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PANCE/EOC > OBGYN #1 > Flashcards

OBGYN #1 Flashcards

1
Q

MCC Acute Mastitis

A

Staph Aureus

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2
Q

Symptoms of acute mastitis

A

Unilateral localized breast pain, cracked nipples or visible fissure, purulent nipple discharge, fever, myalgias, chills

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3
Q

Treatment for acute mastitis

A
  • Supportive
  • Anti-Staph ABX: Dicloxacillin, Nafcillin
  • Continue breastfeeding

-Erythromycin if PCN allergic

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4
Q

Symptoms of a breast abscess

A
  • Unilateral breast pain (symptoms of acute mastitis)
  • Induration and fluctuance
  • May have purulent discharge
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5
Q

Diagnostic for breast abscess

A
  • Drainage via Needle aspiration

- I/D + ABX (Dicloxacillin, Cephalexin)

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6
Q

Congestive mastitis is

A

-Bilateral breast enlargement 2-3 days postpartum due to milk stasis

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7
Q

Management for congestive mastitis

A
  • Breast drainage (manually or breast pump)

- If not breastfeeding, treat with ice packs, tight bras, analgesics and drainage

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8
Q

What is the MC benign breast disorder in reproductive age women

A

Fibrocystic breast changes

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9
Q

Symptoms of fibrocystic breast changes

A

-Multiple, painful or painless breast masses that may increase or decrease in size with menstrual hormonal changes (often worse prior to menstruation)

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10
Q

Diagnostic of choice for fibrocystic breast changes

A

US

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11
Q

What does a fine needle aspiration for fibrocystic breast changes show

A

straw colored or green fluid (no blood)

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12
Q

Treatment for fibrocystic breast changes

A

Supportive

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13
Q

Explain fibroadenoma of the breast

A

Benign solid tumor that is usually nontender.
-Firm, contender, solitary, smooth, well-circumscribed, freely mobile, rubbery lump in breast

-Does not change size with menstruation

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14
Q

Definitive diagnostic for fibroadenoma

A

-FNA: fibrous tissue and collagen arranged in a “Swirl.”

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15
Q

Treatment for fibroadenoma of the breast

A

-Conservative (observation, reassurance, and follow up)

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16
Q

Causes of gynecomastia

A
  • Spironolactone, Ketoconazole, Digoxin
  • Infants (due to high maternal estrogen)
  • Hyperthyroidism, Cirrhosis, Klinefelter syndrome, large cell lung cancer
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17
Q

What is often the first line medication for gynecomastia if needed?

A

Tamoxifen (estrogen antagonist in the breast)

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18
Q

Risk factors for breast cancer

A
  • Genetics: BRCA1 and BRCA2 genes
  • Increasing age
  • Increased number of menstrual cycles (nulliparity, late first pregnancy, early menarche, late menopause)
  • Increased estrogen exposure (obesity, alcohol use, endometrial cancer, OCP)
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19
Q

MC type of breast cancer

A

Infiltrative Ductal Carcinoma

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20
Q

Paget disease of the breast presents as

A

Eczematous nipple lesion. May have bloody discharge from the nipple.

21
Q

Symptoms of a breast cancer mass

A
  • Painless, hard fixed immobile lump
  • Unilateral discharge
  • Upper outer quadrant
  • Axillary lymphadenopathy
22
Q

MC sites of METs from breast cancer

A

Bone, lungs, liver, brain

23
Q

What initial diagnostic is used to evaluate breast masses in women > 40 y/o

A

Mammography

24
Q

What initial diagnostic is used to evaluate breast masses in women < 40 y/o

A

US

25
Q

What is the most accurate diagnostic test for breast cancer?

A

Open biopsy

26
Q

Fine needle aspiration has an advantage and a disadvantage, name them

A
  • Advantage: removes the least amount of tissue

- Disadvantage: if positive, doesn’t allow for receptor testing

27
Q

Large needle (core biopsy) has an advantage and a disadvantage, name them

A
  • Advantage: allows for receptor testing if positive

- Disadvantage: can leave greater deformity

28
Q

For early stage breast cancer, what is the treatment?

A

-Breast conservation therapy (lumpectomy) with sentinel node biopsy and follow up radiation

29
Q

In estrogen receptor positive tumors, what is the treatment of choice?

A

Anti-estrogen hormone therapy (Tamoxifen)

-Most useful in premenopausal patients

30
Q

What is the treatment of choice for ER-positive patients if they are post-menopausal?

A

-Aromatase inhibitor hormonal therapy (Letrozole, Anastrozole, Exemestane)

31
Q

What is the screening recommendation for mammograms?

A

Every 2 years starting at 50 until 74 years old

  • Or 10 years prior to when a 1st degree relative was diagnosed
  • If breast implants, same screening as without
32
Q

How often should women have a clinical breast exam?

A

At least every 3 years in women 20-39 and annually after 40

33
Q

What medications are used in women at high risk for breast cancer for prevention?

A

Tamoxifen or Raloxifene

34
Q

What two types of HPV cause 70% of all cervical cancers worldwide, nearly 90% of anal cancers, and a lot of penile cancer, vaginal/vulvar cancer, and oropharyngeal cancer

A

HPV type 16 and 18

35
Q

HPV types ____ and ____ cause 90% of genital warts

A

6 and 11

36
Q

What HPV does Gardasil 9 target

A

6, 11, 16, 18, 31, 33, 45, 52, 58

37
Q

Inability to maintain pregnancy secondary to premature cervical dilation (in 2nd trimester)

A

Cervical insufficiency (incompetent cervix)

38
Q

Symptoms of incompetent cervix

A

-Painless dilation and effacement of the cervix

39
Q

What is the most accurate and predictive test for incompetent cervix

A

Transvaginal US

-If length 25 cm or less before 24 weeks

40
Q

Treatment for cervical insufficiency

A
  • Cerclage (suturing of os) and bed rest

- May also use weekly injection of 17 alpha-hydroxyprogesterone

41
Q

How to diagnose infertility

A

-Hysterosalpingography (to evaluate tubal patency or abnormalities)

42
Q

What drug induces ovulation?

A

Clompihene

43
Q

3rd MC gynecological cancer

A

Cervical cancer

#1: Endometrial
#2: Ovarian
44
Q

MC type of cervical cancer

A

Squamous cell carcinoma

45
Q

What two types of HPV causes most cervical cancer?

A

16 and 18

46
Q

Symptoms of cervical cancer

A
  • Post-coital bleeding or spotting

- Cervical discharge (maybe)

47
Q

Diagnostic for cervical cancer

A

Colposcopy with biopsy

48
Q

For carcinoma in situ, what is the treatment of choice for cervical cancer?

A 
Excision preferred (Loop electrical excision, LEEP)
-Abalation
49
Q

> 30 years old and HPV negative, how often should a Pap be done?

A

Every 5 years

PANCE/EOC (63 decks)

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