GYNE

Question 1

4 ligaments of the uterus

Answer 1

1. round ligament (anterior surface of uterus through the broad ligaments and inguinal canal , then terminate in the labia majora. Helps with anteversion/suspension. Blood supply is Sampson’s artery
2. Uterosacral ligaments: arise from sacral fascia and insert into posterior inferior uterus. prevents prolapse, contains autonomic nerve fibers.
3. Cardinal ligaments: extend from lateral pelvic walls and insert into lateral cervix and vagina
4. broad ligament: pass from lateral pelvic wall to sides of uterus;contain fallopian tube, round ligament, ovarian ligament, nerves vessels and lymphatics.
5. infundivulopelvic ligament 9suspensory ligament of the ovary): continuous tissue that connects ovary to pelvic wall.

Question 2

ashermans syndrome

Answer 2

acquired condition where scar tissue/adhesions form inside your uterus. Can cause infertility.

Question 3

medical treatments for infertility

Answer 3

1. clomid if anovulatory. It is an estrogen antagonist used in anovulatory patients. blocks brains perception of ciruclating estrogen, resulting in increased release of FSH and LH, which can help to induce ovulation.
2. Letrozole:aromatase inhibitor.
3. bromocriptine or carbamazepine fi elevated prolactin.
4. metformin if PCOS
5. ASA for women with a history of recurrent spontaneous abortions (APLA)

Question 4

medication for gonorrhea

Answer 4

250mg IM ceftriaxone and
1gPO azithromycin

Question 5

medication for chlamydia

Answer 5

1g PO azithro OR doxy 100mgPO 7 days.

Question 6

management of toxic shock syndrome

Answer 6

combined therapy of vanco, clindamycin, piptaz

Question 7

most common ovarian tumor

Answer 7

serous epithelial tumor.

Question 8

marker for ovarian cancer

Answer 8

ca125, inhibin, beta HCG, LDH, AFP, androgens.

Question 9

Meigs syndrome triad

Answer 9

sex cod stromal ovarian tumor: triad of benign ovarian tumor, ascites, and plerual effusion.

Question 10

most common hydatidiform mole

Answer 10

complete mole 46xx or xy. 2 sperm fertilize empty egg or 1 sperm with reduplication. beta HCG will be very high. US would show snow storm with no fetus. Likely will ned Dand C and methotrexate.

Question 11

TF you should treat BV in pregnancy

Answer 11

true. has adverse effects in pregnancy.

Question 12

treatment of BV

Answer 12

metronidazole 500mg po q7 days.
( would see clue cells, positive whiff test, ph>4.5)

Question 13

G1p1 female complains of vaginal dischage. the speculum exam reveals punctations to her cervix. Which is the most likely/

Answer 13

trichomonas. “strawberry cervix”– considered an STiI. purulent vaginal dischage, vulvar irritation, dysuria, dysparunia +/- odor frothy yellow-green. Flagellated organisms.

Treatment is metronidazole is 2g PO single dose.

Question 14

PID treatment

Answer 14

foxydoxy
- cefoxitin 2g IV q6 + doxycycline 100mg po q12
+/- metronidazole.(esp if tuboovarian abscess)

if fever maybe get some imaging to make sure there is no abscess.

Question 15

what infection can cause new born blindness

Answer 15

chalmydia. STI needs to be reported. same with gonorrhea.

Question 16

when is FSH high

Answer 16

follicular stage. then there is an LH surge which causes ovulation.

Question 17

when is progesterone high

Answer 17

luteal phase after ovulation.

Question 18

what specific type of leiomyoma causes abnormal uterine bleeding

Answer 18

usually submucosal. intramural and subserosal doesn’t cause bleeding as often.
leiomyoma are fibroids–benign smooth muscle growth.

Question 19

2/3 rotterdam

Answer 19

-oligo/anovulation– therefore no corpus luteum to secrete progesterone and a period.
- biochemical findings: string of pearls on US
- hirsutism

Question 20

dose of tranexamic acid

Answer 20

1g IV/PO q6hours. used for emergency uterine bleeding.