Mehl. miscelaneous repro DDx for IM 03-24 (1) Flashcards
M. carring of the uterus by fibrous adhesions, aka uterine synechiae?
Asherman syndrome
M. Asherman syndrome cause?
Caused by Hx of instrumentation – i.e., D&C.
M. Asherman syndrome - can cause what?
Can cause amenorrhea.
M. Q will say female has a Hx of LEEP for cervical CIN2 or 3 six months ago + now has pelvic pain with menses + examination shows a small, scarred cervical os. Dx?
Cervical stenosis
M. Cervical stenosis. About pain point.
Pain can occur in theory if outflow of menses is decr., similar to imperforate hymen.
M. Ovarian hyperstimulation syndrome (OHSS). can occur on what women?
Can occur in some women who take fertility meds (e.g., clomiphene) to stimulate egg production.
Results from over-response to the drug, leading to swelling of the ovaries and fluid accumulation in the abdomen, sometimes also affecting the chest.
M. Ovarian hyperstimulation syndrome (OHSS). Symptoms?
Symptoms of OHSS can range from mild (i.e., bloating and mild pain) to severe, involving rapid weight gain, severe pain, and shortness of breath.
M. Ovarian hyperstimulation syndrome (OHSS). Tx?
Usually self-limiting / self-resolves. Just know the Dx exists.
M. Premature ovarian failure aka primary ovarian insufficiency. Term for what?
Term used to apply to idiopathic menopause age 40 or younger.
M. Atrophic vaginitis. Definition?
Vaginal atrophy, leading to thin, dry, itchy, and inflamed vaginal walls.
M. Atrophic vaginitis. due to what?
Usually due to menopause, but can in theory be caused by any etiology of low estrogen.
M. Atrophic vaginitis. can cause what dysfunction?
Can cause dyspareunia
M. Atrophic vaginitis. Tx? first line –> followed?
Topical lubricants are tried first, followed by topical estrogen.
M. Chemo- / radiotherapy- induced amenorrhea.
As the name implies. You just need to be aware that chemo- and radiotherapy can cause amenorrhea.
Shows up on NBME as “primary hypogonadism” as the answer – i.e., the ovaries themselves are hypo-secreting hormones as reason for amenorrhea.
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M. Autoimmune oophoritis.
Idiopathic autoantibody-mediated destruction of ovarian tissue in women of child-bearing age. Rare. Just know it exists.
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M. Carpal tunnel syndrome.
Compression of median nerve within carpal tunnel.
In what trimesters?
Normal in pregnancy due to edema in 2nd and 3rd trimesters.
M. Chronic interstitial cystitis. definition/CP?
Unexplained pelvic pain, bladder pain, and/or dysuria >6 weeks, where all laboratory studies are normal.
Can present with anterior vaginal wall pain (bladder is anterosuperior to vagina).
M. Chronic interstitial cystitis.
Q will say 25F + 6 months of dysuria + pubic pressure + pregnancy test negative + labs all normal. Dx =?
Tx?
Dx = interstitial cystitis straight-up. Not hard. -
Treatment is mundane, soft porn stuff like lifestyle modification and dietary changes. Steroids are a WRONG answer.
