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Clin Med II > Repro Dx > Flashcards

Repro Dx Flashcards

1
Q

abdominal cramping, vaginal bleeding

Cervical os closed, no visible POC, uterus normal size

A

complete spontaneous abortion

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2
Q

Abdominal cramping, vaginal bleeding ± tissue

Cervical os open, POC visible in cervical canal (may also see in vagina)

A

incomplete spontaneous abortion

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3
Q

Non-viable preg not yet expelled
Cervical os closed
No sx

A

missed abortion

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4
Q

Vaginal bleeding w/o cervical Δ

Spotting

A

threatened abortion

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5
Q

Vag bleeding w/ cervical Δ

Abd cramping, mod-heavy bleeding, cervical os open

A

inevitable abortion

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6
Q

Fever, chills, vag discharge, uterine and abd tenderness following abortion

A

septic abortion

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7
Q

Chocolate cyst ovary

A

endometriosis

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8
Q

Uterus larger than expected for date of gestation

Absent fetal heart sounds

A

molar pregnancy

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9
Q

What causes +Breasts and no uterus?

A

Mullerian Agenesis

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10
Q

primary amenorrhea

A

Absence of menarche by age 16 w/ nrml pubertal devel or by 14 w/o pubertal devel or 2 yrs after completion of sexual maturation

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11
Q

secondary amenorrhea

A

Absence of menstruation for at least 3 cycles in females who previously had regular menstrual cycles

or

6 months in females with irregular cycles

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12
Q

primary amenorrhea w/ ↓GnRH: ↓ FSH ↓ LH ↓ Estradiol

A

Hypothal d/o

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13
Q

Poor breast development, 1° amenorrhea, short stature, webbed neck

A

Turner’s Syndrome

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14
Q

No uterus, shortened vagina, hormone levels nrml

A

Mullerian Agenesis

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15
Q

Cyclic pain due to retention of blood, nrml hormone levels

A

Imperforate Hymen

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16
Q

Horizontal “wall” of tissue formed that creates blockage of vagina, nrml hormones

A

Transverse Vaginal Septum

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17
Q

secondary amenorrhea w/ Weight loss, excessive exercise, anorexia nervosa, stress

A

Functional Hypothalamic Amenorrhea

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18
Q

Post-partum pituitary necrosis

Pituitary cell destruction

Severe hypotension 2° to massive hemorrhage

A

Sheehan Syndrome

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19
Q

secondary amenorrhea w/ hot flashes, vaginal dryness

A

Premature Ovarian Failure

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20
Q

secondary amenorrhea w/ presence of Intrauterine adhesions or fibrosis

A

Asherman Syndrome

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21
Q

dx of endometriosis

A

Laparoscopy is gold standard

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22
Q

Dysmenorrhea, dyspareunia (painful sex), dyschezia 

Infertility
Urinary sx  

Tender nodularity of cul-de-sac & uterine
ligaments, “fixed” uterus

10/10 pain curled over, worst pain they’ve ever had

A

Endometriosis

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23
Q

3rd spacing: Bloating, abdominal fullness, n/v/d, weight gain, decreased urine output, excessive thirst, SOB, pleural effusion, calf/chest pain (DVT/PE), electrolyte imbalance

A

Ovarian Hyperstimulation Syndrome (OHSS)

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24
Q

Estrogen ↑

FSH ↑

Anti-mullerian hormone (AMH) ↓ levels

Indicates:

A

↓ ovarian reserve

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25
Q

Intermenstrual bleeding, post-coidal or post-menopausal bleeding, may prolapse through cervix

Usually <1 cm

A

Endometrial Polyps

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26
Q

Heavy menstrual bleeding
Pelvic pain (non-cyclical)
Progressive dysmenorrhea
Asymptomatic

Diffusely enlarged globular “boggy” uterus (soft)
Symmetrical uterine enlargement

A

Adenomyosis

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27
Q

HMB is MC presenting sx
Dysmenorrhea, pelvic pain/pressure, infertility

Compressive sx: urinary freq, difficulty w/ bowel mvts

Enlarged, firm, irregular NT uterus,

A

Leiomyoma

“fibroids”

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28
Q

Post-meno bleeding

Meno/metrorrhagia in pre-meno

Nrml uterus size no PE findings

A

Endometrial Cancer

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29
Q

Presents as rapidly growing mass with vaginal bleeding ± pain

A

Leiomyosarcoma

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30
Q

Dull/sharp, constant/intermittent, pelvic pain, pressure or fullness
Painful intercourse, bloating, torsion

Admexal fullness, admexal/cervical motion tenderness

A

Ovarian Cysts

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31
Q

Filled with serous/watery fluid

Thin walled

Can reach 5-7cm, typically not much larger

A

Simple Cyst

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32
Q 
May be fluid filled: blood, mucous, etc.
 Solid component
 Internal debris
 Thick walled
Septations
  Papilla

> 5cm

“ground glass” appearance with internal echos

A

Complex Cyst

corpus luteal

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33
Q

Simple Cyst composition

A

granulosa cells (SAME cells as follicles)

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34
Q

Occurs as a result of bleeding into a follicle or corpus luteal cyst

A

Hemorrhagic Cyst

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35
Q

“chocolate cysts”

A

Endometrioma

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36
Q

What tumor marker will likely be elevated with Endometrioma

A

CA-125

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37
Q

cyst that occur from hyperstimulation from HCG & resolve after source of HCG is removed

A

Theca Lutein Cysts

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38
Q

Cystadenoma

A

serous and mucinous

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39
Q

Abdominal fullness, back pain, constipation, diarrhea, early satiety, fatigue, nausea

Pelvic pain, pelvic mass, inguinal lymphadenopathy

Weight loss

A

Ovarian Cancer

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40
Q

2nd mc gyn malig and mc cause of gyn rel death

A

Ovarian Cancer

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41
Q

mc type of Ovarian Cancer

A

Epithelial Cell

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42
Q

mc type of Ovarian Cancer in pediatric pop

A

Germ Cell

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43
Q

SEVERE pain (sharp/stabbing/colicky, radiation), nausea/vomiting, low grade fever

A

Ovarian Torsion

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44
Q

Oligomenorrhea (<9 periods/year)

Amenorrhea (no period >3 months)

Obesity

Infertility

Hyperandrogenism: acne, hirsuitism, male-pattern hair loss, ↑ testosterone

Insulin resistance: acanthosis nigricans

Ovarian cysts are rare because they don’t ovulate

Preg complications: early preg loss, gestaional diabetes, pre-eclampsia, preterm birth

A

Polycystic Ovarian Syndrome (PCOS)

AKA Stein-Leventhal Syndrome

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45
Q

acute onset fever, pain, problems voiding
very tender prostate
+leukocytes, (+culture)

A

Prostatitis: Type I - Acute Bacterial Prostatitis

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46
Q

Recurrent UTIs that respond to abx

Pain- lower and, perineal, testicular, scrotal, rectal, back (no fever)

LUTS

painful ejaculation, change in semen color, retarded ejaculation, erectile dysfn

Prostate may be normal, somewhat enlarged, body and somewhat tender

Urine cx usually nrml

A

Prostatitis: Type II - Chronic Bacterial Prostatitis

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47
Q

Pelvic pain, urinary sx, ejaculatory dysfn

No identifiable infectious etiology

A

Prostatitis: Type III - Chronic Abacterial Prostatitis / Chronic Pelvic Pain Syndrome

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48
Q

Asymptomatic but WBC in prostatic secretions or prostate tissue found incidentally during prostate eval

A

Prostatitis: Type IV - Asymptomatic Inflammatory Prostatitis

49
Q

LUTS

Hesitancy, weak stream, interrupted stream, incomplete voiding, straining to void, dribbling, nocturia, incontinence

Recurrent UTIs, enlarged prostate on DRE (normally is 2 fingerbreadths or less)

50
Q

LUTS and nodules palpated on DRE

elevated PSA

A

Prostate Cancer

51
Q

Absent cremasteric reflex

Elevated scrotum on affected side

Enlarged painful testis

Abnormal testicular lie

A

Testicular Torsion

52
Q

Gradual onset of unilateral scrotal pain

Frequently accompanied by urinary sx (e.g.,
dysuria)

Epididymal and/or testicular swelling

A

Epididymitis

53
Q

Unilateral testicular swelling and scrotal
edema 4 to 5 days after parotitis secondary to
mumps

54
Q

“Bag of worms”

↑ in size w/ standing or valsalva maneucer

A

Varicocele

55
Q

Tense, smooth scrotal mass that easily transilluminates

56
Q

Smooth painless mass that transilluminates

A

Spermatocele

57
Q

Discrete painless mass on the testicle, testicular swelling, testicular pain, scrotal “heaviness” or “firmness”

If tz for epididymitis fails may be cancer

Back pain if metastatic

A

Testicular Cancer

58
Q

Inability to retract the foreskin over the glans penis

Painful erections

Hygiene issues may ensue due to difficulty cleansing area

59
Q

Retracted foreskin of uncircumcised penis can not be returned to normal anatomic position →
venous occlusion, edema, arterial insufficiency of the distal penis

A

Paraphimosis

60
Q

Superficial squamous epithelium entrapts nests of glandular columnar cells → mucus trapping → bleb formation

A

Nabothian Cyst

61
Q

Seen in periods of high estrogen- menarche, OCP, pregnancy

Very friable so vulnerable to infection, trauma and bleeding

62
Q

Pts complain of postcoital bleeding

A

Cervical Polyps

63
Q

Painless, premature dilation

Can lead to pregnancy loss or preterm delivery

A

Cervical Insufficiency

64
Q

When HPV infection occurs usually latent and cleared but can stick around long enough to cause change in cells

A

Cervical Dysplasia

Cervical Intraepithelial Neoplasia

65
Q

Abnormal bleeding, watery
discharge, postcoital bleeding,
venous/lymphatic/ureteral
compression

A

Cervical Cancer

66
Q

Primary amenorrhea with high FSH

A

ovarian failure

67
Q

Primary amenorrhea with low or normal FSH

A

hypothalamus/pituitary disorder

68
Q

XXX

A

superfemale (no obvious phenotype)

69
Q

Small testes, reduced fertility, Gynecomastia, male gender identity

A

XXY Klinefelters syndrome

70
Q

painless solid testicular enlargement

A

testicular tumor

71
Q

testicular tumor rule of ninties

A

90% 24-45 yo
90% of germ cell origin
90% of tumors malignant
90% curable with modern therapeutic modalities

72
Q

MC type of testicular tumor

A

germ cell (aggressive)

mc type of germ cell tumor is classic seminoma

73
Q

testicular tumor in infants and < 3 yo

A

yolk sac tumor

74
Q

Pelivc pain, missed LMP, vaginal bleeding

If 3 wk and no sac→ suspicious

Adnexal mass, free fluid in pelvis, hemodynamically unstable, inappropriately rising βhCG with no intrauterine sac

A

Ectopic Pregnancy

75
Q

Abnormal vaginal bleeding

Uterine size > dates

Hyperemesis gravidarum

Bhcg > 100,000 mIU/mL

Hyperthyroidism

PreEclampsia < 20 weeks

A

Gestational Trophoblastic Disease (GTD)

76
Q

T sign on US for multi gestation

A

Monochorionic

77
Q

Lambda (λ) sign for multi gestation

A

Dichorionic

78
Q

Softening and effacement of the cervix prior to onset of contractions

A

Cervical Ripening

79
Q

Stimulation of contraction before onset of labor

80
Q

MC cause of mastitis

A

s aureus from infants pharynx

81
Q

placenta covering opening of cervix

A

placenta previa

82
Q

Defective decidual formation causing abnormla placenta attachment to myometrium

A

placenta accreta

83
Q

premature separation of placenta

A

Abruptio Placentae

84
Q

most common cause of vaginal discharge and odor

A

Bacterial vaginosis (BV)

85
Q

Mc Vulvovaginal tumor

A

Batrholin Gland Cyst/Abscess

86
Q

↑ discharge, white or grey, fishy odor, odor may be worse after sex, no pain with sex (dyspareunia)

Copious thin, white vaginal discharge

+ whiff

A

Bacterial Vaginosis (BV)

87
Q

Very itchy, externally, internally or both

Thick cottage cheese like discharge adherent to vag walls, burning with urination (because urine hits external genitalia)

Discomfort with sex (due to inflammatory response)

Erythema, edema

A

Vulvovaginal Candidiasis

Yeast infection

88
Q

Female comes in with sx- yellow to greenish discharge, irritation, dyspareunia, dysuria, copious frothy (bubbly) discharge

A

Trichomoniasis

89
Q

painless valvular mass, detected on pelvic exam, very large can cause discomfort with walking, sitting or sex, clear, white fluid

A

Bartholin Gland Cyst

90
Q

Tender, warm, painful, mucopurulent vulvovag drainage, likely will show up in ER

A

Batrholin Gland abscess

91
Q

Vaginal lesions + itching
may have bleeding or pain

May have already been tx for something else with no relief

A

Vulvar Cancer

92
Q

Painless vagina and/or postcoital bleeding

A

Vaginal Cancer

93
Q

Breast pain

Cyclic - related to menstural cycle

Non-cyclic

Extramammary

A

Mastalgia (mc is cyclic)

94
Q

Breast pain, swelling, warmth, redness

95
Q

MC cause of Mastitis

96
Q

Dimpling of the breast, nipple retractions

A

breast tumors

97
Q

biggest RF of breast tumors

98
Q

Bilateral cyclic pain, breast swelling, palpable mass ad heaviness, lumpy breasts

A

Fibrocystic Breast Disease

99
Q

MC benign breast cont

A

Fibrocystic Breast Disease

100
Q

Well defined, mobile mass

Can be multiple in same breast or bilaterally

Changes w/ menstrual cycle, ↑ in size w/ preg and extrogen therapy, shinks during menopause

A

Fibroadenoma

101
Q

Single, non-tender, firm, immobile mass

MC in upper outer quadrant

Nipple discharge (unilateral), dimpling, skin thickening, breast pain, skin thickening, breast pain, and eczematous changes

102
Q

mc type of breast ca

A

Ductal carcinoma in situation (DCIS)

103
Q

Acute onset (sx < 6 months) of erythema, edema, and peau d’orange appearance of breast ±palpable lump

Fast progression

A

Inflammatory Breast Cancer (poor prognosis)

104
Q

Men: urethritis ‐ dysuria, mild urethral discharge

Women: cervicitis ‐ mild discharge, urethritis ‐ dysuria, mild urethral discharge

105
Q

Men- dysuria, urethritis and purulent discharge

Women- asymptomatic or vagina discharge, dysuria, cervicitis

106
Q

Fever > 101 °F, pelvic pain, cervical motion tenderness (chandelier sign), annexation tenderness, cervical discharge

107
Q

Gold standard to dx PID

108
Q

Women- likely to be asymptomatic

Confined to genitalia, tender papule with surrounding erythema, becomes pustular and forms painful, undermined ulcer

Tender regional adenopathy

109
Q

Painless ulcerative genital lesions without reginal lymphadenopathy

A

Granuloma Inguinale (Donovanosis)

110
Q

Chancre forms at site of inoculation, initially painless papule, erodes with raised borders and heals within 3-6 wks

maculopapular rash can involve any surface of the body, commonly presents on palms and soles

111
Q

Often asymptomatic

Flesh gray color, papule either sessile or pedunculated

112
Q

Pruritus: pubic, axilla, chest, eyelashes

Visible lice/eggs

maculae ceruleae (taches bleues), bluish‐gray irregularly shaped macules, lower abdominal wall, buttocks, and upper thighs

A

Pubic Lice

113
Q

Lesions and burrows

Pruritus

Grey or skin colored ridges, linear or surpiginous, vessicle/papule at end

114
Q

MC presenting sx of menopause

A

vasomotor instability

115
Q

irritation, burning, itching, vag discharge (yellow-brown), postcoital bleeding, dyspareunia, vaf epithelium red then becomes pale, dec rugation and vag wall beomces smooth

A

vulvovaginal atrophy

116
Q

pelvic pressure, ball coming out of vag has to push it back in to walk and stand

A

uterine prolapse

117
Q

pelvic pressure during bowel mvts, constipation, bulging post wall

118
Q

pressure in pelvis and vag, inc discomfort w/ straining, coughin, bearing down or lifting, incomplete bladder emptying

Clin Med II (19 decks)

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