Gynecology Flashcards
round ligament
allows anteversion of the uterus
broad ligament
contains uterine vessels
infundibular ligamnet
contains ovarian artery, nerve, vein
missed abortion
1st trimester bleeding, closed os, positive sac on ultrasound, no heart beat
threatened abortion
1st trimester bleeding, positive heartbeat
incomplete abortion
tissue protrudes through os
ectopic
acute abdominal pain, positive beta hcg, negative ultrasound for sac (life threatening); missed perios, hypotension
risk factors: previous tubal manipulation, PID, previous ectopic pregnancy
endometriosis
Sxs: dysmenorrhea, infertility, dyspareunia
can involve the rectum and cause bleeding with menses
- endoscopy shows blue mass
TX OCPS
Pelvic inflammatory disease
Sxs: pain, nausea, vomiting, fever, vaginal discharge
Tx: ceftriaxone, doxycyline
Mittelschmerz
rupture of graafian follicle
causes pain that can be confused with appendicitis
occurs 14 days after the 1st day of menses
vaginal cancer
primarily- Squamous cell ca
DES - can cause clear cell ca
Botryoids
rhabdosarcoma that occurs in young girls
vulvar cancer
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
ovarian cancer
OCPS, b/l tubal ligation decrease risk
nulliparity, late menopause, early menarch increase risk
krukenberg tumor
stomach cancer that has metastasized to ovary
path: signet ring cells
Meigs syndrome
pelvic ovarian fibroma thta causes ascites and hydrothorax
TX: excise tumor
Ovarian cancer TX
TAH, B/L oophorectomy for all stages pelvic and para-aortic LN dissection omentectomy 4 quadrant washes chemotherapy: cicplatin and paclitaxel
endometrial cancer
vaginal bleed in postmenopausal women is ca until proved otherwise
serous and papillary worst subtypes
TX: TAH, BSO +/- XRT
cervical cancer
Most common: squamous cell
goes to obturator nodes first
associated with HPV 16 and 18
TX: TAH, > stage IIa + XRT
ovarian cysts- postmenopausal
if sepatated with vasc flow, solid components or papillary projections –> SURGERY
IF not –> observe repeat US in 1 yr
Ovarian cysts- premenopausal
if sepatated with vasc flow, solid components or papillary projections –> SURGERY
In not –> can follow with US unless suspcious findings
