Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3rd year - Obstetrics and Gynecology > Gynecology > Flashcards

Gynecology Flashcards

1
Q

Ontario Cervical Screening Guidelines

A

21-70 years
Interval 3 years if normal
Cessation at 70 if adequate negative screening history last 10 years (3 negative tests q 3y)

Exceptions
Previously treated for dysphasia - annual screening or HPV test and screening both negative q2y
Immunocompromised - annual screening
Total hysterectomy (patient does not have cervix) for benign disease - no screening

REMEMBER any visual cervical abnormality or abnormal sx should be investigated regardless of etiology findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Abnormal cytology results

A

ASCUS - atypical squamous cells of undetermined significance
ASC-H - atypical squamous cells, cannot exclude HSIL
AGC - atypical glandular cells
LSIL - low grade squamous intraepithelial lesion
HSIL - high grade squamous intraepithelial lesion
Neoplasia - squamous carcinoma, adenocarcinoma, others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Follow up of ASCUS under age 30

A
  1. Repeat cytology in 6 months
    - Abnormal result: colposcopy
    - Negative result: repeat colpo
  2. Repeat colpo in 6 months
    - Abnormal: colpo
    - Negative result: routine screening in 3 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Follow-up ASCUS 30 years +

A

Image

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Follow up of LSIL

A

Image

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What’s the deal with Trichomoniasis

A

Only STI that you need vaginal culture for
Need to get to lab <12h
Regular swab, mid vagina, rub well on sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cervical cultures

A

For chlamydia and gonorrhea
Into cervical os 1-2 cm, wipe away heavy discharge if needed
180o rotating into os (chlamydia intracellular)
Labelling needs to say “cervical culture”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bloodwork

A

For HIV, Hepatitis C, Hepatitis B, Syphilis
Needs specific consent for HIV and document on chart
Remember latency periods - if concerned about recent contact repeat at 3 and 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Urine Test (PCR)

A

Now available for chlamydia and gonorrhea
Culture still gold standard
Need dirty urine (urethral) first stream 20 mL (as opposed to UTI need midstream) - no voiding for 2h before taking sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diagnosing Herpes

A

No accepted screening test

Very common - 75% HSV1, 20% HSV 2 (no longer great distinction between oral and genital)

If lesion present - need to open intact vehicle (carefully! With a needle) and culture the liquid with a special swab with liquid virus transport medium - send to lab ASAP within hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pharynx swab tests for

A

Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hepatitis C screening

A

Because there is treatment now, 45 years+ everyone gets Hep C testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rectum swab tests for

A

Gonorrhea and Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Syphilis

A
  1. Starts at soft chancre that is painless at the site of entry (usually genitals) — thus less likely to diagnose as primary syphilis
  2. First lesion resolves
  3. Rash and swollen nodes
  4. Tertiary syphilis with brain, liver manifestations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pelvic inlet

A

Sacrum

Ileopetineal line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What nerve is at risk of denervation during childbirth

A

Pudendal nerve

Internal pudenedal nerve and vessels pass behind the ischial spine through Alcock’s canal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Components of the lavatory ani muscles

A

Iliococcygeus
Pubococcygeus
Puborectalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Role of elevator ani muscles

A

Pulls rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Uterosacral ligament origins

A

Originate from S2-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pelvic diaphragm

A

Legatos ani plus _ coccygeus muscles posteirorly and fasciae coverings of these muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Urogenital diaphragm

A

External to pelvic diaphragm

Comprised of deep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Parasympathetic innervation of the bladder

A

ACh
Muscarinic (M2 + M3)
S2-S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sympathetic innervation of the bladder

A

NA
Alpha1 and beta 3 adrenoreceptors
T10-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Somatic innervation of the bladder

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Risk factors for urinary incontinence
``` Immobility Medcition use Smoking - nicotine and cough (valsalva) Chronic valsalva maneuvers (constipation) Pelvic floor relaxation Pregnancy and childbirth Obesity Neurological problems Hypoestrogenic state - tissues weakened and dry and can fracture with hypoestrogen ```
26
Stress incontinnece definition and etiology
Involuntary loss of urine during increased intra-abdominal pressure Etiology Displacement of UVJ from normal anatomic location (lets urine go before tube hits the back wall, which provides the back pressure to close the tube. This is because the back wall is more floppy and the tube takes more time to get there) Intrinsic sphincter deficiency (tube is very rigid such as past surgery or radiation and becomes more like a tube. ISD is like a plastic straw vs paper straw)
27
Urge incontinence definition and etiology
Known as overactive bladder now The involuntary loss of urine preceded by strong urge to void whether or not the bladder is full Etiology: Detrusor instability — overactive wet Bladder irritants — overactive dry (this one is just giving in to sensation to pee at a certain volume, usually no nocturia)
28
Overflow incontinence
Urine loss associated with over distension of the bladder Etiology Obstructive Neurogenic
29
Functional incontinence
Mental or physical issues may prevent individual from reaching the toilet in time Such as dementia, or mobility, environmental factors
30
If you have women with new overflow incontinence and no previous surgical history, what condition do you have to rule out
MS
31
Most common type of fistula in women
Bladder and vagina (vesicuvaginal fistula)
32
Most common cause of vesicovaginal fistulas in developed world
Hysterectomy Abdominal hysterectomy more commonly because bladder is empty and cleared and easier to miss, vs vaginal
33
Most common cause of vesicuvaginal fistula in developing country
Prolonged labour (constant pressure on bladder from baby’s head causes ischemia)
34
Pelvic organ prolapse
Hernia like protrusions
35
Types of prolapse
Cystocele (anterior vaginal prolapse) Rectocele (lower posterior vaginal prolapse) Enterocele (upper posterior vaginal prolapse) Apical vaginal/uterine prolapse
36
Etiology uterine prolapse
Poor cardinal or uterosacral ligament support
37
Potential complications of cytocele
High PVR and risk of recurrent UTIs due to kinking of the urethra and difficulty voiding. This can result in renal implications
38
Rectocele etiology
.
39
Enterocele etiology
.
40
Rectocele complication
Chronic constipation, diarrhea Flatal, fecal incontinence ...
41
Baden Walker Classification system
.
42
Urogynocological exam
Stroke labia and then clitoris with q tip Looking for symmetric rise of the legatos ani muscles If not symmetric rise need to investigate MS
43
Prolapse examination
Empty bladder before examination
44
Q tip test
Q tip in urethra | 30o+ of hyper mobility is positive test
45
Stress incontinence management
Kegels Topical estrogen, alpha adrenergics (no longer used due to hypertension), duloxetine (no longer available) Prolapse devices Surgery
46
Urge incontinence management
``` Decrease caffeine and nicotine Bladder drill Vaginal estrogen Medications - anticholinergics, beta 3 agonist Pessary Surgery ```
47
What are the most common HPV types that cause cervical cancer?
HPV type 16 and 18 account for 75% of all cervix cancers
48
Risk factors for cervical cancer
``` Smoking Immunosuppression HIV Chlamydia High parity OCP use HPV ```
49
Acetowhite area on colposcopy meaning
Hallmark of dysplasia
50
Investigations for gross lesion on cervix
Biopsy needed to rule out cancer and look with colposcope Pap smear is NOT appropriate
51
Cervix cancer symptoms
- Abnormal vaginal bleeding - Pelvic pain - Involuntary loss of urine or feces through the vagina - Hydronephrosis due to ureter obstruction - Weakness, weight loss and anemia
52
Most common type of cervix cancer
Squamous cell (>60%) Adenocarcinoma 30% Unspecified Consistent decline in SCC, unclear why adeno is on the rise All due to HPV
53
Cervical cancer treatment
Early- surgery (stage I) Locally advanced disease - chemoradiation with external beam radiation and intracavitary brachytherapy with chemo as radiosensitizer
54
Most common gynaecological malignancy in North America
Endometrial cancer
55
Endometrial cancer risk factors
Increased estrogen - Endogenous (obesity, polycystic ovarian syndrome, anovulation/infertility, early menarche, late menopause, nullip) - Exogenous (Tamoxifen) HNPCC Syndrome (Lynch Syndrome) - these patients should be screened with endometrial biopsy/TVUS for endometrial thickness
56
Endometrial cancer signs and symptoms
Signs - obesity, acanthosis nigricans, stigmata of diabetes Symptoms - Unscheduled vaginal bleeding (postmenopausal, non bloody vaginal discharge) - pelvic pain, pressure, mass, weight loss in more advanced disease
57
Most common type of pathology of endometrial cancer
Adenocarcinoma Histology - endometrioid
58
Endometrial cancer treatment
Gold standard is surgery - total abdominal hysterectomy, bilateral salpingo-oophorectomy (+/- pelvic nodes) Surgery is only not recommended if comorbidities that would decrease surgical success Radiation - Primary therapy (rare) - Adjuvant treatment (based on tumour factors)
59
Precursor to endometrial cancer
Endometrial hyperplasia Architecture - simplex or complex Cellularity - atypia or no atypia
60
Ovarian tumour types and epidemiology
Epithelial tumours - women 50-60s Germ cell tumours - younger women Stromal tumours - any age, very uncommon (ex. Granulosa cell tumour, Sertoli-Leydig cell tumour)
61
Ovarian cancer treatment
Surgery and chemo
62
Ovarian cancer etiology
``` Genetic (BRCA 1 and 2) and HNPCC Molecular mechanisms (loss of p53 tumour suppressor gene found in 55% of ovarian cancer) ```
63
Ovarian cancer risk factors
Industrialized countries where dietary fat intake is high, have higher incidence History of nulliparity, infertility, late childbearing and delayed menopause increase risk OCP reduces risk, prophylactic oophorectomy
64
Ovarian cancer signs and symptoms
Vague and usually diagnosed late (highest mortality rate of all gynecologic malignancies) Appetite, N/V Abdominal girth Bladder, bowel
65
Ovarian cancer screening
Ca 125 Ultrasound Usually in symptomatic or post menopausal women
66
Vulvar cancer etiology
HPV strongly associated in young, not in older women
67
Vulvar cancer risk factors
Smoking | Immunosuppression
68
Vulvar cancer signs and symptoms
Pruritus or mass is presentation for more than 50% of women Pain Bleeding 20% of women are asymptomatic
69
Vulvar cancer diagnosis
Lesion biopsy from edge (compare normal to abnormal tissue)
70
Vulvar cancer treatment
Staging is surgical, radical local excision and evaluation of regional nodes

3rd year - Obstetrics and Gynecology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions