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OB/GYN > U-Wise REI and Neoplasia > Flashcards

U-Wise REI and Neoplasia Flashcards

1
Q

Normal puberty sequence

A

Thelarche –> adrenarche (hair growth) –> growth spurt –> Menarche

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2
Q

Body weight needed for menses to begin

A

85-106 pounds

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3
Q

Treatment of true precocious puberty

A

GnRH agonist

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4
Q

Normal menarche range

A

9-17

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5
Q

Look for what else in mullerian agenesis

A

Renal abnormalities

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6
Q

Labs for secondary ammenorrhea

A

FSH/LH, TSH, Prolactin

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7
Q

First test in suspected cushings

A

Overnight dexamethasone suppression test

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8
Q

What causes postpartum hair loss

A

Loss of high levels of estrogen in pregnancy

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9
Q

What is hyperthecosis

A

More severe form of PCOS (balding, clit enlargement, deepening of the voice)

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10
Q

Progestin converts endometrium from what to what

A

Proliferative to secretory

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11
Q

Test for heavy periods that began three months ago in G3P3 42 year old

A

Pelvic US to look for things like polyps or submucosal fibroids

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12
Q

Most common clotting disorder to manifest at menarche

A

VW disease

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13
Q

When is observation not recommended for a uterine polyp

A

When > 1.5 cm

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14
Q

Why is free T elevated in PCOS

A

Sex hormone binding globulin is decreased by elevated androgens

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15
Q

Best tx for submucosal fibroid to preserve fertility

A

Hysteroscopic myomectomy

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16
Q

How do COC help dysmenorrhea

A

Progesterone induces endometrial atrophy –> prostaglandins made in endometrium so less made to cause pain

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17
Q

Who gets GC test

A

All sexually active patients 25 years and younger

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18
Q

Young pts with persistent dysmennorhea despite treatment should get what

A

Laparoscopy

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19
Q

Boggy uterus and heavy bleeding? non surgical tx?

A

Adenomyosis

GnRH agonists, but problem recurs after cessation of treatment

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20
Q

Dysmenorrhea + palpable abnormality

A

Secondary amenorrhea

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21
Q

Women over 40 with heavy bleeding and clear fibroids should still have

A

Endometrial biopsy to rule out cancer

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22
Q

Fibroids path description

A

Well-circumscribed, non-encapsulated myometrium

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23
Q

Premature ovarian failure at what age

A

Under 35

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24
Q

Ca requirement per day in menopausal women

A

1200 mg

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25
Q

Risk factors for osteoporosis

A

Hx of fracture as an adult, low body weight, smoking

Start these patients on bisphosphonates

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26
Q

HRT risks

A

breast ca, MI, CVA, VTE

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27
Q

What do menopausal ovaries continue to produce

A

Androgens –> gets converted to estrogen in fat

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28
Q

Test to help confirm PCOS

A

Testosterone levels

once dx is made, progesterone levels can help determine ovulation

29
Q

Imapramine can cause

A

Hyperprolactinemia

30
Q

Hypothyroidism can cause

A

Hyperprolactinemia

31
Q

Hypothalamic amenorrea levels

A

Normal FSH, low estrogen

Check estrogen levels

32
Q

What is a clomiphene challenge test

A

Give on days 5-9 of cycle and check FSH on days 3 and 10 –> To help determine ovarian reserve

33
Q

Vit def associated with increased in PMS

A

A, E, abd B6

Also Calcium and magnesium

34
Q

What can help determine if its PMS vs crazy

A

Prospective symptom calendar

35
Q

PMS symptoms but all the time think?

A

Hypothyroidism

36
Q

Hysterectomy would only relieve what part of PMS

A

bleeding and cramping

37
Q

Molar pregnancy risks

A

Under 20 or over 40

Asian races who consume less beta-carotene and folic acid

38
Q

Recurrent risk for 1 molar pregnancy? two?

A

1: 1-2%
2: 10%

39
Q

3 findings that can be diagnostic of a mole when together

A

Enlarged uterus, vaginal bleeding, and Beta-hCG > 1,000,000

40
Q

Two odd manifestations of molar pregnancy

A

Tachycardia from hyperthyroidism

HTN from pre-eclampsia

41
Q

Standard tx for molar pregnancies

A

Suction curettage

42
Q

Complete mole features

A

Empty egg by single sperm (46xx)
Trophoblastic proliferation and hydropic degeneration
More likely to go on to GTD

43
Q

Partial mole features

A

69XX-
Present with marked villi swelling
Not as bad, typically documented as missed abortions in older patients

44
Q

How long to try and get pregnant after molar pregnancy

A

6 months after negative b-hCG levels (need to follow hcg to ensure no spontaneous regression)

45
Q

Tx for invasive vulvar cancer

A

Radical vulvectomy and groin node dissection

46
Q

90% of vulvar cancers are

A

Squamous cell (most often thought to be from chronic itch-scratch cycle of lichen sclerosis)

47
Q

Think white “crinkled tissue paper” on vagine

A

Lichen sclerosis

48
Q

Multi centric brown-pigmented papules on perineum likely

A

Vulvar intraepithelial neoplasia from HPV

49
Q

Finding of mass in bartholin gland highly suspicious of

A

Malignancy (esp in post menopausal women)
Excisional biopsy
new ones in old ladies

50
Q

Fiery red and itchy vulva in older woman

A

Paget’s dz

51
Q

ASCUS w/ neg HPV follow up

A

Pap smear in 3 years

52
Q

What is needed for colposcopy to be satisfactory

A

Visualization of the entire lesion –> if its not do cervical conization
also do if biopsy is sig diff than colposcopy

53
Q

Micro invasive cervical Ca invades

A
54
Q

When can women stop having Paps after 65

A

if they do not have a history of moderate or severe dysplasia or cancer and they have had either three negative Pap test results in a row, or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past five years

55
Q

Most common symptom with fibroids

A

Menorrhagia

56
Q

3 mechs that submucosal fibroids may use causing recurrent abortions

A
  1. Focal endometrial vascular disturbance
  2. Endometrial inflammation
  3. Secretion of vasoactive substances
57
Q

What stimulates growth of fibroids

A

Estrogen

58
Q

When is bariatric surgery indicated for BMI under 40

A

> 35 with serious weight related health problem

59
Q

GnRH tx in large fibroids when

A

Usually to reduce size and increase hct before surgery

60
Q

When is myomectomy for fibroids indicated

A

In younger patients who’s fertility is compromised by fibroids who are large enough to distort uterine cavity

61
Q

Largest modifiable risk factor for endometrial Ca

A

Obesity

62
Q

Next step after atypical cells on endometrial biopsy

A

D and C

63
Q

Most common site of distant spread in endometrial Ca

A

Lungs

64
Q

Best test for identifying spectrum of dz in ovarian Ca

A

CT abdomen/pelvis

65
Q

Chemo for ovarian Ca

A

Taxmen and Platinum

66
Q

Most common ovarian tumor found in women of all ages

A

Dermoid tumor (teratoma)

67
Q

Prophylactic what to all rape victims

A

Contraception and antibiotics

68
Q

Best place to have domestic abuse infro

A

Office restroom (most private)

OB/GYN (6 decks)

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