Gynecology Flashcards
- fibroadenoma
- fibrocystic disease
- intraductal papilloma
- fat necrosis
- mastitis
benign breast disease
- ductal carcinoma in situ (DCIS)
- lobular carcinoma in situ (LCIS)
- invasive ductal carcinoma
- invasive lobular carcinoma
- inflammatory breast cancer
- Paget’s disease of breast/nipple
malignant breast disease (breast cancer)
causes of enlarged uterus
- pregnancy
- leiomyoma
- adenomyosis
ALL postmenopausal bleeding is what until proven otherwise?
endometrial carcinoma
when do you start screening for cervical cancer?
21 yoa regardless of onset of sexual activity
frequency of cervical cancer screening if LESS than 30 yoa?
every 3 years w/ cytology ONLY
frequency of cervical cancer screening if MORE than 30 yoa?
every 3 years w/ cytology ONLY, OR every 5 years w/ cytology AND HPV
PAP screening is NOT recommended for?
- greater than 65 yoa w/ recent normal PAP smear
- women w/ total hysterectomy for benign disease
management of ASCUS on PAP smear if f/u is CERTAIN
repeat PAP smear in 3-6 months AND order HPV DNA typing
management of ASCUS on PAP smear if f/u is UNCERTAIN
colposcopy and biopsies
management of ASCUS if REPEAT PAP smear again shows ASCUS or HPV 16 and 18 are found
colposcopy and biopsies
give quadrivalent HPV recombinant vaccine (Gardasil) to?
all females 8-26 yoa
INITIAL w/u for pelvic pain
- pelvic exam
- cervical cultures
- ESR
- WBC (BC if fever is present)
- US
cervicitis management
- cervical cultures
- single dose azithromycin PO and ceftriaxone IM
acute salpingo-oophoritis management
- cervical cultures
- single dose doxycycline PO and ceftriaxone IM (outpt)
- cefotetan or cefoxitin IV and doxycycline IV (inpt)
chronic pelvic inflammatory disease treatment
- infertility
- dyspareunia
- h/o ectopic pregnancy or abnormal vaginal bleeding
- NEGATIVE cervical cultures and labs
- US = B/L cystic pelvic masses (hydrosalpinges)
lysis of tubal adhesions
tuboovarian abscess treatment
- cefoxitin and doxycycline IV
- exlap +/- TAH and BSO (total abdominal hysterectomy bilateral salpingo oophorectomy), or percutaneous drainage
primary dysmenorrhea treatment
- crampy lower abd pain
- N/V, and diarrhea during menstruation
- excessive endometrial PG F2
- NSAIDs
- combination OCP (2nd line)
MCC of secondary dysmenorrhea
endometriosis
endometriosis treatment
continuous PO progesterone
secondary amenorrhea w/u
- B-hCG (pregnancy test)
- TSH
- prolactin
- progesterone challenge test
- estrogen-progesterone challenge test
LH:FSH ratio in PCOS (polycystic ovarian syndrome)
3:1
treatment for PCOS
- OCP
- spironolactone
- clomiphene
- metformin
when is HRT the answer?
- menopausal vasomotor symptoms (hot flashes)
- genitourinary atrophy
- dyspareunia
when is HRT NOT the answer?
- treatment of osteoporosis
- h/o breast or endometrial cancer
- liver disease
- active thrombosis
- unexplained vaginal bleeding
