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MTB STEP 2 (R) > MTB 2 CK - Gynecology > Flashcards

MTB 2 CK - Gynecology Flashcards

1
Q

Diagnostic criteria for PMDD

A

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

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2
Q

How to tx PMS, PMDD

A 
Less caffeine
Less alcohol
Less cigs
Less choc
More exercise
SSRIs if severe
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3
Q

PE findings for menopause

A

Atrophic vaginitis
Decreased breast size
Vaginal and cervical atrophy

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4
Q

How to dx menopause

A

Increased FSH

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5
Q

Contraindications to HRT

A

Breast or endometrial carcinoma

Hx of PE or DVT

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6
Q

Postcoital bleeding indicates

A

Cervical cancer
Cervical polyps
Atrophic vaginitis

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7
Q

Oligomenorrhea indicates

A

Pregnancy
Menopause
Anorexia
Tumor secreting estrogen

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8
Q

Menometrorhagia is

A

Irregular bleeding

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9
Q

Menometrorhagia indicates

A

Endometrial polyps
Endometrial cancer
Exog estrogen
Malignant tumors

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10
Q

Metrorrhagia is

A

Intermenstrual bldg

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11
Q

Metrorrhagia indicates

A

Endometrial polyps
Endometrial/cervical cancer
Exog estrogen

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12
Q

Hypomenorrhea indicates

A

Obstruction

OCPs

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13
Q

Menorrhagia indicates

A

Endometrial hyperplasia
Fibroids
Dysfx uterine bldg
IUD

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14
Q

How to eval AUB

A

CBC
Pt/PTT
Pelvic US

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15
Q

What is dysfx uterine bldg

A

Unexplained abnl bldg usually due to anovulation

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16
Q

Workup in dysfx uterine bldg

A

Hypothyroid
HyperPRL
Endometrial bx

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17
Q

Tx AUB

A

OCPs
D&C if hemorrhaging
Ablation or hysteretomy

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18
Q

How does vaginal diaphragm work

A

Contraceptive jelly on it

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19
Q

How to use vaginal diaphragm

A

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

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20
Q

Benefits of OCPs

A

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

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21
Q

How does vaginal ring work

A

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

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22
Q

How does transdermal patch work

A

Est and prog patch placed on skin for 7 d

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23
Q

How often do you have to get depo

A

q3mo

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24
Q

What is the mechanism of labial fusion

A

Excess androgens (exogenous or endogenous)

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25
Q

Most common cause of labial fusion

A

21 B hydroxylase deficiency

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26
Q

What does lichen sclerosis look like

A

Thin white skin

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27
Q

How to tx lichen sclerosis

A

Topical steroids

28
Q

What does squamous cell hyperplasia look like

A

Raised white lesion from itching

29
Q

How to tx squamous cell hyperplasia

A

Sitz baths or lubricants

30
Q

S/sx of Bartholin cysts

A

Pain
Tenderness
Dyspareunia

31
Q

Tx Bartholin cysts

A

I&D with culture

Marsupialization

32
Q

Pres Trich

A

Profuse frothy green DX
Itching
Abnl odor
Pain

33
Q

How to dx Trich

A

Wet mount for motile flagellates

34
Q

Risk factors for Trich

A

Anything that raises pH
ABx use
DM
Overgrowth of nl flora

35
Q

Tx Trich

A

Flagyl for both partners

36
Q

BV bug

A

Gardnerella

37
Q

Symps BV

A

Gray white vaginal DC with fishy odor

38
Q

Dx BV

A

Wet mount with clue cells

39
Q

Tx BV

A

Flagyl or clinda

40
Q

Pres candidiasis

A

White cheesy vaginal DC

41
Q

Dx candidiasis

A

KOH with pseudohyphae

42
Q

Tx candidiasis

A

Miconazole
Clotrimazole
Econazole
Nystatin

43
Q

What is Paget disease

A

Intrathelial neoplasia in postmenopausal white women

44
Q

Pres of Paget disease

A

Vulvar soreness and pruritis with red lesions with superficial white coating

45
Q

How to dx Paget

A

Bx

46
Q

Tx Paget

A

Radical vulvectomy

47
Q

Most common type of vulvar cancer

A

SqCC

48
Q

Pres of SqCC

A

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

49
Q

How to dx SqCC

A

Bx

50
Q

Staging SqCC

A 
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
51
Q

Tx SqCC

A

Radical vulvectomy

LANectomy

52
Q

What is adenomyosis

A

Invasion of endometrial glands into myometrium

53
Q

When does adenomyosis occur

A

35-50

54
Q

Risk factors for adenomyosis

A

Endometriosis

Uterine fibroids

55
Q

Pres of adenomyosis

A

Dysmenorrhea

Menorrhagia

56
Q

How to dx adenomyosis

A

Clinical!

Large globular boggy uterus

57
Q

Most accurate test for adenomyosis

A

MRI

58
Q

How to tx adenomyosis

A

Hyst

59
Q

Most common sites for endometriosis

A

Ovary

Pelvic peritoneum

60
Q

Pres endo

A 
Cyclic pelvic pain that starts 1-2 weeks before menses and peaks 1-2 days before
Abnl bldg
Nodular uterus
Adnexal mass
Dysmenorrhea
Dyspareunia
61
Q

How to dx endo

A

Laparoscopy for rusty or dark brown lesions

62
Q

Tx endo

A

NSAIDs
OCPs
Danazole, leupron (decrease FSH, LH)

63
Q

Danazol sfx

A

Acne
Oily skin
Wt gain
Hirsuitism

64
Q

Leupron sfx

A

Hot flashes

Decreased bone density

65
Q

Pres PCOS

A 
Amenorrhea
Irregular menses
Hirsuitism
Obesity
Acne
DM2
66
Q

Dx PCOS

A

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

67
Q

Tx PCOS

A

Wt loss
OCPs
Clomiphene and metformin if desire conception

MTB STEP 2 (R) (12 decks)

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