MTB 2 CK - Gynecology

Question 1

Diagnostic criteria for PMDD

Answer 1

Symptoms present for 2 cycles
Symptom-free 1 wk period in first part of cycle
Symptoms present in second half of cycle
Dysfx in life

Question 2

How to tx PMS, PMDD

Answer 2

Less caffeine
Less alcohol
Less cigs
Less choc
More exercise
SSRIs if severe

Question 3

PE findings for menopause

Answer 3

Atrophic vaginitis
Decreased breast size
Vaginal and cervical atrophy

Question 4

How to dx menopause

Answer 4

Increased FSH

Question 5

Contraindications to HRT

Answer 5

Breast or endometrial carcinoma

Hx of PE or DVT

Question 6

Postcoital bleeding indicates

Answer 6

Cervical cancer
Cervical polyps
Atrophic vaginitis

Question 7

Oligomenorrhea indicates

Answer 7

Pregnancy
Menopause
Anorexia
Tumor secreting estrogen

Question 8

Menometrorhagia is

Answer 8

Irregular bleeding

Question 9

Menometrorhagia indicates

Answer 9

Endometrial polyps
Endometrial cancer
Exog estrogen
Malignant tumors

Question 10

Metrorrhagia is

Answer 10

Intermenstrual bldg

Question 11

Metrorrhagia indicates

Answer 11

Endometrial polyps
Endometrial/cervical cancer
Exog estrogen

Question 12

Hypomenorrhea indicates

Answer 12

Obstruction

OCPs

Question 13

Menorrhagia indicates

Answer 13

Endometrial hyperplasia
Fibroids
Dysfx uterine bldg
IUD

Question 14

How to eval AUB

Answer 14

CBC
Pt/PTT
Pelvic US

Question 15

What is dysfx uterine bldg

Answer 15

Unexplained abnl bldg usually due to anovulation

Question 16

Workup in dysfx uterine bldg

Answer 16

Hypothyroid
HyperPRL
Endometrial bx

Question 17

Tx AUB

Answer 17

OCPs
D&C if hemorrhaging
Ablation or hysteretomy

Question 18

How does vaginal diaphragm work

Answer 18

Contraceptive jelly on it

Question 19

How to use vaginal diaphragm

Answer 19

Put it in 6 hours before sex, leave in for 6 hours afterward

Question 20

Benefits of OCPs

Answer 20

Reduce risk of ovarian carcinoma, endometrial carcinoma, and ectopic pregnancy

Question 21

How does vaginal ring work

Answer 21

Est and prog constantly released while it’s left in for 3 weeks

Question 22

How does transdermal patch work

Answer 22

Est and prog patch placed on skin for 7 d

Question 23

How often do you have to get depo

Answer 23

q3mo

Question 24

What is the mechanism of labial fusion

Answer 24

Excess androgens (exogenous or endogenous)

Question 25

Most common cause of labial fusion

Answer 25

21 B hydroxylase deficiency

Question 26

What does lichen sclerosis look like

Answer 26

Thin white skin

Question 27

How to tx lichen sclerosis

Answer 27

Topical steroids

Question 28

What does squamous cell hyperplasia look like

Answer 28

Raised white lesion from itching

Question 29

How to tx squamous cell hyperplasia

Answer 29

Sitz baths or lubricants

Question 30

S/sx of Bartholin cysts

Answer 30

Pain Tenderness Dyspareunia

Question 31

Tx Bartholin cysts

Answer 31

I&D with culture | Marsupialization

Question 32

Pres Trich

Answer 32

Profuse frothy green DX Itching Abnl odor Pain

Question 33

How to dx Trich

Answer 33

Wet mount for motile flagellates

Question 34

Risk factors for Trich

Answer 34

Anything that raises pH ABx use DM Overgrowth of nl flora

Question 35

Tx Trich

Answer 35

Flagyl for both partners

Question 36

BV bug

Answer 36

Gardnerella

Question 37

Symps BV

Answer 37

Gray white vaginal DC with fishy odor

Question 38

Dx BV

Answer 38

Wet mount with clue cells

Question 39

Tx BV

Answer 39

Flagyl or clinda

Question 40

Pres candidiasis

Answer 40

White cheesy vaginal DC

Question 41

Dx candidiasis

Answer 41

KOH with pseudohyphae

Question 42

Tx candidiasis

Answer 42

Miconazole Clotrimazole Econazole Nystatin

Question 43

What is Paget disease

Answer 43

Intrathelial neoplasia in postmenopausal white women

Question 44

Pres of Paget disease

Answer 44

Vulvar soreness and pruritis with red lesions with superficial white coating

Question 45

How to dx Paget

Answer 45

Bx

Question 46

Tx Paget

Answer 46

Radical vulvectomy

Question 47

Most common type of vulvar cancer

Answer 47

SqCC

Question 48

Pres of SqCC

Answer 48

Pruritis Bloody vaginal DC Lesion (small ulcerated to large cauliflower)

Question 49

How to dx SqCC

Answer 49

Bx

Question 50

Staging SqCC

Answer 50

``` While pt is in surgery 0 = in situ I = 2 cm in vulva/perineum III = lower urethra or anus, u/l LAN IV = invasion to bladder, rectum, b/l LAN IVa = distant mets ```

Question 51

Tx SqCC

Answer 51

Radical vulvectomy | LANectomy

Question 52

What is adenomyosis

Answer 52

Invasion of endometrial glands into myometrium

Question 53

When does adenomyosis occur

Answer 53

35-50

Question 54

Risk factors for adenomyosis

Answer 54

Endometriosis | Uterine fibroids

Question 55

Pres of adenomyosis

Answer 55

Dysmenorrhea | Menorrhagia

Question 56

How to dx adenomyosis

Answer 56

Clinical! | Large globular boggy uterus

Question 57

Most accurate test for adenomyosis

Answer 57

MRI

Question 58

How to tx adenomyosis

Answer 58

Hyst

Question 59

Most common sites for endometriosis

Answer 59

Ovary | Pelvic peritoneum

Question 60

Pres endo

Answer 60

``` Cyclic pelvic pain that starts 1-2 weeks before menses and peaks 1-2 days before Abnl bldg Nodular uterus Adnexal mass Dysmenorrhea Dyspareunia ```

Question 61

How to dx endo

Answer 61

Laparoscopy for rusty or dark brown lesions

Question 62

Tx endo

Answer 62

NSAIDs OCPs Danazole, leupron (decrease FSH, LH)

Question 63

Danazol sfx

Answer 63

Acne Oily skin Wt gain Hirsuitism

Question 64

Leupron sfx

Answer 64

Hot flashes | Decreased bone density

Question 65

Pres PCOS

Answer 65

``` Amenorrhea Irregular menses Hirsuitism Obesity Acne DM2 ```

Question 66

Dx PCOS

Answer 66

Pelvic US for b/l enlarged ovaries with cysts High free T LH:FSH > 3:1

Question 67

Tx PCOS

Answer 67

Wt loss OCPs Clomiphene and metformin if desire conception