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GYN > OME > Flashcards

OME Flashcards

1
Q

PRL excess can cause what?

Which leads to what?

A

GnRH deficiency

Amenorrhea post-partum

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2
Q

What drugs are the tx for Stage 4 endometrial cancer w/distant metastasis?

A

Paclitaxel
Doxorubicin
Cisplatin

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3
Q

Pt that is over 30 years old should get paps when? What else?

What age do you stop screening for cervical cancer? What other conditions must be met?

A

Pap and HPV q5 years ages 30-65

65, previous screens were (-), no HPV

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4
Q

What clinical signs would show a ruptured ectopic pregnancy?

Treatment?

A

ABD pain and free fluid in the peritoneum

EX-LAP w/Salpingectomy

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5
Q

What is a + Wrist X-ray?

A

Bone age is greater than 2 years of her chronological age

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6
Q

No passage of contents, closed cervical os, live baby, bleeding present is what?

A

Threatened abortion

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7
Q

A Simple cyst found on imaging measuring 3-10 cm, what is the management?

A

Reimage w/in 12 weeks

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8
Q

What are the sx of hyperemesis gravidarum?

Diagnose how?

A

Severe N/V and dehydration, electrolyte abnormalities

B-HCG levels > 100,000

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9
Q

What is the workup in evaluating precocious puberty?

A

Wrist X-ray
GnRH stim test
If LH elevated, do MRI brain
If not, US of ABD

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10
Q

What’s the 1st step in the workup of secondary amenorrhea? (Exclude UPT, TSH, PRL, Meds)

2nd?

3rd?

4th and 5th?

A

Progestin challenge

Give estrogen and progesterone

FSH and LH ratio

US and MRI

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11
Q

No passage of contents, open cervical os, dead baby is what?

A

Inevitable abortion

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12
Q

How do you diagnose a cystocele?

A

Cervical exam w/Q-tip sign

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13
Q

What is the path behind Kallman syndrome?

A

No hypothalamus so FSH and LH are low

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14
Q

Application of acetic acid on the vulva turns the area what when what is present?

Pathognomonic for what?

Tx?

A

Condylomata acuminatum

HPV

Imiquimod, podophyllin, trichloracetic acid or EXCISE if large

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15
Q

What is a marker of primordial follicles?

What will happen to it over a woman’s life?

A

AMH

Decrease

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16
Q

OAB is what?

What medication is used?

A

Motor urge (hypertonic)

Flomax

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17
Q

Complete mole is caused by what?

Fetal parts present?

A

Bad egg w/no nucleus
Dispermy (all dad’s chromosomes) 46XX

NO

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18
Q

LDH is a tumor marker for what?

A

Dysgerinoma

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19
Q

What diseases present w/NO breast development but there IS a present uterus?

A

Craniopharyngioma
Kallman’s
Turner’s

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20
Q

Passage of contents, closed OS, No baby is what?

A

Complete abortion

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21
Q

What is the treatment for endometrial cancer w/no distant metastasis?

Stage 2?

A

TAH + BSO

“ “ + radiation

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22
Q

What is the treatment for ectopic w/OUT rupture?

With?

A

Salpingostomy

Salpingectomy

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23
Q

What are the germ cell tumors?

A

Dysgerminoma
Endodermal sinus
Choriocarcinoma
Teratoma

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24
Q

PCOS is Dx w/2 of what 3 Rotterdam criteria?

A

Oligo and/or Anovulation
Inc DHEAS, Test or LH:FSH > 3:1
poly cystic ovaries via UA

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25
Q

BRCA+ women have increased risk of what?

When should they be screen?

What is recommended?

A

Ovarian, breast, endometrial

Q6 mo ovarian w/TV US and CA-125

Prophlyactic TAH+BSO age 35, b/l mastectomy at ANY age

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26
Q

PCOS pts are at increased risk of developing what?

A

Endometrial cancer due to anovulation (no progesterone)

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27
Q

What defines hostile mucus?

Treatment?

A

Less than 6cm on smush test

Estrogen

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28
Q

If a Pap smear shows ASCUS, what is the management?

A

Repeat pap q3mo
OR
HPV DNA

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29
Q

When should a girl have menarche by?

Secondary sex characteristics?

A

15

13

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30
Q

When is MAC used in choriocarcinoma?

What does it stand for?

A

Refractory disease, Brain metastasis (look for abnormal MRI)

Methotrexate, Actinomycin D, Cyclophosphamide

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31
Q

What is the most basic form of advanced fertilization?

Middle?

Most?

A

IUI - hyper[ ] sperm inside mom

IVF - make zygote w/natural coming together, then implant in mom

ISCI - force the sperm into the egg after inducing ovulation, then put it back inside

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32
Q

What is the tx for candida infection?

A

TOPICAL fluconazole

If it fails go oral

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33
Q

Endodermal sinus tumor has what tumor cell marker?

A

AFP

Also called yolk sac tumor

34
Q

Passage of contents, open OS, retained parts is what?

A

Incomplete abortion

35
Q

What are the epithelial cell tumors?

A

Serous cystadenocarcinoma
Mucinous Cystadenocarcinoma
Endometroid Cystadenocarcinoma
Brennan Tumor

36
Q

What are the MC causes of fistulas?

Dx how?

Tx?

A

Crohn’s or radiation

Tampon test

Surgery - LIFT procedure (fistulotomy)

37
Q

Which cancers have the highest mortality in women?

Incidence?

A

Ovarian > Endometrial > Cervical

Endometrial > Cervical > Ovarian

38
Q

When should serum progesterone levels rise (daY)?

What medicine can be used to stim ovulation?

A

Day 22

Clomiphene or pergonal

39
Q

GnRH stimulation test that results in increased LH means what?

If negative then do what?

A

Central lesion

US of the ABD

40
Q

What are steps in order to manage PPH?

A 
Uterine massage
Oxytocin, methergine
Balloon tamponade
Ligation of uterine, internal iliac a.
TAH
41
Q

Endometriosis treatment 1st step?
Next?
Then what?

A

NSAID
OCPs
Leuprolide

42
Q

What is the Path behind Craniopharyngioma?

A

No ant. Pituitary so LH and FSH are very low

43
Q

Treatment for mild CAH?

Adrenal failure?

A

Prednisone (turns off ACTH)

Prednisone AND Fludrocortisone

44
Q

The suspensory ligament of the ovary contains what structures?

A

Ovarian vein and artery

45
Q

What are the inpatient regimens to treat PID?

A

Cefoxitin + Doxy
OR
Clinda + Genta

46
Q

How do you remove teratomas?

What can they cause? How?

also called what?

A

Ovarian cystectomy

Ovarian torsion bc they big

Rokitansky nodule

47
Q

What causes Savage syndrome?

What is the other name?

Treat how?

A

Menopause caused by an FSH-R insensitivity (FSH and LH will be elevated)

Resistant ovary syndrome

HRT for pregnancy, but nothing really

48
Q

AIS: is there:
Breasts?
Uterus?

Diagnose how?
Genotype?

A

Yes breast
No uterus

INC testosterone
XY

49
Q

What is the methergine?

MOA?

When is it contraindicated?

A

Smooth m. Constrictor that acts primarily on the uterus

5-HT2A receptors

pt w/HTN and Pre-E

50
Q

No passage of contents, closed OS, dead baby is what?

What must be done?

A

Missed abortion

Induce delivery

51
Q

What is the MC type of fibroid?

A

Submucosal

52
Q

what makes testosterone in a female?

DHEA?

A

Ovaries

Adrenals

53
Q

Pt w/delayed puberty, + Bone age but normal FSH and LH ratio is what?

A

Hypogonadotropic hypogonadism

54
Q

What are the stromal tumors?

A

Sertoli-Leydig

Granulosa-Theca

55
Q

What is the progression of the endometrium to cancer?

A

Atypia —> Complex atypia —> Dysplasia —> adenocarcinoma

56
Q

Cervical cancer that has spread to the sidewall is what stage?

Lower 1/3 of the vagina?

A

IIIb

IIIa

57
Q

When can women receive the HPV vaccine?

A

9-26

58
Q

In terms of hormones, what does anovulation mean?

A

There was no switch to progesterone at 14 days

59
Q

Free fluid in the abdomen w/good blood flow indicates what?

A

Ovarian cyst rupture

60
Q

What are the stages of puberty and their corresponding ages?

A

8 - breasts
9 - arm PIT hair
10 - growth spurt
11 - menarche

61
Q

When do you perform colonoscopy?

Pap smear?

A

Age 50 q10 yr

Age 21 q3 yr

62
Q

Delayed puberty w/+ bone age and INC FSH and LH is most likely what?

A

Hypergonadotropic hypogonadism

Aka the ovaries do not listen

63
Q

PID is diagnosed by what 3 clinical signs?

A

Cervical motion tenderness (chandelier sign)
uterine tenderness
Adnexal tenderness

1 of 3 required

64
Q

Management if woman having life-threatening bleeding?

How to turn off uterine bleeding?

A

2 large bore IVs
IVF
Type and cross
Transfuse PRL

IV Estrogen

65
Q

Reproductive age woman with vaginal bleeding most likely due to what?

A

PAD
Pregnancy
Anovulation
DUB

66
Q

A woman that has secondary amenorrhea and has a PMHx of 5 elective abortions most likely has what?

A

Asherman syndrome

67
Q

What is the Path behind overflow/hypotonic bladder?

What does this mean?

What happens to the bladder?

A

Lesions of spine or nerves (trauma, diabetic neuropathy, MS)

Cannot sense urge to void

Massively distended

68
Q

What what volume in the bladder is there a sense to void?

When does it hurt?

A

250 cc

500 cc

69
Q

What are the output regimens to treat PID?

A

Centriaxone IM + Doxy + Metro
OR
Cefoxitin + Probenecid + Doxy + Metro

70
Q

Abnormal cells on ectocervix indicates what?

Endocervix?

A

LEEP or Cryo

Cone biopsy

71
Q

When diagnosing Lichen sclerosis what else must you r/o? Via what?

Tx for lichen sclerosis?

A

SCC w/punch biopsy

Topical corticosteroids

72
Q

What is the Path behind motor urge (hypertonic) incontinence?

Cystometry shows what?

Tx?

A

Random detrusor contractions

Contractions at ALL volumes

Oxybutynin or propantheline (antispasmodics)

73
Q

When does osteoporosis screening begin for women? W/what?

A

Age 65 w/DEXA

74
Q

What must happen to be considered virilized?

A

Clitoral enlargement
Deepen voice
Amenorrhea

75
Q

Pt w/neurogenic (hypotonic) bladder feels what?

Cystometry shows what?

Tx?

A

Involuntary loss of urine, bladder never empties

ABSENT detrusor contractions, always full bladder

Bethanechol, self-CATH

76
Q

When do you screen w/mammograms?

A

Age 40 q1 year

77
Q

Pt with irritative bladder w/hematuria that has a smoking history most likely indicates what?

1st step in workup?

A

Bladder cancer

Cystoscopy

78
Q

Woman that has amenorrhea w/irregular cycles but bleeds when given progestin most likely has what?

A

PCOS

79
Q

What presents as a black, itchy lesion on the vulva?

Treat how?

A

SCC or Melanoma

Vulvectomy and LN dissection

80
Q

What is the shock index?

W/acute ABD what is the next step?

A

HR > Systolic BP

Ex-Lap

81
Q

Galactorrhea and amenorrhea is suspicious for what?

Treat how?

A

Prolactin o a

Pramixpaxole or Ropinerole

GYN (1 decks)

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