ICR Gyn Stuff Flashcards
Compare the epithelium of the Vagina vs. the Vulva
The vulva and vagina are lined with squamous epithelium. The vulva contains keratinized epithelium, and is hair-bearing. The vagina is onkeratinized,and is nonhair-bearing
What epithelium do we see in the cervix, and what is the zone of metaplasia?
-The cervix contains glandular and squamous epithelium. This zone of metaplasia is a common origin for cervical dysplasia and is what is screened with cervical cytology.
What is bacterial vaginitis and how does it present?
Bacterial vaginitis (BV) is the most common vaginitis, responsible for 50% of vaginitis. BV presents clinically with malodorous vaginal discharge that has a pH greater than 4.5. Clue cells are observed on a saline wet mount.
What is yeast vaginitis and how does it present?
Yeast vaginitis accounts for 25% of vaginitis. Yeast vaginitis presents clinically with itching and irritation, and a thick curd-like non-odorous discharge. pH is between 4 and 5. Budding yeast and hyphae are observed on a KOH smear
What is Trichomonas Vaginitis and how does it present?
Trichomonas vaginitis accounts for 25% of vaginitis. Trichomonas presents
clinically with a greenish vaginal discharge, nonodorous, and motile flagellated trichomoads are observed on a saline wet mount.
What are combination hormonal contraceptives and what are some examples?
Combination hormonal contraception includes oral (oral contraceptive pills or OCP’s), transdermal (Ortho Evra), or vaginal (Nuva Ring) routes of administration. Combination hormonal contraception works by suppressing ovulation, creating a thick cervical mucus barrier, and thinning the endometrium and affecting tubal transport. Failure rates are
Complications of IUDs
Potential complications include uterine perforation, infection, and expulsion
What is a cystocele and how does it present?
Cystoceles form when the bladder prolapses against a weakened anterior vaginal wall. Symptoms may include bulging, inability to empty bladder
What is a rectocele and how does it present?
Rectoceles form when the rectum prolapses against a weakened posterior vaginal wall. Symptoms may include bulging and pressure, an inability to defecate, and a need to place finger into the vagina and push posteriorly to
assist with bowel movements (splinting)
What is a cervical and uterine prolapse and how does it present?
Cervical and uterine prolapse occur when there is a loss of structural support of the uterus, particularly of the uterosacral and cardinal ligaments.
Symptoms include bulging, pressure, and low back pain
What is urge incontinence and how do we treat it?
Urge incontinence (also referred to as “overactive bladder”) is a result of detrusor overactivity, resulting in a sensation of frequency and urgency, with loss of large volumes of urine associated with a sensation of needing to void.
Treatment is with anticholinergics to reduce detrusor contractions
What is stress incontinence and how do we treat it?
Stress incontinence is a result of loss of urethral support, resulting in hypermobility of the urethra. Symptoms include leakage of small amounts of
urine associated with an increase in abdominal pressure, or Valsalva maneuvers. Patients complain of leakage of urine with cough, sneeze, laugh,
jumping, or exercising.
Treatment may be with Kegel exercises, pessary, or
surgical.
What is overflow incontinence and how does it present? How do we treat it?
Overflow incontinence results from neurologic insult and an inability to sense that the bladder is full. Patients report continuous leakage or constant dribbling, and usually have a history suggesting potential for neurologic insult. Treatment may require intermittent self-catheterization.
What is intrinsic sphincter deficiency and how does it present?
Intrinsic Sphincter Deficiency results from a loss of urethral sphincter function. Symptoms may be similar to stress incontinence, but the patient may not exhibit hypermobility of the urethra.
What is endometriosis?
Endometriosis results from endometrial glands and stroma implanted in areas outside of the endometrium
How do we treat endometriosis?
Endometriosis is treated by suppressing endometrial activity, with combination contraception, gonadotropin releasing hormone agonists, or
22:14 surgically by ablating endometrial implants. More drastically, both ovaries
can be removed, resulting in no further estrogen production. Low dosage HRT usually must be provided back to the patient, though, to protect bone health.
Function of Clomid (clomiphine
citrate)
Induces ovulation, possible treatment for infertility caused by anovulation.
Why might we do a myomectomy on a patient who is infertile?
Myomectomy can be done to remove intrauterine fibroids that are causing a mass effect in the uterine cavity preventing pregnancy.
What do we mean by “Estrogen, unopposed?”
Estrogen, unopposed: The continuous and prolonged effect of estrogen on the
endometrium, resulting from a lack of progesterone. This is associated with an
increased risk of endometrial cancer.
Urethrocele?
Urethrocele: Protrusion of the urethra through the supporting structure of the anterior
vaginal wall.
