Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Precision > Repro/Endo > Flashcards

Repro/Endo Flashcards

1
Q

Amenorrhea (FMLD)

A

Primary = Failure of menarche onset by age 15 (in the presence of secondary sex characteristics) or age 13 in the absence of secondary sex characterisitics)

Secondary = Absence of menses for >3mo in a patient with previously normal menstruation or >6mo in a patient who was previously oligiomenorrhea)

MCC of Secondary amenorrhea = Pregnancy

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

Amenorrhea secondary to gonadal dysgenesis, turner syndrome (dx + labs)

A

Karotyping = Definitive dx = 45 XO

Hormonal screening = low estrogen + high FSH + high LH

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

Bacterial vaginosis (FMLD)

A

Vaginal odor worse after sex +/- itching

> 50% may be asymptomatic

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

Bacterial vaginosis (Dx and labs)

A

Amslers criteria
1. Clue cells on saline smear
2. pH >4.5
3. Thin, water grey discharge
4. (+) whiff test, fishy odor with 10% KOH

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

Breast cancer (health maint + prevention)

A

Clinical breast exam age 20-39 ; every 3 years until age 40 then annually

Mammo = age 40 or 10 years prior to age of 1st deg relative was diagnosed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Breast mass (FMLD)

A

Palpable single nontender firm IMMOBILE mass

MC = Upper outer quadrant and findings on mammography

Stereotactic core-needle biopsy or open biopsy = most accurate in establishing diagnosis

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

Cervical cancer (scientific concepts)

A

HPV (Most common = 16,18,31,33,45,52,58)

3rd MC gynecologic cancer
(endometrial = #1, ovarian = #2)

MC Mets = Locally (vagina, parametrium, pelvic)

MC type = Squamous, clear cell carcinoma linked to DES

MC sx = Post-coital bleeding/spotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cervical cancer (Dx and labs)

A

Screening = Pap with cytology
Dx = Colpo with biopsy

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

Contraception (pharm tx)

A

Combination OCP (estrogen + testosterone) = prevents ovulation by inhibiting mid cycle LH surge, thicken cervical mucosa, thin endometrium

Progesin only = Safe during lactation, no estrogen SE

IUD = Most effective, increase risk of PID

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

Dysfunctional uterine bleeding (scientific concepts)

A

Abnormal uterine bleeding in the absence of pelvic pathology, pregnancy

Disruption in normal cyclic pattern of ovulatory hormonal stimulation to endometrial lining

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

Dysfunctional uterine bleeding (Clinical intervention)

A

Dx of exclusion

Workup shows no evidence of organic cause and negative pelvic exam, DUB is the dx

Workup includes: hormone levels, transvaginal ultrasound, endometrial biopsy

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

Endometrial cancer (scientific concepts)

A

Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb).[1] It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body.[8] The first sign is most often vaginal bleeding not associated with a menstrual period.[1] Other symptoms include pain with urination, pain during sexual intercourse, or pelvic pain.

Endometrial cancer occurs most commonly after menopause

Risk factor = Family hx, increased # of ovulatory cycles, infertility, nulliparity, age over 50, BRCA genes, Peutz-jeghers, Turners, HTN, DM

Estrogen-dependent cancer

MC gynecological malignancy

MC type = adenocarcinoma

MC postmenopausal (50-60)

Combination OCPs are protective against both ovarian and endometrial

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

Endometrial cancer (FMLD)

A

Postmenopausal bleeding: endometrial stripe >4mm on transvaginal US

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

Endometrial cancer (Dx and labs)

A

Dx = biopsy, pelvic exam, D&C, transvaginal US, CT, MRI

Labs = CA-125 (seen in both endometrial + ovarian cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Endometriosis (FMLD)

A

Classic Triad (3 D’s)
Dyspaurenia
Dysmenorrhea
Dyschezia

+/- pre-post menopausal bleeding

Infertility

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

Endometriosis (dx + labs)

A

PE = usually normal; adnexal tenderness

Laparoscopy with biopsy = Definitive

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

Endometritis (pharm tx)

A

Infection post c-section = clinda + gentamicin

Group B strep coverage

Infection after vaginal delivery or chorioamnionitis = Amp + Gent

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

Enterocele (FMLD)

A

Pouch of douglas (small bowel) herniated into the upper vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fibrocystic breast disorder (clinical intervention)

A

Ultrasound FNA reveales straw colored fluid (no blood)

Most spontanesouly resolve +/- FNA removal of fluid if symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fragile X syndrome (dx + labs)

A

X-ray spine (scoliosis)

Echo = exclude MVP

Molecular testing + karotyping

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

Gestational diabetes (Dx and Labs)

A

1.Screening done at 24-28weeks = 50g 1hr glucola

  1. Confirmatory 3hr 100g GTT = gold standard; performed in morning after fasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gestational trophoblastic disease (molar pregnancy ) scientific concepts

A

2 MC risk factors = Prior molar pregnancy or extreme in maternal age like 20yo and 35yo

Eomplete egg with NO DNA fertilized by 1 or 2 sperm

46XXX all paternal chromosomes

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

Gestational trophoblastic disease (molar pregnancy ) Dx and labs

A
  1. Beta HCG elevated >100,000 very LOW serum alpha-fetoprotein
  2. US = Snowstorm appearance or “cluster of grapes”; Absence of fetal prats, heart sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gynecomastia (clinical intervnetion)

A
  1. Supportive = depends on cause

Stop offending medsl observation if early in course will most likely resolve spontaneously

Idea tx should start within 6 mo of onset; Surgery if resistant

Limit ETOH consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hydatidiform Mole (clinical intervention)
Surgical uterine evacuation is mainstay of tx to avoid choriocarcinoma Trend weekly beta-HCG until undetectable CXR to look for mets from possible choriocarcinoma
26
Hyperemesis gravidarum (pharm tx)
PO or IV fluids; Multivitamins; Bland diet = BRAT Anitemeitcs = Doxylamine + Pyridoxine, diphenhydramine, zofran (cleft palate risk)
27
Hypothalmic amenorrhea (pharm tx)
Clomiphene (stimulate GnRH secretion from hypothalamus)
28
Hypothalmic amenorrhea (Dx + labs)
AKA when your hypothalamus causes your period to stop. Common causes include excessive exercise, stress and undereating Normal/decreased FSH & LH Decreased estradiol Normal prolactin
29
Invasive mole (hx + pe)
Painless vaginal bleeding + preeclampsia before 20 weeks + hyperemesis Uterine size and date discrepancies
30
Leiomyoma (clinical intervention)
Observation of asymptomatic Myomectomy to preserve fertility Hysterectomy = Definitive tx
31
Molar pregnancy (clinical intervention)
Surgical uterine evacuation (suction curettage) 2. METS = Chemotherapy or methotrexate
32
Mucopurulent cervicitis (scientific concepts)
Depends on cause but start with obtaining culture Empiric tx with Ceftriaxone + azithro + metronidazole +/- doxy while awaiting culture results
33
Ovarian cancer (clinical intervention)
1. Early stage = TAH + lympadenectomy 2. Surgery = Tumor debulking (serum CA-125 monitor tx progress) 3. Chemo = Paclitaxel or Cisplatin Or Carboplatin
34
Ovarian cancer (FMLD)
MC in older, caucasian, nulliparous females +/- sister mary joseph nodule Ascites, abdominal distention, early satiety, changes in bowel habits, or fixed mass
35
Periop antibiotic prophy (pharm tx)
C-section up to 60 min prior If ROM or in labor = Vaginal cleaning with povidine
36
PCOS (scientific concepts)
PCOS is due to insulin resistance (type 2 DM) Associated with abnormal function of HPO axis = increase insulin and increase LH driven increase in ovarian androgen production
37
PCOS (dx and labs)
High androgen levels Pelvic exam Blood test and US can confirm Labs = Decreased FSH, Increased LH, increased testosterone, increased estrogen,
38
Pre-eclampsia (Health maint + prevention)
RF= Nulliparity, control HTN Educate pt to be aware of signs of HTN Steroids to mature fetal lungs if >34wks
39
Pregnancy hypertension (hx and pe)
New onset BP 140/90 AFTER 20 weeks gestation NO proteinuria, edema, or end-organ dysfunction
40
Normal findings, pregnancy (scientific concepts)
During pregnancy cardiac output INCREASES CO peaks around 24 weeks 50% increase in the volume of plasma, 20% in RBC and WBC
41
Pregnancy parturition (scientific concepts)
4 phases 0 = Inhibition 1= Myometrial activation 2- Stimulation 3= Inovulation
42
Pregnancy, Rh Isoimmunization (clinical intervention)
RhoGam given if Rh negative @ 28wks
43
Rectocele (clinical intervention)
1. Prophy = Kegels + weight control 2. Non-surgical = Pessaries + estrogen tx 3. Surgical = Hysterectomy
44
Transitional (gestational) HTN (FMLD)
HTN after 20 weeks gestation; no proteinuria Resolves 12 weeks after postparum; clinically asx
45
Uterine leiomyoma (clinical intervention)
Observation if asx Medical tx = decrease estrogen Surgical = myomectomy , endometrial ablation, or hysterectomy
46
Acromegaly (Dx and labs)
Pituitary adenoma causing hypersecretion of GH after the closure of the epiphyses Screening test = Exogenous (insulin like growth factor 1) Confirmatory test = Oral glucose suppression test = increased FH levels in acromegaly MRI of pituitary
47
Acromegaly (clinical intervention)
1. Transsphenoidal surgery + Bromocriptine (increases dopamine) 2. Radiation therapy if IGF-1 levels are increased post surgery 3. Octreotide = somatostatin analog that supresses GH 4. Pegvisomant: GH antagonist may be added to octreotide
48
Adrenal crisis (pharm tx)
1. IV fluids (normal saline to correct hypotension + hypovolemia) 2. Glucocorticoids (IV hydrocortisone if known addisons) or Dexamethasone (if unknown) 3.Reversal of electrolyte disorders 4. Fludricortisone = synthetic mineralcorticoid similar to aldosterone
49
Adrenal crisis (scientific concepts)
MCC = abrupt withdrawl of steroids Shock = primary manifestation (decreased BP, hypovolemia)
50
Adrenal insufficiency (pham tx)
Addisons disease Addisons = Glucocorticoids + mineralocorticoids Secondary cause = Only glucocorticoids
51
Adrenal insufficiency (dx and labs)
Baseline 8am ACTH, cortisol, & renin levels 1. HIgh dose ACTH (cosynotropinin) stimulation test - screening test 2. CRH stimulation test = differentiates causes of adrenal insufficiency
52
Aldosteronism, primary (scientific concepts)
Occurs independent of renin MCC = adrenal hyperplasia Conn syndrome = Adenoma (HTN, hypokalemia + metabolic alkalosis)
53
Arthropathy, Charcot (joint) FMLD
Aka diabetic foot Joint damage & destruction as a result of peripheral neuropathy from DM, peripheral vascular disease & or other disease Repetitive microtrauma to foot with no sensation & autonomic dysfunction leads to bone resorption & weakening MC area = Midfoot affected with pain and swelling
54
Cushings (hypercortisolism) clinical intervention
3 causes; 3 different treatments 1. Cushings disease (pituitary cause) = transsphenoidal surgery or radiation therapy if unresectable 2. Ectopic ACTH secreting or adrenal tumor = tumor removal, ketoconazole may be used if inoperable 3. Iatrogenic = steroid tx
55
Diabetes insipidus (clinical intervention)
1. Central DI = Desmopressin/DDVAP; Carbamazepine) 2. Nephrogenic (kidney doesnt detect ADH) = sodium/protein restriction use HCTZ and indoemthicin 3. If symptomatic = hypotonic fluid (pure water orally)
56
Diabetes insipidus (Dx and Labs)
1. Fluid deprivation test = Established the diagnosis of DI, continued production of DILUTE URINE (urine osmo <200 and low specific gravity <1.005) 2. Desmopressin (ADH) stimulation test = Differentiate between nephrogenic and central If central = reduction in urine output indicating response to adh If nephrogenic = continued production of dilute urine - no response to ADH
57
Diabetic hypoglycemia (FMLD)
Acute altered mental status; complication of DM MCC = Too much insulin, too little food intake, excess exercise Autonomic: sweating, tremors, palpitations, nervousness, tachycardia CNS: HA, confusion, slurred speech, diziness
58
Diabetic hypoglycemia (clinical intervention)
Mild <60mg/dl = 10-15g fast carb, fruit juice, hard candy = RECHECK every 15 minutes Severe/unconscious = <40mg = IV bolus of D50 or inject glucagon SQ
59
DKA (pharm tx)
SIPS Saline Insulin (reg) Potassium repletion Search for underlying cause and treat it INITIAL treatment = Isotonic normal saline
60
Diabetic nephropathy (Dx and labs)
Mircroalbuminuria = first sign of diabetic nephropathy; increased BP accelerates kidney deterioration Albuminuria, anemia, acidosis Kidney bx = Kimmelsteil -Wilson (nodular glomerulosclerosis = PINK HYALINE AROUND CAPILLARIES FROM PROTEIN LEAKAGE)
61
Graves Disease (Pharm tx)
Aka Hyperthyroidism MC = Radioactive iodine If not pregnant = Methimazole or PTU If pregnant = PTU in 1st trimester then methimazole
62
Gynecomastia (pharm tx)
1. SERM (hormone tx = Tamoxifen) 2. Aromatase inhibitors blocks estrogen synthesis (anastrozole or letrozole) 3. Androgens used in hypogonadism (DHEA)
63
Hyperaldosteronism (Dx and labs)
1. Labs = Hypokalemia with met alkalosis 2. Aldosterone: renin ratio screening 3. Definitive test = SALINE INFUSION TEST 4. CT/MRI - look for mass 5.EKG shows hypokalemia (u wave)
64
Hyperparathyroidism (FMLD()
signs of hypercalcemia Bones, stones, abdominal groans, psych moans Decreased DTR
65
Hyperplasia, congenital adrenal (FMLD)
Autosomal recessive disorder Deficient in enzyme in synthesis of cortisol, aldosterone, or bone Sex of neonate is unclear because of genital ambiguity
66
Hyperprolactinemia (Pharm tx)
Stop offending drug Dopamine agonists (Bromocriptine, cabergoline)
67
Hyperthyroid (scientific concepts)
1. Graves disease = MCC; autoimmune 2. Toxic multinodular goiter (plummer dz) autonomous functioning nodules; MC in elderly 3. Toxic adenoma = one autonomous functioning nodule 4. TSH secreting pituitary adenoma
68
Hypoparathyroidism (dx and labs)
Caropedal spasms, trosseaus and chovsteks sign, increased DTR Triad: Hypocalcemia, decreased PTH, increased phosphate
69
Hypopituitarism (scientific concepts)
Pituitary destruction or deficicent hypothalamic pituitary stimulation Congenital Or Acquired (tumor, infiltrative disease, bleeding into pituitary like Sheehans), pituitary infarction, XRT
70
Hypothyroidism (myxedema) Dx and Labs
Decreased T3/T4 Increased TSH Sx = bradycardia, hypothermia, hypoventilation, hypotensive, hypoglycemia, hyponatremia, delayed T3/T4
71
Hypothyroidism (myxedema) FMLD
Myxedema crisis = Extreme form of hypothyroidism Sx = fatigue, cold intolerance, weight gain, constipation, dry skin, mylagia, menstrual irregularities, goiter, bradycardia, delayed DTR
72
Klienfelter syndrome (dx and labs)
47XXY karyotype Low serum tesosterone
73
Klienfelter syndrome (dx and labs)
47XXY karyotype Low serum tesosterone
74
Klinefelter syndrome (FMLD)
Patients appear normal until puberty Tall, thin,stature, long limbs In adulthood = scoliosis, ataxia, developmental delays, hypogonadism, small testicles, infertility, scarce pubic hair
75
Pheochromocytoma (scientific concepts)
Catecholamine secreting adrenal tumor (Chromaffin cells) Secretes Epi + Norepi 90% benign; may be associated with MEN type 2
76
Pituitary adenoma (FMLD)
In females = Hypogonadism, amenorrhea, galactorrhea, HA, visual changes In men = Hypogonadism, decreased libido, infertility, HA, visual changes
77
Pituitary adenoma (pharm tx)
Prolactinoma = Dopamine agonists (cabergoline, bromocriptine) Somatotroph adenoma = Somatostatin analog (octreotide, lanreotide)
78
Primary adrenal insufficiency (scientific concepts)
Addisons disease Adrenal gland destruction (lack of cortisol and aldosterone) Etiologies: 1. Autoimmune (MC) 2.Infection (MCC worldwide) like TB, HIV, fungal, CMV 3.Vascular (thrombosis or hemorrhage in adgren gland known as Waterhouse-fredrichsen) 4.Metastatic disease or medications (ketoconazole, rifampin, phenytoin, barbituates)
79
Primary hyperaldosteronism (Scientific concepts)
Renin-independent (autonomous) Conn syndrome = adrenal adosteronoma in the zona glomerulosa
80
Primary hyperparathyroidism (clinical intervention)
1. Surgery = Parathyroidectomy 2. Vitamin D/Ca supplementation if this is a secondary problem 3. Tx of hypercalcemia if symptomatic (IV fluids, furosemide)
81
SIADH (dx and labs)
Syndrome of inappropriately HIGH ADH 1. Isovolemic hypotonic hyponatremia = decreased BUN 2. Urine = Increased urine osm 3. Dx made in absence of renal, adrenal, pituitary, thyroid disease, or diuretic use
82
SIADH (pharm tx)
Moderate = ADH receptor antagonists (conivaptan, tolvaptan) Chronic = Demeclocycline (tertracycline)
83
SIADH (clinical intervention_
Tx underlying cause when possible Fluid restriction If severe hyponatremia = IV hypertonic saline Avoid rapid correction to prevent central pontine myelinolyusis
84
SIADH/malignancy (FMLD)
Neuro sx of hyponatremia and cerebral edema = confusion, lethargy, disorientation, seizures Normovolemic, hypotonic, hyponatremic = Decreased serum osmolarity
85
Subacute thyroiditis (clinical intervention)
Aspirin (no anti-thyroid drugs)
86
Thyroglossal duct cysts (FMLD)
Often presents as midline neck cysts closely associated with hyoid bone Asx but can have symptoms Mass will elevate with tongue protrusion or swallowing
87
Thyroidtoxicosis (FMLD)
Thyrotoxicosis is condition due to excess thyroid hormone of any cause Increased T3 + T4 with decreased TSH Sx = anxiety, emotional lability, weakness, tremor, palpitations, heat intolerance, weight loss, a.fib Can progress into coma, hypotension MCC = Event like surgery, trauma, infection, illness, pregnancy
88
Type 1 DM (Scientific concepts)
Pancreatic beta cell destruction Patient no longer able to produce insulin; MC in childhood Type 1A = Autoimmune beta cell destruction triggered by 1 or more environmental factors Type 1B = Nonautominnue beta cell destruction

Precision (5 decks)

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