Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Primary Care > Repro > Flashcards

Repro Flashcards

1
Q

______ is defined as the abnormal presence of endometrial tissue w/in the myometrium (thick, muscular layer of the uterus).

A

Adenomyosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A _____, also known as a fibroid, is a benign smooth muscle tumor that very rapidly becomes cancer. They can occur in any organ, but most often occur in uterus, small bowel, and esophagus.

A

Leiomyoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Secondary causes of dysmenorrhea (or PAINFUL MENSTRUATION) include:

A
  • Endometriosis
  • Adenomyosis
  • Leiomyoma
  • Adhesions
  • PID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

____ is the MC secondary cause of dysmenorrhea in younger patients. ____ is more common with increasing age.

A

Endometriosis MC secondary cause

Adenomyosis w/ increasing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Some defining terms…

A
  • Amenorrhea: absence of menstrual period
  • Cryptomenorrhea: light flow or spotting
  • Menorrhagia: heavy or prolonged bleeding at normal menstrual intervals
  • Metorrhagia: irregular bleeding between expected menstrual cycles
  • Menometorrhagia: irregular, excessive bleeding between expected menstrual cycles
  • Oligomenorrhea: infrequent menstruation
  • Polymenorrhea: frequent cycle interval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is a diagnosis of Dysfunctional Uterine Bleeding (DUB) made?

A

DX OF EXCLUSION

W/u- hormone levels and transvaginal US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is DUB treated?

A
  1. Acute, Severe Bleeding- High-dose IV estrogens or high dose OCPs (D&C if estrogen fails)
  2. OCPs- 1st line! regulates cycles, thins endometrial lining, and reduces menstrual flow (DECREASES endometrial cancer risk by reducing unopposed estrogen)
  3. GnRH agonists- Leuprolide cases temporary amenorrhea (if given in continuous fashion)
  4. Progesterone- orally or IUD
  5. SURGERY- If not responsive to medical treatment:
    - Hysterectomy- definitive
    - Endometrial ablation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

_____ is a type of vaginitis defined by VAGINAL ODOR that is worse after sex and described as “fishy.”

There is copious, grey-white discharge.

Micro: CLUE cells

Treatment: Flagyl

A

Bacterial Vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

____ is a type of vaginitis that is sexually transmitted and is associated with pruritus, dysuria, and dyspareunia.

There is frothy, YELLOW-GREEN d/c and STRAWBERRY CERVIX.

Micro: Mobile protozoa

Treatment: Flagyl

A

Trichomoniasis

*TREAT PARTNER TOO

**Can have perinatal complications and increased risk of HIV transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

____ is a type of vaginitis that is seen in DM, steroids, pregnancy, and abx abuse.

Discharge: thick, curd-like/cottage cheese

Micro: HYPHAE, yeast, and spore

Treatment: Fluconazole or intravaginal antifungals

A

Candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_____ is a type of vaginitis that is an overgrowth of lactobacilli.

Discharge: non odorous

Treatment: D/C tampon use, Sitz bath or douche

A

Cytolytic Vaginitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_____ is an ascending infection of the upper reproductive tract that may lead to sepsis, ectopic pregnancy, or infertility.

A

PID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PID is MC caused by what organisms?

A

GC/Chlam

*Increased risk w/ multiple sexual partners, unprotected sex, prior PID, 15-19y, nulliparous, IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What might you find on PE of someone w/ PID?

A
  • Lower abd tenderness
  • Fever
  • Purulent cervical d/c +/- bleeding
  • CHANDALIER SIGN: CERVICAL MOTION TENDERNESS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PID is primarily a clinical diagnosis. What are some other findings that would point you in that direction (think labs, PE)?

A

(+) gram stain, temp > 38C, WBC>10,000, increased ESR and CRP, CMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is PID treated?

A

Outpatient: Doxycycline + Rocephin + Flagyl

Inpatient: see p. 104

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

_____ is a complication of PID that is associated with hepatic fibrosis/scarring and peritoneal involvement. RUQ due to PERIHEPATITIS and adhesions on anterior surface of liver are common w/ this.

A

FITZ-HUGH CURTIS SYNDROME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

______ is the MC solid lesion of the breast in pts <40y.

A

Fibroadenoma

  • Benign, painless
  • PE: rubbery and mobile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

____ is simple and fluid filled breast mass. Occurs in pts 30-50.

A

Cyst

  • They are often tender
  • Tx- aspiration v. observation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

______ is a fibrotic tissue reaction that is found in patients with a history of trauma or surgery. It is a painful, tender mass/area.

A

Traumatic Fat Necrosis

*Tx- conservative v. excision, must R/O CANCER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

_____ is a cystic enlargement of glands seen in patients 30-50y. There is associated nipple d/c and cyclic mastalgia.

A

Fibrocystic breast changes

*Tx- symptomatic= NSAIDs and cold compress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

_____ is a wart-like tumor of the breast duct. Often occurs in menopausal women. May have clear or bloody d/c.

A

Intraductal papilloma

*Tx- Excision to r/o atypia or Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

_____ is a complication of mastitis. Usually occurs in lactating women. Associated with pain- baby can’t latch. May have fever, cellulitis.

A

Breast abscess

  • Tx- Nurse, MRSA abx, Aspiration
  • *DDX- Inflammatory breast Ca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Malignancy primarily of mild ducts or lobules is otherwise known as _____.

A

Breast cancer

*2nd MC cause of cancer death (after lung)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
RF for Breast Ca include:
BRCA 1 and BRCA 2 -1st degree relative, age >65, hormonal--> increased risk with more menstrual cycles, increased estrogen in postmenopausal women on HRT and OCPs, obesity, and ETOH
26
_____ is the MC type of breast cancer.
Infiltrative Ductal Carcinoma All types- 1. Ductal Carcinoma: - Infiltrative - DCIS 2. Lobular Carcinoma - Infiltrative - LCIS 3. Medullary, mucinoid, papillary, metastatic, mammary Paget's dz. of the breast
27
S/S of breast cancer:
Mass: Painless, hard, FIXED, lump +/- axillary LAD (MC in upper, outer quadrant) Unilateral Nipple D/C: +/- blood, purulent, or green METs to lung, liver, bone, brain
28
PE findings related to breast cancer:
Skin changes: color changes (asymmetric redness), skin retraction, ulceration Changes in breast size and contour Nipple inversion Skin thickening
29
______ is associated with chronic eczematous itchy, scaling rash on the nipples and areola.
Paget's disease of the nipple
30
______ is skin changes that look like the peel of an orange due to lymphatic obstruction. It is associated with a poor prognosis.
Peau d' orange
31
US is recommended as the initial modality to evaluate masses in women < ___ years.
40
32
Staging based on TNM. What does this stand for?
T= TUMOR SIZE N= NODES (AXILLARY) M= METS
33
Adjunctive therapy for breast cancer includes:
1. Radiation- External beam or brachytherapy (internal) 2. Anti-Estrogen (Tamoxifen): used in ER positive. Binds and blocks estrogen receptor in breast tissue. 3. Aromatase Inhibitor (Letrozole, Anastrozole): used in POST-MENOPAUSAL ER positive women. Reduces production of estrogen. 4. Monoclonal Ab treatment (Herceptin): used in HER2 (+) - ADR- Cardiotoxicity
34
Neoadjuvant treatment for breast cancer includes:
1. Chemotherapy- used in stage II-IV and inoperable dz. Especially ER (-) (can also be adjuvant treatment) * Ex: Doxorubicin, Cyclophosphamide, Fluorouracil, Docetaxel 2. Tamoxifene or Raloxifene can be used in postmenopausal or women >35y with high risk. * Treatment usually used for 5 years!!
35
Pelvic organ prolapse is MC after ____.
Childbirth
36
Types of pelvic organ prolapse include:
1. Cystocele: posterior bladder herniating into the anterior vagina 2. Enterocele: pouch of Douglas (small bowel) into the upper vagina 3. Rectocele: distal sigmoid colon (rectum) herniates into the posterior distal vagina
37
Grades of Pelvic Organ Prolapse:
I: descent into upper 2/3 of vagina II: cervix approaches introitus III: outside introitus IV: entire uterus is outside vagina- complete prolapse
38
Treatment of Pelvic Organ Prolapse involves:
1. Prophylactic- Kegels, weight control 2. Nonsurgical- Pessaries, estrogen (improves atrophy) 3. Surgical- Hysterectomy; Uterosacral or sacrospinous ligament fixation
39
S/s of Menopause are:
Estrogen deficiency causing- menstrual cycle alterations, vasomotor instability (hot flashes), mood changes, increase in cardiovascular events, HYPERlipidemia, osteoporosis, and dyspareunia
40
How is Menopause diagnosed?
FSH MOST SENSITIVE! -INCREASE IN SERUM FSH > 30 IU/ML (decreased LH and estrogen- Estrone predominates)
41
Treatment of Menopause...
1. Hot flashes: estrogen, progesterone, Clonidine 2. Vaginal atrophy: transdermal/transvaginal estrogen 3. Osteoporosis prevention: Calcium + Vitamin D, wt bearing exercise, bisphosphonates, calcitonin, estrogen (+/- progesterone), SERM 4. HRT: -Estrogen ONLY: Benefits= most effective symptomatic treatment! Risks= INCREASED RISK of ENDOMETRIAL CANCER, VTE, and liver disease -Estrogen + Progesterone: Benefits= decreased risk of osteoporosis, VTE, and dementia Risks= increased risk of breast ca ??
42
Serum b-hCG can detect pregnancy as early as __ days after conception. Urine b-hCG can detect pregnancy as early as __ days after conception.
Serum- 5 days Urine- 14 days
43
Fetal heart tones are heart around __ to __ weeks.
10-12 weeks (Normal 120-160bpm)
44
Pelvic US can detect fetus around __ to __ weeks.
5-6 weeks
45
Fetal movement occurs between __ to __ weeks.
16-20
46
Remember GPAL...
G- Gravida= # of times pregnant P- Para= # of births (>20 weeks), including viable or nonviable (stillbirth) A- Abortus= # of pregnancies lost for whatever reason (miscarriages, abortions) L- Living= # of living children
47
To estimate date of delivery do LMP + 9 months + 7 days
Nagele's Rule (really Lucy's rule because I switched the equation around)
48
Normal IUP can be visualized by transvaginal US when b-hCG is > ______ and by transabdominal US when b-hCG is > ______.
Transvaginal US- >1800-2000 Transabdominal US- >3500-5000 * Serial quantitative b-hCG should double Q24-48hrs * *In ectopic- fails to double
49
What type of contraception inhibits ovulation?
Progestin only! *Pills, Implanon, Depo Provera shot, Mirena **Safe during lactation :)
50
What are some Pros and Cons to OCPs?
Pros: Protection against- osteoporosis, ovarian cysts, ovarian ca, endometrial ca; improves acne, less PID and ectopic Cons: smokers have to stop at >35 y, Gallstones, increased fluid retention, increased risk of DVT and PE
51
Osteoporosis is an ADR associated with _____ (type of birth control).
Implanon
52
_____ is left effective in overweight patients.
Patch
53
____ must be removed before intercourse and replaced within 3 hours.
Nuvaring
54
____ associated with most types of cervical cancer.
HPV *45 is avg age of dx
55
Types of cervical cancer...
1. Squamous- 90% | 2. Adenocarcinoma- 10%
56
S/S of cervical cancer:
MC= POST COITAL BLEEDING/SPOTTING *Dx: Colposcopy with biopsy, pap smear with cytology for screening
57
Treatment of cervical cancer...
Stage 0, Carcinoma in Situ= Excision, Ablation, or TAH-BSO (total hysterectomy and bilateral salpingo-oophorectomy) Stage I, Microinvasion= Surgery: TAH-BSO; Radiation (+/- Chemo- Cisplatin) Stage II-IVa (local METS)= Radiation (XRT) + Chemo b (Cisplatin +/- 5FU) IVb (Distant METS)= Palliative radiation therapy, chemotherapy
58
Gardasil vaccine recommended to those aged __ to __.
11 to 26 * Schedule: - <15y= 2 doses at least 6 months apart - >15y= 3 doses with 2nd dose given 2 months after first and then 3rd dose given 3-4 months later.
59
Spontaneous abortion is defined as occurring before __ weeks.
20 * MC weeks 1-7 * *Etiology= MC is fetal chromosomal abnormality
60
____ abortion is MC cause of 1st trimester bleeding. No POC is expelled, cervical OS is closed, and pregnancy MAY BE VIABLE or abortion may follow.
Threatened *Tx- supportive, RhoGAM if indicated
61
____ abortion is when NO POC is expelled and there is progressive cervix dilation. Pregnancy is not salvageable.
Inevitable *Tx- 1st Trimester= D&C 2nd Trimester= D&E
62
____ abortion is when SOME POC is expelled and SOME RETAINED. Cervical Os is dilated. There is HEAVY bleeding.
Incomplete * Tx- - May be allowed to finish - 1st= D&C; D&E after - Pitocin - RhoGAM if indicated
63
___ abortion is when ALL POC is expelled. Cervical Os is usually closed.
Complete *Tx- RhoGAM if indicated
64
____ abortion leads to fetal demise but it still remains in uterus. No POC is expelled. Cervical Os is closed.
Missed *Tx- 1st Trimester= D&C 2nd Trimester= D&E -Misoprostol
65
___ abortion is when retained POC becomes INFECTED. Cervical Os is closed and there is CMT. May have foul brown d/c, uterine tenderness, and spotting-->heavy bleeding.
Septic *Tx- D&E to remove POC and broad ABX +/- Hysterectomy if refractory

Primary Care (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions