other Flashcards
normal postvoid residual volume
less than 150 in women
less than 50 in men
RF for pseudocyesis
- history of infertility
2. prior pregnancy loss
violent muscle contraction during seizure can lead to
posterior dislocation of the shoulder
abdominal pain in chiladbearing age woman - next step
pregnancy test –> if (+) –>. US
if (-) –> consider CT
Pubic symphysis diastasis - RF
- fetal macrosomia
- multiparity
- precipitous labor
- operative vaginal delivery
Pubic symphysis diastasis - presentation
- difficulty ambulating
- radiating suprapubic pain
- Pubic symphysis tenderness
- intact neurologic examination
Pubic symphysis diastasis - management
- conservative
- NSAID
- Physical therapy
- pelvic support
Vesicovaginal fistula - RF
- pelvic surgery
- Pelvic irradiation
- Prolonged labor/childbirth trauma
- Genitourinary malignancy
Vesicovaginal fistula - clinical features
painless, continuous urine leakage from the vagina
Vesicovaginal fistula - diagnostic studies
physical exam
dye test
cystourethroscopy
vaginismus treatment
vaginal dilators
Pelvic organ prolapse - definitions
cystocele - bladder rectocele - rectum enterocele - small intestine procidentia apical prolapse - uterus, vaginal vault
Pelvic organ prolapse - RF
obesity
multiparity
hysterectomy
postmenopausal
Pelvic organ prolapse - Clinical presentation
Pelvic pressure obstructed voiding urinary retention urinary incontinence constipation fecal urgency, incontinence sexual dysfunction
Pelvic organ prolapse - management
weight loss pelvic floor exercise vaginal pessary surgical repair (complete herniation of the uterus requires mechanical correction: pessary, surgical repair)
MgSO4 in patients with renal failure
high risk of toxicity
genito-pelvic pain/penetration disorder - RF
- history of abuse
- lack of sexual knowledge
- sexual trauma
genito-pelvic pain/penetration disorder - clinical features
pain with vaginal penetration
distress/anxiety over symptoms
no other medical cause
genito-pelvic pain/penetration disorder - treatment
desensitization therapy
kegel exercise
anovulation of obesity
normal FSH and LH levels
ovaries are still producing estrogen but progesteron is not produced
definition of infertility
failure to archieve pregnancy after 12 months of unprotected intercourse for a couple in which the woman is age less than 35 or 6 months if she is 35 or older
last solution for urinary incontinence
pelvic floor surgery
1st test imaging to assess Fallopian tube patency
hysterosalpingogram
Fenale reproductive system - ligaments
- infundibulopelvic ligament (suspensory ligament of the ovary)
- Cardinal ligament
- Round ligament of uterus
- Broad ligament
- Ovarian ligament
- uterosacral
Fenale reproductive system - ligaments an what they connect
- infundibulopelvic (suspensory ligament of the ovary) –> ovaries to lateral pelvic
- Cardinal –> cervix to side wall of pelvis
- Round ligament of uterus –> uterine fundus to labia major
- Broad –> uterus, fallopianm tuves and ovaries to pelvic side wall
- Ovarian –> madian pole of ovary to lateral uterus
- uterosacral –> uterus to the anterior aspect of the sacrum
infundibulopelvic (suspensory ligament of the ovary) contains
ovarian vessels
cardinal ligament contains
uterine vessels
Round ligament of the uterus contains
nothing
Broad ligament contains
ovaries, fallopian tuves, round ligaments of uterus
ovarian ligament contains
nothing
5a reductase def (vs insensitivity)
phenytopically female at birth BUT develop virilization at puberty (eg. clitoromegaly + have no breast development)
ovarian cancer can present as an adnexal mass with pelvic pain and bloating to to abnormal proliferation of ….
ovarian or tubal epithelium or peritonueum
granuloma inguinale - pain?
no
endometriosis - heave menstrual bleeding?
NO
another cause, beside ovarian ca, that can elevate the levels of Ca-125
PID
endometriosis - when to to laparoscopy to confirm diagnosis
- contraindications to medical therapy
- need for definitive diagnosis
- history of infertility
- concern for malignancy or adxenal mass
- fail to treatment
diagnosis of granulosa cell tumor - next step?
endometrium biopsy
dopamine agonists for lactation suppression
NO - not approved
- wearr a supportive bra, aboid nipple stimulation + manipulation + use ice packs and analgeesics to releive pain
contraceptive method with weight loss
levonorgestrel intrauterine device
- also amenorrhea –> imroves anemia + abnormal uterine bleeding
aromatase def
virilization of female fetuses –> normal internal genitalia with ambigiguous external
HPV vaccine - age
all girls + women: 11-26
boys and men: 9-21 or 9-26 if sex with men
what age start PAP test in a woman who already is sexually active
21 (regardless of age of onset of sexual activity in immunocompetenet patients
manipulation of teratoma
avoided because of the risk of chemical peritonitis
OCP - benign breast disease
OCPs decrease the risk for benign breast disease
OCPs decreases the risk of …. cancer
ovarian + endometrial
diagnosis of vulvovaginal candidiasis - next step
hemoglobin A1c
aspiration of breast mass (clear fluid) in 20 years old - next step
follow up in 2 months
OCP - lipids
elevate TG
chlamydia or gonor in women - MC manifestation
asymptomatic
hypothalamic amenorhea - vasomotors?
NEVER
- if there are, look for something else
endometrial ablation?
surgical procedure that destroys the endometrium –> treatment for regular heahy bleeding in premenopausal women that can be perforemd only after a benign endometrial biopsy)
anovulation 2ry to obesity - FSH/LH levels
normal
Bipolar treatment in pregnancy
lamotrigine
renal colic in pregnant patients - test
U/S of kidneys and pelvis
- low dose CT urography maybe be consdered only in the 2nd and 3rd trimesters
