Gyn quick associations Flashcards
Positive b-hCG + intrauterine pregnancy, closed os
Threatened abortion
Enlarged uterus + menometrorrhagia for months
Fibroids, molar pregnancy, adenomyosis
Bleeding associated with severe menstrual pain
Endometriosis, adenomyosis
AUB + perimenopausal or postmenopausal
endometrial hyperplasia or cancer
AUB started with menarche
von Willebrand dz
positive b-hCG + severe pain, no fetus in uterus on US
ectopic pregnancy
AUB after intercourse + no pain, normal sized uterus
Polyp or glandular tissue on cervix
post menopausal - vaginal atrophy
AUB + wt gain, fatigue, constipation
hypothyroidism
AUB + bitemporal hemianopsia
Prolactinoma
AUB + Obesity, hirsutism, acne, insulin resistance
PCOS - confirm with U/S
Primary amenorrhea + Parent went through puberty late with subsequent normal growth and development
Constitutional delay
Primary amenorrhea + excessive exercise, stress, and or weight-loss
Functional hypothalamic amenorrhea
Primary amenorrhea + short stature, webbed neck, low hairline
Turner syndrome
Primary amenorrhea + breast development, absent uterus, no pubic/axillary hair
Androgen insensitivity syndrome - 46, XY
Primary amenorrhea + breast development, absent uterus, with pubic/axillary hair
Mullerian agenesis - normal hormone levels
Primary amenorrhea + cyclic pain, bluish vaginal bulge on exam
Imperforate Hymen
Primary amenorrhea + anosmia; no secondary sexual characteristics
Kallmann syndrome - replace hormones
Secondary amenorrhea - mc cause
Pregnancy
Secondary amenorrhea with hirsutism, insulin resistance, acne, infertility, “string of pearls” on US
PCOS
Secondary amenorrhea with clitoromegaly, Voice deepening, increase muscle mass
Elevated androgens - tumor or exogenous use
Secondary amenorrhea with fatigue, cold intolerance, weight gain, constipation, delayed relaxation of DTRs
hypothyroidism
Secondary amenorrhea + anxiety, palpitations, tremor, heat intolerance, weight loss, diarrhea
Hyperthyroidism
Secondary amenorrhea + bitemporal hemianopsia + galactorrhea
Prolactinoma
Secondary amenorrhea in patient with schizophrenia + galactorrhea
S/E of antipsychotic
Secondary amenorrhea + hot flashes, vaginal dryness
Menopause, primary ovarian insufficiency
Secondary amenorrhea with history of postpartum hemorrhage
Sheehan sn
Secondary amenorrhea with history of D&C for septic abortion
Asherman syndrome
Infertility + history of gonorrhea or chlamydia
PID - get hysterosalpingogram (HSG)
Infertility + severe dysmenorrhea, dyspareunia, pelvic pain
endometriosis - get laprascopy
Infertility + history of pelvic irradiation
Primary ovarian insufficiency - check FSH level
Infertility + history of tubal surgery
tubal obstruction - get hysterosalpingogram (HSG)
Infertility + enlarged uterus with irregular contours
uterine fibroids - US
Infertility + history of D&C for septic abortion
Asherman syndrome - get hysteroscopy
Prolapsed bladder through anterior wall of the vagina
cystocele
urethral prolapse
urethrocele
Prolapse of rectum through posterior wall a vagina
rectocele
Prolapse of uterus through apical wall of vagina
Uterine prolapse
Prolapse of intestines into vagina, history of hysterectomy
enterocele
Flesh colored papule with cauliflower like appearance
Condyloma accumulata - HPV 6, 11
Multi nucleated giant cells on Tzanck smear
HSV 1/2 - herpes
U/L Inguinal LAD with “groove” sign with history of painless ulcer that resolved spontaneously
Lymphogranuloma venerium - C. trachomatis L1-L3
Painless nodule(s) with shallow, beefy red base; intracellular gram negative rods on Wright-Giemsa stain
Granuloma inguinale (donovan bodies on stain) - Klebsiella granulomatis
Painful ulcer with exudative/purulent base, painful inguinal LAD, bubos, culture shows gram-negative rod’s in school of fish pattern
Chancroid - H. ducreyi
Painless, clean-based ulcer with heaped up border, heals spontaneously
Chancre of primary syphilis - T. pallidum
Adenexal mass Women of reproductive age
Physiologic ovarian cyst
Adenexal mass + dysmenorrhea, dyspareunia, pelvic pain
Endometrioma
Adenexal mass + fever, vaginal discharge, cervical motion tenderness
tuboovarian abscess
Adenexal mass + abdominal pain, vaginal bleeding, positive pregnancy test
Ectopic pregnancy
Adenexal mass in otherwise normal pregnancy
corpus luteum cyst
ovarian tumor + elevated CA125
epithelial tumors - serous or mucinous
ovarian tumor + elevated LDH
dysgerminoma
ovarian tumor + elevated AFP
yolk sac
Teratoma (benign)
embryonal
ovarian tumor + elevated AFP and hCG
embryonal
ovarian tumor + elevated estrogen and inhibin
granulosa cell
ovarian tumor + elevated testosterone
Sertoli-Leydig cell
MC breast tumor in teen and young women
Fibroadenoma
MC Mass in patients 35-50
fibrocystic changes
Often present for serous or bloody nipple discharge
Intraductal papilloma
Large, painful breast mass with high fever
Breast abscess
Multiple painful breast masses just before menstruation
Fibrocystic changes
Bulky breast mass with leaf like projections on biopsy
Phyllodes tumor