Pedia Gynecology, Precocious Puberty Flashcards

1
Q

Most common position for gynecologic exam

A

Frog leg

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2
Q

Position for gynecologic exam of older children Also used for children with foreign body or discharge

A

Knee chest

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3
Q

Most common shape of hymen

A

Crescent

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4
Q

Most common gynecologic problem in prepubertal females

A

Vulvovaginitis

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5
Q

Most common cause of vulvovaginitis

A

Poor perineal hygiene

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6
Q

Pathognomonic sign of labial adhesion

A

Midline vertical line

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7
Q

Treatment for labial adhesion

A

Topical estrogen cream

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8
Q

Most common symptom of urethral prolapse

A

Prepubertal bleeding

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9
Q

Treatment for urethral prolapse

A

Topical estrogen cream

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10
Q

Thinning of vulvar epithelium with loss of rete pegs common in prepubertal and postmenopausal women

A

Lichen sclerosus

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11
Q

Treatment for lichen sclerosus

A

Avoid trauma or irritants Topical steroids Sitz bath

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12
Q

Majority of foreign body cases are within the ages of

A

3 and 9 years old

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13
Q

Classic symptom of foreign body in the vagina

A

Foul smelling bloody discharge

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14
Q

Treatment for vulvar lacerations

A

Bed rest for 24 hours Ice pack Analgesics

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15
Q

Treatment for vulvar hematoma if less than 4cm non expanding

A

Bed rest Compress Analgesic

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16
Q

Treatment for vulvar hematoma if more than 4cm and expanding

A

Evacuate clot

17
Q

High index of suspicion for sexual abuse if the child presents with

A

Posterior fourchette injury Hymenal laceration Transections from 3 and 9 o clock position

18
Q

Most common type of ovarian cysts

A

Functional cysts

19
Q

Surgical intervention done if the patient has torsion of the ovarian cyst to preserve fertility

A

Cystectomy

20
Q

Most common benign ovarian tumor

A

Teratoma

21
Q

Most common malignant germ cell tumor of the ovary

A

dysgerminoma, endodermal sinus tumor & immature teratoma

22
Q

Goal of treatment in precocious puberty

A

Induce pseudomenopause

23
Q

LH levels of ____ is diagnostic of precocious puberty

A

LH >5 mIU/ml

24
Q

Most common cause of precocious puberty

A

Idiopathic

25
Q

Most common ovarian tumor that can cause precocious puberty

A

Granulosa cell tumor

26
Q

This syndrome causes precocious puberty due to mutation in G3 protein activating adenylate cyclase that leads to constant secretion of FSH, LH, TSH and GH

A

McCune Albright syndrome

27
Q

First symptom of McCune Albright syndrome

A

Vaginal bleeding

28
Q

Triad of McCune Albright

A

3 Ps- pigment, polyostotic, pockets Cafe au lait spots Polyostotic fibrous dysplasia Cysts of skull and long bones

29
Q

This test differentiates incomplete from true precocious puberty

A

GnRH agonist stimulation test

30
Q

Indications for medical treatment of precocious puberty is when menarche happens before _____ or bone age is more than _____ of chronological age

A

Menarche <8 years old Bone age >2 years of chronological age

31
Q

GnRH dependent drug of choice in precocious puberty

A

Leuprolide

32
Q

Excessive terminal hair growth is dependent on what hormones

A

Androgens

33
Q

In females, testosterone is secreted by what organ?

A

Ovaries

34
Q

In females, adrenal gland secretes this hormone

A

DHEAS

35
Q

This disease occurs when you have bilaterally enlarged ovaries (5-7cm) with gradual onset Theca cells produce testosterone and virilization happens around 4th decade of life

A

Stromal hyperthecosis

36
Q

Drug of choice for hirsutism

A

Spironolactone