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Panre > Reproductive > Flashcards

Reproductive Flashcards

0
Q

What happens in phase two of the menstrual cycle?

A

Ovulation, increase in estrogen (estradiol) leads to increase in LH and ovulation.

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1
Q

First day of menstrual bleeding is what phase?

A

Follicular

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2
Q

What is phase III of the menstrual cycle?

A

Luteal, increase in progesterone leads to decrease in LH and FSH and endometrial development.

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3
Q

Describe what happens in dysfunctional uterine bleeding?

A

Constant non cyclic blood estrogen levels leads to growth and development of the endometrium. Without ovulation and progesterone it overgrows and sloughs off at irregular times.

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4
Q

Treatment for dysfunctional uterine bleeding?

A

OCP, progesterone x 10 days per month. If ,no Meds work consider endometrial ablation or hysterectomy.

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5
Q

What is the most common gynecological malignancy in the Us.

A

Endometrial carcinoma. Estrogen dependent.

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6
Q

What are the risk factors for endometrial carcinoma?

A

Obesity, HTN, DM, nulliparity.

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7
Q

Post menopausal vaginal bleeding…. What do you do?

A

Always abnormal! Check endometrial bx.

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8
Q

Treatment for endometrial carcinoma?

A

Hysterectomy and post op radiation.

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9
Q

What is the most common presentation of endometriosis?

A

Dysmenorrhea and deep dyspareunia.

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10
Q

Definitive dx txt for endometriosis?

A

Laparoscopic exam with bx.

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11
Q

What is the medical treatment options for endometriosis and how does that t work?

A

OCP, NSAIDs, danazol, lupron. All suppress estrogen.

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12
Q

What is adenomyosis?

A

Islands of endometrial tissue within the myometrium. Common exam finding is tender , enlarged boggy uterus. Tx. TAH.

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13
Q

What is a leiomyoma and presenting complaints?

A

Uterine fibroids. Most common indication of hysterectomy. Present with bleeding, pain and pressure.

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14
Q

Physical exam findings of large, irregular hard pelvic mass with shadowing on ultrasound?

A

Leiomyoma or fibroids.

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15
Q

How to treat leiomyoma?

A

Myomectomy. Hysterectomy.

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16
Q

What is metritis? Who is at an increased risk? Common organisms? Treatment?

A

Post partum uterine infection. Increased risk with c section. Group a strep, staph. Aureus.
Treat with clindamycin plus gent = c section
Amp plus gent after vaginal birth.

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17
Q

What is a cystocele?

A

Posterior bladder protrudes into vagina

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18
Q

What is a enterocele?

A

Pouch of Douglas protrudes into vagina.

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19
Q

What is a rectocele?

A

Rectum into posterior vagina.

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20
Q

Incontinence when you laugh or sneeze and treatment.

A

Stress. Kegal, estrogen , surgery.

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21
Q

Large incontinence with no event, pos nocturia and urgency. Treatment?

A

Urge. Anticholinergics.

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22
Q

Small continuous incontinence with fullness, pressure, frequency. Treatment?

A

Overflow. Catheter, a blocker, anticholinergic.

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23
Q

This is the 5th MC cancer in women and the highest mortality rate.

A

Malignant ovarian neoplasms.

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24
Q

Presentation and sx of ovarian cancer?

A

Often asymptomatic until mets. Abdominal fullness, back pain, decreased energy, urinary frequency.

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25
Q

Chemo agent for ovarian ca?

A

Cisplatin

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26
Q

Patient presents to clinic with infertility, irregular menses, hirsutism, obesity and acne. Dx? Management?

A

PCOS. Treat with OCPs Metformin, clomid.

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27
Q

What virus is linked to cervical carcinoma?

A

Human papilloma virus

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28
Q

Patient presents with post coital bleeding, watery discharge and pelvic pain. Think?

A

Cervical carcinoma.

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29
Q

CIN 1: cancer in _ years.

A

7

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30
Q

CIN 2: cancer in _ years?

A

4

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31
Q

If positive Pap smear follow up?

A

Pap every 6 months x 2 years.

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32
Q

Painless bleeding and vaginal discharge In second trimester?

A

Incompetent cervix. Treat with bed rest, cerclage.

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33
Q

Describe vaginal ca? Dx, tx?

A

Rare, usually secondary to other ca. 80% squamous cell carcinoma. Usually asymptomatic. Dx with Pap smear and bx. Treat with radiation.

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34
Q

Describe vulvar cancer. Presentation, dx, tx?

A

Peak age 70. Most squamous cell carcinoma.
Pt complains of pruritus,red or white ulcerative lesions. Dx with bx.
Treat with surgery, RT, chemo.

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35
Q

Flagyl GETS what bugs?,

A

Giardia, entomebia, trichomoniasis. And BV.

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36
Q

Toxic shock syndrome caused by?

A

Staph aureus

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37
Q

This is due to lactobacillus decrease and overgrowth of g. Vaginalis.

A

BV

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38
Q

Vaginal discharge with bad odor, worse after sex. Thing grey discharge. Positive clue cells and pos Whiff test. Dx? Tx?

A

BV. Treat with flagyl or clindamycin.

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39
Q

Vaginal Schaffer with rancid odor, frothy green and strawberry cervix. Dx? Tx?

A

Trichomonas. Flagyl. Treat partner!

40
Q

Vaginal itching and burning with white cheese like discharge. Dx? Tx?

A

Yeast infection. Fluconazole. Clotrimazole.

41
Q

This is a spontaneous ascending reproductive tract infection. Patient presents with pelvic pain, dyspareunia, vaginal discharge, nausea and vomiting. Looks sick.

A

PID.

42
Q

Criteria for dx of PID?

A

Must have : abdominal tenderness, adenexal tenderness, cervical motion tenderness.

43
Q

Treatment for PID? Inpatient? Outpatient?

A

Inpatient: cephalosporin plus doxy.
Outpatient: rocephin plus doxy.

44
Q

What is fitz-Hugh-Curtis syndrome?

A

Peri hepatitis due to peritoneal involvement from PID. Causes hepatic fibrosis and scaring.

45
Q

What type of HPV is linked to cervical cancer?

A

16, 18, 31, 33, 35

46
Q

MC cause of amenorrhea?

A

Pregnancy

47
Q

Causes of primary amenorrhea if breasts present and uterus present?

A

Imperforate hymen, vaginal septum, anorexia, pregnancy

48
Q

Causes of primary amenorrhea if breast absent and uterus present?

A

HP failure, gonadal dysgenesis.

49
Q

Lab testing and results for dx of hypothalamic pituitary dysfunction?

A

FSH and LH decreased ( not stimulated by GNRH from post pituitary) , prolactin normal. Treat underlying cause.

50
Q

Lab test results for amenorrhea caused by ovarian failure?

A

FSH and LH high. Symptoms of menopause usually present. Dx with progesterone challenge test.

51
Q

If progesterone challenge test causes withdrawal bleeding?

A

Patient is anovulatory and treat with hormone replacement therapy.

52
Q

If progesterone challenge test causes no bleeding or bleeding does not occur?

A

The patient is hypoestergenic or has an outflow problem. Surgery and hysterscopy required.

53
Q

Dysmenorrhea?

A

Painful menstruation.

54
Q

PMS is elated to what phase of the menstrual cycle?

A

Luteal. Follicular is sx free.

55
Q

Describe menopause.

A

Cessation of menses for one year with increase in FSH and LH.

56
Q

Contraindications for hormone replacement therapy?

A

Liver dz, thrombotic events, endometrial or breast ca.

57
Q

Premenstrual breast pain with multiple well define d mirror images or sheets of dense tissue. Mobile, no axillary involvement or nipple discharge. Dx? Tx?

A

Fibrocystic disorder. No tx required.

58
Q

One or two smooth, rubbery, well circumcised breast lumps. Movable no axillary or nipple discharge. Dx?

A

Fibroadenoma. Can enlarge in pregnancy.

59
Q

Lactating women with sudden onset fever, chills, body aches with erythema and tenderness to breast. Dx? Tx?

A

Mastitis. Give dicloxicillin and continue to breastfeed.

60
Q

Fluctuant mass on breast with pain, fever, swelling? Dx? Tx?

A

Breast abscess. Surgical drainage. Naficillin, vanc.

61
Q

Second most common malignancy in women?

A

Breast cancer

62
Q

Micro calcification on mammogram?

A

Suspect malignancy.

63
Q

How do OCP work?

A

Inhibit mid cycle LH surge preventing ovulation, thickening the cervical mucosa.

64
Q

Contraindications doe OCP?

A

Pregnancy, liver dz, vascular dz, smoker, uncontrolled HTN, thrombophilia.

65
Q

When can the ultrasound detect the fetus?

A

5-6 wks

66
Q

Fetal heart tone by Doppler when?

A

10-12 wks

67
Q

Quickening at what time?

A

16-20 wks.

68
Q

Cervix with bluish color at 8-12 wks ?

A

Chadwick’s sign

69
Q

How do you determine EDD?

A

First day of LMP plus 7 days minus 3 months.

70
Q

When to do the glucose tolerance test?

A

24-28 wks

71
Q

Uterus at 12 wks?

A

Pubis

72
Q

Uterus at 14 wks?

A

Between pubis and umbilicus.

73
Q

Uterus at 20-22 wks?

A

At umbilicus.

74
Q

Uterus at 38 wks?

A

Zyphoid.

75
Q

When do you measure alpha fetoprotien?

A

15-20 wks. Increased in neural tube defects. Decreased in Down syndrome.

76
Q

When do you give rhogam?

A

28 wks and within 72 hrs of delivery

77
Q

When do you test for group b strep?

A

32 wks

78
Q

Describe a non stress test and a positive result.

A

Measures fetal heart rate for 20 min. Normal (reactive ) shows fetal heart rate acceleration.

79
Q

Describe a contraction stress test and a normal result.

A

Measure fetal heart rate in response to uterine contraction. Normal (negative) shows no decelerations.

80
Q

Spontaneous uterine contractions late in pregnancy with no cervical dilation are?

A

Braxton hicks.

81
Q

Fetal head descending into pelvis?

A

Lightening

82
Q

Passage of blood tinged mucosa late in pregnancy.

A

Bloody show.

83
Q

Active labor?

A

4 cm dilation

84
Q

Stage two of labor?

A

Complete dilation of cervix through delivery of infant.

85
Q

Stage 3 of labor?

A

After delivery of infant and ends with delivery of placenta.

86
Q

Abortion?

A

Termination of pregnancy prior to 20 wks.

87
Q

Bleeding prior to 20 wks with closed os and no products of conception passed?

A

Threatened abortion.

88
Q

Moderate bleeding with severe abdominal cramping, cervical os dilated but no products passed?

A

Inevitable abortion

89
Q

Some products passed prior to 20 wks?

A

Incomplete abortion

90
Q

Embryo no viable but retained in uterus, no contractions, bleeding absent?

A

Missed abortion.

91
Q

Patient presents with amenorrhea, unilateral abdominal pain, irregular menses?

A

Assess BHCG. Should double every 24-48 hrs. Ultrasound and surgery. Ectopic pregnancy.

92
Q

Risk factors for ectopic pregnancy?

A

Hx of infertility, hx of one in past, hx of tubal ligation, hx of PID, IUd use.

93
Q

HTN of 140/90 with no other sx?

A

Gestational HTN.

94
Q

HTN with protienuria or edema?

A

Preeclampsia

95
Q

Preeclampsia with convulsions?

A

Eclampsia.

96
Q

Preeclampsia tx?

A

Bed rest, monitoring, magnesium sulfate, methldopa.

97
Q

Eclampsia treatment?

A

Magnesium, delivery

Panre (18 decks)

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