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EOR Family med > OB/GYN > Flashcards

OB/GYN Flashcards

1
Q

leading cause of CA death in women worldwide

A

breast CA

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2
Q

USPSTF screening breast CA

A

b/l screening mammography for women at normal risk at 50 years and repeating q 2 years until pt is 74 years old

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3
Q

“high risk” for breast CA

A

first degree relative w breast CA
Hx of radiation therapy to the chest btwn ages 10 and 30
ancestry associated w increased incidence of BRCA1 and BRCA2
known hereditary breast or ovarian CA syndrome
Hx of breast, ovarian, peritoneal, tubal CA

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4
Q

Screening recs for breast CA for high risk

A

annual MRI o the breasts

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5
Q

MC type of breast CA

A

invasive ductal carcinoma
infiltrating lobular carcinoma (2nd)

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6
Q

classic presentation of breast CA

A

hard, immobile breast mass

advanced dz:
axillary lymphadenopathy
skin changes (dimpling or ulceration)

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7
Q

RF for breast CA

A

advanced age
obesity
high estrogen
dense breast tissue
insulin resistance
in utero exposure to diethylstilbestrol (DES)
hormone replacement therapy after menopause
pregnancy at advanced age
nulliparous women

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8
Q

MC benign breast condition

A

fibrocystic breast disease

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9
Q

who does fibrocystic breast disease usually affect

A

premenopausal women between 30 and 50

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10
Q

characterization of fibrocystic breast disease

A

multiple painful, swollen, mobile, lumpy, and well-circumscribed masses in both breasts that appear before menses and resolve with the start of the menstrual cycle

may have serous nipple discharge

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11
Q

aspiration of fibrocystic breast disease

A

straw-colored fluid without blood

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12
Q

only FDA approved tx for fibrocystic breast disease

A

Danazol

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13
Q

fibroadenoma

A

MC breast tumor in young women
painless, solitary, smooth, firm, mobile, rubbery, well-defined mass

does not wax and wane w menstruation

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14
Q

imaging for nontender breast mass in pts < 30 – basically if breast mass is unknown but not necessarily suspicious for malignancy - what should you do first

A

US (of whichever breast)

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15
Q

when do HPV infections usually resolve

A

within 12 mos - if longer, more likely cancerous or precancerous

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16
Q

RF cervical CA

A

early age of sexual activity
multiple partners
hx of STI
hx or vaginal or vulvar neoplasia/CA
low socioeconomic status
immunosuppression (think HIV)

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17
Q

two major types of cervical CA

A

squamous cell (MC)
adenocarcinoma

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18
Q

progesterone only options contain

A

Levonorgestrel
Norethrindrone

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19
Q

cystocele

A

posterior bladder wall herniates through the anterior wall of the vagina

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20
Q

sx cystocele

A

feeling of fullness/bulge in vaginal area worse w abdominal pressure (valsalva) and better w rest
urinary incontinence
more frequent UTI
pt may leak urine if asked to cough

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21
Q

tx for cystocele

A

supportive if sx don’t bother pt
pessary if sx bother patient
surgery is definitive

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22
Q

menorrhagia

A

blood loss > 80 mL

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23
Q

what should be considered in ppl w menorrhagia

A

coagulation studies

24
Q

PALM-COEIN

PALM = structural
COEIN = nonstructural

A

Polyps
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometriosis
Iatrogenic
Not yet classified

25
prenatal visits
q 4 weeks from 4-28 weeks gestation q 2 weeks from 28-36 weeks gestation weekly after 36 weeks
26
what should be assessed at each prenatal visit
weight BP fetal heart rate urinalysis glucose presence of fetal movement presence of vaginal bleeding
27
when do you assess fundal height
at each visit starting at 20 weeks
28
screening for defects
15-24 weeks gestation
29
6-12 weeks gestation testing
random blood glucose CBC serologic test for syphilis, rubella antibody titer, varicella antibody titer, HIV testing, ABO and RH typing with antibody screen, Hep B surface antigen, sexually transmitted infection screening for chlamydia
30
maternal quad screen
alpha fetoprotein hCG estradiol inhibin A
31
when is anatomical US performed
18-20 weeks
32
screening for gestational DM and anemia
24-28 weeks
33
pts who are RH negative
anti-D immunoglobulin at 28 weeks
34
unopposed estrogen in a women with intact uterus
increased risk of endometrial CA and endometrial hyperplasia
35
severe critical PID
high fever N/V severe pain abscess perihepatitis pregnancy
36
combo therapy PID
one time IM injection of Ceftriaxone 14 days of oral doxy and metronidazole
37
tx PID if doxy not well tolerated
7 day course Azithromycin
38
cystocele versus rectocele
cystocele - smooth mass w vaginal rugae protruding from the anterior vaginal wall rectocele - smooth mass w vaginal rugae protruding from the posterior vaginal wall
39
spontaneous abortion
pregnancy loss before 20 weeks of gestation
40
RF spontaneous abortion
> 35 prior pregnancy loss substance use (tobacco, caffeine, alcohol, illicit substances) subchorionic hemorrhage stress DM obesity' thyroid disease inherited thrombophilias presence of IUD during pregnancy
41
sx spontaneous abortion
crampy lower abdominal pain uterine bleeding
42
what is recommended for all women undergoing a spontaneous abortion
uterine US serial quantitative beta-human chorionic gonadotropin levels
43
threatened spontaneous abortion
cervical os closed no passage of fetal tissue
44
inevitable spontaneous abortion
cervical os opened no passage of fetal tissue
45
incomplete spontaneous abortion
cervical os open there is passage of fetal tissue (some still remain in uterus)
46
complete spontaneous abortion
cervical os is closed complete passage of fetal parts and placenta uterus contracted
47
missed spontaneous abortion
in utero death cervical os closed non passage of fetal tissue
48
septic spontaneous abortion
infection of uterus open with purulent cervical discharge and uterine tenderness no passage (may be incomplete)
49
trichomoniasis
protozoan parasite trichomonas vaginalis
50
sx trichomoniasis
increased malodorous discharge dysuria urinary frequency dyspareunia vaginal itching/irritation greenish/yellow vaginal discharge friable cervical mucosa (strawberry cervix)
51
wet mount (saline microscopy) trich
flagellated motile trichomonads ph > 5
52
tx trichomoniasis
Metronidazole 2 g PO single dose or 500 mg twice daily for 7 days
53
Bacterial vaginosis
vaginal discharge that is thin, milky, white-gray and a fishy odor
54
saline wet mount for BV
epithelial cells covered by bacteria (clue cells)
55
tx bacterial vaginosis
metronidazole 500 mg twice daily for 7 days (safe in pregnancy)

EOR Family med (25 decks)

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