Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE STEP 2 CK RETAKE > Gynecology > Flashcards

Gynecology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What HPV strains cause cancer

A

16, 18, 30s

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

Risk Factors for Cervical cancer

A

HPV, Sex, STDs, Smoking

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

Cervical CA
Presentation
Dx, Tx

A 
Asx Screening, post-coital bleeding 
Dx: Pap-smear, staging 
Tx: ASCUS-HPV DNA 
Ectocarcinoma-Local Ablation 
Endocarcinoma-Cone biopsy
Stage IIa or less-resection
Stage IIb or greater-debulking +/- chemo/rad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stage I Cervical Cancer

A

contained in the cervix

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

Stage II Cervical Cancer

A

IIa- upper 2/3 of the vagina

IIb- involvement of the cardinal ligament

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

Stage III Cervical Cancer

A

IIIa- lower 1/3 of vagina

IIIb- Pelvic side wall

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

Stage IV Cervical Cancer

A

IVa- Adjacent organs

IVb- Distant mets

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

Endometrial Cancer Patient presentation/patient history

A 
unopposed estrogen exposure or prolonged estrogen exposure 
Anovulation
Age
Nulliparity
Obese 
Early Menarche/late Menopause 
HRT/SERM for breast CA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Endometrial CA warning sign

A

postmenopausal bleeding

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

Postmenopausal Bleeding

Dx, Tx

A

Dx: Bx
Tx: Hyperplasia-progesterone
CA:TAHBSO
+/- Chemo/rad (Paclitaxel, cisplatin, doxorubicin)

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

Ovarian Cancer-Germ Cells

A

Dysgerminoma, endodermal sinus, teratoma, choriocarcinoma

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

Dysgerminoma Tumor marker

A

LDH

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

Endodermal Sinus Tumor marker

A

AFP

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

Choriocarcinoma Tumor marker

A

B-HCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Germ Cell tumors
Presentation
Dx, Tx

A

Teenage girls, adnexal mass, weight gain, usually stage I
Dx: Transvaginal ultrasound
Tx: Unilateral salpingoophrectomy

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

Ovarian Cancer- epithelial cell

A

Cystadenocarcinoma-Serous, Mucinous, Endometroid

Brenners

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

Epithelial Cell Tumors, Tumor Markers

A

CA-125

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

Epithelial Cell Tumors
Presentation
Dx, Tx

A 
Postmenopausal woman nulliparous-there could be renal failure, SBO, Ascites 
Dx: Transvaginal ultrasound
CT scan for staging 
Tx: TAHBSO 
Paclitaxel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

BRCA1-HNPCC

Ovarian cancer screening

A

Risk factor for epithelial cancer -

screen with ultrasound and CA-125

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

Granulosa-Theca Cell Tumor

Presentation

A

Secrete Estrogen

Dx: Transvaginal Ultrasound

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

Sertoli-Leydig Cell Tumor

Presentation

A

Secretes Testosterone

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

Complete Hydatidiform Mole
Presentation
Dx, Tx

A

All sperm, Good fertilization with a bad egg
Presentation: Size-Date discrepancy
>100k B-Hcg
Hyperthyroidism
Hyperemesis gravidarum
Grape-like mass, adenexal mass
Dx: Transvaginal ultrasound-snow storm appearance
Tx: Suction curretage
afterwards-OCP for 12 months and monitor B-HCG

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

Incomplete Mole
Presentation
Dx, Tx

A

Fetal parts found
Egg Sperm Sperm fertilization
presentation, Dx, Tx and follow up are the same as complete mole

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

Choriocarcinoma
Presentation
Dx, Tx

A 
Malignant, gestational contents 
Pt: high levels of B-HCG
can occur after a miscarriage, molar or normal pregnancy 
Dx: Transvaginal ultrasound
Bx with curretage 
Stage with CT 
Tx: Surgical-TAHBSO, Debulking
Medical-Methotrexate, Actinomycin D, Cyclophosphamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Post-partum Hemorrhage
Presentation
Tx

A 
500c-after vaginal birth
1000cc-after c-section 
non-surgical: uterine massage
oxytocin
balloon tamponade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Teratoma
Presentation
Dx, Tx

A 
usually benign
young female in her teens 
Asx, Weight gain
Dx: Ultrasound=enormous mass 
Tx: Cystectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Adenexal mass Simple Cyst

Presentation

A

Small, Consistent, unilocular, anechoic, homogenous
<3cm=watch and wait
<10cm=repeat imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Adenexal mass Complex Cysts

Presentation

A

Big, Septations, Loculated, Multi-Echoic
heterogenous
>10cm=remove

29
Q

Endometriosis
Presentation
Dx, Tx

A 
Pt: Dysmenorrhea, Dyspareunia, Infertility 
Dx: U/S=cyst (endometrioma)
OCP trial=endometriosis
Dx Lap with laser ablation 
Tx: NSAIDs (pelvic Pain)
OCPs
30
Q

Ectopic Pregnancy
Presentation
Dx, Tx

A 
RF-stricture or PID 
Pt: Amenorrhea/spotting
Abdominal pain 
UPT (+)
Dx: UPT(+)
B-HCG >2000
Empty uterus on US 
Tx: Salpingosotmy if no ruputre
salpingectomy if ruptured 
Methotrexate +/- leucovorin
31
Q

When do you use methotrexate +/- leucovorin

A

B-HCG <5000
Gestational size <3 cm
No fetal heart tones
not using folate

32
Q

Tubo-Ovarian Abscess
Presentation
Dx, Tx

A 
Abdominal or pelvic pain 
no other cause + 1 of 3 
1. CMT
2. ADT
3. UT 
possible fever and leukocytosis 
white cells on a wet prep 
Dx: U/S abscess 
Tx: Inpatient IV
1. Cefoxitin+Doxy+MTZ
2. Clindamycin+gentamicin
33
Q

Stress Incontinence
Presentation
Dx, Tx

A

Sneeze and pee
No urge or nocturnal symptoms
Tx: kegel
Surgery

34
Q

Hypertonic, Overactive Bladder
Presentation
Dx, Tx

A 
(+) Urge and nocturnal symptoms 
Leaking with contractions 
Dx: Physical is normal 
U/A normal 
decreased cystometry 
Tx: Oxybutynin
35
Q

Irritative Bladder
Presentation
Dx, Tx

A 
Caused by inflammation, stones, CA, UTI
Frequency, urgency, Dysuria 
(+) urge 
no nocturnal symptoms 
Dx: U/A=WBCs
Tx: UTI=ABx
Stones=Imaging
CA=imaging
36
Q

Fistula
Presentation
Dx, Tx

A 
Continuous leak 
normal function 
Dx: Physical=fistula 
Tampon Test 
Tx: Fistulotomy
37
Q

Causes of vaginal bleeding in the premenarchal age

A

Foreign body
sexual abuse
precocious puberty

38
Q

Causes of vaginal bleeding in the reproductive age

A

Pregnancy, Anatomy, AUB, Cervical CA

39
Q

Causes of vaginal bleeding in the postmenopausal age

A

vaginal atrophy
endometrial CA
HRT

40
Q

Vulvovaginitis-Candida
Presentation
Dx, Tx

A 
DM, Steroids, Abx 
Thick white discharge adherent to the vaginal wall 
no odor
Wet prep-hyphae
Tx= Topical antifungal
oral fluconazole
41
Q

Vulvovaginitis-Bacterial
Gardenerella
Presentation
Dx, Tx

A

Copious thin white discharge
Fishy odor
wet prep-clue cells
Tx: MTZ

42
Q

Vulvovaginitis-Trichomonas
Presentation
Dx, Tx

A 
Yellow-green discharge 
Frothy 
Strawberry Cervix 
Wet-prep: Flagella, motile 
Tx: MTZ, treat both partners
43
Q

Cervicitis
Presentation
Dx, Tx

A 
Inflammation of the cervix
usually caused by NG/CT
(+) CMT, discharge, no PID
NG/CT PCR 
gonorrhea- GNR diplococci
Chla-NOS many WBCs 
Tx=NG=Ceftriaxone 
CT=Doxyxycline/azithromycin
44
Q

PID
Presentation
Dx, Tx

A
  1. Pelvic/abdominal pain
    2.no other cause
    1 of 3:
    1.CMT
  2. ADT
  3. UT
    Dx: Transvaginal ultrasound
    Tx: inpatient-
    cefoxitin+Doxy
    Clindamycin+Gentamycin
    Outpatient-
    Ceftriaxone+doxy+MTZ
45
Q

Threatened abortion Features

A

No passage of contents
closed cervical os
live baby on U/S

46
Q

Inevitable abortion features

A

No passage of contents
Open cervical os
Dead baby on U/S

47
Q

Incomplete abortion features

A

Passage of clots or fetal parts
Open cervical os
Retained fetal parts on U/S

48
Q

Complete abortion features

A

passage of contents
Closed cervical os
Nothing on U/S

49
Q

Causes of vaginal bleeding

PALM COEIN

A

Polyps
Adenomyosis
Leiomyomas
Malignancy

Caogulopathy 
Ovarian Dysfunction 
Endometrium 
Iatrogenic=IUD
Not yet Classified
50
Q

Fibroids (leiomyoma)
Presentation
Dx, Tx

A 
benign growths that are responsive to estrogen 
Pt: Asx nodularity 
Anemia/bleeding
Pain, infertility
Dx: Transvaginal ultrasound 
Tx: OCPs=IUD
if kids=myomectomy
no kids=TAH
51
Q

PCOS
Presentation
Dx, Tx

A 
Pt: Fat and hairy 
Metabolic Syndromes (HTN,DM,HLD)
Menometorrhagia 
Infertility 
Dx: 1. Anovulation AND
2.Biochemical (DHEAS, increased Testosterone) OR
3. Follicles on U/S
Tx: Metformin
OCPs
Clomiphene
Spironolactone
52
Q

Puberty Ages

A

Tits (breasts) 8
Pits (axillary) 9
Mits (growth spurt) 10
Lips (menarche) 11

53
Q

What defines precocious puberty

A

No menarche by 15

No secondary sex characteristics by 13

54
Q

Craniopharyngioma/Kallmans
Presentation
Dx, Tx

A 
either a problem with hypothalamus or the anterior pituitary - no FSH/LH
Pt: no secondary sex characteristics
there are uterus and tubes 
Dx: decreased FSH/LH 
MRI differentiates the two diseases 
Tx: give estrogen and progesterone 
possible resection if there is a tumor
55
Q

Mullerian Agenesis
Presentation
Dx, Tx

A 
(x,x) karyotype
Pt: Secondary sexual characteristics with female genitalia 
no uterus or tubes 
Dx: Karyotype 
Normal testosterone, FSH, LH 
Tx: Elevate the vagina
56
Q

Androgen Insensitivity syndrome
Presentation
Dx, Tx

A 
(x,y) resistance to testosterone 
Pt: secondary sexual characteristics 
external sexual characteristics 
no uterus or tubes 
Dx: Karyotype 
Increased testosterone, normal FSH, LH
Tx: elevate vagina 
after puberty-orchiectomy
57
Q

Turner Syndrome
Presentation
Dx, Tx

A

Webbed neck, Broad spaced nipples, Shield like chest, Coarctation, Bicuspid Aortic Valve
secondary sexual characteristics
uterus and female genitalia present
Dx: Karyotype (x,o) increased FSH and LH
U/S-Streak ovaries
Tx: Estrogen and progesterone
F/U echocardiogram

58
Q

Causes of secondary amenorrhea

A 
Pregnancy MC 
Hypothyroidism 2nd MC 
Prolactin 
Medications 
HPO Axis
59
Q

Secondary Amenorrhea Diagnostic Tests

A

Progesterone Challenge
Estrogen & Progesterone
FSH & LH
MRI

60
Q

Progesterone challenge positive

A

Bleeding indicated PCOS

61
Q

Estrogen and progesterone positive (bleeding)

A

Check FSH & LH
Check FSH/LH ratio
increased-ovarian problem
normal/decreased-brain do MRI

62
Q

Hostile Mucous indications

A

(-) Fern sign
(-) Sperm
< 6cm smush test

63
Q

Normal Mucous indications

A

(+) fern, sperm

> 6cm Smush

64
Q

PCOS
Presentation
Dx, Tx

A 
Hirsuitism 
Increased testosterone 
Normal DHEAS 
Bilateral Ovaries 
LH/FSH= >3:1
follicles on US
Tx: Exercise and weight loss 
metformin 
OCPs
Clomiphene
65
Q

Sertoli-Leydig Tumor
Presentation
Dx, Tx

A 
Virilization 
Very High levels testosterone
DHEAS-Normal 
Unilateral Ovary 
US shows tumor 
Tx: Resection
66
Q

Adrenal Tumor
Presentation
Dx, Tx

A 
Virilization
Testosterone Normal 
DHEAS very increased 
Unilateral Adrenal
CT/MRI
Adrenal Vein Sampling 
Tx: Resection 
Make sure to do the adrenal vein sampling before surgery
67
Q

CAH
Presentation
Dx, Tx

A 
Hirsuitism 
Testosterone Normal 
DHEAS elevated 
Bilateral Adrenals 
CT/MRI 
17-OH progesterone in the urine 
Tx: Cortisol 
fludrocortisone
68
Q

When should you perform a DEXA scan

A 
All get DEXA @ 65 
60 if a smoker 
Bisphosphonates 
Give vitD and calcium
if VitD deficient-50ku
promote exercise

USMLE STEP 2 CK RETAKE (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions