gynecology Flashcards
bloody nipple discharge
intraductal papilloma
difference differentielle of breast mass(5)
fibrocystic disease fibroadenoma mastitis/abscess fat necrosis breast cance
most common breast lesion in women < 30 ans
fibroadenoma
increased risk of Ca
exposure to estrogen
case of increase exposure to estrogen(3)
early menarche
late menopause
nulliparity
localisation of ca sein
45% occur in the upper outer quadrant
fat diet in ca du sein(2)
high fat diet
low fiber diet
stage 1 tumor du sein
Tumor size < 2 cm
Stage II tumor du sein
Tumor size 2–5 cm
Stage III tumor du sein
Axillary node
involvement
Stage IV tumor du sein
Distant
metastasis
Tumor markers for recurrent breast cancer(2)
CEA and CA 15-3 or
CA 27-29.
Most reliable prognosis factor for breast cancer
TNM
Behavioral methods of contraception(2)
rythm
coitus interruptus
barrier methods(4)
diaphragm
cervical cap
IUD
condoms
quid of rythm
Uses body temperature
cervical mucus
consistency to predict time of fertilit
side effect of IUD(6)
vaginal bleeding uterine perforation, IUD migration, infection ectopic pregnancy risk of PID
hormonal methods(3)
OCP
prosterone minipills
Depo provera
Quid of OCP.s
combination of estrogen and progestin
action of OCP(3)
Suppress ovulation by inhibiting FSH/LH;
change the consistency of cervical mucus
making the endometrium unsuitable for implantation
hormonal method which can be used in lactating women(4)
depoprovera(DMPA)
progestin mini pills
levonorgestrel
post coital morning after pills
infertility in patient taking Depo provera
till 10 months
ovulation in progestin minipills
40 % des cas
quid of levonorgestrel(2)
norplant
progesterone
Absolute contraindications to OCPs
Pregnancy.
■ A history of thromboembolic disorders (past or present).
■ A history of stroke or CAD (past or present).
■ Breast cancer (known or suspected).
■ Undiagnosed abnormal vaginal bleeding.
■ Estrogen-dependent cancer (known or suspected).
■ A benign or malignant tumor of the liver (past or present).
■ Cigarette smoking in women > 35 years of age
Absolute contraindications to IUD use
Pregnancy. ■ A history of PID. ■ Acute cervical, uterine, or salpingeal infection. ■ Suspected gynecologic malignancy. ■ Undiagnosed abnormal vaginal bleeding.
quid of Adenomyosis
endometrial tissue in the myometrium that makes
the uterus symmetrically enlarged and globular
endometriosis
growth of endometrium outside the uterus
laparoscopy of endometriosis
dark brown (“powder-burned”) appearance blue black (raspberry appearrance)
secret in rx endometriosis
suppress ovulation 4 -9 months
med used in endometriosis
danazol
GNRH analog
OCPs
quid of GNRH analog(2)
nafarelin
leuprolide
anatomic abnormalities causing primary amenorrhea(4)
mullerian anomalies
vaginal agenesis
hyperforate hymen
testicular feminisation
hormone in anatomic abnormalities causing primary amenorrhea(2)
asherman syndrome
cervical stenosis
ovarian and uterine dysfunction causing primary amenorhea with high FSH(2)
gonadal dysgenesis
ovarian failure
characteristics in testicular feminisation
High LH
ovarian and uterine dysfunction with low or normal FSH(2)
constitutionnal development delay
steroidogenic enzyme defects
secondary amenorrhea with high FSH with ovarian or uterine dysfunction
premature ovarian failure
primary hypogonadism before 40
menopause
secondary amenorrhea with low or normal FSH in ovarian and uterine dysfunction
PCOS
secondary amenorrhea with high BHCG
pregnancy
primary amenorrhee with central regulatory disorders
low or normal FSH
primary amenorrhee with central regulatory disorders cause(2)
Hypothalamic dysfunction
primary pituitary dysfunction
quid of hypothalamic dysfunction causing primary amenorrhee(6)
kallman syndromes anorexia stress excess exercice weight loss tumor
pituaitary dysfunction causing secondary amenorrhea(2)
sheehan
hyperprolactinemia
Menorrhagia(2)
increase amount of flow(> 80 ml per cycle) prolonged bleeding(> 8jrs)
oligomenorrhea
35 a 90 jours between cycles
polymenorhea
cycle < 21 jours
metrorragia
bleeding between periods
Menometrorrhagia
excessive and iregular bleeding
most commoncause f uterine bleeding and amenorrhea
pregnancy
quid of menopausal uterine bleeding
vaginal bleeding that occurs > u egal 6 months following the cessation of menstrual function
post menopausal bleeding
cancer
post menopausal bleeding causes(5)
atrophic endometrium endometrial proliferation and hyperplasia endometrial ca cervical ca prise d'estrogens sans progestins
hirsutism and virilization with high testo and normal DHEAS
ovarian neoplasm
hirsutism and virilization and high DHEAS > 7 Microgram(2)
adrenal tumor
cushing syndrome
hirsutism and virilization with high Testo > 70 ng/dl and high DHEAS but less than 7(3)
PCOS
adrenal hyperplasia
cushing’s syndrome
hirsutism and virilization with normal DHEAS and normal testo
low end organ sensitivity
HAIR-AN syndrome
variant of PCOS
symptom of HAIR-An syndrome(3)
hyperandrogenism
insulin resistance
acanthosis nigricans
Menopause wreaks HAVOC
Hot flashes Atrophy of the Vagina Osteoporosis Coronary artery disease
most common cause of infertility
low sperm cunt and motility(40%)
Most common localisation of ectopic
ampulla oviduct
High BHCG and absence of an intra uterine pregnancy on ultrasound
ectopic pregnancy
diagnosis of vaginitis (trichomonas and bacterial vaginitis)
wet prep
diagnosis for yeast
KOH
Chandelier sign
PID
quid of chandelier sign
cervical tenderness motion
bacterial vaginosis leukorea(2)
grayish-white
fishy
trichomonas discharge(2)
yellow green
frothy
yeast discharge
cottage cheese texture
clue cells
vaginose bacterienne
Azole during pregnancy
no azole in pregnant women
HPV serotype
type 16 18 31
most common cause of death in cervical cancer
uremia
uterine mass continues to grow after menopause
rule out malignancy
Bethesda system
Mild dysplasia=CIN1=low garde SIL
Bethesda system in CIN 2
Moderate dysplasia=High grade SIL
Bethesda system in CIN 3
severe dysplasia=high grade dysplasia
Bethesda system in CIN 3 carcinome in situ
High grade HSIL
Invasive cancer in Dysplasia and CIN system
invasive ca
CIN 1 rx
Pap smear and colposcopy every 3-4 months for one year
CIN 2 et 3 exocervix
laser or
Cryotherapy
CIN 2 et 3 endocervix rx(2)
Conisation with loop electrosurgical excision procedure
cold knife biopsy
palpable adnexal in a premenarchal or postmenopausal patient
ovarian neoplasm
Marker for ovarian tumor epithelial
CA-125
endodermal sinus ovarian tumor marker
AFP
Embryonal carcinoma ovarian tumor (2)
AFP
HCG
choriocarcinoma tumor marker
HCG
Dysgerminoma ovarian tumor marker
LDH
urinary incontinence without specific urogenital pathology
DIAPPERS Delirium/confusionnal state Infection Atrophic vaginitis/uretritis Pharmaceutical Psychiatric causes Excessive urinary output Restricted mobility stool impaction
cause of excessive urinary output(3)
hyperglycemia
hypercalcemia
CHF
4 types of incontinence
total
stress
urge
overflow
quid of stress incontinence(2)
uncontrolled loss at all times
in all positions
cause of stress incontinence
pelvic flow weakness
Urge incontinence
preceded by a strong unexpected urge to void
cause of urge incontinence
detrusor hyperreflexia
sphincter dysfunction
disease with urge incontinence(2)
inflammatory conditions
neurogenic bladder disorder
rx of urge incontinence
anticholinergic medication
overflow incontinence
seen in patient with chronic urinary retention
etiologies of overflow incontinence(4)
tumor
strictures
neurologic factors
medications
cause of urge incontinence(4)
cystitis
stone
tumor
CNS causes
