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Clin Med- Repro > PEARLS book > Flashcards

PEARLS book Flashcards

1
Q

if the egg is not fertilized, the corpus lutetium soon _______, causing a FALL OF ESTROGEN AND PROGESTERONE LEVELS

A

deteriorates!

endometrium is no longer maintained and sloughs off, “menstruation”

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2
Q

What predominates during the follicular phase?

A

estrogen!

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3
Q

GnRH from the hypothalamus causes an increased in FSH and LH from the pituitary gland, which…..

A

stimulates the ovaries

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4
Q

____ causes follicle and egg maturation in the ovary

A

FSH

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5
Q

____ stimulates maturing follicle estrogen production

A

LH

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6
Q

_____ builds up the endometrium (“proliferation”)

A

estrogen

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7
Q

What predominates during the luteal (secretory) phase?

A

Progesterone

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8
Q

abnormal frequency/intensity of menses due to nonorganic causes

A

dysfunctional (abnormal) uterine bleeding

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9
Q

cryptomenorrhea

A

light flow or spotting

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10
Q

Menorrhagia

A

heavy or prolonged bleeding at normal menstrual intervals

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11
Q

Metorrhagia

A

bleeding between menstrual cycles

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12
Q

Menometrorrhagia

A

irregular intervals with varying degrees of bleeding

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13
Q

Management for anovulation (due to unopposed estrogen)

A

OCPs
Progesterone
GnRH agonists

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14
Q

cluster of physical, behavioral, mood changes with cyclical occurrence during luteal phase menstrual cycle (7-14 days before onset of menses)

A

PMS

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15
Q

benign uterus smooth muscle tumor
*growth related to estrogen production (regresses with menopause)

most common in african americans

A

Leiomyoma (uterine fibroids)

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16
Q

Most commonly presents with bleeding and menorrhagia! can present with abdominal pressure also

*exam shows lg, irregular hard palpable mass in abdomen or pelvis during bimanual exam

A

Leiomyoma (uterine fibroids)

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17
Q

How is diagnosis of leiomyoma (uterine fibroids) made?

A

ultrasound

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18
Q

Most leiomyoma (uterine fibroid) cases are managed through…

A

observation!

sometimes inhibition of estrogen

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19
Q

presence of normal endometrial tissue outside the endometrial (uterine) cavity

*ectopic endometrial tissue responds to cyclical hormonal changes!

A

endometriosis

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20
Q

MC site of ectopic endometrial tissue?

A

Ovaries

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21
Q

Risk factors:
nulliparity
family hx
early menarche

onset usually under 35!!**

A

Endometriosis

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22
Q

Classic triad=

  1. cyclic premenstrual pelvic pain (or low back pain)
  2. Dysmenorrhea
  3. Dyspareunia
also dyschezia (painful defecation)
**most common cause of infertility!!**
A

Endometriosis

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23
Q

How is endometriosis definitively diagnosed?

A

Laparoscopy biopsy

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24
Q

Endometriosis involving the ovaries large enough to be considered a tumor, usually filed with old blood appearing chocolate colored (chocolate cysts**)

A

Endometrioma

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25
Q

Conservative tx of endometriosis

A

ovulation suppression:
OCPs + NSAIDs
Progesterone tx

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26
Q

Surgical tx of endometriosis

A

Laparoscopy with ablation (if fertility desired)

TAH-BSO with salpingoophorectomy (if no desire to conceive)

27
Q

MC GYN malignancy in US
mostly post menopausal!!!*
Estrogen dependent cancer

A

endometrial cancer

28
Q 
Risk factors=
Increased estrogen exposure
Nulliparity
Chronic anovulation
Obesity
Estrogen replacement therapy
Tamoxifen
HTN
DM
A

Endometrial cancer

29
Q

Clinical manifestations: abnormal bleeding..post menopausal bleeding*, menorrhagia

A

Endometrial cancer

30
Q

Diagnosis made through endometrial biopsy
(esp if endometrial stripe is greater than 4 mm!)

**majority=adenocarcinoma

A

Endometrial cancer

31
Q

Management for stage I endometrial cancer

A

TAH-BSO +/- post op radiation

stage II would be TAH-BSO with lymph node excision and post op radiation

32
Q

Gravida
Para
Abortus

A 
Gravida= # times pregnant
Para= # of births, including viable or nonviable births (still births)
Abortus= # of pregnancies lost
33
Q

Cessation of menses longer than 1 year due to loss of ovarian function

*FSH assay most sensitive initial test

A

Menopause

34
Q

Estrogen deficiency changes: menstrual cycle alterations, vasomotor instability (i.e. hot flashes), mood changes, skin/hair/nail changes, CV events, hyperlipidemia, osteoporosis, dyspareunia

*atrophic vaginitis: thin yellow discharge with pH greater than 5.5, pruritus

A

Menopause clinical manifestations

35
Q

Cystic enlargement of ovarian structures (mature follicle that fails to rupture)

*unilateral RLQ or LLQ pain

dx made with ultrasound

A

Ovarian cysts

36
Q

Highest mortality rate of GYN cancers

*risk factors:
family hx, increased number of ovulatory cycles (infertility, nulliparity, under 50, BRCA genes)

A

Ovarian cancer

37
Q

Rarely symptomatic until late stages of dz.

DOES PRESENT WITH ASCITES**

A

Ovarian cancer

38
Q
  1. amenorrhea
  2. obestity
  3. hirsutism

*due to insulin resistance

A

PCOS

39
Q

DES (a synthetic estrogen) can increase risk of…

A

Cervical carcinoma and vaginal cancer

40
Q

HPV 16, 18, 31, 33

A

Related to cervical carcinoma

41
Q

HPV 16, 18, 31

MC presentation= vaginal pruritus, post coital bleeding

Dx= red/white ulcerative, crusted lesions. bx!

A

Vaginal cancer

42
Q

Ascending infection of the upper reproductive tract

MC cause= gonorrhea, chlamydia

A

PID

43
Q

Pelvic/lower abdominal pain, dysuria, dyspareunia, vaginal discharge, N/V

Lower abdominal tenderness, fever. Chandelier sign

A

PID

44
Q

All 3:

  1. abdominal tenderness
  2. adnexal tenderness
  3. cervical motion tenderness
A

PID

45
Q

Dx made with pelvic ultrasound

**tx underlying cause!

A

PID

46
Q

Duct obstruction leading to retained secretions and gland enlargement

*may be infectious or caused by trauma

A

Bartholin cyst

47
Q

If infected…tender, unilateral vulvar mass, edema/inflammation

if noninfected…non tender, unilateral mass

A

Bartholin cyst

usually will just self resolve

48
Q

Classic triad:

  1. unilateral/pelvic abdominal pain
  2. vaginal bleeding
  3. amenorrhea
A

Ectopic pregnancy

49
Q

Serial beta-HCG fails to double
(normal pregnancy should double every 24-48 H)

*dx made with transvaginal ultrasound

A

ectopic pregnancy

50
Q

Absence of gestational sac with levels of beta-HCG greater than 2000 strongly suggests…

A

ectopic or nonviable intrauterine pregnancy

51
Q

Which drug can be give in a stable ectopic pregnancy to destroy trophoblastic tissue

A

Methotrexate

52
Q

Management of choice if an ectopic pregnancy has ruptured?

A

Laparoscopic salpingostomy

53
Q

Severe abdominal bleeding, dizziness, N/V, syncope, signs of shock

A

Signs of ruptured ectopic pregnancy

54
Q

Abnormal labor progression..3 categories

  1. power=uterine contraxns
  2. Passenger= size or position of baby
  3. Passage=uterus or soft tissue abnormalities
A

Dystocia

55
Q

Nonmanipulative= first line. McRoberts maneuver (increase pelvic opening with hyper flexion of hips)

A

Used first line for SHOULDER DYSTOCIA

56
Q

Manipulative= second line. woods “corkscrew” maneuver..180 should rotation; C section

A

Used second line for SHOULDER DYSTOCIA

57
Q

Increasing pelvic opening with hyper flexion of hips..maneuver used for shoulder dystocia

A

McRoberts maneuver

58
Q

Chlamydia trachomatis

*MC cause cervicitis

A

Chlamydia

59
Q

May be asymptomatic
Mucopurulent cervicitis
Increased freq, dysuria
Abdominal pain, PID, post coital bleeding

LGV; PAINLESS genital ulcer

A

Chlamydia

60
Q

Dx with LCR***, cultures, DNA probe

A

Chlamydia

61
Q

Neisseria gonorrheae

May be asymptomatic
Vaginal discharge, cervicitis, increased frequency, dysuria

Dx= culture, DNA

A

gonorrhea

62
Q

Haemophilus ducreyi

A

Chancroid

63
Q

Trepomena pallidum

A

Syphillis

64
Q

Flat, papular pedunculate or flesh colored growths…“cauliflower like” lesions

A

HPV

Clin Med- Repro (11 decks)

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