Reproductive

Question 1

when does obstetrical dating start

Answer 1

the first day of the LMP

Question 2

what is the average length of pregnancy

Answer 2

266 days from conception

280 days from LMP

Question 3

what percept of prenancies are ectopic

what percent of those are in the fallopian tube

Answer 3

0.5%

95% in the fallopian tube

Question 4

risks for ectopic pregnancy

Answer 4

salpingitis

prior ectopic pregnancy

prior tubal surgery

cigerette smoking

Question 5

what percent of people with ecoptic pregnancy will have at least one risk factor

Answer 5

50%

Question 6

what is the presentation of ectopic pregnancy

Answer 6

vaginal bleeding

pelvic pain

usually starts in the firs ttrimester

Question 7

describe pelvic pain associated with ectopic pregnancy

Answer 7

usually mild, starts at 6-8 weeks in

Question 8

describe pelvic pain associatd with ectopic pregnancy

Answer 8

usually starts at weeks 7-9

can vary from cramping to sharp pain

Question 9

what is necessary for the evaluation of first trimester pain and bleeding

Answer 9

ultrasound is mandatory to catch ectopic pregnancy brefore rupture

Question 10

US findings of ectopic pregnancy

Answer 10

No IUP “empty uterus”

adnexal mass

free fluid in the cul de sac

Question 11

IUP

Answer 11

intrauterine pregnancy

Question 12

what is the risk of a ruptured ectopic pregnancy

Answer 12

death

Question 13

what is the presentation of ruptured ectopic pregnancy

Answer 13

massive intrabdominal blood loss

severe pain

syncope

Question 14

what is the treatment of an ectopic pregnancy

Answer 14

removal of affected tube

blood transfusion

Question 15

treatment of unruptured ectopics

Answer 15

methotrexate with follow up

laproscopy with preservation (little) or removal (big) of the tube

Question 16

endometriosis

Answer 16

endometrial glands and stroma outside the uterus

Question 17

what demographic is more likley yo hae endometriosis

Answer 17

infertile women 25-35%

Question 18

symptoms of endometriosis

Answer 18

dysmenorrhea

dysparenunia

constant deep seated pelvic or rectal pain

infertility

Question 19

dyspareunia

Answer 19

painful intercourse

Question 20

what are the diagnostic considerations for endometriosis

Answer 20

laparoscopy

open surgery

US

Question 21

two variants of endometriosis

Answer 21

benign and aggressive

Question 22

benign variant endometriosis characteristics

Answer 22

later onset

superficial lesions

slow progression

Question 23

aggressive variant endometriosis characteristics

Answer 23

early onset

invasive lesions

rapid progression

Question 24

causes of endometriosis

Answer 24

retrograde mensturation that allows viable endometrial cells to implant on pelvis structures or travel in lymph that the immune system fails to elimante

Question 25

5 common locations of distant endometriosis

Answer 25

umbilicus intestine upper abdomen lung brain

Question 26

treatment for endometriosis

Answer 26

NSAIDs for dysmenorrhea ovarian suppresssion surgery

Question 27

three ways to use hormone suppression to treat endometriosis

Answer 27

contraceptives Pituitary down regulation mild androgens

Question 28

what is the definitive surgical treatment for endometriosis

Answer 28

hysterectomy and oophorectomy

Question 29

three areas of cancer of the reproductive system

Answer 29

breast cancer ovarian uterine

Question 30

four facts regardings breast cancer and age increasing risk rare before... mean age diagnosis time

Answer 30

risk increases with age rare before 40 mean age of diagnosis 60-61 time from origin to diagnosis 2-8 years

Question 31

how long does it take for a breast cancer tumor to double in size

Answer 31

20-100 days

Question 32

what is the risk of breast cancer in females without estrogen what about men with estrogen

Answer 32

male level risk increased risk because of estrogen

Question 33

what is the risk factor for breast cancer associated with familial linkage but...

Answer 33

risk is increased 3-4x if a mother or sister has breast cancer 75% of patients have no history

Question 34

two breast cancer mutations that increase risk what type of genes are mutated what is the life time risk with the mutation

Answer 34

BRCA 1 and 2 tumor suppressor mutations 50-85%

Question 35

what other cancers are associated with BRCA 1 and 2

Answer 35

ovarian pancreatic fallopian prostate

Question 36

in what countries are breast cancers most commonly found why

Answer 36

developed countries related to fat content

Question 37

what is the connection between ethanol and breast cancer

Answer 37

slight increase in ris

Question 38

what is the usual presentation of breast cancer

Answer 38

a painless lump found by the patient

Question 39

what are three less common presentations of breast cancer

Answer 39

nipple erosion or discharge skin dimpling inflammatory breast carcinoma

Question 40

four types of breast cancer screenings

Answer 40

monthly self exam annual breast exam mammography blood test for tumor markers

Question 41

at what age does mammography have a proven value

Answer 41

between ages 50-70, no value under age 40

Question 42

five ways to treat breast cancer

Answer 42

surgery radiation chemo anti estrogen driugs antibodies against growth factors

Question 43

what are the three primary surgical treatments of breast cancer

Answer 43

lumpectomy mastectomy axillary node dissection

Question 44

what factors decrease risk for ovarian cancer

Answer 44

pregnancy oral contraceptive use tubal ligation

Question 45

three orgin sites for ovarian cancer which is the most common

Answer 45

epithelial germ cell stromal/sex cord epithelial

Question 46

serous and mucinous cystadenocarcinoma are examples of what type of ovarian cancer origin

Answer 46

epthelial

Question 47

does removing or blocking fallopian tubes increase to decrease risk of ovarian cancer

Answer 47

decrease

Question 48

how does early diagnosis effect prognosis of ovarian cancer but...

Answer 48

early detection increases prognosis but only 20% of cases are detected earyl

Question 49

what is common when ovarian cancer starts to spread in the abdomen

Answer 49

obstruction, malabsorption

Question 50

three sites of distant metastases in ovarian cancer

Answer 50

liver lung bone

Question 51

two treatment options for ovarian cancer

Answer 51

surgery chemo

Question 52

when pursuing surgical treatment of ovarian cancer, what needs to be removed

Answer 52

uterus, ovaries, fallopian tubes, omentum

Question 53

three types of uterine cancer

Answer 53

cervical cancer endometrial cancer leiomyosarcoma

Question 54

what is the main cause of cervical cancer what are two synergistic factors

Answer 54

HPV smoking, immunosuppression

Question 55

what types of HPV are associted with warts what are associated with cervical cancer

Answer 55

6, 11, 42, 43 16, 18, 33, 35, 45

Question 56

how effective is gardasil against cervical cancer what about genital warts

Answer 56

prevents 70-90% of cervical cancer only some protection

Question 57

what are the conventional screens for HPV

Answer 57

pap smear liquid based medium

Question 58

three treatments of cervical cancer

Answer 58

radial hysterectomy and lymph node dissection radiation chemo

Question 59

three factors that increase risk for endometrial cancer two factors that decrease risk

Answer 59

estrogen exposure, insufficient progesteron, genetics oral contraceptives, progestin use

Question 60

what is the effect of birth control on the risk for the following cancers breast ovarian cervical endometrial

Answer 60

possible increased risk decreased risk no impact decreased

Question 61

how is endometrial cancer diagnosed

Answer 61

post menopausal bleeding endometrial biopsy/d & c ultrasound MRI for staging

Question 62

treatment for endometrial cancer

Answer 62

radiation surgery hormones chemo

Question 63

psoriasis

Answer 63

chronic, relapsing skin disorder that causes itching, joint inflammation, and depression

Question 64

how common is psoriasis what is the typical age of onset what is the gender bias

Answer 64

very common (1-3%) 15-25 yrs none

Question 65

describe the incidence of psoriasis from the follow ethnicities caucasians african americans native americans

Answer 65

most common uncommon very rare

Question 66

psoriasis is associated with increased risk for what diseases

Answer 66

inflammatory bowel disease skin cancer upper GI cancer lung cancer

Question 67

what is the etiology of psoriasis

Answer 67

it is a T cell mediated immune disease which also involves TNF and interleukins

Question 68

what is the familial genetic influence with psoriasis

Answer 68

1/3 of people will have a positive FHx 70% chance that twins will have this together

Question 69

what is the pathophysiology of psoriasis

Answer 69

excessively rapid turnover of the epidermis (3-5 days instead of 21-30 days)

Question 70

what is the goal of psoriasis treatment

Answer 70

slow the turnover rate of the epidermis

Question 71

what are the treatments for psoriasis ranked by toxicity what is the relationship between toxicity and effectiveness

Answer 71

topical, photo, systemic increasingly effective treatment is increasingly toxic

Question 72

three examples of topical psoriasis treatment

Answer 72

corticosteroids anthralin coal tar

Question 73

two photo treatments of psoriaisis

Answer 73

UVB, PUVA

Question 74

three systemic treatments of psoriaisis

Answer 74

cyclosprin methotrextate retinoids

Question 75

hypertrophic scars

Answer 75

raised or expanded scars that often form in reaction to suboptimal healing

Question 76

keloid scars

Answer 76

idiopathic benign neoplastic extension of scars

Question 77

what is the relationship between keloids and skin pigmentation

Answer 77

increasing pigmentation increases risk

Question 78

what is the most common age group to form keloids

Answer 78

10-20

Question 79

five treatment options for keloids

Answer 79

corticosteroid injections cryotherapy radiation surgical excision laser reduction

Question 80

two benign forms of skin cancer one maglignant type

Answer 80

basal cell and squamous cell carcinoma melanoma

Question 81

what is the most common form of skin cancer what is the common cause what is the risk if left untreated

Answer 81

basal cell carcinoma UV light local destruction, rarely metastasis

Question 82

what is the common cause of squamous cell carcinoma when would it be considered deadly

Answer 82

UV light when it is in the oral cavities or mucus membranes

Question 83

two treatment options for basal or squamous cell carcinoma

Answer 83

outpatient excision or thermal ablation

Question 84

what is the main risk factor for melanoma why is the incidence increasing but the mortality decreasing

Answer 84

sun exposure sun worship - early detection, better treatment

Question 85

diagnosis of melaoma

Answer 85

biopsy ABCDE ugly duckling

Question 86

ABCDE for melanoma

Answer 86

assymetry border color diameter evolution

Question 87

treatment for melanoma

Answer 87

excision chemo immunotherapy

Question 88

two considerations to account for with surgical excision of melanoma

Answer 88

wide surgical margins with lymph node sampling

Question 89

three forms of immunotherapy against melanoma

Answer 89

interferon tumor vaccines lymphocyte training

Question 90

dermatological manifestation of heart failure

Answer 90

pitting edema

Question 91

dermatological manifestation of insufficient oxygenation

Answer 91

clubbing and cyanosis

Question 92

dermatological manifestation of vascular insufficiency

Answer 92

venous stasis ulcers

Question 93

three types of coagulopathies

Answer 93

low platelet counts clotting factor deficiencies excessive anticoagulation

Question 94

three signs of clotting abnormalities in the skin

Answer 94

petechiae purpura easy bruising

Question 95

two types of lupus

Answer 95

systemic discoid (only skin)

Question 96

three causes of contact dermatitis

Answer 96

allergic reaction similar to poison ivy/oak/sumac