Secrets - Gynecology Flashcards
Inpatient treatment of PID.
Cefoxitin or cefotetan plus doxycycline
Outpatient treatment of PID.
Ceftriaxone plus doxycycline
Most likely cause of infertility in a normally menstruating woman younger than age 30 years?
PID
Pap smear shows this if +HPV.
Koilocytosis: abnormal epithelial cells w/ the following changes:
- peri-nuclear halo
- nuclear enlargement
- hyperchromasia of nucleus
- irregularity of nuclear membrane contour
Treatment for + HPV.
Acid, cryo therapy, laser, podophyllin
Features of Secondary Syphilis.
Disseminated disease w/ constitutional sxs:
- Maculopapular rash (including palms and soles)
- Condylomata lata (moist, smooth, wart-like, PAINLESS, white lesions on genitals)
- Confirm w/ FTA-ABS serology
Pediculosis tx.
Lice tx Permethrin cream (or malathion)
Patients with chlamydia should be treated for presumed gonorrhea infection. T/F
FALSE, do not automatically give gonorrhea tx to pts with chlamydial infection.
After ruling out pregnancy, if the cause of secondary amenorrhea from hx and PE is nor obvious, what is the next step?
Administer progesterone to assess the pt’s estrogen status:
-If bleeds, pt has enough estrogen, then check LH
If secondary amenorrhea, withdrawal bleed w/ progesterone and HIGH LH.. dx
PCOS
If secondary amenorrhea, withdrawal bleed w/ progesterone and low or normal LH…next step?
Check prolactin and TSH levels:
- If high TSH, then hypothyroidism causes high prolactin
- If prolactin is high w/ normal TSH, order MRI to r/p pituitary adenoma.
If secondary amenorrhea, FAILS to have vaginal bleeding after progesterone….next step?
Inadequate estrogen levels so check FSH levels:
- If FSH high, POF
- If FSH low or normal, r/o brain tumor
If you suspect Premature Ovarian Failure, look for?
H/o autoimmune disorders, Karyotype abnormalities like Turner syndrome or Fragile X, and history of chemotherapy/radiation.
At what age can primary amenorrhea be diagnosed?
Age 16 yrs or in the absence of menstruation within 2 years of developing secondary sex characteristics.
Unilateral sero-sanguinous nipple discharge, with no breast mass association..dx?
Intraductal papilloma, small benign tumor that grows in lactiferous ducts, beneath the areola; Slight increase in risk of carcinoma.
