregularities, acne, hirsutism and infertility, what is the likely diagnosis?

Answer 25

PCOS

Question 26

What is Primary Ovarian Insufficiency and when does it present?

Answer 26

LOW estrogen even with HIGH FSH @ < 40

Question 27

What are some symptoms of Primary Ovarian Insufficiency?

Answer 27

Menopausal symptoms and Menstrual irregularities

Question 28

What is the treatment for Primary Ovarian Insufficiency?

Answer 28

Give Estrogen