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Women's health > structural/other (10%) > Flashcards

structural/other (10%) Flashcards

1
Q

what is an enterocele

A

pouch of douglas (small bowel) prolapses into upper vagina

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2
Q

tx for prolapse (cystocele, enterocele, rectocele, uterine)

A

ppx- kegals, wt control

nonsurgical- pessaries (sx relief), estrogen tx (improves atrophy)

surgical- hysterectomy, uterosacral or sacrospinous ligament fixation

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3
Q

what is the presentation of ovarian torsion

A

sharp sudden then waxing, non-radiating pain

n/v/d

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4
Q

what is the dx of ovarian torsion

A

doppler

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5
Q

what is the tx for ovarian torsion

A

emergent laparoscopy

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6
Q

what is the usu onset of endometriosis

A

35yo+

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7
Q

what is the MC site of endometriosis

A

ovaries

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8
Q

what is the classic triad of endometriosis

A

cyclic premenstrual pelvic pain +/- LBP
dysmenorrhea
dyspareunia

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9
Q

what does PE usu show w endometriosis

A

usu normal +/- fixed, tender adnexal masses

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10
Q

what is the definitive dx of endometriosis

A

laparoscopy- raised patches of thick, discolored scarred or powder burn

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11
Q

what are tx options for endometriosis

A

ovulation suppression- OCPs + NSAIDs, progesterone, leuprolide, danazol

surgery- lap w ablation (if fertility desired), hysterectomy if not desired

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12
Q

MOA of progesterone in tx of endometriosis

A

suppresses GnRH –> endometrial atrophy + suppressed ovulation

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13
Q

MOA of leuprolide

A

GnRH analog –> pituitary FSH/LH suppression

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14
Q

MOA of danazol

A

testosterone induces pseudomenopause –> suppresses FSH + LH

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15
Q

RFs for endometriosis

A

famhx
nulliparity
early menarche

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16
Q

what is an endometrioma

A

involves ovaries, large enough to be considered a tumor

usu CHOCOLATE-COLORED (old blood)

17
Q

what size cyst should be removed?

A

> 8cm or if symptomatic

18
Q

what causes a follicular ovarian cyst

A

follicle fails to rupture + continues to grow

19
Q

what does US show w follicular ovarian cyst

A

smooth, thin-walled, unilocular

20
Q

what should be done for follicular ovarian cyst

A

nothing unless >8cm or symptomatic- usu resolve spontaneously 2-3mo

21
Q

what causes a corpus luteal ovarian cyst

A

C/L fails to degenerate after ovulation

AKA hemorrhagic cyst

22
Q

what does US show w corpus luteal ovarian cyst

A

complex, thicker walled w peripheral vascularity (RING OF FIRE - also in ectopic, check B-hCG)

23
Q

what causes a theca lutein ovarian cyst

A

excess B-hCG –> hyperplasia of theca interna cells

24
Q

what does US show w theca lutein ovarian cyst

A

bilateral, septations don’t show enhancement on US

25
Q

what is leiomyoma

A

uterine fibroid- benign smooth musc tumor

regress after menopause (related to estrogen)

26
Q

what is the MC benign gyn lesion

A

leiomyoma

27
Q

when are fibroids MC

A

35yo+, african american

28
Q

what does PE show if pt has fibroids

A

large, irregular hard palpable mass in abd/pelvis
ASYMMETRIC
FIRM
NONTENDER

29
Q

what does fibroid look like on US

A

focal heterogenic mass w shadowing

30
Q

tx for fibroids

A

observe
medical- inhibit estrogen- leuprolide (GnRH agonist –> inhibits GnRH secretion, most effective med), progestins (cause endo atrophy to decrease bleeding)
surgical- TAH (definitive), myomectomy (preserve fertility)

31
Q

When is adenomyosis MC

A

later reproductive years

32
Q

presentation of adenomyosis

A

progressively worsening bleeding + pain, +/- infertility

PE- SYMMETRIC, TENDER, SOFT/BOGGY

33
Q

definitive dx of adenomyosis

A

hysterectomy

34
Q

tx for adenomyosis

A

TAH (only effective)

conservative if fertility desired (analgesics, low dose OCPs)

35
Q

what is infertility

A

fail to conceive s/p 1yr, 6mo if mom 35yo+

36
Q

MC pathogens in bartholin cyst

A

e. coli
s. aureus
n. gon

37
Q

presentation of bartholin cyst

A

unilateral vulvar mass

inflamed + edematous + tender if infected

contender if non-infected

Women's health (7 decks)

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