GYN pretest Flashcards
who should have DEXAs?
postmenopausal not on HRT or women over 65
parabasal cells on pap mean what?
postmenopausal –> they lack estrogen
vaginal cysts
gartner duct– embryonic origin of mesonephric duct, on lateral wall, small and benign
inclusion cyst–from burth trauma or surgery
bartholin –> on the labia,
cervical cancer will spread first to which nodes?
paracervical
how often are cystic teratomas (dermoid cysts) bilat?
10%
how do you classify microinvasive CIN?
not >3mm into BM and not >7mm lateral spread
how does vulvar carcinoma spread throuhg nodes?
SUPERFICIAL inguinal –> deep iliac –> external iliac
characterize syphillis in stages
1) chancre
2) dissemination –> maculopapular rash on palms and soles
3) tertiary –> optic atrophy, tabes dorsaliz, AA, gumas
an indication for cone biopsy?
when colpo is not in proportion of scary pap
go to treatment for vulvodynia
avoid anything touch vagina
topical lidocaine, estrogen creams
what are clue cells?
vaginal epithelial cells with bacteria on them
how can fibroids contribute to PPH?
uterine distortion that prevents appropriate contraction
how would you medically treat a pt with endometriosis who wanted to get pregnant?
GnRH agonist –> after suppression effects are over, no problems getting pregnant
Danazol= “pseudomenopause”, causes endometrial atrophy
what structure in the male secretes MIF?
testes –> so no testes= no MIF= uterus in a phenotypical male
46xy
primary ammenorrhea with absent uterus?
mullerian agenisis (46xx)
order to primary amenorrhea (GMAT)
gondal dysgenesis > mullerian agen 46xx > testicular feminization 46xy
most effective treatment for PMS?
SSRI
hair growth is caused by _______ not _________
androgens! not estrogen, which does about everything else in pubrty and development
for fertility, when should a hysterosalpingogram be done?
mid follicular, day 8ish
how do you check progesterone levels to see if ovulation is appropriate?
serial levels from day 14-21
you see an atrophic endometrial stripe in someone with acute uterine bleeding… what do you do
ESTROGEN will rebuild endometrium and stimulate clotting at capillary level
stress incont
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
urge incont. Whats the first line treatment? Next line?
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)
functional incont
pt cannot reach toilet in time to due to physical/cognitive/psych limitations
urethral diverticula
present with dribbling incont after voiding
- suburethral mass palpated in vaginal exam
- dyspareunia
what imaging test is CI in patients with high Cr?
CT with contrast
what volumes do you feel fullness, urge, max capacity?
100
350
450
oxybutinin treats:
detrusor insability
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
procedentia, risk factors
CERVIX come out beyond vagina
- parity
- menopause
- pelvic surgery
- intraabd pressure
first line therapy for prolapse among most urogyns?
pessary
colpocleisis
complete obliteration of vaginal lumen
***only in women who will NOT be sexuall active
outpatient procedure for strss incont?
urethral sling
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!
how should you manage someone with persistent UTI sx despite treatment?
follow up urine culture to look for resistant organisms
