Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gynecology and obstetrics > NAGY GYN > Flashcards

NAGY GYN Flashcards

1
Q

Symptoms and diagnosis of ectopic Pregnancy

A

Symptoms:
- Signs of pregnancy (PPP)
- Irregular bleeding
- Abdominal pain
-Peritoneal signs

Diagnosis:
- hCG: doubles every day in pregnancy, does not in ectopic pregnancy (still increased)
- US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of endometriosis

A

Symptoms:
- Dysmenorrhea
- Abdominal pain
- Problems with defacation
-Dyspareunia (painful intercourse)

Diagnosis:
- US
- Laparascopic visualization and removal!! (DX and TX?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Uterine fibroids

A

Types:
- Intramural
- Submucosal
- Subserosal
- Broad ligamental fibroids (?)

Treatment:
- Individual factors are important, can be removed by laparoscopy, but hysterectomy is the only complete treatment

Complications:
- Problems with conception
- Infertility
- Can become very large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bacterial vaginosis: etiology, symptoms, diagnosis, treatment

A

Etiology: Gardenella or another anaerobic bacteria. NOT an STD

Symptoms:
- Vaginal discharge
- Foul smell
- Dyspareunia

Diagnosis:
- KOH prep(potassium hydroxide), see clue cells

Treatment: Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

External female genitalia parts

A

Vulva:
- Labia minora and majora
- Clitoris
- Bartholin glands
- Perineum
- Fourchette

(Internal and external border: hymen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of primary amenorrhea

A
  • Müllerian agenesis
  • Androgen insensitivity syndrome
  • Primary hypogonadism; Turner syndrome
  • Secondary hypogonadism: Kallman syndrome and pituitary tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A postmenopausal woman has thickened endometrium on US. What do you do next?

A

Dilation and curettage, and histology.

It is suspect for corporal/endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Stein-Leventhal syndrome? And the metabolic disorder associated with it?

A
  • Another name for PCOS
  • Associated with insuline resistance/DM
  • Diagnostic criteria: anovulation, hyperandrogenism, > 10 follicles
  • Lab: increased LH:FSH ratio (3:1)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some genital malformations?

A
  • Mullerian agenesis/Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome)
  • Bicornuate uterus
  • Septate uterus
  • Vaginal atresia
  • Imperforate hymen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to differentiate btw. Bartholin cyst and abscess?

A

Abscess will be painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Benefits and risks of hormone contraceptives

A

Benefits:
- Decreased incidence of ovarian and enometrial cancer
- Decreased bone loss
- Treats dysmenorrhea
- Treats acne
- Decreases risks of trisomies with increasing age

Risks:
- Thrombosis, DVT/stroke (especially with other diseases/postpartum)
- Increased BP
- Weigth gain (edema, not true anymore)
- Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of complete uterine prolapse

A

Vaginal hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Barrier and chemical contraceptive - what barriers do we have?

A
  • Female and male condoms
  • Pessaries: Cervical cups, Diaphragm
  • Sponges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What endocrinological change occurs in puberty?

A

Before puberty, GnRH release is continous, when we reach reproductive age, it becomes pulsatile.
- It increases in frequency and amplitude from the hypothalamus, stimulating the anterior pituitary to release LH and FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Female sex development

A
  • External genitalia develop from genital and urogenital folds
    -Muellerian duct (paramesonephric) gives rise to the upper vagina, cervix, uterus and fallopian tubes
  • Absence of Y-chromosome leads to total regression of Wolffian duct (mesonephric)
  • Ovaries develop from germinal epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to confirm intersexuality

A

(Not 100% sure answer)
- Karyotyping (check chromosomes)
- Secondary sex characteristics
- Check internal gonads
- Mental/psychological is the last stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of PID and complications

A

Empirical AB therapy
- Outpatient: one single IM dose of ceftriaxone + PO doxycycline, add metronidazole if signs of vaginitis
- Inpatient. IV cephalosporin (cefoxitin, cefotaxime) + doxycycline, if tuboovarian abscess, add metronidazole

(How long?)

Important to treat due to risk of complications:
- Fitz-Hugh-Curtis syndrome
- Tuboovarian abscess
- Infertility
- Ectopic pregnancy
- Chronic pelvic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Types of benign ovarian tumors

A

Epithelial
- Serous cystadenoma
- Mucinous cystadenoma
- Endometrioid

Gonadal stromal tumors
- Granulosa theca cell tumors
- Sertoli-Leydig cell tumors

Germ cell tumors
- Dysgermimoma
- Teratoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Obstetric and gynecological evaluation in patient without complain

A
  • Bimanual examination
  • Pap smear
  • Breast exam
  • Speculum examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do diagnose stage 1 in corporal cancer?

A

Less or more than 50% of the myometrium? Diagnose with transvaginal-US, if more than 4 cm do dilation and curettage for biopsy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Vulvodynia

A

Vulvar discomfort, most often descibed as burning pain, occuring in the absencse of relevant visible findings or a specific, identifiable neurological disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Perimenopause diagnosis

A
  • Exclude pregnancy
  • FSH constantly increases
  • No follicles in ovaries on US
  • Vulvovaginal atrophy on physical exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classification of human sexuality

A

-Heterosexual
- Homosexual
- Bisexual
- Transsexual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Mayer-Rokitansky-Kuster-Hauser (MRKH syndrome)?

A

Mullerian agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is hydatidiform mole?
- Snowstorm pattern on US - No fetus (- Abnormal growth of trophoblasts)
26
Endometrial (corporal) cancer screening
Only screen women with high risk by measuring endometrial thickness
27
How to check for fallopian stricture?
Hysterosalpingography (X-ray w/ dye in uterus to check openness and shape of fallopian tubes)
28
Difference between virulism and hirsutism
- Hirsutism is a clinical presentation of virilization; the apperance of male secondary sex characteristics in a female - Hirsutism: dark hair on back, lip and chest. - Other symptoms of virilization: clitoromegaly, deep voice, male pattern hair loss, acne, increased muscle mass
29
What is radical vulvectomy?
Surgical removal of vulva and inguinofemoral lymph nodes
30
Screening of ovarian cancer
- US : multilocular cysts, solid areas, metastases, ascites and bilateral lesions ( one point per) - Ca-125 - HE4 (human epidydimis protein 4) - RMI: risk of malignancy index, if over 200 you should be suspiscious for malignancy. Based on: - US features - Menopausal status - Levels of Ca-125
31
Cause of pelvic pain
- Dysmenorrhea - Endometriosis - PID - Ruptured ectopic pregnancy - Adnexal torsion
32
Possible locations of ectopic pregnancy
- Fallopian tubes (ampulla) - Uterine horns - Cervix - Scar from prior C-section - Abdomen
33
Diagnosis of hydatidiform mole
- b-HCG (very high) - Snowstorm or honeycomb (partial mole) pattern on US - Confirmation with biopsy
34
Histology of types of breast cancer
- Ductal and lobular
35
Endometrial benign lesions that are not fibroids:
- Adenomyosis - Endometrial polyps
36
Vulvar cancer treatment
- VIN: local excision - Radical vulvectomy (+ inguinofemoral lymphadenectomy)
37
Symptoms of cervical cancer
Vaginal bleeding
38
Cause of dysmenorrhea
- Endometriosis - Idiopathic
39
18 year old patient with primary amenorhea, 46XY, breast developed but no pubic hair. What is the diagnosis?
Genetically male - androgen insensitivity syndrome?
40
Pearl index definition
Definition: number of unintended pregnancies in 100 women over 1 year of contraception use. Tells us about th efficacy of various contraceptive methods. Condoms: 3-26 (depends on user knowledge) It is much lower in OC than in condoms
41
Diagnose a patient with: Hirsutism, acne, obesity, amenorrhea, insuling resistance
Stein-Leventhal/PCOS
42
If you see a single unicellular cyst on one ovary US, how would you treat it?
- Watchful waiting is usually enough - Can be removed surgically if there is a risk for torsion or rupture
43
How do you diagnose cervical cancer?
Pap smear
44
Treatment of choriocarcinoma? Prognosis? 5 year survival rate?
- Methotrexate - Good prognosis - 95% survival rate
45
Conization in pregnant women?
??
46
Basis of cancer therapy
Surgery, radiotherapy and chemotherapy, combination of all
47
Types of breast cancer surgery
- Lumpectomy - Quadrantectomy - Mastectomy - Radical mastectomy
48
Treatment of infertility
- Ovarian follicle stimulation - Retrieve egg via US guidance - Mix sperm and egg - Incubation - Transfer 2-5 embryos into uterus; preferably cleavage or blastocyst stage - Best to do on day 20-24 of menstrual cycle ??
49
Stage 3 of cervical cancer
3A: Lower third of vagina is involved 3B: Whole parametrium infiltrated Tx: Chemoirradiation
50
Diagnosis of postmenopause
Consistently elevated FSH
51
Treatment of cervical cancer
Depends on the stage - Transabdominal hysterectomy - Radical hysterectomy (uterus, cervix + parametrium and LNs) - Radical trachelectomy (fertility perserving, large part of cervix is removed and some lymph nodes) - Chemoirradiation, palliative chemo, RT or surgery
52
Symptoms of perimenopause
- Hot flashes - Night sweats - Mood swings - Vaginal dryness - Loss of libido
53
What infections cause painless lymphadenopathy with genital lesions, and what causes painful lymphadenopathy?
Painless: syphilis ( painless ulcer and painless lymphadenopathy) Painful: lymphogranuloma venerum
54
Symptoms of genital herpes
- Vesicles on genitals: painful, pruritus, discharge, dysuria, - Sometimes systematic symptoms: fever, malaise, lymphadenopaty
55
Choricarcinoma follow up
b-HCG
56
Secondary amenorrhea; what is the progestin test?
- Give progestin, and then withdraw it - If there is withdrawal bleeding then the diagnosis is PCOS/Anovulation - If there is no bleeding, further diagnostic tests should be done
57
Causes of secondary amenorrhea
- Pregnancy (Normal) - Menopause (Normal) - Lactation (Normal) - Hypothyroidism - Drugs (antidopaminergic) - Pituitary tumors
58
Treatment of ectopic pregnancy
- Laparascopy - Salpingostomy - Salpingectomy
59
What does a functional ovarian cyst look like?
- Look: Unilateral, uniloculated, simple cell inside, no papillary protrusion into the cyst - Types: follicular, corpus luteum, theca-lutein cyst
60
How to differentiate malginant from benign ovarian cysts?
- MRI - US - Ca-125 - Biopsy
61
Dysfunctional uterine bleeding in a 42 year old woman. What do you do?
D&C
62
40 year old woman with dysmenorrhea. What do you do?
D&C
63
Types of endometrial hyperplasia?
- Simple typical: increase in glands but normal glandular structure - Complex typical: crowded irregular glands - Simple atypical: simple hyperplasia with presence of atypical cells - Complex atypical: complex hyperplasia with presence of atypical cells. Highest malignant potential (30%)
64
What are the stages of cervical cancer? At what stage is it observable?
1: Confined to Cervix - 1A: microscopically visible (Tx; TAH) - 1B: macroscopically visible (Tx; TAH + pelvic LND) 2: Invades beyond uterus, to upper vagina and perimetrium, but not beyond pelvic wall (Tx; TAH + pelvic LNDs) 3: Invades lower 1/3 of vagina (3A) or pelvic wall (3B) 4. Invades bladder/rectum or distant metastasis (Tx: palliative chemo, RT, surgery)
65
What are the changes seen in puberty?
- Accelerated growth - Development of secondary sexual characteristics, axillary hair growth, - Tanner stages for pubic hair growth and breast enlargement Stages of development: - Gonadarche (acrivation of gonads) - Adrenarche (increase in androgen production) - Thelarche (apperance of breast tissue) - Menarche (first menstrual bleed, non ovulatory) - Spermache (first sperm production, nocturnal sperm emissions) - Pubarche (apperance of pubic hair, axillary hair, odor and acne)
66
How often do you screen for infections``
?==
67
Common STDs?
Chlamydia, gonorrhea, syphilis, genital herpes (HSV-2), genital warts (HPV)
68
What is the equivalent of prostate in a female?
Upper 1/3 of vagina, consist of glands and smooth muscle
69
Case: woman with no menses for 7 weeks, after uterine examination you dont find any intrauterine pregnancy. What do you do?
- Measure b-HCG, if not doubeling every day it is an indication of ectopic pregnancy - Laparoscopy is the therapy
70
What is enterocele?
Small bowel prolapse. Occurs when the small intestine (small bowel) descends into the lower pelvic cavity and pushes at the top part of the vagina, creating a bulge. Due to wall weakness.
71
Benign lesions of the vulva
- Lichen Sclerosus (post-menopausal) - Lichen Simplex Chronicus
72
Treatment of syphilis
2,4 mill units of Penicillin G
73
Radical mastectomy
Removal of the whole breast + axillary lymph node dissection
74
At what stage of cervical cancer can you see it with your naked eye?
1a2
75
When to begin evaluation of primary amernorrhea?
Usually wait until 18 nowadays. (Nagy) Textbook answer: Age 16 2 years after onset of puberty 14 if no puberty
76
What is conization?
Cone shaped portion of the cervix is removed. Using scalpel, laser or electrosurgical techniques. Can be diagnostic (HSIL) or therapeutic (CIN2+3) - Or both at the same time
77
Types of urinary incontinence
- Stress - Urge - Overflow - Neurogenic
78
Staging of ovarian cancer
Screening of high risk group: Ca-125 and US 1: Confined to ovaries or FT's 2: Ovaries + pelvic or peritoneal involvement 3: Ovaries + spread to peritoneum outside the pelvis and/or metastasis to retroperitoneal LNs 4: Distant metastasis to e.g liver, lung and pleural fluid
79
Most common vaginal infections
- Bacterial vaginosis (Gardenella or mycoplasma) - Trichomonas - Candida
80
Most comom causes of infertility
Male: sperm disorders, erectile dysfunction Female: anatomical (PID, Asherman syndrome, endemetriosis), ovulatory dysfunction, abnormal cervical mucus
81
Etiology of cervical cancer
HPV 16 and 18
82
Treatment of benign vulvar lesions
Surgical excision
83
In uterine prolapse, what type of surgery?
Vaginal hysterectomy
84
Most common complaints in pediatric gynecology?
- Infection (bad diaper-washing) - Amenorrhea - Precocious or delayed puberty
85
Endometriosis drugs
- Make a pseudopregnancy with oral contraceptives - Make a pseudomenopause with Leuprolide
86
Urinary incontinence and dx
Irritative: due to cystitis, tumor or foreign body --> urinanalysis Stress: Cough test Urge: tx is anticholinergics Overflow/Neurogenic: tx is cholinergics
87
Mayer-Rokitansky-Kuster-Hauser Syndrom
Mullerian Agenesis Failiure of mullerian ducts to develop
88
Pap-smear (Papanicolau classification)
0. Improper sample 1. Normal 2. WBC and superficial cells on the slide 3. Unsure 4. Atypical cells, suspicious for malignancy 5. True malignancy
89
Bethesda
Reporting cervical or vaginal cytological Pap smear. 1- Quality of the slide 2- General description ( positive or negative) 3- Detailed description (HSIL OR LSIL) 4- Recommendations
90
Marsupialization of Bartholins cyst
Cyst is opened at the edges, sutured and forms an open pocket so that it can drain. Heals by itself.
91
Asherman syndrome
Adhesions and fibrosis in the uterine cavity. Reversible infertility. Endometrial ablation also causes this.

Gynecology and obstetrics (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions