GYN pretest Flashcards

1
Q

who should have DEXAs?

A

postmenopausal not on HRT or women over 65

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2
Q

parabasal cells on pap mean what?

A

postmenopausal –> they lack estrogen

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3
Q

vaginal cysts

A

gartner duct– embryonic origin of mesonephric duct, on lateral wall, small and benign

inclusion cyst–from burth trauma or surgery

bartholin –> on the labia,

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4
Q

cervical cancer will spread first to which nodes?

A

paracervical

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5
Q

how often are cystic teratomas (dermoid cysts) bilat?

A

10%

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6
Q

how do you classify microinvasive CIN?

A

not >3mm into BM and not >7mm lateral spread

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7
Q

how does vulvar carcinoma spread throuhg nodes?

A

SUPERFICIAL inguinal –> deep iliac –> external iliac

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8
Q

characterize syphillis in stages

A

1) chancre
2) dissemination –> maculopapular rash on palms and soles
3) tertiary –> optic atrophy, tabes dorsaliz, AA, gumas

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9
Q

an indication for cone biopsy?

A

when colpo is not in proportion of scary pap

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10
Q

go to treatment for vulvodynia

A

avoid anything touch vagina

topical lidocaine, estrogen creams

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11
Q

what are clue cells?

A

vaginal epithelial cells with bacteria on them

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12
Q

how can fibroids contribute to PPH?

A

uterine distortion that prevents appropriate contraction

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13
Q

how would you medically treat a pt with endometriosis who wanted to get pregnant?

A

GnRH agonist –> after suppression effects are over, no problems getting pregnant

Danazol= “pseudomenopause”, causes endometrial atrophy

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14
Q

what structure in the male secretes MIF?

A

testes –> so no testes= no MIF= uterus in a phenotypical male

46xy

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15
Q

primary ammenorrhea with absent uterus?

A

mullerian agenisis (46xx)

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16
Q

order to primary amenorrhea (GMAT)

A

gondal dysgenesis > mullerian agen 46xx > testicular feminization 46xy

17
Q

most effective treatment for PMS?

18
Q

hair growth is caused by _______ not _________

A

androgens! not estrogen, which does about everything else in pubrty and development

19
Q

for fertility, when should a hysterosalpingogram be done?

A

mid follicular, day 8ish

20
Q

how do you check progesterone levels to see if ovulation is appropriate?

A

serial levels from day 14-21

21
Q

you see an atrophic endometrial stripe in someone with acute uterine bleeding… what do you do

A

ESTROGEN will rebuild endometrium and stimulate clotting at capillary level

22
Q

stress incont

A

MOST COMMON
intravesical pressure exceeds max urethral pressure—> aka incompetence of urethral sphincter with normal ureththral pressure profile
**no destrusor activity proceeding leakage

***25% of women will ahve for a few months after vaginal birth

23
Q

urge incont. Whats the first line treatment? Next line?

A

second most common, inc with inc AGE!!
-bladder leaks due to uninhibited detrusor contraction >15cmH20 and urethral relaxation

tx= bladder training, dec xs fluids/ caffiene. Next line is oxybutinin (anticholinergic)

24
Q

functional incont

A

pt cannot reach toilet in time to due to physical/cognitive/psych limitations

25
urethral diverticula
present with dribbling incont after voiding - suburethral mass palpated in vaginal exam - dyspareunia
26
what imaging test is CI in patients with high Cr?
CT with contrast
27
what volumes do you feel fullness, urge, max capacity?
100 350 450
28
oxybutinin treats:
detrusor insability
29
define: cystocele, rectocele, enterocele
cystocele: prolapse of ANTERIOR wall of vagina rectocele: prolapse of POSTERIOR wall of vainga enterocele: prolapse of bowel wall up and beyond hymenal ring
30
procedentia, risk factors
CERVIX come out beyond vagina - parity - menopause - pelvic surgery - intraabd pressure
31
first line therapy for prolapse among most urogyns?
pessary
32
colpocleisis
complete obliteration of vaginal lumen | ***only in women who will NOT be sexuall active
33
outpatient procedure for strss incont?
urethral sling
34
how do you manage uterine/ vaginal vault prolapse? esp in old ladies or medically complicated?
probably go for a pessary because they are not a surgical candidate If she has uterine prolapse and no sx, then don't treat!
35
how should you manage someone with persistent UTI sx despite treatment?
follow up urine culture to look for resistant organisms