Lecture 1 - Into to Gyn Flashcards
HPV:
What 2 serotypes are low risk? What STI does it cause?
What are the 4 high risk serotypes? high risk for what?
6,11; condyloma acuminata;
16, 18, 31, 33; cancer
HPV vaccine:
what 4 serotypes are included?
what kind of vaccine is this?
6, 11, 16, 18;
subunit
condyloma accuminata: described as “_____-like” lesions;
on histology, there is _____ hyperplasia, ____keratosis, and most importantly _____
cauliflower-like;
epidermal, hyper;
koilocytosis
where do you take a pap smear from? can stain with _____ to cause lesions to appear white
transformation zone of cervix (squamocolumnar junction);
aceto-acid
treatment of HPV or CIN = _____ ( an immune modulator), _____ ( a mitotic poison), chloracetic acid
imiquimod;
podophyllotoxin
also cryotherapy, CO2 laser, excision
what does CIN usually present as?
abnormal vaginal bleeding (often post-coital)
endometriosis:
non-neoplastic or neoplastic?
proliferation of endometrial like _____/____ outside endometrial cavity
non-neoplastic;
glands, stroma
3 possible ways of dissemination of endometrial tissue:
_____ menstruation;
______ transformation of multipotent stem cells;
transportation of endometrial tissue via ____ or ____
retrograde;
metaplastic;
lymph, vascular
3 common sites of endometriosis
ovary (Most common), pelvis, peritoneum
endometriosis:
causes blood filled “_____ _____” in ovary; can cause PID or ectopic pregnancy if it is located in the _____
chocolate cysts;
fallopian tube
endometriosis:
can cause _____ pelvic pain, bleeding, _____ (pain with defecation), _____ if near the bladder
cyclic;
dyschezia;
dysuria
also infertility, dysmenorrhea, dyspareunia
endometriosis:
causes brown, hemorrhagic yellow “____ ____” nodules. abdominal pain and _____ in the peritoneum
gun powder;
adhesions
gardenerella/bacterial vaginosis: inflammation? thin, white discharge with \_\_\_\_ odor. \_\_\_ cells; ph = \+ \_\_\_\_ test
no; fishy; clue; elevated ( greater than 4.5 ); whiff
trichomonas: inflammation? frothy, \_\_\_\_\_ (color), foul smelling discharge; see \_\_\_\_ \_\_\_\_ on wet mount; ph =
yes (Strawberry cervix);
yellow-green;
motile trichomonads;
greater than 4.5
candida: inflammation? thick, white "\_\_\_\_ \_\_\_\_" discharge; \_\_\_\_\_ with KOH; pH =
yes;
cottage cheese;
pseudohyphae;
normal (4-4.5)
what 2 bacterial infections are most associated with Pellvic inflammatory disease (PID)
chlamydia, neisseria
PID:
due to ____ infection from lower genital tract due to _____ levels of lactobacilli
ascending;
decreased
PID:
what is the chandelier sign?
____ ____ discharge
cervical motion tenderness;
purulent cervical
PID:
pain occurs shortly ____ menses;
increased risk of _____ pregnancy, infertility, chronic pain, adhesions of peritoneum to the liver (_______ syndrome)
after;
ectopic;
fitz-hugh-curtis syndrome
also salpingitis, endometritis, hydrosalpinx, abscesses
ectopic pregnancy:
most often occurs where?
often clinically mistaken for ______
ampulla of fallopian tube;
appendicitis
ectopic:
____ than expected rise in HCG, __menorrhea
lower;
amenorrhea
what chemo drug can be used to treat ectopic pregnancy? (if diagnosed early/no pain)
methotrexate
2 highest risk factors for ectopic pregnancy?
prior ectopic pregnancy, previous tubal surgery
also PID, infertility, ruptured appendix, IUD use
leiomyoma/fibroids: usually multiple or single? described as "\_\_\_\_\_ (color), \_\_\_\_\_ tumors" higher risk in what ethnicity? sensitive to \_\_\_\_\_
multiple white whorled tumors;
african americans
estrogen
leiomyoma:
tumor size ____ with pregnancy, ____ with menopause;
smoking and OCP’s _____ risk
most common presentation?
increases, decreases;
decreases;
asymptomatic (According to pathoma)
leiomyoma:
presents as abnormal _____ bleeding, which if severe can cause _____ anemia
uterine;
iron-deficiency
also pelvic pain, miscarriage,
fibroids:
interfere with _____ and ____ growth but not ovulation.
implantation, placental growth
various menses definitions:
____ = pain with menses;
oligomenorrhea = bleeding ___ than 35 day cycle;
polymenorrhea = bleeding ____ than 21 day cycle
dysmenorrhea;
greater;
less
menses definitions:
____ = heavy, irregular menstruation;
_____ = heavy menstrual bleeding with greater than 80 mL blood loss or more than ___ days of menses
menometorrhagia;
menorrhagia, 7 days
Polycystic ovarian syndrome (PCOS)
increased _____ ratio; increased _____ from theca interna cells–> decreased rate of follicular maturation causing unruptured _____ and ___ovulation
LH:FSH;
androgens;
follicles (Cysts), anovulation
PCOS: \_\_\_\_\_ dysfunction (endocrine thing) is thought to alter hypothalamic hormonal feedback. associated with \_\_\_\_ (metabolic). increased androgens causes \_\_\_\_\_ and \_\_\_\_\_
insulin (ie resistance);
obesity;
acne, hirsuitism, fertility probs
PCOS:
increased risk of _____ cancer due to unopposed ____
associated with ______ (endocrine disorder)
endometrial, estrogen;
Type II DM
PCOS treatment: \_\_\_\_ \_\_\_\_ (Decreases peripheral estrone formation); \_\_\_\_\_\_ (prevent endometrial hyperplasia due to estrogen);
weight loss;
OCPs
lichen sclerosis:
_____ of epidermis and dermal _____;
seen in ______ women;
“_____ like” vulvar skin
atrophy, fibrosis;
post-menopausal;
parchment;
abnormal bleeding in post-menopausal women
_____ is extension of endometrial tissue into the uterine myometrium. causes pain and _____ during reproductive years
adenomyosis;
menorrhagia
endometrial polyps can be a side effect of ____
tamoxifen
