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OB/GYN > Slides 2 > Flashcards

Slides 2 Flashcards

1
Q

63 år gammel kvinne med 2 cm lesjon på venstre labium major. Har vært der i 3 mnd. neste steg?

A

Eksisjonsbiopsi

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2
Q

18 år gammel dame med smertefull hevelse i venstre labium som har blitt gradvis verre siste 3 dager. Hun har prøvd OTC smertelindring og Sitz-bad.

Hva er neste steg?

A

Insisjon og drenasje

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3
Q

21 år gammel dame på college. Har brukt OCP siste 3 årene. Har en 2 mm pigmentert flat lesjon med uregelmessig kant på venstre labium. Hva er neste steg

A

Eksisjonsbiopsi

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4
Q

36 year old woman with complaints of chronic vaginal infection. She reports little vaginal discharge, but rather a 1 year history of progressively worsening vulvar discomfort that has escalated to pain sufficient to preclude intercourse and tampon use.

Inspection of the vulva demonstrates focal inflammation, punctation and ulceration of the perineal and vaginal epithelium. An attempt to perform a bimanual exam of pelvic organs reveals intense pain and tenderness at the posterior introitus and vestibule

What is the best next step?

A

Topical anesthetics and antidepressants treatment

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5
Q

What is the immediate precursor lesion for vulvar cancer

A

Unknown

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6
Q

56 year old woman has Bx-proven VIN III. She undergoes wide excision and returns 3 months later with vulvar pruritus

What should you advise the patient

A

She may need a repeat biopsy

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7
Q

A 65 year old woman presents with complaints of vulvar redness, pruritus and occational weeping from the skin

Examination reveals erythematous, eczematous lesions on labia minora and the periclitoral area

This is consistent with Pagets disease of the vulva. What characterizes Pagets disease of vulva?

A

Frequently associated with invasive carcinomas

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8
Q

Most common type of vulvar cancer

A

Squamous cell carcinoma

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9
Q

What is the most common Sx of vulvar carcinoma in elderly women?

A

Pruritus

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10
Q

A 1 cm vulvar carcinoma with tumor-positive unilateral lymph nodes would be stage….

A

Stage 3

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11
Q

A 58 year old woman with 1 cm vulvar ulcer. A biopsy shows invasive SCC with more than 1 mm of stromal invasion

What is the preferred treatment

A

Radical local excision and ipsilateral inguinofemoral lymph node dissection

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12
Q

A 58 year old woman with 1 cm vulvar ulcer. A biopsy shows invasive SCC with more than 1 mm of stromal invasion

If the lymph nodes are negative, what is the 5 year survival?

A

90%

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13
Q

A 58 year old woman with 1 cm vulvar ulcer. A biopsy shows invasive SCC with more than 1 mm of stromal invasion

The patient undergoes radical vulvectomy. Which of the following is the most common complication of radical vulvectomy?

A

Breakdown of the surgical wound

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14
Q

A 72-year old woman has had a radical vulvectomy for stage II vaginal SCC. She wants to know the most likely site of recurrence if the tumor comes back. Where would the tumor likely appear?

A

At the site of tumor resection

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15
Q

Which of the following tumors of the vulva has the best prognosis

Stage 1 verrucous carcinoma

Melanoma

Stage 1 SCC

Basal cell carcinoma

Rhabdomyosarcoma

A

Basal cell carcinoma

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16
Q

A 56 year old woman presents with painless mild vaginal spotting. She had a hysterectomy at age 40 for persistent cervical dyspalsia. She is otherwise healthy and takes no medications

On further review of symptoms she has occasional urgency and dysuria. On pelvic examination, a 0.5 cm lesion is felt and visualized in the anterior vagina. What is the best next stsep=

A

Perform directed punch biopsy of the lesion

17
Q

A 30 year old woman presents for antenatal examination. On examination, she reports that her mother used DES during her pregnancy.

What is she most at risk for?

A

Clear cell adenocarcinoma of vagina

18
Q

What is a malignant tumor of the vagina of young children that appears clinically as a mass of grape-like edematous polyps?

A

Sarcoma botryoides

19
Q

A 72 year old woman complains of vaginal bleeding. On exam, a 2 cm vaginal lesion is found in the upper 1/3 of the anterior vagina. On bimanual and rectovaginal examination, the mass extends to the lateral pelvic wall.

On biopsy, vaginal carcinoma is confirmed

What stage cancer does this patient most likely have?

A

Stage 3

20
Q

A 72 year old woman complains of vaginal bleeding. On exam, a 2 cm vaginal lesion is found in the upper 1/3 of the anterior vagina. On bimanual and rectovaginal examination, the mass extends to the lateral pelvic wall.

On biopsy, vaginal carcinoma is confirmed

Which of the following is the most likely histology of the vaginal carcinoma?

A

Squamous cell carcinoma

21
Q

A 72 year old woman complains of vaginal bleeding. On exam, a 2 cm vaginal lesion is found in the upper 1/3 of the anterior vagina. On bimanual and rectovaginal examination, the mass extends to the lateral pelvic wall.

On biopsy, vaginal carcinoma is confirmed

What is the best treatment

A

Combined chemo and radiotherapy

22
Q

11 year old giril with sudden onset abdominal pain and inability to void

Vague cyclic abdominal pain. After catheter placement, urin is drained, but abdomen is still distended

1) Diagnosis
2) Treatment
3) After treatment?

A

Diagnosis: hymen imperforata

Treatment: excision of central part of hymen

After treatment: regular gynecology check up due to higher risk of endometriosis

23
Q

18 year old white hispanic woman with a FHx of cervical cancer seeks medical advice conserning primary profylaxis against cervical cancer. What is your advice?

A

Vaccination against HPV

24
Q

A 35 year old white non-Hispanic nullipara with HSIL. Physical exam reveals normal vulva and vagina. Cervi slightly enlarged. Body of uterus normal size and shape, easily moveable and painless. Both adnexa without any pathology

What is the next step in diagnosis?

A

Colposcopy with cervical biopsy

25
Q

A nulliparous 32-year old black patient with a histroy of infertiliy was diagnosed with CIS. What treatment is most appropriate?

A

Conisation

26
Q

A 49 year old white non-hispanic multipara was referred to OBGYN due to abnormal vaginal bleeding that occured 6 months after her last period

Physical exam: normal vulva and vagina. The cervix of normal size and shape. Body of uterus enlarged with irregular shape but easily moveable and painless. Both adnexa without any pathology.

Per rectum examination showed no abnormality. Which is the appropriate next stage?

A

Dilatation and curettage

27
Q

Hvor mye RhoGAM for 30 mL føtalt blod?

A

300 mikrogram for 30 mL føtalt blod

Gi 10 mikrogram RhoGAM for hver mL føtalt blod over 30 mL

28
Q

Leiomyoma - risk factors

A

African american

FHx

Early menarche

29
Q

TSH-verdi som signifikerer hypotyreose

A

TSH > 2.5

30
Q

Behandling av GBS

A

Ampicillin

31
Q

Makrosomi - definisjon

  • DM
  • Ikke-DM
A

DM: 4250

Ikke-DM: 4500

32
Q

Metimazol: bivirkninger i fosteret

A

Aplasia cutis

Agranulocytose

33
Q

Hvor produseres AFP

A

i leveren

34
Q

Iodine supplement

  • Preconception
  • In pregnancy
A

Preconception: 150 microgram

In pregnancy: 250 mikrogram

35
Q

GBS-screen: hvrodan gjør du det

A

Prøve fra vagina og rektum

36
Q

28 year old woman with 6 cm left ovarian tumor. Normal menses. Infectious discharge in vagina. What tests?

A

TV-USG, Ca-125, B-hCG and CRP

(Ultrasound picture shows simple cyst)

Tx = cystectomy (cysts > 6 cm gives risk of torsion)

37
Q

35 year old woman with ASC-H on routine Pap. Next step?

A

Colposkopy and biopsy

If Bx shows CIN 2 or 3: do LEEP

38
Q

OCP and Pap smear (in poland)

A

Do Pap before starting OCP

Do Pap every year (because she is on OCP)

OB/GYN (21 decks)

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