Gyn/Sexuality Module Flashcards

1
Q

Clomiphene citrate:
Mechanism:
Used for?

A

Oral estrogen antagonist/agonist, increases gonadotropin

-Used to infertility

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2
Q

Absolute contraindications for OCPS

A
  • Thromboembolic disorders (no risk with just Progesterone)
  • Pregnancy
  • Decreased liver function
  • Smokers >35 years
  • Known or suspected breast cancer
  • Abnormal vaginal bleeding
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3
Q

OCP Mechanism of Action:

Estrogen + Progestin

A

Estrogen: Inhibits follicular maturation and selection of dominant follicle by decreasing FSH; also decreases breakthrough bleeding

Progestin: Prevents LH surge

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4
Q

Medroxyprogesterone acetate:

What is it and what is in it

A

Birth control shot
Progestin ONLY
May last up to 1 year

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5
Q

IUDS (Copper and Levonorgestrel)

When is it contraindicated?

A

Contraindicated in malshaped uterus, fibroids, active presence of gonorrhea or chlamydia

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6
Q

What is Leuprolide?

  • Mechanism
  • Indications
A

Leuprolide is a GnRH analogue. It suppresses pituitary LH and FSH release –> Leads to decrease in estrogen

Used to treat large submucosa fibroids

Side effects: vasomotor symptoms, decrease in bone density, insomnia, expensive

Can’t use longer than 6 months

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7
Q

Risk factors for Cervical Cancer?

A
Same risk factors as STDS: 
Women who have had multiple sex partners 
Begin sex at an early age
Male sex partners with cervical cancer
Current or Prior HSV infections
Women who have HIV or history of STDS
Smokers, abusers, immunocompromised
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8
Q

When is biopsy indicated for patients with breast cancer?

A

ALWAYS indicated in patients with suspicious physical exam and normal imaging

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9
Q

What is Lobular Carcinoma in situ a marker for?

A

It is a risk factor! Marker of increased risk or precursor of a potentially unstable breast

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10
Q

1 Risk factors for Breast Cancer

A

Age and Gender

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11
Q

Prognostic vs Predictive Factor

A

Prognostic: Relative benefit regardless of treatment (ex. HER-2 positive predictive and prognostic factor)

Predictive: relative benefit in terms of improved response to a specific Rx (Examples ER and PR positive tumors are predictive factors for therapy.

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12
Q

When do you do Manual Vacuum Aspiration?

A

Simplest, safest, least expensive - MUST exam aspirated tissue

Do in the first trimester, up to 5-10 from Last Menstrual Period.

Good for mothers who are Rh-

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13
Q

When do you do dilatation and curettage?

When is the procedure complete?

A

Also a vacuum. Do at a freestanding clinic.

MUST DILATE the cervix to perform the D&C

Procedure not complete until you provide adequate contraception

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14
Q

What is Mifepristone?

A

Progesterone antagonist - can give for those <9 weeks gestational age

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15
Q

Describe changes in menstrual cycle in Menopause

A

Have shortened cycles!

Fewer oocytes recruited –> decreased estradiol –> increased FSH

Higher FSH levels cause the follicles to mature faster and produce enough Estradiol to trigger an LH surge

Ovulation will occur 1 week early but Luteal phase remains the same

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16
Q

What site is infected with chlamydia in a 4 year old with Tanner 1 breast? Why?

A

Normal would infect the columnar epithelial of the cervix, but since there is no estrogen in a child of this age the squamous cells of the vagina are ‘thin’ and not cornified. So there is NO columnar epithelium on the cervix. Would see the infection in her VAGINA

17
Q

Why don’t we do routine pap smears in adolescents?

A

Although HPV is high in adolescents, most will clear the infection and don’t develop cancer of the cervix

18
Q

Endometrial adenocarcinoma: What features

A

NO STROMA

19
Q

What is the most important risk factor for Ovarian cancer?

A

Age foo

20
Q

Serous Tubal Intra-Epithelial Carcinoma (STIC)

A

Are ovarian inclusion cysts that might originate from epithelial lining of fallopian tube

Fimbril cell damage –> p53 mutation –> migration into the ovary