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USMLE step2 > Gynecology > Flashcards

Gynecology Flashcards

1
Q

normal female development

A

growth acceleration->thelarche–>pubarche–>menarche

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2
Q

men development

A

testicular enlargement–>penile growth–>pubarche–>facial hair

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3
Q

premature menopause

A

cessation of the menses before age 40

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4
Q

2 Dysmenorrhea DDX

A 
endometriosis
adenomyosis
fibroids
adhesions 
PID
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5
Q

adenomiosis triad

A

menorrhagia, enlarged boggy symmetrical uterus

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6
Q

AUB(abnormal uterine bleeding)

PALM COEIN

A 
PALM(structural causes)
-polyps
-Adenomyosis
-Leiomyoma
-Malignancy
COEIN(nonstructural)
-Coagulopathy
-Ovulatory dysfunction
-Endrometrial
-Iatrogrenic
-Not yet classified.
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7
Q

endometrial biopsy indication

A
  • endometrium is >4mm in postmenopausal woman

- in the patient is >35years of age with risk factors for endometrial hyperplasia(obesity,diabetes)

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8
Q

rotterdam criteria

A

PCOS (2/3)

  • polycystic ovaries(via ultrasound)
  • oliog. and/or anovulation
  • clinical and/or biochemial evidence of Hyperandrogenism
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9
Q

many WBCs and no organism on saline smear, suspect?

A

Chlamydia

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10
Q

suspicious breast mass first step in workup

A

before 30 mammogram

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11
Q

most accurate test for adenomyosis

A

MRI

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12
Q

postcoital bleeding

A

cervical cancer until proven otherwise

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13
Q

dysfunctional uterine bleeding treatment

A

OCP

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14
Q

DUB with acute hemorrage treatmetn

A
  • fluid until stable

- D &C

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15
Q

labial fusion

A

excess androgens

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16
Q

bartholin gland cyst

A

I and drainage if persist marsupialization

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17
Q

bilateral cancer in vaginal treatment

A

radical vulvectomy

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18
Q

only definitive treatment for adenomyosis

A

hysterectomy

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19
Q

endometriosis pain synmtomatology

A

pain start 1 to 2 weeks before menstruation , peaks 1 to 2 days before mesntruation, PAIN ENDS WITH MESNTRUATION

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20
Q

treatment for endometriosis in satisfacty childbearing female

A

hysterectomy and bilateral salpingo-oophorectomy

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21
Q

male normla development

A

testicular enlargement–>(9-14y)–>penile growth—>pubarche—->facial hair

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22
Q

MOST effective emergency contraceptive method

A

Copper T IUD(99% effective) used within 7 days of unprotected sex

23
Q

1amenorrhea/delayed puberty

A
  • absence of menses by age 16 with 2 sexual develop present.

- absence of 2 sexual characteristics by age 14

24
Q

absence of 2 sexual characteristic

A

MEANS NO ESTROGEN

25
Q

1 amenorrhea with absence of 2 sdexual characteristic

A
  • TURNER
  • CENTRAL HYPOGONADISM
  • undernourishment,stress,hyperprolactinemia or exercise
  • CNS tumor
  • Kallman syndrome(anosmia)
  • constutional growth delay
26
Q

1 amenorrhea with 2 sexual characteristics(estrogen prodcution but other anatomic or genetic problem)

A
  • mullerian agenesis(absence 2/3 of vagina)
  • imperforated hymen(hematocolpos
  • complete androgen insensitivity
  • congenital adreanl hyperplasia:virilization with amenorrha or oligomenorrhea
27
Q

first step en 1 and 2 amenorrhea

A

pregnancy test

28
Q

1 amenorrhea

A

CHECK pag 339 firts aid CK

29
Q

2 amenorrhea definition

A

absence of menses for 6 months in women who have passed menarche.

30
Q

2 amenorrhea causes

A
  • pregnancy
  • ovary:PCOS, premature ovarian failure
  • hypothalamus
  • Neoplasm
  • Functional hypothalamic amenorrhea(nutrition,exercise,stress)
  • systemic disease
  • Pituitary:adenoma,sellar mases,sheehan syndrome
  • thyroid
  • uterine:asherman syndrome,cervical stenosis.
31
Q

2 amenorrhea workup

A

1-.pregnancy test
2-. TSH and prolactin
3-.Progestin challenge
*if positive(withdrawal bleed):anovulation
*if negative(no bleed):uterine abnormality or estrogen deficiency

32
Q

premature ovarian failure treatment

A

if uterine present —> OCP

33
Q

2 dysmenorrhea DDx

A
  • endometriosis
  • adenomyosis
  • fibroids
  • adhesion
  • PID
34
Q

most common cause of infertility in women

A

PCOS

35
Q

increase DHEA

signs of hyperandrogenism

A

adrenal tumor

36
Q

indication for drainage of tubo-ovarian/pelvic abscess

A

persist after antibiotic

-larger than 4-6cm

37
Q

more mortal gynecologic neoplasm

A

ovarian

38
Q

HPV 16

A

squamous cell carcinoma

39
Q

HPV 18

A

adenocarcinoma

40
Q

ASCUS or LSIL before 24y

A

repeat cytology at 12 months

41
Q

ASCUS or LSIL after 24 Y

A

ASk for HPV DNA test

if positive COLPOSCOPY

42
Q

direc to colposcopy

A

ASC-H
HSIL
HPV DNA +

43
Q

indication por cervical ablation or incision

A

CIN II and CIN III
+ margin: papa in 6m
- margin: pap in 12 m

44
Q

microinvasice carcinoma treatmetn

A

cone biopsy

45
Q

precocious puberty

A

-secondary sexual characteristics in a child before 8 years

ASK FOR GnRH

46
Q

causes of peripheral precocious puberty

A 
CAH
adrenal turmors
McCune-Albright syndrome
gonadal tumors
exogenous estrone,OCP
ovarian cyst
47
Q

centra precocious puberty treatment

A

Leuprolide

48
Q

breast cancer

stages

A

stageII:more than 2 cm
StageIII:nodal involvement
stageIV: mets

49
Q

OCP absolute contraindication

A
  • migraine with aura
  • more than 15 cigarretes/days over 35y
  • 2 stage hypertention
  • history DVP
  • stroke or ischemic heart disease
  • Breast cancer
  • cirrhosis and liver cancer
  • major surgery with prolonged immobilization
50
Q

epithelial carcinoma

A

increased CA-125

51
Q

ASCUS with HPV DNA negative …next best step

A

repead co-testing in 3 years

52
Q

breast cancer treatment during pregnancy

A

CX, no radiatiation, and no chemo during first trimester

53
Q

next step if sperm analysis comes out abnormal

A

repeat the test

USMLE step2 (21 decks)

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