PANCE reporductive Flashcards
what is the definition of dysfunctional uterine bleeding
this mean either bleeding too much or too little
How do you treat dysfunctional uterine bleeding
OCP’s
what is the definition of dysmenorrhea
painful menstration due to a pelvic pathology
what is the the definition of primary dysmenorrhea
Not due to a pelvic pathology
what is the definition of secondary dysmenorrhea
due to a pelvic pathology
what is the pain pattern of dysmenorrhea
diffuse pelvic pain around the time of menses
primary tx of dysmenorrhea
NSAIDs
secondary tx of dysmenorrhea
OCPs
premenstraul syndrome happens in what phase
luteal
premenstraul syndrome tx (2)
SSRI
OCP
what is the definition of primary and secondary amenorrhea
Primary: failure of menarche onset
secondary: absense of menses for > 3 months
what is the MC cause of amenorrhea
pregnancy
what are the 5 causes of amenorrhea
- Pregnancy
- Hypothalamus
- pituitary dysfunction
- ovardian disorders
- uterine disorder
what is the definition of menopause
cessation of menses for > 1 year
what is the average age for menopause
50-52
what is the best lab value for menapause
inc FSH
who can you give unapposed estrogen to
women who still have a uterus
what is a leimyoma or fibromyoma classified as
uterine fibroid
what is the growth of leimyoma dependent on
estrogen
MC age for Leimyoma
35
MORE COMMON ON BLACK X5
what are the MC symptom of uterine fibroid
bleeding
pelvic pain
leimyoma physical exam
large palpable mass in abdomen of pelvis
what are the 3 progressive tx for leimyoma
- Observation
- leuprolide
- hysterectomy
“islands of endometrial tissue within the myometrium
adenomyosis
“tender boggy uterus”
adenomyosis
endometritis risk factors
postpartum
postabortabl
C section
endometritis tx
Clindamyacin + gent
presence of endometrial tissue outside the endometrial cavity
endometriosis
endometriosis triad
- cyclic premenstrual pelvic pain
- dysmenorrhea (painful menstruation)
- dyspareunia
dx of endometriosis
laparoscopy
endometriosis tx
OCP
how do you dx endometriosis
biopsy
what is the MC gynecological malignancy in the US
endometrial
what is protective against endometrial cancer
- OCP
postmenapausal bleeding think what
endometrial cancer
functional ovarian cyst treatment
most resolve without treatment
what is the triad for PCOS
- amenorrhea
- obesity
- hirsutuism
PCOS is due to
insulin resistance
string of perls what dx
PCOS
what are the three tx for PCOS you would do all three
- OCP
- spronolactone
- insulin
what HPV causes cervical cancer
18 and 16
what type of cancer is cervical
squamous
what is the MC symptom of cervical cancer
post coital bleeding
what is the HPV vaccination done
11-26 years old
if < 15 2 doses 6 months apart 0,6
if > 15 3 doses within 6 months 0,2,6
what is the pap schedule
start age 21
end age 65
every 3 years
what is the MC presentation of vulvar cancer
itching
what is the medication ospemifene used for
vaginal dryness
what is the most common cause of mastitis
s, aureus
can mothers breastfeed with masitis and on meds
yes
if a breast mass increases and decreases with menstruation what is the cause
fibrocycstic changes
what is the #1 type of breast cancer
infiltrative ductal carcinoma
infiltrative ductal carcinoma mets where
axillary
is breast cancer painful
no
Painless, hard fixed, non mobile lump
MC quadrant for breast cancer
upper outer
what are the guidelines for breast cancer screenig
- average risk: 40-75 every 2 years
- start at 40 years old if increased risk factors
start 10 years prior than 1st degree relative dx
what is day one of menstruation
This is when bleeding starts
what should a female do her breast exam
day 5-7 (monthly)
ascending infection of the upper reproductive tract
PID
chandelier sign and cervical motion tenderness is associated with what pathology
PID
endometrial cancer tx
hysterectomy
what pathology
Grey white dischnage that smells like fish
Clue cells
bacterial vaginosis
how do you treat bacterial vaginosis
metronidazole
how do you treat trich
metronidazole
when is blood and urine hcG detected
- Blood: 5 days
- Urine: 14 days
at 20 weeks where should the fundal weight be
unbilicus
EDD nagules rule
1st day of last menstral period + days days - 3 months
when do you check nuchal luncency
12 weeks
downs test 2ns teimester
low afp
spina bifida test 2ns trimester
high afp
gestational dm screen
24-28 weeks
when do RH - mothers get rogam
28 weeks and
72 he prior to birth
● Dysfunctional uterine bleeding
3 causes
anovulatory cycles,
HPA problem,
cancer
● Endometrial cancer
tx
hysterectomy with bilateral salpingo-oophorectomy; chemo/radiation
● Dysfunctional uterine bleeding can be a cause of
cancer
falling-out” sensation
● Uterine prolapse
what size in ovarian cyst do you have to remove
> 8 cm
○ post-coital bleeding
may be a sign of what
Cervical carcinoma
what do you treat ● Cervicitis - Chlamydia
with if they are pregnant
erythromycin
● Cervicitis - Candidiasis
fluconazole
Trichomonas Tx
Metronidazole 2mg PO
CLUE CELLS
- Bacterial Vaginosis
- Bacterial Vaginosis TX
Metronidazole 2mg PO
● Incompetent cervix
WHAT WEEK
S/S: 14-20 weeks pregnant
prolapse of anterior vaginal wall with descent of bladder
● Cystocele
prolapse of posterior vaginal wall with descent of rectum
● rectocele
● Vagina/vulva neoplasm
cause / type
; SCC (MCC)
● Atrophic Vaginitis
tx
intravaginal estrogen
○ Cause: excess prostaglandin and leukotriene levels
● Primary dysmenorrhea
Primary dysmenorrhea is due to what
non pelvic pathology
Primary dysmenorrhea causes
NSDAIDs 2-3 days prior, mefenamic acid
● Premenstrual syndrome
tx (2)
pyridoxine (B6),
OCP
● Menopause
has an increase in what hormone
FSH
what breast pathology is painful
● Fibrocystic disease
● Galactorrhea
MCC
prolactinoma (MCC);
bromocriptine, cabergoline are tx for what
prolactinoma / ● Galactorrhea
cervical motion tenderness, purulent discharge, adnexal mass/tenderness
PID
most common Implanted contraceptive
medroxyprogesterone max use 2 years
how quickly do you need to use emergency contraceptive
72 hours
● Infertility
1st line
semen analysis
what is this medication used for clomiphene citrate
Infertility
when do you check BG in prego
24-28
what week prego do you check for group B strep
group B strep
what week is the fundal height at the umbilicis
20 weeks
