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10_OB GYN > Gynecology > Flashcards

Gynecology Flashcards

1
Q

genetic female sex is determined by

A

absence of SRY gene

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2
Q

process that will determine development of fallopian tubes

A

absence of mullerian inhibiting factor

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3
Q

when does ovary develop

A

11 or 12th wk AOG

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4
Q

functions as fetal kidney in 4 wks AOG

A

mesonephros

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5
Q

metanephros begins development when

A

5 wks AOG

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6
Q

wolffian ducts (mesonephric duct) will diff into

A

male internal genitalia

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7
Q

mullerian ducts (paramesonephric duct) will diff into

A

female internal genitalia

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8
Q

interstitial cell (Leydig cell) produce what hormone

A

testosterone ➝ mesonephric duct dev

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9
Q

sertoli cell produce

A

AMH, MIS ➝ inh of paramesonephric duct dev

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10
Q

paraurethral glands aka

A

skene’s glands/ lesser glands

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11
Q

vulvovaginal glands aka

A

bartholin’s glands / greater vestibular glands

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12
Q

blood supply of vagina

A

upper 1/3: uterine artery
middle 1/3: inf vesical art
lower 1/3: middle rectal and internal pudendal art

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13
Q

lymphatic drainage of vagina

A

upper, middle 1/3: ext and int iliac nodes

lower 1/3: inguinal nodes

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14
Q

nerve supply of vagina

A

upper, middle 1/3: sympa via hypogastric plexus, PS via S2-S4
lower 1/3: general somatic nerve via pudendal nerve

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15
Q

ligament support of vagina

A

upper 1/3: upper portion of cardinal ligaments and parametria
middle 1/3: levator ani and lower portion of cardinal ligament
lower 1/3: urogenital and pelvic diaphragm

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16
Q

epithelium change in transformation zone of the cervix

A

SSE to columnar

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17
Q

layers of the endometrium

A 
stratum functionale (zona spogiosa, compacta) 
stratum basale
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18
Q

4 segments of FT

A

intramural interstitial
isthmus
ampulla
infundibulum

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19
Q

narrowest portion of FT and site of tubal ligation

A

isthmus

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20
Q

site of fertilization in FT

A

ampulla

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21
Q

suspensory ligament of ovary aka

A

infundibulopelvic ligament

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22
Q

cardinal ligament aka

A

transverse cervical

Mackenrodt ligament

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23
Q

anesthesia in perineum after radical hysterectomy due to damage of

A

genitofemoral nerve

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24
Q

interfere with adduction of thigh and hip and sensory function of the medial aspect of thigh due to damage of

A

obturator nerves

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25
Q

footdrop and sensory and motor loss over the latral lower leg after improper placement of legs in stirrups or prolonged dorsal lithotomy position is due to damage of

A

peroneal nerve

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26
Q

prohibits flexion of the hip, patient is not able to lift leg off the bed after damage due to pressure from lateral blade of a self-retraining retractor during abdominal hysterectomy

A

femoral nerve

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27
Q

GnRH agonist drug

A

-relin

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28
Q

GnRH antagonist drug

A

-relix

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29
Q

hypogonadrotopic hypogonadism aka

A

Kallman syndrome

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30
Q

FSH acts on what cells

A

granulosa cells of ovarian follicles ➝ follicular growth

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31
Q

LH acts on what cells

A

theca cells on luteal cells ➝ steroid hormone production

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32
Q

primary oocyte is arrested in

A

prophase

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33
Q

primary oocyte will complete first meiotic division at

A

onset of puberty

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34
Q

seondary oocyte is arrested in

A

metaphase II

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35
Q

completion of 2nd meiotic division only occurs

A

fertilization

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36
Q

when does corpus luteum regress

A

9-11 days after ovulation

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37
Q

straight to slightly coiled lined by pseudostratiied columnar epithelium- endometrial phase?

A

proliferative

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38
Q

severe coiling of spiral arteries

A

menstruation

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39
Q

Def of prim amenorrhea

A
  • absence of menses in a woman who has never menstruated for 15 yrs
  • girls who have not menstruated within 5 yrs of breast development
  • thelarche by age 13
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40
Q

first sign of puberty

A

breast budding

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41
Q

last sign of puberty

A

menarche

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42
Q

damage to pituitary unrelated to pregnancy

A

Simmonds disease

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43
Q

diagnostic of idiopathic GnRH dep precocious puberty

A

LH>5mIU/mL

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44
Q

medical condition defined by a combination of hypothyroidism, precocious puberty (usually with delayed bone age) and ovarian cysts in pre- and post-pubertal girls

A

Van Wyk-Grumbach syndrome

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45
Q

Most common ovarian tumor causing GnRH-indep ovarian tumor

A

Granulosa cell tumor

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46
Q

McCune Albright Syndrome Triad

A

Pigment: cafe au-lait spots

polyostotic: fibrous dysplasia
pockets: cysts of skull and long bones

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47
Q

vaginal pH of newborns

A

acidic

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48
Q

Rotterdam criteria

A

any 2 of the ff:

  1. menstrual irreg
  2. hyperandrogenism
  3. PCO on UTZ
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49
Q

srug with superior antiandrogen activity

A

cyproterone acetate

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50
Q

PCOS in UTZ

A

≥ 12 follicles (2-9 mm)

inc ovarian volume > 10 cm3

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51
Q

defn of infertility

A

inability of a couple to conceive after 1 yr of trying

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52
Q

infertility evaluation for women with regular cycle

A

serum progesterone

N: >10 ng/mL = adeq luteal function

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53
Q

infertility evaluation for women with oligomenorrhea

A

induce ovulation

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54
Q

infertility evaluation for women older than 35

A

serum FSH and estradiol obtained on cycle day 2

serum FSH:
>10 miU/mL: abn
>20 miU/mL: bad prog

serum E2:
>70pg/mL: dec prog on ovarian reserve

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55
Q

infertility evaluation for healthy asymptomatic woman

A

-CBC, BT RH, rubella, pap smear w/in 12 mos, CF, infectious dse screening

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56
Q

schedule for HSG

A

week ff the end of menses

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57
Q

CI for HSG

A

hx of salphingitis, (+) tenderness on pelvic exam

58
Q

first line tx for anovulation

A

Clomiphene

59
Q

how to give clomiphine citrate

A

daily for 5 days beginning day 3 to 5 after the onset or spontaneous menses or withdrawal bleeding induced by progesterone

60
Q

2 indications for IVF as primary therapy

A

bilateral tubal occlusion

severe female factor

61
Q

can be used in infertile woman with functioning oviducts

A

gamete intrafallopian transfer (GIFT)

62
Q

tier 1 FP methods are __ effective

A

highly

IUD
subdermal implants
sterilization

63
Q

MC pathogen of IUD infection

A

Actinomyces

64
Q

tier 2 FP methods are __ effective

A

very

injectables, pills, patch, ring

65
Q

ovulation inhibition dose is defined as

A

lowest amount of prog needed to suppress LH

66
Q

Contraceptive patch is aka __ and contains __

A

ORTHO vera

75 micrograms of ethinyl estradiol and 6 mg norelgestromin

67
Q

How is contraceptive patch applied?

A

1 patch/wk for 3 wks and no patch for wk 4

applied to buttocks, upper outer arm, lower abdomen, or upper torso inc breasts

68
Q

MOA of contraceptive patch

A

inh gonadotropin release and prevention of ovulation

69
Q

vaginal ring aka and contains

A

Nuvaring

2.7 mg ethinylestradiol and 11.7 mg etonorgestrel

70
Q

Criteria for lactation amenorrhea method

A
  1. (+) amenorrhea
  2. exclusive BF
  3. performed up to 6 mos after delivery
71
Q

Who should NOT breastfeed?

A
  1. HIV (+)
  2. active/ untreated TB, may resume BF 2 wks afte starting TB meds and is verified non-infectious
  3. active herpes lesion
72
Q

Fertile period acc to calendar rhythm method

A

prev shortest cycle -18

prev longest cycle -11

73
Q

when to abstain acc to standard days method

A

days 8-19

74
Q

when to abstain acc to basal body temp

A

from 1st day of menses until 3 days after temp rises of 0.2 to 0.5

75
Q

when to abstain acc to cervical mucus method or billings ovulation method

A

presence of a clear, wet and slippery mucus secretion until the 4th day after her peak day of wetness

76
Q

when to abstain acc to sympto-thermal method

A

when woman senses cervical secretions and the 3rd full day after rise in BBT

-comb of BBT and Billing’s ovulation method

77
Q

active ingriients of spermicides

A

Nanoxyl-9

78
Q

Menopause is defined as

A

12 mos of amenorrhea after the LMP wo attributable cause

79
Q

absolute CI for HRT

A

porphyria cutanei tards

80
Q

cycle length

A

28 +/- 7 days

81
Q

flow duration

A

4-7 d

82
Q

menstrual blood loss

A

35 (55-60mL)

83
Q

ave iron loss/ menses

A

16 mg

84
Q

PALM-COEIN stands for

A

polyp, adenomyosis, leiomyoma, malignancy and hyperplasia

coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified

85
Q

3 components of endometrial polyp

A

endometrial glands, stroma, central vascular channels

86
Q

role of progestogens in AUB tx

A
  • dec synthesis of estrogen receptors
  • stops endometrial growth
  • organize endometrium
  • stimulate arachidonic acid formation
87
Q

role of NSAIDS in AUB tx

A
  • inh conversion of arachidonic acid to PG

- block formation of both thromboxane and prostacyclin pathway

88
Q

MC location of endometrial implant

A

ovary

89
Q

MC pathologic presentation of adenomyosis

A

symmetrical

90
Q

MC tumor found in the vulva

A

Sebaceous cyst

91
Q

MC large cyst of the vulva

A

Bartholin’s Duct Cyst

92
Q

3Ds of Diverticulum

A

Dysuria
Dyspareunia
Dribbling of urine

93
Q

MC benign solid tumor of the vulva

A

Fibroma

94
Q

2nd most frequent type of benign vulvar mesenchymal tumor

A

Lipoma

95
Q

MC benign neoplastic growth of cervix

A

Cervical polyp

96
Q

Most freq pelvic tumor and the MC tumor in women

A

Leiomyoma

97
Q

first line for mgmt of symptomatic intracavitary myomas

A

hysteroscopic myomectomy

98
Q

MCC of simple cystic adnexal mass in the reproductive age

A

Functional cysts

99
Q

MCC of complex adnexal mass

A

benign cystic teratoma

100
Q

MCC of pelvic mass

A

Pregnancy

101
Q

most freq ovarian epithelial tumors

A

serous cystadenoma

102
Q

“coffee bean” appearing nucleus

A

Brenner tumor

103
Q

MC benign neoplasm in prepubertal female

A

Benign cystic teratoma

104
Q

MC benign SOLID tumor of the ovary

A

fibroma

105
Q

Triad of Meig’s syndrome

A
  1. ovarian fibroma
  2. ascites
  3. hydrothorax
106
Q

Primary imaging modality for adnexal mass

A

TV UTS with color doppler imaging

107
Q

HPV strains with high risk for invasive CA

A

16, 18, 45, 58

108
Q

MC histology of cervical CA

A

SCCA

109
Q

Staging for cervical CA

A

I: CA confined to the cervix
II: CA extends beyond cervix but not to pelvic wall or lower third of vagina
III: CA extends to pelvic wall and/or involves lower third of vagina and/or causes hydronephrosis or non-func adenoma
IV: CA extends beyond true pelvis or has involved mucosa of bladder/ rectum

110
Q

Staging for endometrial CA

A

I: confined to corpus
II: extension to cervix but not beyond uterus
III: outside uterus, within pelvis
IV: invades bladder and/or bowel mucosa +/- distant metastasis

111
Q

MC ovarian CA

A

epithelial

112
Q

Most freq ovarian epithelial tumors

A

Serous tumors

113
Q

HOBNAIL CELLS

A

Clear cell

114
Q

MC ovarian malignancy in women <30 yo

A

Germ cell

115
Q

MC benign tumor <30 yo

A

Dermoid

116
Q

Schiller Duval bodies

A

Yolk sac tumor

117
Q

Call-Exner bodies

A

Granulosa theca tumor

118
Q

Precocious puberty

A

Granulosa theca tumor

119
Q

Nipple projections in dermoids

A

Tubercle of Rokitansky

120
Q

Presents as virilization

A

Sertoli-Leydig tumor

121
Q

Numerous hyaline droplets

A

Yolk sac Tumor

122
Q

Presence of thyroid tissue in the ovary

A

Struma ovarii

123
Q

Tumor marker is HCG

A

Choriocarcinoma

124
Q

Tumor marker is AFP

A

Yolk sac tumor

125
Q

Tumor marker is LDH

A

Dysgerminoma

126
Q

analogous to seminoma in males

A

Dysgerminoma

127
Q

composed of malignant syncitiotrophoblast and cytotrophoblast

A

ChorioCA

128
Q

Ovarian tumor presenting as vaginal bleeding in adults

A

Granulosa theca

129
Q

MC ovarian malignant tumor <30 yo

A

Dysgerminoma

130
Q

Ovarian tumor consisting of eosinophilic bodies surrounded by granulosa cells

A

Granulosa theca

131
Q

“school of fish”

A

H. ducreyi
Chancroid
Tx: Azith/ Ceftri

132
Q

LGV caused by __

Tx?

A

Chlamydia trachomatis

Doxycycline

133
Q

3 phases of LGV

A

shallow painless ulcer → bubo (painful adenopathy) →multiple draining sinuses and fistula

134
Q

Beefy red ulcer

A

Donovanosis
subcutaneous involvement: pseudobuboe

Klebsiella granulomatosis

135
Q

bipolar or safety pin appearance

Tx?

A

Klebsiella granulomatosis

Doxycycline

136
Q

Amsel’s clinical criteria for bac vaginosis

A

3/4

  • homogenous vaginal discharge
  • pH ≥ 4.5
  • amine-like odor when mixed with KOH (whiff test)
  • clue cells ≥ 20% vaginal epithelial cells
137
Q

Tx for bacterial vaginosis and trichomiasis

A

Metronidazole

138
Q

“profuse frothy discharge with unpleasant odor”

A

Trichomoniasis

139
Q

Gold standard for N. gonorrhea and Chlamydia infection

A

Nucleic acid amplification test

140
Q

Tx for Chlamydia

A

Azithromycin

10_OB GYN (3 decks)

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