OB/GYN Flashcards
What hormones are increased in granulose cell tumor
Increased estradiol and inhibin
Clinical fts of adult granulosa cell tumor
breast tenderness, postmenopausal bleeding and abnormal uterine bleeding
Clinical features of primary dysmenorrhea
pain first 2-3 days of menses, Nausea and vomitting, diarrhoea with normal pelvic exam
Causes of Functional hypothalamic amenorrhea
Excessive weight loss
Strenuous exercise
eating disorder
Chronic illness
Abnormal uterine bleeding in a premenopausal patient with painless regular menses .. most likely diagnosis?
and treatment
Endometrial polyp treat doing a hysteroscopic polypectomy
Fused labia minor which appear thin and partially block the urethral meatus with multiple excoriations in a prepubertal female .. dx and ethology?
Labial adhesions due to low oestrogen and inflammation
What screening is required in all postnatal women who are having difficulty at home with infant?
Edinburgh Postnatal Depression Scale (EPDS)
What is the first line investigation in a women with pelvic pain and/or adnexal mass
U/S
Clinical presentation of Epithelial Ovarian CA
SOB, Constipation/bloating, vomiting, Asx adnexal mass, pelvic/abdominal pain
Lab and U/S findings of Epithelial Ovarian CA
Elevated CA-125, solid mass, thick septations and ascites
Thin white, wrinkled skin over labia minora with excoriations, versions and fissures from severe pruritus, dysuria and dyparenuria in a prepubertal girl (also can happen in a peri/postmenopausal woman)
Lichen sclerosus
1st line therapy for lichen sclerosus
Clobetasol (potent topical steroid)
Mittelschmerz
Normal ovulation causing pain in the middle of the menstrual cycle
High fever, hypotension, tachycardia and a diffuse red macular rash in the palms and soles in a female patient using tampons
Toxic Shock Syndrome
Modifiable risk factors for breast cancer
HRT
Nulliparity
Increased age at first live birth
Alcohol
Risk factors for cervical cancer that are not sexually related
Immunosuppresion
OCPs
Tobacco use
Low socioeconomic status
Next best step in a patient with endometrial cells on Pap test >45
In contrast to women <45 this finding is abnormal and requires an endometrial biopsy
In a female patient who requests contaception but has problems with anemia and heavy menstrual bleeding what is the contraception of choice and why?
Levonorgestrel-containing IUD (long acting 5 years)
a common side effect is amenhorrea which improves anemia and abnormal uterine bleeding
Young female with cyclic pain and blue bulge tinged bulge between labia (bulging vaginal mass) (common cause of primary amenorrhea)
Imperforate hymen
If patient is suspected with chorioamnionitis what is the next best step
Abx and deliver immediately
Clinical features of chorioamnionitis
Maternal fever + >1 of the following
Fetal tachy (>160)
Purulent amniotic fluid
Maternal leukocytosis
Emergency contraception for pregnancy prevention
Copper IUD (0-120hrs) Ulipristal acetate (0-120hrs) Oral levonorgestrel (0-72hrs)
Contraindications for copper IUD in emergency contraception
- Wilsons disease
- Complicated organ transplant failure
- Acute pelvic infection
- Severe uterine cavity distortion
Contraindiation for taking emergency contraception
Patients that test positive for pregnancy
Clinical feature of androgen-secreting tumors (Sertoli-Leydig cell)
Frank Virilization including Male pattern baldness Deepened voice Clitoromegaly Increased muscle bulk
Postapartum hemorrahge with vaginal sidewall defect and minimal bleeding from cervical OS.
Vaginal Laceration
Etiology and risk factors for Primary Dysmenorrhea
Excessive endometrial prostaglandin F2 Age <30 (Menarche <12) BMI <20 Tobacco Sexual abuse
Women with Mullerian agenesis should undergo what evaluation due to which concurrent embryogenic source and development
Renal U/S due to renal abnormality development
What is Uterine Tachysystole
> 5 contractions every 10 mins
How do you manage uterine tachysystole with late fetal decelerations
- supportive measures (repositioning etc.)
2. d/c utertonic agents (oxytocin) until abnormalities are resolved
Patient has lower abdominal pain, fetal declarations and previous myomectomy repair what are you conserned about and what is the next best step
Uterine rupture
Urgent laparotomy and C/S
What is postpartum urinary retention defines as and what is the mode of diagnosis and treatment
Urinary retention >6hrs
Uterine catherization is both diagnostic and therapeutic
Contraindications for IUD placement
Endometrial or Cervical CA
Pregnancy
Unexplained Vaginal bleeding
Test of diagnosis in vesicovaginal fistulas especially those not visible on PE
Bladder dye testing
Increased risks of vaginal cancer
age >60
DES in utero (clear cell not squamous)
smoking
HPV
When do you stop PAP testing if everything is normal
65
What is the next best step in a patient with a greyish discharge from the breast
TSH and FSH
