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PNCE > Reproductive JB > Flashcards

Reproductive JB Flashcards

1
Q

MCC vaginitis

A

Bacterial vaginosis

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2
Q

bacterial vaginosis etiology

A

gardnerella vaginalis

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3
Q

Bacterial vaginosis dx

A 
Amsels criteria: 
Clue cells 
pH>4.5
thin, homogenous watery grey white discharge
\+ whiff test
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4
Q

Bacterial vaginosis tx

A

metronidazole
safe in pregnancy, may use gel or PO
clindamycin

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5
Q

Bacterial vaginosis need to tx partner?

A

no

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6
Q

Breast cancer dx

A

mammogram
US - initially for <40yo
FNA w/ bx

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7
Q

Breast cancer preventative measures

A

Mammogram annually >40yo or 10yrs prior to 1st degree relative diagnosis
Breast exam (clinical) 20-39yo q 3yrs. >40yo annually
Self exam: monthly >20yo, after menstruation or day 5-7

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8
Q

Breast cancer tx

A 
Anti estrogen (tamoxifen) for ER positive tumors 
aromatase inhibitors (letrozole, anastrozole) for postmenopausal with ER + breast cancer
monoclonal ab (trastuzamab or Herceptin) for HER2 positivity
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9
Q

Breast cancer preventative medication

A

SERM (tamoxifen or raloxifene) for postmenopausal or >35yo w/ high risk of breast cancer.
use for 5y

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10
Q

Vulvular cancer sx

A

DES exposure

pruritic (MC)

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11
Q

MC type vulvular cancer

A

BCC

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12
Q

Vulvular cancer dx

A

Pap w/ cytology

colposcopy w/ bx

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13
Q

Cervical cancer associated with:

A

HPV 16, 18

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14
Q

MC type cervical cancer

A

SCC

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15
Q

Cervical cancer w/ DES exposure

A

clear cell carcinoma

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16
Q

MC sx of cervical cancer

A

post coital bleeding

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17
Q

Cervical cancer prevention

A

HPV vaccine (Gardasil 9)

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18
Q

Contraception safe during lactation

A

Progestin only OCPs

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19
Q

Most effective form of contraception besides abstinence

A

IUD

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20
Q

IUD risk

A

increased risk of PID

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21
Q

dysfunctional uterine bleeding tx

A

hormone tx
IUD
tx underlying

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22
Q

eclampsia dx

A

preeclampsia + seizures or coma
abrupt tonic clonic seizures 1-2m
post ictal hyperreflexia

23
Q

eclampsia tx

A 
ABCDs
magnesium sulfate for seizures 
lorazepam 2nd line if refractory
Deliver fetus once pt stabilized 
hydralazine
24
Q

endometrial cancer PE

A

postmenopausal bleeding

endometrial stripe >4mm on transvaginal US

25
Q

endometrial cancer dx

A 
bx
pelvic exam
D&C
transvaginal US 
CT/MRI
Labs: CA-125 (both endometrial and ovarian cancer)
26
Q

combo OCPs are protective against

A

ovarian and endometrial cancer

27
Q

endometrial cancer MC sx

A

postmenopausal bleeding

28
Q

Endometriosis sx

A

Triad: cyclic premenstrual pelvic pain +/- low back pain, dysmenorrhea, dysparenuria
infertility

29
Q

endometriosis dx

A

laparoscopy w/ bx definitive

30
Q

endometriosis tx

A

combined OCP + NSAID
progesterone, leuprolide, danazol
surgery: laparoscopy w/ ablation if fertility desired. TAH-BSO if no desire for conception

31
Q

endometritis risk factor

A

C-section
PROM >24h
vaginal delivery
D&C

32
Q

Endometritis tx

A

infection post c section: clindamycin + gentamicin. May add ampicillin for group B strep coverage. Zosyn is alternative
infection after vaginal delivery or chorioamnionitis: ampicillin + gentamicin

33
Q

What herniates in enterocele

A

pouch of Douglass herniates into upper vagina

34
Q

Fibrocystic breast disorder dx

A

US

FNA: straw colored fluid

35
Q

Gestational diabetes dx

A

Screening: 24-48 wks gestation w/ 50g oral glucose challenge (non fasting)
Confirmatory: 3h 100g OGTT gold standard. done in the morning after overnight fast

36
Q

Gestational diabetes tx

A

Labor induction at 38wks if uncontrolled
delivered at 40wks if controlled/no macrosomnia
insulin TOC
glyburide safe in pregnancy and metformin

37
Q

gestational HTN tx

A

methyldops 1st line chronic/preexisting HTN

labetalol, hydralazine, nifedipine

38
Q

Molar pregnancy (gestational trophoblastic dz) sx

A

Painless vaginal bleeding
uterine size/date discrepancies
preeclampsia before 20wks
hyperemesis gravidarum

39
Q

Molar pregnancy tests

A

bHcG >100,000
low AFP
US: snowstorm/cluster of grapes. no fetal heart sounds or feta lparts

40
Q

gynecomastia tx

A

clomiphene
tamixifen
danazol

41
Q

hyperemesis gravidarum tx

A 
doxylhamine + pyridoxine FDA approved 
metaclopramide 
diphenhydramine
zofran (cleft palate risk)
promethazine
42
Q

Hypothalamic amenorrhea labs

A

normal/decreased FSH and LH
decreased estradiol
normal prolactin

43
Q

hypothalamic amenorrhea tx

A

clomiphene

44
Q

menopause dx

A 
FSH assay most sensitive initial test (increased FSH)
increased LH
decreased estrogen 
same androstenedione levels
estrone predominant
45
Q

menorrhagia tx

A

OCP
Progesterone
GnRH agonist: leuprolide w/ add back progesterone

46
Q

Molar pregnancy tx

A 
surgery. suction curettage mainstay asap, weekly bHcG levels 
hysterectomy
rhogam
avoid pregnancy for 1y
high risk of choriocarcinoma
47
Q

Mucopurulent cervicitis tx

A

STD
Obtain culture
Tx w/ ceftriaxone + azithromycin + metronidazole +/- doxycycline pending result

48
Q

Ovarian cancer tx

A

Early: TAH-BSO + selective lymphadenectomy
Surgery: monitor w/ CA-125
chemo: taclitaxel + cisplatin or carboplatin

49
Q

placenta previa dx

A

pelvic US, do not do pelvic exam

50
Q

PCOS sx

A

triad: amenorrhea, obesity, hirsutism

51
Q

PCOS labs

A

decreased FSH, increased LH, increase testosterone, increased estrogen, low SHBG, high androstenedione

52
Q

PCOS tx

A

combo OCP mainstay. avoid norgestrel and levonorgestrel
hirsutism: spironolactone, leurprolide, finasteride
infertility: clomiphene
wedge resection

53
Q

preeclampsia sx

A

HTN + proteinuria +/- edema after 20wks, up to 6wks postpartum
hyperreflexia

54
Q

Rectocele tx

A

prophylactic: kegal, weight control
Nonsurgical: pessary (sx relief), estrogen tx (for atrophy)
Surgical: hysterectomy, ligament fixation

PNCE (33 decks)

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