Gynecology

Question 1

round ligament

Answer 1

allows anteversion of the uterus

Question 2

broad ligament

Answer 2

contains uterine vessels

Question 3

infundibular ligamnet

Answer 3

contains ovarian artery, nerve, vein

Question 4

missed abortion

Answer 4

1st trimester bleeding, closed os, positive sac on ultrasound, no heart beat

Question 5

threatened abortion

Answer 5

1st trimester bleeding, positive heartbeat

Question 6

incomplete abortion

Answer 6

tissue protrudes through os

Question 7

ectopic

Answer 7

acute abdominal pain, positive beta hcg, negative ultrasound for sac (life threatening); missed perios, hypotension
risk factors: previous tubal manipulation, PID, previous ectopic pregnancy

Question 8

endometriosis

Answer 8

Sxs: dysmenorrhea, infertility, dyspareunia
can involve the rectum and cause bleeding with menses
- endoscopy shows blue mass
TX OCPS

Question 9

Pelvic inflammatory disease

Answer 9

Sxs: pain, nausea, vomiting, fever, vaginal discharge
Tx: ceftriaxone, doxycyline

Question 10

Mittelschmerz

Answer 10

rupture of graafian follicle
causes pain that can be confused with appendicitis
occurs 14 days after the 1st day of menses

Question 11

vaginal cancer

Answer 11

primarily- Squamous cell ca

DES - can cause clear cell ca

Question 12

Botryoids

Answer 12

rhabdosarcoma that occurs in young girls

Question 13

vulvar cancer

Answer 13

elderly nulliparous, obese
TX: < 2 cm (stage I) - WLE and ipsi inguinal node dissection
> 2vuvlectomy b/l nodal dissection post op XRt if margins < 1cm

Question 14

ovarian cancer

Answer 14

OCPS, b/l tubal ligation decrease risk

nulliparity, late menopause, early menarch increase risk

Question 15

krukenberg tumor

Answer 15

stomach cancer that has metastasized to ovary

path: signet ring cells

Question 16

Meigs syndrome

Answer 16

pelvic ovarian fibroma thta causes ascites and hydrothorax

TX: excise tumor

Question 17

Ovarian cancer TX

Answer 17

TAH, B/L oophorectomy for all stages
pelvic and para-aortic LN dissection
omentectomy
4 quadrant washes
chemotherapy: cicplatin and paclitaxel

Question 18

endometrial cancer

Answer 18

vaginal bleed in postmenopausal women is ca until proved otherwise
serous and papillary worst subtypes
TX: TAH, BSO +/- XRT

Question 19

cervical cancer

Answer 19

Most common: squamous cell
goes to obturator nodes first
associated with HPV 16 and 18
TX: TAH, > stage IIa + XRT

Question 20

ovarian cysts- postmenopausal

Answer 20

if sepatated with vasc flow, solid components or papillary projections –> SURGERY
IF not –> observe repeat US in 1 yr

Question 21

Ovarian cysts- premenopausal

Answer 21

if sepatated with vasc flow, solid components or papillary projections –> SURGERY
In not –> can follow with US unless suspcious findings