Gynae 1 Flashcards
Describe the most common risk factor for uterine fibroids (leiomyomas)
Race, specifically Black race
What is the most common site for uterine fibroids (leiomyomas)?
Intramural
What is the most common symptom of uterine fibroids (leiomyomas)?
Bleeding
What complications are associated with the submucosal type of uterine fibroids (leiomyomas)?
Infertility and recurrent abortion
What complication is associated with the subserosal type of uterine fibroids (leiomyomas)?
Torsion
How is severe pain during pregnancy in uterine fibroids (leiomyomas) managed?
Ischemic necrosis is an important complication
Define the impact of estrogen levels on uterine fibroids (leiomyomas) prognosis
Mainly affected by estrogen levels, rare before puberty, and degenerates after menopause
What is the recommended treatment for young females with uterine fibroids (leiomyomas) who still want children?
Myomectomy
Describe the treatment approach for uterine fibroids (leiomyomas) in older patients who do not want children
Hysterectomy
What is the significance of red degeneration in fibroids?
Associated with timing during pregnancy, presenting with abdominal pain and fever
How is primary dysmenorrhea managed in young females?
First line treatment with NSAIDs, second line with OCPs
Describe the most common site of endometriosis
Ovary, often presenting as a chocolate cyst
What are the common symptoms of endometriosis in young patients?
Infertility, dysmenorrhea, dyspareunia, dyschezia
What is the investigation of choice for endometriosis?
Laparoscopy
How is endometriosis treated in young patients?
Encourage pregnancy
What are the side effects of danazol in endometriosis treatment?
Menopausal symptoms like acne, hirsutism, and hot flushes
Describe the treatment for androgen insensitivity syndrome
Removal of testes after puberty due to defect in androgen receptors
What are the common characteristics of Turner syndrome?
Short stature, low IQ, webbed neck, wide-spaced nipples, and CHD
Describe the clinical presentation of congenital adrenal hyperplasia in infants.
Infants with congenital adrenal hyperplasia may present with weight loss, vomiting, dehydration, salt-losing features like hyponatremia, hyperkalemia, and hypoglycemia. Female infants may have masculinized external genitalia.
What is the most common cause of hirsutism in idiopathic hirsutism?
Idiopathic hirsutism is most commonly caused by spironolactone.
Define primary amenorrhea in the context of Kallman syndrome.
Primary amenorrhea in Kallman syndrome is characterized by low levels of GnRH, FSH, and LH, leading to absent menstruation and anosmia.
How is secondary amenorrhea defined, and what is the initial test recommended for diagnosis?
Secondary amenorrhea is the absence of menstruation for at least 3 months in women with previously normal menstrual cycles. The initial test recommended is a beta-hCG to rule out pregnancy.
Describe the clinical features of polycystic ovarian syndrome (PCOS).
PCOS is characterized by irregular bleeding, obesity, acne, hirsutism, infertility, and acanthosis nigricans due to insulin resistance.
What is the treatment approach for infertility in PCOS patients?
Infertility in PCOS patients can be treated with clomiphene or human menopausal gonadotropin as first-line options.
Explain the hormonal profile seen in PCOS.
In PCOS, androgen and testosterone levels are increased, LH levels are elevated, and the LH:FSH ratio is reversed (greater than 2).
Describe the management of hypothalamic pituitary failure.
Hypothalamic pituitary failure can be managed with pulsatile GnRH therapy.
What is the most common malignancy associated with premature ovarian failure?
Endometrial cancer is the most common malignancy associated with premature ovarian failure.
How is congenital adrenal hyperplasia typically treated?
Congenital adrenal hyperplasia is usually treated with cortisone.
Explain the genetic inheritance pattern of congenital adrenal hyperplasia.
Congenital adrenal hyperplasia is typically inherited in an autosomal recessive pattern.
What are the causes of secondary amenorrhea other than pregnancy?
Causes of secondary amenorrhea include obesity leading to polycystic ovaries, excessive exercise, low body fat, emotional distress, hyperprolactinemia, brain tumors, chemotherapy drugs, antipsychotic medications, hyperthyroidism, and reduced ovarian function.
Describe the clinical features of congenital lymphedema.
Congenital lymphedema presents with swelling due to abnormal lymphatic drainage present at birth.
How is congenital lymphedema managed?
Congenital lymphedema is managed with compression garments and physical therapy.
Explain the hormonal changes seen in premature ovarian failure.
Premature ovarian failure is characterized by increased FSH levels.
What is the recommended treatment for premature ovarian failure?
Premature ovarian failure can be treated with estrogen and progesterone replacement therapy after puberty.
What is the treatment for bacterial vaginosis during pregnancy?
Metronidazole