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Ob/Gyn Dreams > Gynecology > Flashcards

Gynecology Flashcards

1
Q

OCPs up risk of what in RUQ

A

hepatic adenoma

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2
Q

delayed puberty definition

A

girls: > 12 w/o breast growth

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3
Q

tx: prolactinoma

A

cabergoline or bromocriptine
(try one then the other)
if neither work –> transsphenoidal resection

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4
Q

dx: syphilis

A

primary: dark field microscopy or direct florescence Ab testing (lesion tissue)

secondary/tertiary: RPR, VDRL; confirm with fluorescent treponemal Ab absorbed test (FTA-ABS)

Neurosyph (CSF): VDRL best

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5
Q

tx: syphilis

A

1/2: penicillin G (1 dose)

latent: 3 doses
neurosyphilis: continuous infusion

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6
Q

tx: fibroids

A 
GnRH agonists (shrinks them)
definitive: hysterectomy or myomectomy (depend on kid-wanting)
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7
Q

tx: body dysmorphic disorder

A

CBT, SSRI

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8
Q

Krukenberg tumor?

A

gastric CA throws mets to ovaries

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9
Q

mgmt: ASCUS

A

21 - 24: repeat pap in 12 mo

25+: HPV test
(+)–> colp
(-) –> repeat cyto in 3 years

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10
Q

RFs endometrial CA

A

unopposed estrogen use
DM
age
fam hx

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11
Q

21-hydroxylase deficiency – what are the junk like?

A

males: normal
females: ambiguous

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12
Q

tx: 21-hydroxylase def

A

initially: IV hydrocortisone

then glucocorticoid and mineralocorticoid therapy for life

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13
Q

tx: TSS

A

IV fluids

IV nafcillin + aminoglycoside (clinda)

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14
Q

trichomoniasis puts at risk for…

A

HIV and HIV transfer

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15
Q

management: bloody nipple discharge

A

apparently surgery

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16
Q

how does hypothyroidism –> galactorrhea?

A

low thyroid hormone –> increased TRH and TRH stimulates both TSH and prolactin from pituitary

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17
Q

normal vaginal pH

A

3.8 - 4.2

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18
Q

candida vaginal pH

A

normal

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19
Q

trichomoniasis vaginal pH

A

> 4.5

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20
Q

tender utero-sacral nodules

A

endometriosis

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21
Q

dx: endometriosis

A

laparoscopy (gun-powder lesions)

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22
Q

palpable testes in labia majora

A

androgen insensitivity syndrome

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23
Q

who do you screen for syphilis?

A

high risk: MSM, sex workers, risky business

+ preggos

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24
Q

mgmt: LSIL

A

21-24: no colp
HPV (-): repeat cyto + HPV in 1 year
HPV(+) or not done: colp

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25
age of precocious puberty
7 in females | 8 in males
26
risks of tamoxifen
``` hot flashes (MC) endometrial CA DVTs ```
27
AEs: MTX
``` hepatotoxicity stomatitis (mouth ulcers) pancytopenia lung fibrosis alopecia ```
28
MTX rescue
leucovorin
29
ddx hirsutism
PCOS 21-hydroxylase def androgen secreting tumors (often ovarian) Cushing syndrome
30
lady stuff + liver things
think Fitz-Hugh-Curtis
31
suspected orgs in osteomyelitis after UTI
klebsiella | pseudomonas
32
tx: syphilis (pt has severe PCN allergy)
primary: doxy x 14 secondary: doxy x 14 latent: doxy x 28 tertiary: ceftriaxone x 14 preggo: desensitize then PCN
33
hormones in PCOS
T up (or norm) E up LH (up or norm)/ FSH imbalance
34
OCP AEs
DVT HTN hepatic adenoma rare: stroke/MI
35
tx: symptomatic bartholin cyst
I+D | Word catheter
36
dx: endometriosis
laparoscopy (usually don't need definitive dx)
37
risks of endometriosis
infertility
38
when do you use a pessary
stress incontinence (3rd line)
39
explain the hormones in primary ovarian insufficiency
(a type of hypogonadotropic hypogonadism) ovaries stop functioning --> estrogen down amps up feedback @ hypothalamus --> increased GnRH and FSH
40
explain the hormones in hypothalamic hypogonadism
usually they're too skinny --> shuts down hypothalamus | less GnRH --> less FSH --> less estrogen
41
explain the hormones in PCOS
(i think) the ovaries are crap and not really ovulating --> estrogen down hypothalamus goes nuts trying to help --> GnRH up (but not pulsatile) this makes LH go up more than FSH (which is low/normal) then also you're making a bunch of androgens and they get converted to estrone which is an estrogen but doesn't help so you get high (unhelpful) estrogen Total: GnRH up, LH up, FSH low/norm, E up
42
tx: disseminated GC
IV ceftriaxone, switch to oral cefixime when clinically improved
43
mgmt: pap --> atypical glandular cells
could be cervical or endometrial adenocarcinoma who: > 35 or < 35 w/ RFs (obese, anovulation) mgmt: colp, endocervical curettage and EMB
44
breast: peau d'orange
inflammatory breast carcinoma
45
breast: firm, mobile spherical, palpable mass (young woman)
fibroadenoma (benign)
46
breast: unilateral nipple discharge w/o skin changes or other sx
``` intraductal papilloma (benign) even if discharge is bloody ```
47
breast: fever, diffuse warmth, erythema
mastitis
48
breast: dimpling/contour changes
infiltrating ductal carcinoma or lobular breast carcinoma | or inflammatory breast carcinoma
49
breast: diffuse erythema, edema and dimpling
inflammatory breast carcinoma
50
mammography: microcalcifications
ductal carcinoma in situ
51
breast: diffuse nodularity with b/l mastalgia
fibrocystic changes
52
breast: fixed, palpable mass with irregular borders
lobular breast carcinoma
53
ages for HPV vaccine
female: 11 - 26 males: 9 - 21 (9 - 26 for MSM or HIV)
54
psych med --> infertility
dopa blockers
55
workup: primary amenorrhea
uterus? yes --> FSH (increased --> karyotyping; decreased --> MRI) no --> karyotype, serum T (XX, normal --> abnormal mullerian; XY, normal --> androgen insensitivity syndrome)
56
definition abnormal uterine bleeding
``` heavy > 7 days more often than every 21 days less often than every 35 any post meno bleeding ```
57
when do you do an EMB: > 45 yo
any abnormal uterine bleeding
58
when do you do an EMB: < 45 yo
abnormal uterine bleeding + (any of following) - unopposed estrogen exposure - failed medical mgmt - lynch syndrome (HNPCC)
59
needs to stop paps
65 or hysterectomy w/o CIN 2+ AND 3 neg paps/2 co-tests
60
PCOS a/w
metabolic syndrome (DM, HTN) OSA NASH endometrial hyperplasia/CA
61
painful genital ulcers
``` HSV haemophilus ducreyi (has big LNs too) ```
62
painless genital ulcers
treponema pallidum chlamydia trachomatis granuloma inguinale (klebsiella granulomatis)
63
when to get CA-125 for ovarian cancer dx
post meno and see a mass on U/S (it's more specific in post meno) high --> get MRI or CT
64
workup: secondary amenorrhea
1. beta hCG 2. prior uterine procedure? --> hysteroscopy 3. check prolactin, TSH, FSH - up prolactin --> brain MRI - up TSH --> hypothyroid - up FSH --> premature ovarian failure
65
OCPs down risk of what CA
ovarian | endometrial
66
talk through hormones in irregular teen periods
not enough GnRH --> less GSH/LH --> not really ovulating
67
PCOS @ risk for what cancer
endometrial
68
tx: septic pelvic thrombophlebitis
anticoagulation | broad spectrum antibiotics
69
urinary problems post menopause
GU syndrome of menopause | E deficiency --> atrophy of vagina and urethral epithelium --> UTIs, incontinence (stress and urge)
70
pelvic U/S: ovarian mass w/ thickened endometrium
granulosa cell tumor
71
female: high T and androstenedione, no estradiol or estrone
aromatase deficiency
72
morbid obesity effect on girl hormones
--> anovulation ovaries still make E --> normal FSH/LH they just don't make progesterone
73
ovarian tumor making E
granulosa cell tumors
74
ovarian tumor making beta hCG
dysgerminoma
75
ovarian tumor making androgens
sertoli-leydig
76
ovarian tumor making LDH
dysgerminoma
77
pain from endometriosis vs pain from dysmenorrhea
endometriosis usually hurts a couple days before menses, not first couple days of menses
78
b/l cordlike thickening of breasts
fibrocystic changes
79
tx: fibrocystic changes
NSAIDs or OCPs
80
chemo effects on lady hormones
transient amenorrhea | ovarian failure happens earlier
81
pain worse with bladder filling or sex and relieved by voiding
interstitial cystitis
82
effects of E on thyroid things
up TBG | need more levo if hypothyroid

Ob/Gyn Dreams (2 decks)

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