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PANCE > OB/GYN > Flashcards

OB/GYN Flashcards

1
Q

Menometrorrhagia

A

heavy bleeding at normal intervals

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2
Q

Metrorrhagia:

A

bleeding between cycles

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3
Q

Menometrorrhagia

A

irregular intervals with excessive bleeding

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4
Q

Polymenorrhea

A

frequent cycles <21 days

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5
Q

Tx of DUB

A

NSAIDs, hormonal (oral contraceptive pills [OCPs], intrauterine device [IUD]),
ablation/surgery if persistent

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6
Q

Definition of Primary Amenorrhea

A

the absence of menarche by age 15 yo with normal 2° sexual characteristics or by age 13 yo without

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7
Q

Workup for Primary Amenorrhea

A

pregnancy test, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH)

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8
Q

Dx the cause of primary amenorrhea as an outflow obstruction

A

Breast present, uterus present, w/ either transverse vaginal, or imperforate hymen

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9
Q

Dx the cause of primary amenorrhea as ovarian causes

A

Breast absent, Uterus present w/ Increased FSH, and LH

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10
Q

Dx the cause of primary amenorrhea as hypothalamus pituitary failure

A

Breast absent, uterus present, decreased FSH, and LH (ex athletes, anorexia)

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11
Q

Definition of 2º Amenorrhea

A

cessation of menses of 6 mo with previous normal cycles

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12
Q

etiologies of 2º Amenorrhea

A

1) Pregnancy (MC)
2) hypothalamus dysfxn
3) Pituitary Dysfxn
4) Ovarian disorders
5) Uterine disorders

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13
Q

Workup for secondary amenorrhea

A

1) beta hcg
2) FSH, LH
3) Prolactin
4) estrogen
5) TSH
6) U/S

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14
Q

dx hypothalamic dysfxn in 2º amenorrhea

A

1) normal or low fsh and lh
2) low estradiol
3) normal prolactin

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15
Q

management of 2º amenorrhea if caused by hypothalamic dysfxn

A

clomiphene, lifestyle changes, CBT

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16
Q

dx of 2º amenorrhea caused by pituitary dysfxn

A

1) dec FSH, LH

2) inc prolactin

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17
Q

dx of 2º amenorrhea caused by ovarian disorders

A

1) inc FSH, LH
2) dec estradiol
3) perform a progesterone challenge- if w/d bleeding then it is an ovarian abnormality. no w/d bleeding perform a prog/estrogen challenge. if bleeding then ovarian abnormality. no bleeding in both tests suggests a uterine abnormality.

18
Q

what is the cause of primary dysmenorrhea

A

inc prostaglandins

19
Q

clinical manifestations of dysmenorrhea

A

pain right before or with the onset of menses

20
Q

management of primary dysmenorrhea

A

1) NSAIDs 1st line
2) OCP
3) if meds all fail laproscopy

21
Q

def of PMS

A

Cyclic cluster of physical & emotional changes
• Must occur 2 weeks prior to menstruation & must have 7 symptom free days at
beginning of cycle
• Must occur for 2 consecutive cycles to be diagnosed

22
Q

sx of PMS

A

physical (bloating, headache, breast pain, bowel changes), emotional
(irritability, depression), behavioral (poor concentration, food cravings)

23
Q

tx of PMDD

A

SSRIs

24
Q

def of PMDD

A

severe PMS with functional impairment

25
Q

clinical manifestations of Adenomyosis

A

menorrhagia
dysmenorrhea
possibly infertility
tender, symmetrically uniformly enlarged “boggy” uterus.

26
Q

management of Adenomyosis

A

TAH- only effective therapy

to preserve fertility- nsaids and OCPs

27
Q

clinical manifestations of leiomyoma (uterine fibroids)

A

Bleeding is the MC presentation (menorrhagia), dysmenorrhea.
abd pain pressure depending on the size and location.
bladder: frequency and urgency.

28
Q

P/E findings of leiomyoma

A

large, irregular hard palpable mass on bimanual exam.

29
Q

diagnosis of leiomyoma

A

pelvic u/s

30
Q

management of leiomyoma

A

most just observe
leuprolide- most effective medical
hysterectomy- definitive
myomectomy to preserve fertility

31
Q

mc site of endometriosis

A

ovaries

32
Q

classic presentation of endometriosis

A

1) cyclic premenstral pelvic pain
2) dysmenorrhea
3) dysparaunia
4) dyschezia
5) possible spotting
6) infertility

33
Q

dx endometriosis

A

laparoscopy w/ biopsy

34
Q

mc cause of infertility > 30yo

A

endometriosis

35
Q

treatment of endometriosis

A 
def - TAH- BSO
medical- combined ocps- 
                nsaids
                progesterone
                leuprolide
                danazol
ablation
36
Q

presentation endometrial hyperplasia

A

menorrhagia
metrorrhagia
post-menopausal women

37
Q

dx of endometrial hyperplasia

A

U/S, endometrial biopsy

38
Q

tx of endometrial hyperplasia

A

Tx:
o Hyperplasia without atypia: progestin
o Hyperplasia with atypia: TAH

39
Q

cause of endometrial hyperplasia

A

Due to unopposed estrogen

40
Q

presentation endometrial ca

A

Presents with abnormal vaginal bleeding

41
Q

mc type of endometrial ca

A

adenocarcinoma

42
Q

dx of endometrial ca

A

endometrial biopsy

PANCE (1 decks)

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