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Gyne Flashcards

1
Q

Major factor for vulvovaginitis

A

Poor perineal hygiene

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2
Q

Vulvovaginitis mgt

A

Improve hygiene

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3
Q

MCC of foul smelling bloody vaginal discharge

A

Tissue

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4
Q

Presence of translucent vertical line at the midline

Mgt

A

Adhesive vulvitis

Estrogen cream BID x 3 weeks

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5
Q

Autoimmune process common among prepubes and postmenopause

A

Lichen sclerosus

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6
Q

Figure of 8
Hourglass
Parchment like appearance

Tx

A

Lichen

Clobetasol (mature)

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7
Q

In genital trauma, you should rule out

A

Sexual abuse

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8
Q

Precocious puberty?

A
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9
Q

LH, FSH and estrogen levels of Idiopathic precocious puberty

A

Within normal range

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10
Q

GnRH stimulation test in Central prec pubes

A

Increase FSH and LH

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11
Q

Hormone levels of Pseudo precocious pubes

A

LH and FSH dec

Estrogen highly elevated

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12
Q

Causes of GnRH independebt precocious puberty

A

Granulosa cell tumor

McCune Albright syndrome

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13
Q

Peripheral precocious pubes on GnRH stimulation test

A

No change in LH and FSH

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14
Q

Triad of McCune albright

A

Precocious puberty
Pigmentation (cafe au lait spots)
Polyostotic Fibrous dysplasia

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15
Q

Differentiate central from peripheral precocious puberty

A

GnRH stimulation test

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16
Q

Idiopathic precocious puberty treatment of choice

A

GnRH

Involution of secondary sexual characteristics
Reverses ovarian cycle and changes growth pattern
Given until puberty

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17
Q

MC gyne problem in prepubes

A

Vulvovaginitis

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18
Q

DOC for acute excessive bleeding in hemo unstable pts

A

IV estrogen 24 mg q4hrs for 24 hrs
conjugated equine estrogen

If unresponsive, GnRH agonist and D&C

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19
Q

DOC for acute excessive bleeding in hemodynamically stable pts

A

CEE 10mg q6 x 2-3 weeks

Followed by medoxyprogesterone x 7-10 days

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20
Q

Mgt for ovulatory chronic bleeding

A

Contraception: OCP and levo IUD w or wo NSAIDs and Tranexamic acid

Fertility: NSAIDs and Tranexamic acid

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21
Q

Mgt in Anovulatory chronic bleeding

A

Contraception: OCPs

Fertility: cyclic progestin therapy D14-25 each cycle

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22
Q

First line tx for dysmenorrhea

A

Nsaids

OCPs for those who desire contraception

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23
Q

Hypothalamic failure presenting with hypo hypo assoc with anosmia

A

Kallman’s syndrome

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24
Q

Gonadal failure presenting with hyper hypogonadism

A

Turner’s syndrome

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25
Q

Other etiology of Hyper hypo besides Turner syndrome

A

Premature ovarian failure

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26
Q

MC cause of primary amenorrhea

A

Imperforate hymen

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27
Q

2nd MC cause of primary amenorrhea

A

MRKHS

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28
Q

Triad of Stein-Leventhal syndrome

A

Hirsutism
Amenorrhea (anovulation)
Obesity

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29
Q

Major criteria for PCOS

A

Chronic anovulation

Hyperandrogenemia

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30
Q

Pituitary cell destruction sec to hypotensive episode during pregnancy

A

Sheehans syndrome

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31
Q

Tx of hyperprolactinemia

A

Dopamine agonist- bromocriptine

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32
Q

Pathognomonic sign of menopause

A

Hot flushes

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33
Q

Tx of decreased libido in menopause

A

IM testosterone

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34
Q

MC bone fracture during menopause

A

Vertebral bone fractures

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35
Q

Mainstay of tx of menopause

A

Estrogen replacement therapy

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36
Q

Grading of POP

A

Grade I- halfway to introitus
Grade II- to introitus
Grade III- outside introitus
Grade IV- uterus, anterior and posterior wall outside

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37
Q

Source of testosterone in females

A

Ovary

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38
Q

Source of DHEA-S in females

A

Adrenal glands

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39
Q

Source of 3alpha diol G

A

Peripheral conversion

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40
Q

Adrenal androgen dependent hairs

A

Pubic and axillary hairs

Low androgen threshold

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41
Q

Gonadal androgen dependent hairs

A

Midline, facial, intermammary

High androgen threshold

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42
Q

Idiopathic form of increase in 5 a reductase enzyme

A

Follicle sensitivity

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43
Q

Ezyme deficient in late onset CAH

A

21 a hydroxylase enzyme

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44
Q

Tx of late onset CAH

A

Glucocorticoid to suppress elevated 17 HP

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45
Q

Tx of hair follicle androgen sensitivity

A

Spirinolactone

To suppress 5alpha reductase

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46
Q

Likelihood of conception within one cycle of timed micycle intercourse

A

Fecundability

20%

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47
Q

Midluteal progesterone level required for ovulation

A

> 10ng/ml

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48
Q

Test for ovarian reserve

A

Clomiphene citrate challenge test

FSH >12 mU/mL on the third day of cycle

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49
Q

Normal semen analysis value

A 
Volume 2-5 ml
>20 million/ml
Motility >50%
Normal >30%
pH 7.2-7.8
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50
Q

Drug for ovulation induction

A

Clomiphene citrate

51
Q

DES exposure can lead to

A

Clear cell adenocarcinoma of the daughter

52
Q

Screening for pap smear

A

3 years before sexual activity

Or age 21

53
Q

Mgt of ASCUS

A

Colposcopy and biopsy
Or
Repeat pap smear after 3 months

54
Q

Mgt of LSIL

A

Repeat pap smear after 3 mos

55
Q

Mgt of HSIL CIN II

A

Colposcopy and biopsy

If confirmed, ablative or excisional

56
Q

Mgt of cervical scca on pap smear

A

Colposcopy and biopsy

57
Q

Mgt if HSIL CIN III

A

Colposcopy and biopsy

If confirmed, ablative and excisional
Remove whole transformation zone by conization

58
Q

Mgt if HSIL CIN III but no desire for future pregnancy

A

Hysterectomy

59
Q

MC symptom of cervical CA

60
Q

MC cause of death in cervical CA

61
Q

Cervical CA stage

Presence of hydronephrosis

62
Q

Cervical CA stage
To vagina but not beyond lower 1/3
Without parametrial invasion
>4cm

63
Q

Cervical CA stage

To bladder or rectum

64
Q

MC uterine anatomic anomaly

A

V- septate

65
Q

MC type of myoma

A

Hyaline degeneration

66
Q

Myoma during pregnancy

A

Carenous/red degeneration

67
Q

MC type of myoma accdg to epithelia

A

Intramural

68
Q

Tx of asymptomatic myoma

69
Q

Tx of symptomatic myoma

A

3-6 mos of GnRH analogue

70
Q

Definitive tx of myoma

A

Hysterectomy

71
Q

Tx of sypmtomatic EM polyp

A

Hysteroscopic resection

72
Q

MC site of endometriosis

73
Q

Chocokate cyst or powder burn

A

Endometriosis

74
Q

Dx procedure of endometriosis

A

Laparoscopy

75
Q

Definitive tx of endometriosis

76
Q

Medical tx of endometriosis

Pseudomenopause

77
Q

Medical tx of endometriosis

Medical oophorectomy

A

GnRH agonist

Leuperolide

78
Q

Medical tx of endometriosis

Psuedopregnancy

79
Q

Presents with dysmenorrhea, menorrhagia and diffusely enlarged uterus

A

Adenomyosis

80
Q

Dx modality for adenomyoma

A

MRI- differentiate from myoma preop

USG

81
Q

Diagnostic method for EM hyperplasia

82
Q

Primary determinant if premalignant potential of endometrial tissue

A

Cytologic atypia

83
Q

Tx of endometrial hyperplasia without atypia

84
Q

Tx of EM hyperplasia with atypia

A

Hysterectomy

85
Q

EM biopsy repeated after how many months with progestin tx?

86
Q

MC cause or postmenopausal bleeding

A

EM atrophy

87
Q

Key determinant of nodular spread of EM Ca

A

Depth of invasion

88
Q

Most frequent site of distant meta

A

Lungs
Retroperitoneal nodes
Abdomen

89
Q

Tx of EM CA

A

TAHBSO
Node sampling
Peritoneal washing

90
Q

Radiation is started in what stage if EM CA

91
Q

MC simple pelvic mass in reproductive age

A

Functional cyst

92
Q

MC complex adenaxal mass in reproductive age

A

Benign cystic teratoma

93
Q

MC cause of pelvic mass

94
Q

Honey comb cyst

Bilateral

A

Theca Lutein Cyst

95
Q

Mgt for Follicular and Corpus Luteum cyst

A

Observe and repeat usg after 6-8 weeks

96
Q

Mgt of adnexal mass after menopause or before puberty

A

Laparoscopy

If solid, more than 8cm, persist more than 8 weeks in a menstruating woman

97
Q

Ovarian tumor with coffee bean appearing nucleus

A

Brenner tumor

Transitional cell tumor

98
Q

MC neoplasm in prepubertal female

A

Benign cystic teratoma

Dermoid cyst

99
Q

MC benign solid tumor of the ovary

100
Q

Triad of Meig’s syndrome

A

Ovarian fibroma
Ascites
Hydrothorax

101
Q

Mgt of benign ovarian tumors

A

Unilateral Salpingo-oophorectomy

102
Q

MC ovarian epithelial cell malignancy

A

Serous tumor

103
Q

Hobnail cells

Or cells with abundant glycogen

A

Clear cell adenoca

104
Q

Elevated CA 125

A

Epithelial cell tumor

105
Q

Mgt of epithelial ovarian CA

A

Phase 1: cytoreduction or debulking
Phase 2: postoperative chemo (carboplatin, taxol)
Ff-up: CA 125 q3 mos x 2 yrs, q6 mos x 2 yrs

106
Q

MC malignant germ cell tumor

A

Dysgerminoma

107
Q

Ovarian tumor:
LDH
Bilateral

A

Dysgerminoma

108
Q

Ovarian tumor:
AFP
Embryonic structures

A

immature teratoma

109
Q

Ovarian tumor:

BHCG

A

Choriocarcinoma

110
Q

Ovarian tumor:
AFP
Schiller duval bodies

A

Yold sac tumor

Endodermal sinus tumor

111
Q

Ovarian tumor with groved coffee bean nuclei in small clusters around a central cavity

A

Granulosa theca cell

call exner bodies

112
Q

MC cause of labial fusion?

MGt?

A

Excess androgen

Cortisol + surgery

113
Q

Tx of lichen simplex chronicus

A

Medium potency topical steroids BID 4-6weeks

114
Q

Erosive vaginitis inside the vagina causing vaginal stenosis

Pruritic, purple, papule

A

Lichen planus

Vaginal hydrocortisone, surgical excision of adhesion

115
Q

MC tumors in the vulva

A

Epidermal inclusion cyst

Sebaceous cyst

116
Q

Why is biopsy done in Bartholin’s duct cyst in >40yo

A

R/O bartholin’s gland CA

117
Q

MC benign solid tumor of the vulva

118
Q

Tx of lichen sclerosus

A

Testosterone cream

Topical steroids

119
Q

Tx of Vulvar carcinoma stage I to III

A

Wide radical vulvar excision and bilateral inguinal-femoral node dissection

120
Q

If presenting with gram negative diplococci infection, tx?

A

Ceftriaxone 250mg IM
+
Azithromycin 1 gm Single dose or Doxycycline 100mg BID x 14 days

121
Q

Definitive dx of PID

A

Laparoscopy

122
Q

In patient tx of PID

A

Cefotetan/ Cefoxitin + Doxy

Or

Clindamycin + Gentamicin

123
Q

16 yo male with pelvic kidney

OB-Gyne (4 decks)

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