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CK_Gyn > OME/Books 2 > Flashcards

OME/Books 2 Flashcards

1
Q

fat, hairy woman, male pattern distribution

A

hirsutism (moderate androgen elevation)

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2
Q

hirsutism + clitormegaly, deep voice, male muscle pattern

A

virilization (severe androgen elevation)

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3
Q

two types of androgens and where they are produced in woman

A

testosterone - ovaries (u/s)

DHEA-S - adrenal glands CT/MRI

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4
Q

hisurtism, moderately elevated testosterone, normal DHEA-S, bilteral ovaries finding on imaging

A

PCOS

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5
Q

2 ways to dx PCOS

A
  1. imaging (ovarian cysts on ultrasound

2. LH/FSH > 3:1

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6
Q

rx PCOS

A
  • exercise wt loss
  • metformin (also helps with ovulation)
  • OCPs/clomiphene if fertility wanted
  • anti-androgens like sprironolactone
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7
Q

virilization, very elevated testosterone, DHEAS normal, unilateral ovary

A

Sertoli leydig tumor of ovary

find tumor on u/s and resect (unilateral oophorectomy)

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8
Q

virilization, very elevated DHEAS, normal testosterone, unilateral adrenal

A

adrenal tumor

dx with adrenal vein sampling (confirm laterality) then cut out one of the adrenal glands)

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9
Q

elevated DHEAS, no change in testosterone, hirsutism, bilateral adrenal glands on CT/MRI, elevated 17 hydroxyprogesterone in urine

A

CAH

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10
Q

definitive test for CAH

A

17 oh progesterone in urine

accumulates in the absence of 21 beta hydroxylase (body is trrying to make more cortisol and aldosterone, so hypertrophies)

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11
Q

rx CAH (21 b hydroxylase)

A 
cortisol
fludrocorticosne (repletes aldosterone)
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12
Q

hirsut, normal everything

A

familial hirsutism

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13
Q

underlying pathophys menopause

A

ovarian failure (decreased estrogen, no fertilitY)

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14
Q

T:F menopause is protective against UTI

A

FALSE, menopausal women are more vulnerable to UTI

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15
Q

after how many missed cycles can you dx menopause

A

cessation of cycles for more than 12 consecutive cycles

CLINICAL DX

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16
Q

when you’re having early menopause symptoms what labs can you get?

A

elevated FSH!!!

FSH elevated in menopause

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17
Q

risk of systemic HRT for menopausal symptoms

A

increased risk breast cancer

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18
Q

rx hot flashes

A

SSRI (venlefaxine)

estrogen creams

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19
Q

what screenings should be given to postmenopausal womens

A

fasting lipids

bone scan at 65 (supplement with vit D and Ca), recommend exercise

20
Q

risk factors breast cancer (3)

A
  1. increased estrogen (early menarche, late menopause, HRT, obesity)
  2. radiation (hx of radiation for lymphoma then gets breast cancer)
  3. genetic (BRCA1/2)
21
Q

how to dx possible breast cancer

A

mammogram
core needle biopsy

(better than FNA, less invasive than exicisional)

22
Q

how to approach breast mass in patient <30

A
  1. wait a few cycles
  2. if it persists, do U/S
  3. if it shows mass (no fluid), do FNA
  4. if bloody do mammogram/biopsy
23
Q

how to locally treat breast cancer

A

stage with sentinel lymph node, if positive do axillary lymph dissection

radiation + surgery

note: breast conserving therapy = radical mastectomy

24
Q

systemic chemo for breast cacner

A

doxorubicin (watch out for CHF)
cyclophosphamide
paclitaxel

25
Q

her/neu positive breast cancer treatment

A

trastuzumab

26
Q

estrogen/progesterone positive breast cancer

A

youn g- selective estrogen receptor (i.e. tamoxifen), raloxifene) modifiers
old - aromatase inhibitors

27
Q

risks tamoxifen

A

increase risk DVT and endometrial cancer (estrogen blocker in breast, estrogen AGONIST in uterus)

28
Q

side effect of trastuzumab

A

REVERSIBLE CHF

unlike doxorubicin, which causes irreversible CHF

29
Q

adolescent female, asymptomatic 1 cm non tender mobile rubbery breast mass

A

fibroadenoma

30
Q

27 year old complains of breast pain which increases with menses; lumpy bumpy breast

A

fibrocystic changes

31
Q

34 eyar old woman complains of unilateral serosanguineous nipple discharge from breast, no mass

A

intraductal papilloma

must r/o malignancy

32
Q

rx fibrocystic changes

A

avoid caffeine
tight fitting bra
OCPs/progestin

33
Q

T/F evaluation breast cancer stops after negative mammogram

A

NO NEED A BIOPSY IF THERE’S A MASS

34
Q

inheritance of BRCA1

A

autosomal dominant

35
Q

MCC cause of digital clubbing (3)

A
  1. lung malignancy
  2. CF
  3. right to left cardiac shunts
36
Q

lower abdomoinal pain, intercycle spotting, fever, breathing wrose with inspiration, pleurtic chest pain

A

PID with perihepatitis (fitz hugh curtis0

37
Q

post op patient develops sudden onset hypotension, syncope, new RBBB, JVD

A

right heart strain + syncope in post op patient = massive PE

38
Q

longest acting non hormonal contraception and disadvantage?

A

copper IUD

but disadvantage is it may increase bleeding

39
Q

non IUD long acting reversible contraceptive

A

skin implants (explenon, implanon)

40
Q

good contraception option for person who doesn’t want that long of an effect but also has poor compliance

A

depo-provera (injection every 3 months)

41
Q

risk of hormonal contraception

A

increase risk of DVT/PE

42
Q

what three things together increase risk of DVT when on contraception

A
  1. estrogen
  2. smoking
  3. age>35
43
Q

which contraception protect against STI?

A

barrier methods

condom/diaphragm

44
Q

patient comes in with fever, severe infection, WBC count 45, LAP score high, neutrophil predominance (metamyelocytes>myelocytes)

A

leukomoid reaction

CML has elevated WBC count, but has low LAP and immature neutrophils (myelocytes>metamyelocyes

45
Q

levornogestrel requirement

A

use within 72 hours of intercourse

will not abort current pregnancy

CK_Gyn (4 decks)

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