Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Absite > OBGYN > Flashcards

OBGYN Flashcards

1
Q

At what week can US detect pregnancy?

A

US can detect pregnancy at 6 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the B HCG level at which a gestational sac can be seen in transvaginal US?

A

Gestational sac seen in transvaginal US with B HCG > 1,500.

Fetal pole: B HCG 6,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classification of spontaneous abortions

A

Missed: 1st trimester bleeding, closed os, sac on ultrasound, no heartbeat
Threatened: 1st trimester bleeding, heartbeat
Incomplete: tissue protrudes through os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the leading diagnoses for a premenopausal female patient with pelvic pain?

A

1 ectopic pregnancy, #2 hemorrhagic ovarian cyst, #3 PID, #4 appendicitis, #5 adnexal torsion.

Mittelschmerz: rupture of Graafian follicle, pain that can be confused with appendicitis; 14 days after 1st day of menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the purpose of ovarian cystectomy?

A

Removes mass and preserves ovary; used for benign conditions or if diagnosis is uncertain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is salpingo-oophorectomy used?

A

Used for cancer or non-viable ovarian tissue after torsion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What indicates a strongly suspected ectopic pregnancy?

A

If no sac is seen and BHCG is > 3000.

MC site: ampullary portion of Fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment for stable ectopic pregnancy?

A

If stable, treat with MTX (methotrexate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the treatment for unstable ectopic pregnancy?

A

If unstable, go to OR; unruptured and stable - salpingotomy- evacuate hematoma, repair tube VS just methotrexate; ruptured or unstable - salpingectomy (remove fallopian tube)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the contraindications to MTX in ectopic pregnancy?

A

BHCG > 5,000.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should be done for a female presenting with pelvic pain?

A

Start with US with Doppler first; will see absent blood flow to ovary in Adnexal (ovarian) torsion.

Get a qualitative BHCG first, if positive (think ectopic pregnancy) then get quantitative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common cause of adnexal torsion?

A

MCC by a tumor in the ovary; presence of adnexal mass should raise suspicion of torsion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for a necrotic ovary due to torsion?

A

If necrotic, perform salpingo-oophorectomy.

Always check to see if ovary recovers try your best to preserve ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the risk factors for tubo-ovarian abscess?

A

Previous PID, IUD in place.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is a tubo-ovarian abscess diagnosed?

A

Cervical motion tenderness and adnexal mass on exam.

  • Get BHCG to rule out ectopic
  • US for Dx: if Abscess is > 6 cm  requires percutaneous drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for a tubo-ovarian abscess if stable and non-ruptured?

A

IR drainage if > 6 cm; doxycycline and ceftriaxone for antibiotics.

Only operate if ruptured or life threatening or failed drainage; just drain abscess, no drains, NO OOPHERECTOMY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common site for endometriosis?

A

MC site: ovaries.

Endometriosis – blue mass. Tx: OCP, danazol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common type of vaginal cancer?

A

MC type: squamous.
XRT used for most cancers of vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can Diethylstilbestrol (DES) cause?

A

Can cause clear cell carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment for Botryoides rhabdomyosarcoma in young girls?

A

Grape-like mass
Treatment: resect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for vulvar cancer?

A

-MC SCC. Goes to inguinal nodes
-Stage 1 (< 2 cm): WLE (2 cm margin) ipsilateral inguinal and femoral node dissection.
-Stage 2 (> 2 cm): Modified radical vulvectomy; remove bilateral labia major, minora, clitoris, with bilateral inguinal/femoral node dissection. Postop XRT if close margins (< 1 cm)
-Paget’s, VIN III or higher, carcinoma in situ - all premalignant; treatment: WLE (0.5-1 cm margins), laser ablation, or topical imiquimod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does OCP increase the risk of?

A

Increases risk of cancer of: breast, cervical.

23
Q

What does OCP decrease the risk of?

A

Decreases risk of cancer of: endometrial and ovarian.

24
Q

What is the second most common cause of gynecologic death?

A

Ovarian cancer; #1 is endometrial.

25
Q

What is the most common type of endometrial cancer?

A

MC type: endometrial adenocarcinoma.

26
Q

What is the diagnosis method for endometrial cancer?

A

Endometrial curettage or brush biopsy.

27
Q

What is the treatment for stage I endometrial cancer?

A

Stage I – endometrium
TAH and BSO.

28
Q

What is the treatment for stage II endometrial cancer?

A

Stage II - cervix
TAH and BSO, para-aortic and pelvic LN dissection, and post-op XRT.

29
Q

What is the treatment for stage III endometrial cancer?

A

Stage III – vagina, peritoneum and ovary
TAH and BSO, para-aortic and pelvic LN dissection, and post-op XRT.

30
Q

What is the treatment for stage IV endometrial cancer?

A

Stage IV – bladder and rectum
TAH and BSO, para-aortic and pelvic LN dissection, and post-op XRT.

31
Q

What is cervical cancer associated with?

A

Associated with HPV 16, 18.

HPV 6 and 11 = warts

32
Q

What is the most common type of cervical cancer?

A

Squamous cell is MC.
Goes to obturator nodes first

33
Q

What does a Pap smear look for?

A

Looks for intraepithelial neoplasia or dysplasia. if present: need Colposcopy biopsy

Colposcopy biopsy – does not biopsy entire cervix, only small part. Invasive cancer can’t be ruled in or out with this

34
Q

What is the treatment for CIN 1?

A

Cervical intraepithelial neoplasia 1 (CIN 1) = mild dysplasia
Repeat pap smear in 1 year.

35
Q

What is the treatment for CIN 2?

A

CIN 2 = moderate dysplasia
Need either cryoablation/laser ablation or excision for treatment.

36
Q

What is the treatment for CIN 3?

A

CIN 3 = high grade dysplasia
Need either cryoablation/laser ablation or excision for treatment.

if high grade CIN or more invasive found: need conization (inner lining of cervix removed) If no BM penetrated you are done

37
Q

What is the treatment for microscopic disease without basement membrane invasion?

A

Cone biopsy (inner lining of cervix removed).

38
Q

What is the treatment for stage I and IIa cervical cancer?

A

Stage 1: Cervix
Stage 2: upper 2/3 of vagina
TAH and pelvic LN dissection.

39
Q

What is the treatment for stage IIb or higher cervical cancer?

A

Stage 3: pelvis, side wall, lower 1/3 of vagina; hydronephrosis
Stage 4: bladder and rectum
IV chemo-XRT (Cisplatin and paclitaxel)

-If that fails need pelvic exenteration (TAH-BSO, take vagina, rectum, bladder)

40
Q

What is the treatment for incidental ovarian cyst/tumor found intra-op in premenopausal women?

A

If simple cyst, < 5 cm, do not touch this intra-op.

41
Q

What is the treatment for complex cyst or > 10 cm found intra-op in postmenopausal women?

A

Consider removal vs do nothing; perform laparoscopic oophorectomy -> path.

-If CA: LEAVE ALL further procedure (TAH BL oophorectomy) for GYN to deal with post op

42
Q

What is the treatment for PCOS?

A

Clomiphene.

43
Q

What is the treatment for uterine leiomyomas (fibroids)?

A

OCP.

44
Q

Ligaments

A

Round ligament: allows ante version of uterus
Broad ligament: contains uterine vessels
Infundibular ligament: contains ovarian artery, nerve, vein
Cardinal ligament: holds cervix and vagina

45
Q

Ovarian cancer

A

-MC found in post-menopausal women
-Decreased risk with: OCP and BL tubal ligation
-Increased risk with nulliparity, early menarche, late menopause
-Sx: abdominal or pelvic pain; change in stool or urinary habits; vaginal bleeding
-Diagnosis is often delayed. 60% found at stage III
-Dx: US and CA-125; diagnostic laparoscopy

46
Q

Types of Ovarian Cancer

A

-Choriocarcinoma (BHCG)
-Struma ovarii (thyroid tissue)
-Sertoli-Leydig cell (androgens, masculinization)
-Teratoma
-Granulosa-theca (produces estrogen, precocious puberty)
-Mucinous, serous, papillary
Worst prognosis: Clear cell type
Best prognosis: malignant germ cell tumor

47
Q

Ovarian Cancer Stages

A

Stage I: one or both ovaries/fallopian tubes.
Stage II: limited to pelvis.
Stage III throughout abdomen or positive nodes

48
Q

Ovarian Cancer Treatment

A

Stage IV distant mets.

Tx and staging for all stages:
- Total abdominal hysterectomy + BL Salpingo-oopherectomy
- Plus pelvic and para-aortic LN sampling, Omentectomy, 4 quadrant wash out
- Debulking of any tumor left (cytoreductive surgery)
- Followed by chemo; cisplatin and paclitaxel, IV and intraperitoneal
- Cytoreduction (debulking) is affective here

49
Q

Krukenberg tumor

A

Stomach CA that has metastasized to ovary; signet ring cells

50
Q

Meige’s syndrome

A

Pelvic ovarian fibroma that causes ascites and hydrothorax (MC on Right)
Excision of tumor cures syndrome

51
Q

Endometrial cancer

A

MC gynecologic CA
Risk factors: nulliparity, late 1st pregnancy, obesity, tamoxifen, unopposed estrogen

Vaginal bleeding in postmenopausal patient is endometrial cancer until proved otherwise

Uterine polyp has low chance of CA

Abdominal approach with surgery (not trans-vaginal)

52
Q

Vaginal, cervical, endometrial, testicular/ovarian CA nodes

A

Vaginal CA, and cervical CA goes to internal iliac (obturator) nodes first
Endometrial and testicular/ovarian CA - para-aortic nodes

53
Q

Post menopausal ovarian cyst

A

*Postmenopausal: Much lower threshold to remove ovary if post menopausal

If complex cyst: septated, has increased vascular flow on Doppler, solid component, or has papillary projection: laparoscopic oophorectomy with intra-op frozen section

if ovarian CA: convert to open TAH with contralateral oophorectomy

If simple cyst: follow with US

54
Q

Premenopausal ovarian cyst

A

If thought to be benign but causing symptoms just remove cyst and NOT ovary  cystectomy

If thought to be malignant  laparoscopic oophorectomy with intra-op frozen

Absite (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions