OB/GYN IV Flashcards
When is a pelvic exam indicated in an adolescent patient
Abnormal symptoms
sexually active
What are the common vulvovaginal lesions
- Lichen sclerosus et atrophicus
- Trauma
- Labial agglutinations
- Prolapsed Urethra
- Vaginal discharge
What is the treatment of lichen sclerosus
improved personal hygeine is the first step
What is labial agglutination
result from vulvat inflammation or skin disease, and the hypoestrogentic state. It is the adhesion of the labia minora in the midline
What is the most often malignant vaginal tumor
Sarcoma botryoides
How will sarcoma botryoides present
arises from mesenchymal tissue of the cervix or vagina, usually on the anterior wall of the upper vagina. Grows rapidly, fills the vagina, and then protrudes through the introitus
What are the 2 groups of ovarian tumors
Non germ cell (40%) Germ cell (60%)
What are the non germ cell origins tumors
lipoid cell tumors (estrogen producing)
Granulosa-theca cell tumor (Estrogen producing)
What are the germ cell origin tumors
- benign cystic teratomas
- benign cysts
- Arrhenoblastomas (androgen producing)
- Dysgerminomas and gonadoblastomas
- Endodermal sinus tumors
- Embyonal carcinomas (hCG secreting tumros)
- Immature teratomas
What is MRKH syndrome
Vaginal and uterine agenesis. Represents a failure of the caudal mullerian duct to fuse with the urogential sinus
What are some causes of amibiguous genitalia
- Congenital Adrenal Hyperplasia (CAH)
- Adrenal Tumors
- Maternal ingestion of androgenic substances
- Childhood ingestion of androgens
- Androgen insensitivity syndrome (AIS)
What is the average age of onset of puberty
9 years
What is responsible for initiation of puberty
Increased production of LH and FSH
When is the peak growth velocity
11 - 12 years, usually 1 year before menarche
When does thelarche begin
9-11
It is usually completed over a 3 year period
It is a sign of ovarian estrogen production
What is adrenarche
refers to the production of androgens from the adrenal gland
What is pubarache
the development of axillary and pubic hair that results from the adrenal and gonadal androgens.
Usually follows thelarche
What is the average age of onset of menses
12-13
What is precoious puberty
secondary sexual characteristics before 8 years of age in caucasion girls and 7 years in african americans
What is delayed puberty
characterized by the absence of breast development by age 13 or the absence of menses by age 16
what is swyner syndrome
(46, XY)
characterized by a female phenotype with amenorrhea and lack of secondary sex characteristics
Inherited as X linked recessive
At what age will menses cease to occur spontaneously
40-58
90% between 45 and 55
What is premature menopause
permanent cessation of menses ocurring before age 40
What is the hallmark of reproductive aging
elevation of FSH to greater than 10 IU/mL in the early follicular phase (between day and day 5 of the menstrual cycle)
When menses have been absent for 1 year, FSH levels are persistently greater than 30 IU/mL