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Family Medicine EOR > OBGYN > Flashcards

OBGYN Flashcards

1
Q

CIN types

A

CIN 1: mild, lower 1/3
CIN 2: moderate, lower 2/3
CIN 3: severe, over 2/3

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2
Q

Gardasil vaccine

A

Recommended at age 11-12 (from Hannah’s quizlet)

Age 9-14: 2-dose - 0 months and 6-12 months OR 3-dose - 0, 2, 6 months
Age 15-45: 3-dose (0, 2, 6 months)
(from Epperly’s slides)

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3
Q

Cervical cancer screening

A

Start at age 21
Pap every 3 years until 30
Pap & HPV every 5 years from 30-65 OR pap only every 3 years

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4
Q

When to stop screening for cervical cancer?

A

65+
No hx of moderate or severe dysplasia
3 negative paps in a row

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5
Q

Pap smear results

A

ASCUS (undetermined significance)
ASCH (cannot exclude high-grade lesion)
LGSIL (low-grade squamous intraepithelial, corresponds to CIN 1)
HGSIL (high-grade squamous intraepithelial, corresponds to CIN 2/3)
AGC (atypical glandular cells)

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6
Q

Treatment of ASCUS

A

Repeat paps every 6 months until normal

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7
Q

Next step for LGSIL and HGSIL

A

Colposcopy and biopsy

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8
Q

Treatment of CIN 1

A

Expectant management
2 paps every 6 months or pap & HPV test every 6 months

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9
Q

Treatment of CIN 2 or 3

A

Surgical procedure

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10
Q

HPV strains most correlated with cervical cancer

A

16, 18, 45

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11
Q

S/S of cervical cancer

A

Abnormal vaginal bleeding
*Postcoital bleeding

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12
Q

Treatment of cervical cancer

A

Radical hysterectomy and lymphadenectomy

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13
Q

Most common gyn malignancy

A

Endometrial cancer

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14
Q

Risk factors for endometrial cancer

A

Unopposed estrogen
Obesity

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15
Q

Risk reduction for endometrial cancer

A

Combo OCP use
Smoking

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16
Q

S/S of endometrial cancer

A

Abnormal uterine bleeding

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17
Q

MCC of endometrial cancer

A

Adenocarcinoma

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18
Q

Diagnosis of endometrial cancer

A

US first
Biopsy

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19
Q

Treatment of endometrial cancer

A

Total hysterectomy with bilateral salpingo-oopherectomy

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20
Q

Lactational amenorrhea

A

Exclusive breastfeeding leading to amenorrhea and contraception

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21
Q

MOA of OCP

A

Ovulation suppression

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22
Q

Benefits of combination OCP use

A

Reduced endometrial and ovarian cancer
Increase bone mass
Acne improvements
Dysmenorrhea improvement

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23
Q

SE of combo OCP use

A

VTE
Cervical dysplasia
Breast cancer

24
Q

CI of combo OCP use

A

Migraines with aura
Smokers over 35
Hx of VTE
Hx of breast cancer

25
Q

CI for progestin only OCP use

A

breast cancer

26
Q

Paragard characteristics (Copper IUD)

A

Every 10 years
Non-hormonal

27
Q

Nexplanon characteristics (implant)

A

Every 3 years
Progesterone only

28
Q

Depo characteristics (injection)

A

Every 3 months
Progesterone only

29
Q

IUD characteristics

A

Progesterone only

30
Q

Cystocele

A

Protrusion of the bladder into anterior vagina

31
Q

S/S of pelvic organ prolapse

A

Fullness and pressure (“falling out” sensation)
Pelvic pain
Urinary incontinence
Straining

worse with prolonged standing
better with lying down.

32
Q

Uterine prolapse

A

Descent of uterus into the vagina

33
Q

grading for uterine prolapse

A

grade 0: no descent
grade 1: descent into upper 2/3 of vagina
grade 2: cervix approaches introitus
grade 3: cervix outside introitus
grade 4: uterus outside vagina

34
Q

Rectocele

A

Protrusion of rectum into posterior vagina

35
Q

Enterocele

A

pouch of douglas small bowel herniating into upper vagina.

36
Q

Treatment of pelvic organ prolapse

A

Pessary
Kegels
Surgical treatment (hysterectomy)
Estrogen for vaginal atrophy

37
Q

Dysmenorrhea

A

Painful menstruation

38
Q

Etiology of dysmenorrhea

A
  • primary = increased prostaglandins
  • secondary = pelvis/uterus pathology (endometriosis, PID, ect. )
39
Q

Treatment of dysmenorrhea

A

NSAIDs
Hormonal contraceptives

if unresponsive to 3 cycles of initial therapy, consider laparoscopy.

40
Q

When does PMS/PMDD tend to occur

A

1-2 weeks prior to menses lasting until 2nd/3rd day of menses

41
Q

S/S of PMS and PMDD

A

HA
Fatigue
Breast tenderness
Bloating
Abdominal pain
Mood swings
Irritability

42
Q

PMS vs PMDD

A

PMS: cluster of physical, behavioral and mood changes with cyclical occurrence during the luteal phase of menses
PMDD: Severe PMS presenting with clear functional impairment and predominant psych symptoms

43
Q

Treatment of PMS/PMDD

A

Mild: behavioral modifications and symptomatic tx
Severe: SSRIs and OCPs

44
Q

Menorrhagia

A

Heavy bleeding

45
Q

Hypomenorrhea

A

Light bleeding

46
Q

Metrorrhagia

A

Bleeding between normal menses

47
Q

Polymenorrhea

A

Menses occurring too frequently

48
Q

Menometrorrhagia

A

Bleeding with irregular intervals and amount

49
Q

Oligomenorrhea

A

Menses occurring too infrequently

50
Q

What is a common underlying cause of dysfunctional uterine bleedig

A
  • anovulation: ovaries producing estrogen but not ovulation (corpus luteum)
  • unopposed estrogen leads to endometrial growth and shedding.
51
Q

what physical exam findings may be present in dysfunctional uterine bleeding

A
  • abnormal bleeding with normal exam
  • mass or enlarged irregular uterus (leiomyoma)
  • symmetrically enlarged uterus (adenomysosis or endometrial cancer)
52
Q

Evaluation of dysfunctional uterine bleeding (DUB)

A

Pelvic US
Endometrial biopsy
Hysteroscopy

53
Q

when is endometrial biopsy warranted in dysfunctional uterine bleeding

A

to rule out cancer in all women >35 with obesity, HTN, or DM with postmenopausal bleeding.

54
Q

Treatment of DUB 2/2 acute hemorrage

A
  • IV estrogen (premarin)
  • observation and COC’s
  • refractory = IUD
  • definitive = hysterectomy
55
Q

Treatment of postmenopausal DUB

A

Hormones
US
Hysteroscopy

Family Medicine EOR (11 decks)

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