Semester 2 MedSurg Exam 2 Flashcards by Tiana Brinton

What procedure should not be done prior to an infant having corrective surgery for hypospadias?

Circumcision

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What other complication is common with epispadias?

Bladder exstrophy

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Which hormone is most present for the first stage of the menstrual cycle?

Estrogen

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Which hormone is most present for the second stage of the menstrual cycle?

Progesterone

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Which hormone signals release of progesterone and triggers ovulation during the menstrual cycle?

Luteinizing hormone

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What is the function of progesterone?

It prepares the uterine lining to be implanted

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Which hormone stimulates the ovaries to produce estrogen and where is it made?

Follicle stimulating hormone/pituitary gland

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During which phase does PMS occur?

Luteal phase

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What is primary vs. secondary dysmenorrhea?

Primary is directly related to the period, secondary is caused by the presence of another diagnosis such as endometriosis or fibroids

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What is metrorrhagia?

Bleeding between periods

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What is primary vs. secondary amenorrhea?

Primary amenorrhea = not having a period by age 15
Secondary amenorrhea = having a regular period initially but then no periods for ≥3 months

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What is menorrhagia vs. metrorrhagia?

Menorrhagia=excessive bleeding
Metrorrhagia=bleeding between periods

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What does shoulder pain indicate in someone who has just undergone a gynecological laparoscopy?

Shoulder pain is a normal side effect of the CO2 which is inserted into the abdominal cavity to separate the reproductive system from the surrounding organs

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During what period is there an increased likelihood of breast cancer?

Perimenopause

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What is the term for an abnormally thickened uterine lining and what does it indicate?

Endometrial hyperplasia, and it is an abnormal finding that most often indicates cancer

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Which two vitamins have been shown to help some people with PMS and perimenopause symptoms?

Vitamins B6 and E

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Which conditions are contraindications for receiving HRT?

Hx of breast or uterine cancer, impaired liver function, vascular thrombosis, or undiagnosed abnormal vaginal bleeding

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What two additional structures are included in a radical hysterectomy?

Lymph nodes and upper 1/3 of the vagina

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Prior to a hysterectomy (or any surgery), what will the provider tell the patient to discontinue taking?

NSAIDs, anticoagulants, and Vitamin E

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What is the most common cause of PID?

STIs (gonorrhea and chlamydia are most common if infection is STI based)

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What does a positive chandelier sign indicate and what is another term for it?

PID or peritonitis. It is also called cervical motion tenderness

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What is the purpose of mifepristone and how is it used to treat fibroids?

It’s a progesterone antagonist and it’s given to prevent endometrial bleeding (without progesterone, blood will not get to the uterine lining)

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What is the most common type of ovarian cyst?

Follicular cyst

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What is the difference between a follicular ovarian cyst and a luteal ovarian cyst?

Follicular = graafian follicle doesn’t release its egg during ovulation which creates a cyst
Luteal = fluid accumulates during the luteal phase and the corpus luteum turns into a cyst

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Which chromosomes are the BRCA genes and what do they do?

Chromosomes 11 and 17, and they are tumor suppression genes

Where is the most common place on/around the breast for breast cancer to occur?

Upper outer quadrant

What do SERMs do?

Blocks the effects of estrogen on breast cells

What do aromatase inhibitors do?

Prevent the adrenal glands from producing estrogen

Which type of breast cancer is commonly misdiagnosed as a skin condition and what are the symptoms?

Paget's disease (mammary duct malignancy). Symptoms include nipple lesion that spreads to the areola, and eczema-like rash (itchy, red, inflamed)

A patient presents at the doctor's office with a red, warm, inflamed breast and peau d'orange. What is the most likely diagnosis?

Inflammatory carcinoma

What is tumor differentiation?

How similar the tumor cells look to the surrounding tissue cells (the more differentiation the worse it is)

What is Triple Negative breast cancer?

HER2, estrogen receptors, and progesterone receptors are all negative

When is the best time to perform a breast self exam after menses?

5-7 days (or once a month on the same day each month if there is no menstrual cycle)

What are the mammogram screening guidelines?

Annually starting at age 45 if no risk factors, or age 40-44 if high risk. Women ≥55 may opt to do every 2 years if otherwise healthy

What is a sentinel lymph node biopsy?

A biopsy taken from the first lymph node in the lymphatic basin that receives drainage from the primary tumor

What are the timing parameters for radiation therapy?

5 days a week for 5-6 weeks, ~6 weeks after surgery, and after chemo is completed

What are the potential long-term effects of radiation therapy?

Dental disease, lung disease, osteoporosis, cardiovascular disease

What is the risk vs benefit of Tamoxifen?

It inhibits estrogen-induced cellular growth in the breasts but promotes it in the uterus (increasing risk of uterine cancer)

What is the #1 risk factor for cervical cancer?

HPV

What is the biggest risk factor for uterine (endometrial) cancer?

Hormone fluctuations. Early menses, late menopause, nulliparity

What is the more common type of endometrial cancer?

Estrogen-dependent

Which gynecological cancer is labeled "the silent killer?"

Ovarian

Where is prostate cancer most likely to metastasize to?

The bones

What are some things a PSA >4 likely indicate?

Prostate cancer, BPH, acute urinary retention, or acute prostatitis

Why would a patient also get a CT scan and Xray once they get their Gleason score results?

To see if the prostate cancer has metastasized to the bones or lymph nodes

What is the first-line treatment for prostate cancer?

Radical prostatectomy

Is chemotherapy effective on prostate cancer?

No, but it can be used as an adjunct therapy if the cancer has metastasized

What are the parameters for prostate screening?

Annually for men ≥50 or ≥45 for African American men or men who have a first-degree family history of prostate cancer

What is the IPSS questionaire?

A series of questions that grade BPH symptoms to determine whether they're mild, moderate, or severe

What would an enlarged, tender prostate with nodules indicate?

Prostate cancer

How many mL/min is the target amount for a urine flow test?

12 mL/minute

What is autonomic dysreflexia and what are the symptoms?

Sudden hypertensive crisis caused by overextension of the bowel or bladder triggering the sympathetic nervous system. Symptoms include severe HTN, goosebumps, diaphoresis, headache, blurred vision, anxiety, and pallor

What is the difference between prerenal, intrarenal, and postrenal failure?

Prerenal is due to lack of perfusion, intrarenal is direct damage to the kidney (such as from a med), and postrenal is due to an obstruction which causes urine to back up into the kidney

What is normal vaginal pH range?

3.8 to 4.5

Which type of vaginal infection is characterized by an overgrowth of anaerobic bacteria, lack of lactobacilli, and a vaginal pH >4.7?

Bacterial vaginosis

What physical symptoms are associated with the primary, secondary, and tertiary stages of syphilis?

Primary=chancre sores Secondary=rash, white lesions in moist areas, and generalized signs of infection Tertiary=aoritis, neurosyphillis

Out of gonorrhea, chlamydia, and syphilis, which is transferable to a fetus via the placenta?

Syphilis

What is an important patient teaching regarding antibiotics and gonorrhea/chlamydia?

Finish the full course, wait 7 days after finishing before having sex, and get tested again 3 months after treatment

What is the most common type of breast cancer?

Infiltrating ductal carcinoma