The Patients: Identifying Cases Flashcards
A pt presents with a mucus filled lump on the surface of the cervix. It appears as a small translucent and slightly yellow lump. It is determined that squamous metaplasia had covered some tall columnar endocervical epithelium and left a small tunnel or cleft for mucus to collect it. What might this be? How is it treated?
Nabothian Cyst. Nothing need be done. It’s benign and is considered a normal finding.
A 30yo G3P3 presents complaining of intermittent bleeding especially after sex. Upon exam, it is noted that multiple small, smooth, red, finger-like projections are found in the cervical canal connected to the os by a narrow pedicle. What might these be? What would you do about it?
Cervical polyps. Most can be removed in clinic. Treat infection if it is present.
A 35 yo female pt presents for a diabetes assessment. She has not been able to get pregnant and notes that she has not had a period for some time. You note she has facial hair and is obese. What might this be? How would you know? What is a risk factor associated with it? What would you do about it?
PCOS. Check serum FSH, LH, prolactin, and TSH. A1C should also be assessed because of PCOS association with insulin resistance. Cardiovascular disease is a risk factor if it is not treated. Treat with Clomiphene if they want to become pregnant. Treat with Medroxyprogesterone Acetate if pregnancy is not being sought.
A pt presents for a routine visit. She has no symptoms, but a during transvaginal ultrasound they did for fun, a dermoid cyst was found that was comprised of all 3 germ layers and even had some hair and teeth in it. What might this be? How would you remove it?
Teratoma. Laproscopically removed
A pt presents with menorrhagia, pain with intercourse, and painful menses. An enlarged uterus is identified on exam. She is also found to be slightly anemic. It is determined that perhaps some endometrial tissue has migrated to the outer muscular walls of the uterus. What might this be? How might you have to treat it?
Adenomyosis. Fully hysterectomy may be necessary in severe cases.
A female pt presents with an inability to get pregnant. She suffers from dysmenorrhea, dyspareunia, and constant pelvic pain that worsens just prior to her period. Upon pelvic exam, you note tender nodules in the posterior vaginal fornix and pain upon uterine motion. It’s been happening for some time, but now she is concerned because there appears to be blood in her urine and in her stool as well. Surgery is performed to diagnose and treat it and you see multiple red, petechial lesions on peritoneal surface, but some appear cystic and are dark brown/blue/black appearing with the surrounding surface thickened and scarred. What are you thinking?
Endometriosis…for shizzle!
A pt presents with a large cyst that aches a bit and causes some dyspareunia. It is a result in failure in ovulation. What is it? What will you do?
Follicular ovarian cyst. Should resolve within 60 days.
A pt presents with what started as local pain and tenderness that has suddenly become severe pain in her pelvic region. At first her period was delayed but now she is amenorrheaic. The PA thinks she has ovulated normally but that blood has accumulated within the central cavity causing a cyst. What is the PA thinking it is? How will she treat it?
Corpus luteum ovarian cyst. Usually goes away after 1-2 months
A female pt presents with bilateral pelvic “heaviness/aching”. The pt has been undergoing HCG therapy but the PA also thinks she may be having a molar pregnancy. What might this be? What should be done?
Theca lutein ovarian cyst. It should disappear spontaneously but if there is a molar pregnancy, it must be terminated and treated first. A discontinuation of HCG therapy will help also.
A pt has PMS pain in her pelvis, this is likely (cyclic/noncyclic) pelvic pain.
Cyclic
A pt has pain from a ruptured ovarian cyst, this is likely (cyclic/noncyclic) pelvic pain.
Noncyclic
A pt has PID pain, this is likely (cyclic/noncyclic) pelvic pain.
Noncyclic
A pt has endometriosis, this is likely (cyclic/noncyclic) pelvic pain.
Cyclic
A pt has endometritis, this is likely (cyclic/noncyclic) pelvic pain.
Noncyclic
A pt has pain associated with pelvic malignancies, this is likely (cyclic/noncyclic) pelvic pain.
Noncyclic
