Test 4 part 4

Question 1

A transperitoneal endoscopic technique that allows visualization and instrumentation of the pelvic structures through small incisions
Allows for diagnosis and management of gynecologic disorders without laparotomy

Answer 1

Laparoscopy

Question 2

The surgical opening of the abdomen for exploration

Answer 2

Laparotomy

Question 3

Complete removal of the uterus

May or may not remove ovaries and fallopian tubes (bilateral salpingo-oophorectomy or BSO

Answer 3

Hysterectomy

Question 4

Removal of uterus without removal of cervix
Theory for use of this procedure is that innervation of bladder is less likely affected and patient belief that cervix removal leads to decrease in sexual pleasure

Answer 4

Partial hysterectomy

Question 5

Removal of uterine body and cervix
Done for invasive cancer
May occur with or without BSO

Answer 5

Total hysterectomy

Question 6

Removal of uterus, cervix, & BSO & portion of vagina. Performed for invasive cancers of the cervix

Answer 6

Radical hysterectomy

Question 7

Cysts that occur secondary to hormonal stimulation. Rare prior to menarche or after menopause (

Answer 7

Functional types

Question 8

Most common type of cyst

Follicle fails to rupture and release egg during ovulation

Answer 8

Follicular

Question 9

Cyst that forms from failure of corpus luteum to degenerate-seals and generates a cavity filled with fluid or blood

Answer 9

Luteal (hemorrhagic)

Question 10

cysts that are usually larger than 5 cm
Forms from skin precursor cells and develop when ovarian cells multiply
Most common ovarial germ cell tumor

Answer 10

Dermoid

Question 11

treatment for endometrial cancer

Answer 11

Hysterectomy with BSO

May need additional chemo or radiation

Question 12

is a dynamic entity formed during puberty and, histologically, is the area where the glandular epithelium is being replaced by squamous epithelium

Answer 12

Transformation zone

Question 13

is adjacent to the borders of the ectocervix and the endocervix of the canal.

Answer 13

Squamocolumnar junction

Question 14

most cervical dysplasia occurs where

Answer 14

The transformation zone

Question 15

when does the onset of menses typically happen

Answer 15

between 9 and 16 average age is 12

Question 16

when does puberty usually occur

Answer 16

between ages 8 and 13

Question 17

puberty is triggered by

Answer 17

the production of GnRH from the hypothalamus

Question 18

GnRH stimulates

Answer 18

the pituitary to produce Gonadotropins that stimulate ovarian estrogen

Question 19

appearance of breast tissue and or pubic hair before age 8

Answer 19

precocious puberty

Question 20

begins day 1 of menstruation, lasts for 12-14 days. Graafian follicle (GF) matures under the influence of LH and FSH. It is the GF that produces estrogen

Answer 20

Follicular phase

Question 21

Begins when estrogen peaks and ends with release of the oocyte from mature GF – referred to as ovulation.
LH surge 12- 36 hours prior to ovulation
Decrease in estrogen and increase in progesterone levels prior to LH surge

Answer 21

The ovulatory phase

Question 22

begins after ovulation, last for ~ 14 days. Corpus luteum (CL) forms from the empty follicle
High levels of progesterone from the corpus luteum
If pregnant – corpus luteum continues progesterone production
No pregnancy – Corpus luteum degenerates  decrease in progesterone  menstruation

Answer 22

Luteal phase

Question 23

Starts after the end of menstruation and ends with ovulation
Endometrium prepares for implantation  thicker & vascular
Changes results from increase in estrogen Graafian foll:

Answer 23

proliferative phase

Question 24

Begins after ovulation & ends with the onset of menstruation
Endometrium continue to thicken – primary hormone here is the progesterone produced by corpus luteum
Pregnancy  endometrium develops further
No pregnancy corpus luteum degenerates  endometrium degenerates

Answer 24

secretory phase

Question 25

In response to hormonal changes  sloughing off of the endometrium

Answer 25

menstrual phase

Question 26

normal cycles last from

Answer 26

21-35 days

Question 27

how many days of menstrual flow

Answer 27

2-7 days

Question 28

average blood loss is

Answer 28

20-60 cc

Question 29

Absence of menarche beyond the age of 16. May or may not occur with other signs of puberty such as secondary sex characteristics.

Answer 29

Primary amenorrhea

Question 30

Cessation of menses after menarche has occurred and periods have been successive for a period of time

Answer 30

Secondary amenorrhea

Question 31

Painful menstrual cramps without underlying pathology
Occurs only during ovulatory cycles
First occurrence happens within a year after menarche

Answer 31

Primary dysmenorrhea

Question 32

Treatment for primary dysmenorrhea

Answer 32

NSAIDS
Birth control
Warm application
Rose tea
rarely CCB

Question 33

This type of pain often lasts longer than normal cramps, it may begin long before the period starts
The pain may get worse when menstruation begins and not go away after the period ends
Occurs later in life

Answer 33

Secondary dysmenorrhea

Question 34

Common causes of secondary dysmenorrhea

Answer 34

Endometriosis

Fibroids/leiomyomas

Question 35

Tissue from the lining of the uterus is located outside of the uterus, such as in the ovaries and fallopian and responds to monthly fluctuations of hormones. This tissue also breaks down and bleeds. This bleeding occurs outside of the uterus and vagina, can cause pain, especially right before, during, or after a period.

Answer 35

Endometriosis

Question 36

(also called myomas)—muscle tumors or growths that form on the outside, the inside, or in the walls of the uterus. These tumors are not cancerous, but they can cause pain and heavy menstrual bleeding

Answer 36

Fibroids/ leiomyomas

Question 37

is abnormal uterine bleeding related to hormones that directly affect the menstrual cycle.
Disruption of normal cycle and no another pathology
Eventually the uterine lining outgrows its blood supply and begins to slough off at irregular intervals.

Answer 37

Anovulatory uterine bleeding

Question 38

Excessive and prolonged bleeding at regular intervals.

Answer 38

menorrhagia

Question 39

Bleeding between periods or after menopause – most significant

Answer 39

Metrorrhagia

Question 40

Irregular, frequent, prolonged, and excessive bleeding

Answer 40

Menometrorrhagia

Question 41

Infrequent and or scant bleeding of variable duration

Answer 41

Oligomenorrhea

Question 42

Uterine bleeding occurring at regular intervals of

Answer 42

Polymenorrhea

Question 43

Abnormal ovualtory cycles  regular and cyclic, but with abnormal patterns of bleeding.
Abnormal bleeding that occurs with ovulatory cycles may be physiologic, pathologic, or pharmacologic in nature

Answer 43

Ovulatory AUB