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Step2CK > Gyn Uworld > Flashcards

Gyn Uworld Flashcards

1
Q

what hormone are PCOS deficient in

A

progesterone

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2
Q

at risk for what with PCOS

A

endometrial carcinoma from increased estrogens causeing hyperplasia

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3
Q

unnopposed estrogen is increased risk for what

A

endometrial cancer

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4
Q

common age endometriosis

A

nulliparous age 25-35

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5
Q

medical Tx endometriosis

A

NSAIDs and OCPs

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6
Q

If Sx do not improve with NSAIDs and OCPS in endometriosis

next step

A

laparscopy

because is Dx and therapeutic when biopsying ablating or excising

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7
Q

25 yr old nulligravid
bimaanual shows tenderness in posterior vaginal fornix and decreased uterine mobility
no adenexal masses
thickening of uterosacral ligaments

A

endometriosis

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8
Q

common complication endometriosis

A

infertility

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9
Q

aromatase deficiency

A 
rare genetic disorder
cannot convert androgens to estrogens
virilization XX child
cliteromegaly
delayed puberty
osteoporosis
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10
Q

hormone levels in aromatase deficiency

A

high FSH and LH with low estrogen

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11
Q

mccune albright

A

cafe au lait
polyostotic fibrous dysplasia and auronomous endocrine hyperfunction
GnRH independed precocious puberty

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12
Q

kallmans syndrome

A

hypogonadotropic hypogonadism with anosmia
delayed puberty
low or absent LH and FSH

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13
Q

ruptured ovarian cyst signs

A

sudden onset severe unilateral lower abdomina pain after activity or sex

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14
Q

signs ovarian torsion

A

sudden onset severe lower abdominal pain on one side
nausea and vomiting
unilateral tender adenexal mass

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15
Q

enlarged ovary with decreased blood flow

A

ovarian torsion

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16
Q

best reccommendation for patient to avoid breast cancer

A

decrease alcohol intake

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17
Q

in postmenopasual women

next step after detecting adenexal mass

A

transvaginal US and serum CA-125

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18
Q

first steps for abnormal uterine bleeding in premenopausal woman

A

exclude pregnnancy

CBC coags, tSH

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19
Q

risk factors for endometrial cancer

A 
>45
obesity
DM
unopposed Estrogen exposure
PCOS
early menarche/late menopause
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20
Q

why not go to transvaginal US in premenopausal women looking for endometrial strip

A

because differ in thickness depending on cycle
instead do Bx
older post menopasual patients transvaginal US is better test

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21
Q

when to do endometrial Bx in premenopausal patient

A

persistent Sx with negative lab results

risk factors for endometrial cancer

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22
Q

physiologic galactorrhea

A

bilateral and no blood

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23
Q

Sx fibroids

A

heavy menses with clots
constipation
urinary frequency, pelvic pain and heaviness
enlarged uterus on exam

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24
Q

Sx adenomyosis

A

dysmenorrhea, pelvic pain, menorrhagia and bulky globular tender uterus

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25
Q

how do tamoxifen and raloxifene work

A

estrogen agonist and antagonist activity
estrogen agonist in uterus– inc endometrial CA
tamoxigen is antagonist in breast

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26
Q

common side effect tamoxifen

A

hot flashes

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27
Q

inc risk for what with tamoxifen

A

endometrial cancer and DVT

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28
Q

flaty velvety wart like lesion

A

condyloma lata- secondary syphilis

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29
Q

lichen sclerosis

A

white thin and wrinkled skin over labia

elderly and have pruritis

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30
Q

vulvar lichen planus

A

middle aged women
hyperkeratotic erosive papulosquamous
pruritis, soreness and vaginal discharge

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31
Q

important factor for invasive ductal carcinoma

A

HER2neu

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32
Q

how to detect her2neu

A

FISH or immunohistochemical staining

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33
Q

what chemo is effective against her2neu+

A

trastuzumab and anthracycline

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34
Q

hormone levels of LH and FSH in PCOS

A

excess LH

little FSH

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35
Q

injury to pelvic floor muscles cna result in what

A

urethral hypermobility and urethral prolpase
get stress incontinence
cystocele

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36
Q

Dx test for urethral hypermobility

A

Q tip test checking the angle

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37
Q

Tx for stress incontinence

A

kegel exercises

urethral sling

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38
Q

boggy tender uniformly enlarged uterus

A

adenomyosis

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39
Q

initial workup if suspect adenomyosis

A

Pelvic US and MRI

definitive is with histo exam of uterus

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40
Q

bimanual and speculum shows dilated cervix with firm dark red round mass at os

A

prolapsing leimyoma uteri (fibroid)

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41
Q

most common Sx of submucous fibroid

A

heavy and prolonged menstrual bleeding

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42
Q

tx for woman with endometrial Bx showing complex hyperplasia without atypia

A

potent progestin to stop effects of estrogen

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43
Q

premature ovarian failure causes in women

A

chemo, radiation, autoimmune ovarian failure, turners, fragile X

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44
Q

hormone levels in premature ovarian failure

A

decreased Estrogen levels causing increased FSH and LH usuall FSH:LH >1

45
Q

role of bhCG

A

maintenance of corpus luteum

46
Q

cervical mucus in ovulatory phase

A

profuse, clear and thin

47
Q

cervical mucus in post and pre ovulatory phase

A

scant opaque and thick

48
Q

when is cervical mucus more basic

A

during ovulation >6.5

49
Q

what stimulates prolactin

A

TRH and serotonin and GnRH

50
Q

medications that cuase high prolactin

A

antipsychotics, TCAs and MAOIs

51
Q

unilateral bloody nipple discharge

A

intraductal papilloma

52
Q

first step for workup of bloody nipple discharge of breast unilaterally

A

mammo to rule out carcinoma

53
Q

next step to identify fibroids causing stress incontinence

A

US of pelvis

54
Q

posterior acoustic enhavement of breast mass

A

fluid

55
Q

aspiration of breast mass revealed clear fluid and mass disappeared. next step

A

return 2-4 months for follow up clinical breast exam

56
Q

what is the reason for amenorrhea in crazy athlete

A

estrogen deficiency

57
Q

hormones in female olympic athletes

A

decreased LH and GnRH

estrogen deficiency

58
Q

most efficient emergency contraceptive

A

copper IUD

59
Q

risk of amenorrhea from HPO axis suppression from extreme weight loss or exercise

A

decreased bone mineral density

60
Q

first step for determining infertility

A

semen analysis

61
Q

which side is more common for ovarian torsion

A

right

62
Q

risk factors for ovarian torsion

A

pregnancy, ovulation induction for infertility, ovarian masses

63
Q

Dx ovarian torsion

A

color doppler

64
Q

antibiotics for lactational mastitis

A

dicloxacillin or cephalexin

65
Q

first line test to assess fallopian tube patency

A

hysterosalpingogram

66
Q

risk of PID later for pregnancy

A

fallopian tube scaring

67
Q

obesity cause of infertiliy

A

anovulation from not enough progesterone

68
Q

Tx for vaginismus

A

kegel exercises and gradual dilatation

69
Q

first step for breast mass- non malignant like but patient has +FMH breast cancer

A

US

70
Q

if breast US shows complex cyst or solid mass, next step

A

image guided core biopsy

71
Q

OCP increase risk for what cancer

A

cervical

72
Q

what liver disorder do OCP increase risk for

A

hepatic adenoma

73
Q

heavy menses in young patient with first year of menses

A

anovulation

74
Q

patient with new onset night sweats, insomnia and irregular menses.
in middle aged

A

check TSH and FSH

75
Q

pagets is associated with what breast cancer

A

adenocarcinoma

76
Q

chocolate appearing material in ovarian cyst

A

old blood

endometrioma

77
Q

gold standard Dx endometriosis

A

laparoscopy

78
Q

patient with high grade squamous epithelial lesion on cervix and is pregnant

A

repeat pap and colpo after delivery

79
Q

when do you do a LEEP procedure

A

when >25 and have HGSIL of cervix

unless post menopausal or pregnant

80
Q

common cause heavy menstrual bleeding

A

fibroids

proliferation smooth muscle in myometrium

81
Q

what significantly decreases risk of ovarian CA in BRCA + patients

A

prophylactic BSO

82
Q

ulcer in syphlis

A

painless that forms punched out base with raised indurated margins

83
Q

non modifiable breast cancer risk factors

A

genetic mutation in first degree relative
swhite
>50 years old
early menarche or later menopause

84
Q

Dx fibroids

A

pelvic US

85
Q

normal increase bhCG in pregnancy

A

increase every 2 days

86
Q

infertility definition in women >35 years old

A

trying for 6+ months

87
Q

how to assess infertility due to aging

A

early follicular phase GSH level, clomiphene challenge test

inhibin B level

88
Q

what increases risk for clear cell adenocarcinoma of vagina and cervix

A

in utero exposure to DES

89
Q

males exposed inutero to DES

A

microphallus
cyrptorchidism
hypospadias
testicular hypoplasia

90
Q

side effect tamoxifen

A

hyperplasia endometrium

91
Q

21-24 year old with atypical squamous cells of undetermined significance on pap
next step

A

repeat cytology in 1 year

92
Q

birth control for woman undergoing chemo for breast cancer

A

copper IUD

93
Q

common side effet of OCPs

A

worsening HTN

94
Q

5 alpha reductase deficiency

A

cannot convert testosterone to DHES
abiguous genitalia at birth
male internal urogenital tract from AMH

95
Q

mullerian agenesis

A

no upper vagina, cervix or uterus otherwise notmal female developmen
normal pubic and axillary hair
female testosterone levels

96
Q

what is HELPP

A

systemic inflammation and platelet consumption

97
Q

next step in HELPP

A

delivery
Mg
anti HTN

98
Q

suspect lichen sclerosis, next step

A

vulvar punch biopsy

99
Q

risk with lichen sclerosis

A

vulvar squamous cell carcinoma

100
Q

Tx lichen sclerosis

A

topical corticosteroids

101
Q

need to do what before starting herceptin Tx

A

echo because risk of cardiotoxicity especially in those with low EF

102
Q

best chance for pregnancy with premature ovarian failure

A

in vitro fertilizaiton using donor oocytes

103
Q

CI to raloxifene and tamoxifen

A

VTE disorders like PE, DVT and retinal vein thrombosis

104
Q

msot common Sx vaginal CA

A

vaginal bleeding and malodorous vaginal discharge

105
Q

fat necrosis of the breast

A

fixed mass with skin or niple retraction and gives calcifications in spiculated pattern on mammo
fat globules and foamy macrophages on Bx

106
Q

how does clomiphene work

A

estrogen analog that imporves GnRH release and RSH release improving chance of ovulation

107
Q

when is HPV screening started

A

> 30

108
Q

when to stop paps

A

> 65 if previous negative screens

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