GYN Miscellaneous Flashcards
What occurs with Ovarian Torsion?
Rotation of the ovary around the infundibulopelvic ligament
How will Ovarian Torsion present? Physical exam finding?
SUDDEN onset unilateral pelvic pain + N/V
Exam: Adnexal tenderness
What should you do if you suspect Ovarian Torsion?
Surgical emergency
How will Ovarian Torsion present?
SUDDEN onset unilateral pelvic pain + N/V and adnexal tenderness
What is Mittelschmerz?
Pelvic pain with ovulation
When will Mittelschmerz occur?
Day 14 – 2 weeks after period
Pelvic organ prolapse includes what things?
Cystocele
Rectocele
Uterine prolapse
What are some possible signs of a Cystocele?
Urinary incontinence/retention
Feeling of incomplete emptying
– able to pee if they stick fingers in vagina
What are some possible signs of a Rectocele?
Fecal incontinence/constipation
– able to poop if they stick fingers in vagina
What are some treatment options for pelvic organ prolapse? (3)
Pelvic floor strengthening
Pessary placement
Surgeries
Postmenopausal women are at an increased risk for recurrent UTIs due to atrophy. What are 3 treatment options?
Estrogen cream
Post-coital antibiotics
Daily antibiotics
What causes Stress Urinary incontinence?
Laxity of pelvic floor muscles
How will Stress Urinary Incontinence present?
Urine leakage with sneezing, coughing, laughing, lifting
What causes Urge Urinary Incontinence?
Detrusor muscle hyperactivity
How will Urge Urinary Incontinence present?
Unexpected urge to void randomly
How will Overflow Urinary Incontinence present?
Urine leakage with high post-void residual volume
How will a Vesicovaginal Fistula present?
Constant leakage of fluid from vagina – pee
What may you see on vaginal exam with a Vesicovaginal Fistula?
Area of red raised granulation tissue on vaginal wall
What test can detect a Vesicovaginal Fistula?
Bladder dye test
What is Pseudocyesis?
False belief you are pregnant + pregnancy symptoms
What is the pathophysiology of Polycystic Ovarian Syndrome?
- HIGH levels of Estrogen that results in elevated LH and NO LH surge = Anovulation
- HIGH Testosterone –> Male features
- Polycystic ovaries
How will PCOS present?
- Anovulation and menstrual irregularities
- Acne, hirsutism, male pattern baldness
- Obesity
- Infertility
If a PCOS patient is NOT trying to conceive, what is the treatment?
OCPs +/- Metformin
If a PCOS patient is trying to conceive, what is the treament?
Clomiphene/Letrozole to induce ovulation
If a patient is struggling with obesity, menstrual irregularities, acne, hirsutism and infertility, what is the likely diagnosis?
PCOS
What is Primary Ovarian Insufficiency and when does it present?
LOW estrogen even with HIGH FSH @ < 40
What are some symptoms of Primary Ovarian Insufficiency?
Menopausal symptoms and Menstrual irregularities
What is the treatment for Primary Ovarian Insufficiency?
Give Estrogen
