Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards > Gynecology > Flashcards

Gynecology Flashcards

1
Q

Gonorrhea treatment

A

Ceftriaxone 500 mg IM

- 1 gram if weight > 120 kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chlamydia treatment

A

Doxycycline 100 mg bid * 7 days

- Azithromycin 1 gram once if pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cervical cancer screening with hiv

A

Start earlier: within 1 year of sexual activity or hiv diagnosis, no later than 21
Screen more often: cytology x 3 or co-testing q3 to start

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for lymphogranuloma venereum

A

Doxycycline 100 mg bid x 21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Syphillis treatment

A

Primary, secondary, early tertiary: Penicillin 2.4 million units IM
Late tertiary: 2.4 x 3
Neurosyphillis: inpatient iv penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for granuloma inguinale (Klebsiella granulomatis)

A

Doxycycline 100 mg BID x 14 days

Azithromycin 1 gram every week x 3 weeks or until painless red bump or ulcer gone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PID treatment

A

Ceftriaxone 1 gram iv qd + doxycycline 100 mg bid + metronidazole 500 mg bid until 24 hours clinically improvement > 14 days total

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to redose cefazolin

A

4 hours from preop dose

1500 mL blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antibiotics before uterine evacuation

A

Doxycline 200 mg once

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ultrasound diagnosis of pregnancy failure

A

Crown-rump length 7+ mm without heartbeat
Mean sac diameter 25+ mm and no embryo
Absence of embryo with heartbeat 2 weeks after gestational sac without yolk sac
Absence of embryo with heartbeat 11 days after gestational sac with yolk sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Do you pretreat before endometrial ablation?

A

Yes to thin endometrium to level that necrosis can be achieved
- all ablation trials other than Novasure did pre-treatment with danazol or Gn-RH agonist or suction aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mechanism of mifepristone

A

Selective progesterone receptor modulator

- Acts as antiprogestin by binding to progesterone receptor with greater affinity than progesterone itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism of misoprostol

A

Prostaglandin E1 analogue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dose of mifepristone

A

200 mg orally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Length of ureter

A

30 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Path of ureter

A

Renal pelvis > psoas muscle > crosses bifurcation of common iliac vessels > medial leaf of broad ligament > crosses under uterine artery > curves into bladder through tunnel of wertheim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Length from bladder to do uretero-neocystotomy vs uretero-uretero anastomosis

A

5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cheney incision

A

2 cm above pubic symphysis > excise rectus tendon 1-2 cm off pubis
- can damage inferior epigastrics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Absorption of catgut

A

Plain: 7 days

Chromic catgut: 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Absorption of Vicryl

A

Loses 50% tensile strengths in 21 days

- 6-10 weeks to dissolve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Absorption of PDS or Maxon

A

Loses 50% strength in 60 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Definition of post-op fever

A

Temp > 101.5F

Two or more temperatures 100.4F or higher 4 hours apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Two non-absorbable sutures

A

Silk, nylon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Baden-Walker staging system

A

Stage 1: Cervix to ischial spines

2: Cervix between spines and intriotus
3: Cervix below introitus
4: Procidentia (uterus below intriotus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

At time of hysterectomy, how do you manage the vaginal apex?

A

Incorporate uterosacral ligaments into vaginal cuff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Surgical management options of vaginal vault prolapse

A

Plication of uterosacral ligaments
Sacrospinous ligament suspension
Sacrocolpopexy
Colpocleisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Difference between LeForte and complete colpocleisis

A

Uterus remains in place with LeForte

- preop endometrial sampling and cervical cancer screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment of enterocele

A

Plication of uterosacral ligaments in the midline

Obliteration of the cul-de-sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Evaluation of urinary incontinence

A
  • history, bladder diary
  • prolapse exam
  • cough test
  • neurological exam
  • post-void residual (abnormal > 150 mL)
  • q-tip test for urethral hyper mobility (goes with sui)
  • urinalysis and culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Components of office cystometry

A

First sensation
First desire to void
Bladder capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Medical therapy for urge incontinence

A

Beta-3 adrenoreceptor agonist (Mirabegron 50 mg qd)
Anti-muscarinics (oxybutynin 2.5 mg qd, tolterodine)

If refractory, intravesicular Botox or sacral neuro modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Repair of rectovaginal fistula

A

Excise the fistulous tract
Close in non-overlapping layers with Vicryl
Post-operative stool softeners and Sitz baths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Repair of Vesico-vaginal fistula

A

Excision of tract
Bladder submucosal layer
Bladder muscularis layer
Vaginal mucosal closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Normal hCG rise

A

35+% rise over 2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Contraindications to methotrexate for ectopic pregnancy

A

Ruptured ectopic (hemoperitoneum)
Hemodynamically unstable
Immunosuppression, renal, liver, blood disease
Relative: hCG > 5000 iu/ml, fetal cardiac activity, > 4 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Two dose methotrexate regimen

A

50 mg/m2 BSA on days 1 & 4

- repeat dose if day 7 not 15% decrease from day 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Single dose methotrexate regimen

A

50 mg/m2 BSA

- Repeat dose if <15% decrease from day 4 to 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Steps of appendectomy

A

Dissect the meso-appendix
Ligate appendiceal vessels (off SMA)
Clamp and cut base of appendix
Purse-string stump and invert

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Breast cancer risk with BRCA

A

BRCA-1 and 2: 45-85% breast cancer risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Ovarian cancer risk with BRCA

A

BRCA-1: 40%

BRCA-2: 10-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

FIGO GTN staging

A 
Age
Duration from antecedent pregnancy
Type of prior pregnancy 
Pre-treatment hCG
Largest tumor size
Site of metastases
Number of metastases
History of failed chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Karyotype of partial mole

A

69 xxx or 69 xxy

Fetus may be present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Karyotype of complete mole

A

46 xx or 46 xy (all paternal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Embryologic origins of vagina

A

Upper 1/3: Müllerian ducts

Lower 2/3: Urogenital sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How does HPV cause cervical cancer?

A

High risk HPV strains produce E6 and E7 proteins > destruction of tumor suppressors p53 and RB > abnormal cell cycle progression

46
Q

Pathological features of CIN

A

Koilocytic change, nuclear atypica, increased mitotic activity, disordered cellular maturation

47
Q

HPV strains in 9-valent vaccine

A

Wart causing: HPV types 6, 11

Cancer causing: HPV types 16, 18, 31, 33, 45, 52, 58

48
Q

Pathological feature and treatment of chronic endometritis

A

Plasma cells

Doxycycline 100 mg BID 14 days

49
Q

Incidence of cancer in fibroids

A

1/250 (FDA), 1/10,000 (AQHR)

50
Q

Histologic features of leimyosarcoma

A

Necrosis, mitotic activity, cellular atypia

51
Q

Hormonal findings of PCOS

A

LH: FSH > 2

  • LH acts on theca cells to induce androgen production > hirsutism
  • Androgen converted to estrone in adipose tissue > decreased FSH
52
Q

Brenner tumor

A

Benign surface epithelial ovarian tumor

  • Used to be transitional cell or bladder tumor
  • path: coffee bean nuclei (also seen in granulosa cell)
53
Q

How often are dermoids bilateral?

A

10%

- 1% malignancy rate

54
Q

Tumor marker for dysgerminoma

A

LDH

55
Q

Tumor marker for endodermal sinus tumor or yolk sac tumor (germ cell tumors)

A

AFP

Schiller duval bodies on histology

56
Q

Pathologic finding of yolk sac or endodermal sinus tumors

A

Schiller-Duval bodies

Elevated AFP

57
Q

Meigs syndrome

A

Pleural effusions, ascites, and fibroma (benign sex cord stromal tumor)

58
Q

Risk of choriocarcinoma after molar pregnancy

A

Complete mole: 16%

Partial mole: 4%

59
Q

Lifetime risk of ovarian cancer

A
  1. 6% or 1 in 60

- 5% with positive family history

60
Q

Non-cancer differential for adnexal mass

A

Non-gyn: Diverticular abscess, appendiceal abscess, nerve sheath tumor, pelvic kidney, retroperitoneal sarcoma
Gyn: TOA, hydrosalpinx,teratoma, endometrioma, fibroid, paratubal cyst, serous or mucinous cystadenoma, Mullerian anomalies

61
Q

Work up of ambiguous genitalia

A

Blood pressure, pelvic exam, testosterone, 17-OHP

62
Q

Work up for primary amenorrhea

A

Physical vs ultrasound

  • Uterus present: FSH/LH, AMH, Karyotype
  • Uterus absent: Karyotype, testosterone levels
63
Q

Differential for primary amenorrhea

A

Uterus present: Functional, Turners syndrome, primary ovarian insufficiency, Kallman’s
Uterus absent: AIS, 5-alpha reductase deficiency, Mullerian agenesis

64
Q

A-C of 3rd degree laceration

A 
A: <50% external sphincter 
B: 50-100% external sphincter
C: Internal and external sphincter
- overlap repair only possible for class c
65
Q

1st degree perineal laceration

A

Vaginal mucosa only

66
Q

Peroneal nerves injuries

A

Lateral tibial compression > foot drop

- controls muscles that lift ankle and toes upward

67
Q

Sciatic nerve injuries

A

External rotation of hip with knee extension (candy cane stirrups) > weakness of knee flexion and foot dorsiflexion

68
Q

Femoral nerve injuries

A

Retractors along psoas in thin patients > sensory deficit of anterior/medial thigh, weakness of hip flexion and knee extension

69
Q

Virchow’s triad

A

Hypercoagulable state
Venous stasis
Endothelial damage/vessel wall injury

70
Q

Ovarian tumors with elevated hCG

A

Dysgerminoma, choriocarcinoma

71
Q

CA-125: CEA ratio for ovarian cancer

A

CA-125/CEA > 25

  • 91% sensitive
  • 100% specific for ovarian cancer
72
Q

Diagnostic criteria for PID

A

Lower genital tract inflammation (discharge, cervical friability, tenderness)
Temperature (101F), elevated ESR/CRP, positive NAAT/culture, abnormal discharge (WBCs on microscopy)
Necessary: uterine, adnexal or cervical motion tenderness

73
Q

Point A

A

Medial parametria (where uterine artery and ureter cross)

  • 2 cm superior to lateral vaginal fornix
  • 2 cm lateral to cervix
74
Q

Point B

A 
Lateral parametria (to obturator nodes)
- 5 cm from midline at level of point A
75
Q

Impact of 1 unit of FFP or cryopreciptate

A

Increase in 50 mg/dl fibrinogen

76
Q

Options for positive CIN 2/3 margins

A

Co-testing and ECC at 4-6 months

  • repeat excision acceptable
  • simple hysterectomy acceptable if required-excision not feasible
77
Q

Absolute risk of persistent/recurrent HSIL

A

17%

- related to hpv persistence (doubles risk)

78
Q

Surveillance for AIS after negative margins

A

Co-testing, ECC every 6 months for 3 years

Annually until hysterectomy

79
Q

Anal wink nerves

A

S2-S4

80
Q

Timing of anticoagulation after regional anesthesia

A

4 hours for LMWH, 1 hour for heparin

81
Q

Recurrence of AIS by margin status

A

2.5% with negative margins

20% with positive margins

82
Q

How does estrogen increase VTE risk?

A

Increases hepatic production of coagulation factors (factor VII, X, fibrinogen)

83
Q

Differential diagnosis of vulvar ulcer

A 
Infection
- Herpes
- Syphillis
- Chancroid
- Granuloma inguinale (Klebsiella)
- Lymphogranuloma venereum
- Molluscum contagiosum 
Cancer
Behçet’s disease
Stevens Johnson syndrome
84
Q

How does Lugol’s iodine work?

A

Stains glycogen dark

- dysplastic cells have high cell turnover and low glycogen stores > light compared to normal tissue

85
Q

Ovarian cancer risk reduction with rrBSO

A

80-90%

  • rrBSO reduces breast cancer risk in BRCA-2 patients
  • Prophylactic mastectomy reduces breast cancer risk by 90%
  • Tamoxifen reduces breast cancer risk by 60%
86
Q

Histology of lichen sclerosus

A

Absence of rete pegs

87
Q

Age at which to biopsy with Bartholins abscess

A

40 years

88
Q

Length and purpose of Word catheter

A

4 weeks to create a fistula tract from gland to skin

89
Q

Delay in starting hormonal conception after emergency contraception

A

Levonorgestrel 1.5 mg: No need to delay

Ulipristal 30 mg: Delay OCPs for 5 days

90
Q

How does the harmonic scalpel work?

A

Ultrasonic energy > protein denaturization

91
Q

Ultrasound findings of molar pregnancy

A

Complete mole: Theca lutein cysts, vesicular pattern

Partial mole: Cystic changes in placenta, non viable fetus

92
Q

Immunochemistry of complete vs partial mole

A

P57: Maternally expressed > negative in complete mole (46 paternal genes)

93
Q

HCG follow up after molar pregnancy and HCG normalization

A

Monthly HCG for 6 months (ACOG)

-1 year if GTN

94
Q

FIGO/WHO criteria for post-molar GTN

A

Plateauing HCG (+/- 10%) for 4 values over 3 weeks
Rising HCG (10+%) for 3 values over 2 weeks
Persistent HCG for 6 months
Histologic diagnosis of choriocarcinoma or invasive mole
Clinical or radiologic evidence of metastases

95
Q

Initial HCG monitoring after evacuation of molar pregnancy

A

Weekly HCG monitoring

96
Q

Hemostatic agents that will work in DIC

A 
Thrombin+gelatin (eg Floseal)
- converts fibrinogen to fibrin
- matrix for clot formation 
Fibrin sealant (eg Tissel)
- combines thrombin with fibrinogen
97
Q

Topical hemostatic agents that require functional coagulation cascade (ie not in DIC)

A

Oxidized regenerated cellulose
- activates extrinsic coagulation cascade
Collagen
- activates extrinsic coagulation cascade
Gelatin matrix
- matrix for clot formation

98
Q

Options for vaginal vault support

A

Abdominal sacrocoplexy
Sacrospinous ligament suspension
Obliterative procedures

99
Q

Space-filling pesssaries

A

Donut
Gelhorn
Cube

Opposite is support pessary (eg ring with support)

100
Q

Hyponatremia management after hysteroscopy

A

Typically isotonic or hypertonic hyponatremia

- correct with diuresis and IV administration of hypertonic saline 3%

101
Q

Electrolyte poor hysteroscopic solution

A 
Glycine 1.5%
Sorbitol 3%
Mannitol 5%
- Stop at 1000 mL
- Used with monopolar
102
Q

Renal anomalies with congenital uterine anomalies

A

20-30% on time

On same side as uterine anomalies

103
Q

STI prophylaxis after sexual assault

A 
Ceftriaxone 500 mg IM
Azithromycin 1 gram single dose
Metronidazole 2 gram single dose
Offer Hep B and HPV vaccine
HIV risk assessment
104
Q

Progesterone treatment options for endometriosis

A

Norethindrone acetate 5 mg daily (max 15 mg)
- also used as add-back on GnRH agonist
Depo provera q12 weeks
Levonorgestrel IUD

105
Q

Max length of GnRH agonist therapy

A

12 months

- add back norethindrone 5 mg or provera 2.5 mg at 6 months

106
Q

Anterior abdominal wall layers

A 
Skin
Subcutaneous tissue
Camper’s and Scarpa’s fascia
External oblique
Transversus abdominis 
Internal oblique
Rectus abdominis
Transversalis fascia
Extra peritoneal fat
Peritoneum
107
Q

Bladder cystotomy repair

A

Running of mucosa
Interrupted of muscularis
Running of serosa
- 3-0 Vicryl

108
Q

Oral GnRH antagonist for fibroids

A

Elagolix

  • 300 mg BID
  • Add-back: 1 mg estradiol and 0.5 mg norethindrone
  • up to 2 years
109
Q

TXA dosing

A

IV: 1 gram
Oral: 1.3 g TID for up to 5 days during menstruation

110
Q

Ultrasound findings of endometrioma

A

Homogenous (ground glass) echos in a cystic mass

  • Ultrasound 80% sensitive
  • MRI 90% sensitive
111
Q

Ultrasound findings of dermoid

A 
Hyperechoic nodule with acoustic shadowing
Fluid-fluid level
Calcification 
Absence of Doppler flow
- US 98-100% specificity
112
Q

Splenectomy technique

A

Anterior

  • Gastrocolic and gastroepiploic artery and vein
  • short gastric
  • splenocolic and splenophrenic ligaments
  • splenic artery
  • splenic vein

Posterior (clockwise starting at 9 o’clock)

  • gastrosplenic ligament, short gastrics
  • splenophrenic ligament
  • splenocolic ligament
  • splenorenal ligament
  • splenic artery and vein

Boards (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions