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0 - OB2 > Untitled Deck > Flashcards

Untitled Deck Flashcards

1
Q

What is a nevus?

A

A mole or cluster of melanocytes from the embryonic neural crest, common in the vulva.

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2
Q

How do benign nevi appear on examination?

A

Flat, elevated, or pedunculated with sharp borders, even color, and symmetric shape.

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3
Q

What is the most common malignancy transformation of a nevus in the vulva?

A

Melanoma.

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4
Q

What is the ABCD rule for melanoma?

A

Asymmetry, Border irregularity, Color variation, Diameter >6mm.

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5
Q

What is the treatment for a dysplastic nevus in the vulva?

A

Excision with a 0.5–1 cm margin.

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6
Q

What is the most common solid tumor of the vulva?

A

Fibroma.

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7
Q

How does a vulvar fibroma typically present?

A

A slow-growing, solid mass, usually 1–10 cm, most commonly in the labia majora.

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8
Q

What is the management of a vulvar hematoma <10 cm?

A

Conservative treatment with compression and ice packs.

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9
Q

What is the treatment for vulvar hematomas >10 cm or expanding?

A

Surgical evacuation and identification of the bleeding vessel.

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10
Q

What are common causes of vulvar pruritus?

A

STI, vulvar dystrophy, lichen sclerosis, contact dermatitis, and diabetes.

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11
Q

What is the most common cause of vaginal trauma?

A

Coitus.

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12
Q

What is the management of a vaginal laceration due to coital trauma?

A

Suturing under anesthesia and checking for injury to the urinary or GI tract.

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13
Q

What are common predisposing factors for vaginal trauma?

A

Virginity, postpartum state, menopause, and intercourse after prolonged absence.

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14
Q

What is the most common site for vaginal lacerations?

A

The transverse tear of the posterior fornix.

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15
Q

How is vaginismus defined?

A

Painful coitus due to involuntary vaginal muscle contractions.

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16
Q

What is the management for straddle injuries in children?

A

Conservative treatment and ruling out abuse.

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17
Q

How is vaginal stenosis typically diagnosed?

A

Inability to pass a 1–2 mm dilator and ultrasound findings.

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18
Q

What are the symptoms of congenital imperforate hymen?

A

Primary amenorrhea, cyclic abdominal pain, and hematometra.

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19
Q

What diagnostic tool is preferred for hematometra?

A

Ultrasound.

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20
Q

What is the treatment for hematometra caused by imperforate hymen?

A

Surgical incision and drainage.

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21
Q

What is a cervical myoma?

A

A leiomyoma arising from the cervix, causing symptoms like dysuria and dyspareunia.

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22
Q

What is the main risk factor for cervical stenosis?

A

Previous surgeries like LEEP or cryotherapy.

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23
Q

How does cervical stenosis present in premenopausal women?

A

Dysmenorrhea, pelvic pain, and infertility.

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24
Q

What is the treatment for cervical stenosis?

A

Dilation under ultrasound guidance.

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25
Q

What is the most common cause of cervical lacerations?

A

Obstetric deliveries or mechanical dilation during procedures.

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26
Q

What is an endometrial polyp?

A

A localized overgrowth of endometrial glands and stroma.

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27
Q

What is the typical age group for endometrial polyps?

A

Women aged 40–49 years.

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28
Q

What medication increases the risk of endometrial polyps?

A

Tamoxifen.

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29
Q

What is the gold standard for diagnosing endometrial polyps?

A

Hysteroscopy.

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30
Q

What is the most common symptom of endometrial polyps?

A

Abnormal uterine bleeding.

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31
Q

What is the most common pelvic tumor in women?

A

Leiomyoma.

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32
Q

What hormone primarily drives the growth of leiomyomas?

A

Estrogen.

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33
Q

What is the most common type of leiomyoma?

A

Intramural leiomyoma.

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34
Q

What type of leiomyoma is most symptomatic?

A

Submucosal leiomyoma.

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35
Q

What is the FIGO classification for a submucosal leiomyoma protruding into the uterine cavity?

A

Type 0.

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36
Q

What is adenomyosis?

A

Ectopic endometrial glands and stroma within the myometrium.

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37
Q

What is the definitive treatment for adenomyosis?

A

Hysterectomy.

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38
Q

How does adenomyosis typically present?

A

Dysmenorrhea, menorrhagia, and a diffusely enlarged uterus.

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39
Q

What is the most common benign tumor of the fallopian tube?

A

Adenomatoid tumor.

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40
Q

What is the management of paratubal cysts?

A

Observation or excision if symptomatic.

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41
Q

What is the most common benign ovarian cyst?

A

Follicular cyst.

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42
Q

What is Meigs syndrome?

A

A triad of ovarian fibroma, ascites, and pleural effusion.

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43
Q

What are the features of benign nevi in the vulva?

A

Sharp borders, even color, symmetric shape, and asymptomatic.

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44
Q

What type of trauma commonly causes vulvar hematomas in children?

A

Straddle injuries.

45
Q

What is the first-line management for pruritus of vulvar origin?

A

Establish diagnosis, treat the underlying cause, and improve hygiene.

46
Q

How does lichen simplex chronicus develop?

A

Chronic untreated dermatitis leads to a leathery appearance of the skin.

47
Q

What is the primary risk factor for melanoma of the vulva?

A

Family history of cancer.

48
Q

What is the most common site of vaginal tears during trauma?

A

The posterior fornix.

49
Q

What are the symptoms of a postcoital vaginal tear?

A

Profuse bleeding and sharp pelvic pain.

50
Q

How is sexual assault-related vaginal trauma managed?

A

Suturing under anesthesia, ruling out injuries to urinary and GI tracts.

51
Q

Why is vaginal trauma common in postmenopausal women?

A

Vaginal atrophy due to estrogen deficiency.

52
Q

What diagnostic tests should be performed for suspected vaginal abuse in children?

A

A thorough examination and documentation, with imaging if necessary.

53
Q

What is a vascular leiomyoma of the cervix?

A

A leiomyoma with thick-walled blood vessels causing potential bleeding.

54
Q

How does cervical stenosis lead to hematometra?

A

Obstruction of the cervical canal prevents normal menstrual blood flow.

55
Q

What is a congenital cause of cervical stenosis?

A

Müllerian duct anomalies.

56
Q

What imaging modality is preferred for diagnosing cervical stenosis?

A

Ultrasound.

57
Q

What is the primary symptom of postmenopausal cervical stenosis?

A

Hematometra or hydrometra.

58
Q

What are the histological components of an endometrial polyp?

A

Endometrial glands, endometrial stroma, and central vascular channels.

59
Q

What is the treatment of choice for symptomatic endometrial polyps?

A

Hysteroscopy with dilation and curettage.

60
Q

What are the differential diagnoses for endometrial polyps?

A

Submucosal leiomyomas, retained products of conception, and carcinoma.

61
Q

How does tamoxifen contribute to endometrial polyps?

A

It stimulates endometrial hyperplasia due to its estrogenic effects on the uterus.

62
Q

What is the incidence of malignancy in endometrial polyps?

A

3–5%.

63
Q

What is the pseudocapsule in a leiomyoma?

A

Compressed myometrium surrounding the leiomyoma, useful in surgery.

64
Q

What is the relationship between leiomyomas and pregnancy?

A

They may enlarge due to increased estrogen and progesterone.

65
Q

What is the most common complication of submucosal leiomyomas?

A

Abnormal uterine bleeding and infertility.

66
Q

What is the risk of malignant transformation in leiomyomas?

A

0.3–0.7%.

67
Q

What is the FIGO classification system used for in leiomyomas?

A

Categorizing leiomyomas based on their location and relationship with the endometrium.

68
Q

What layer of the uterus is disrupted in adenomyosis?

A

The barrier between the endometrium and myometrium.

69
Q

How does adenomyosis differ from leiomyoma in imaging?

A

Adenomyosis appears as a diffusely enlarged uterus with no clear demarcation.

70
Q

What age group is most symptomatic for adenomyosis?

A

35–50 years old.

71
Q

What is the standard criterion for diagnosing adenomyosis histologically?

A

Endometrial glands >2.5 mm from the basalis layer.

72
Q

Why is hysterectomy the definitive treatment for adenomyosis?

A

It completely removes the affected uterus.

73
Q

What are hydatid cysts of Morgagni?

A

Pedunculated paratubal cysts near the fimbrial end of the fallopian tube.

74
Q

How does fallopian tube torsion present clinically?

A

Acute abdominal pain, often during pregnancy or with an ovarian mass.

75
Q

What is the relationship between salpingectomy and ovarian cancer prevention?

A

Removal of the fallopian tubes reduces the risk of high-grade serous carcinoma.

76
Q

Why is it important to preserve ovaries during salpingectomy?

A

Ovaries produce estrogen, which is vital for overall health up to age 64.

77
Q

What is Halban’s triad in corpus luteum cysts?

A

Delay in menses, unilateral pelvic pain, and a small adnexal mass.

78
Q

How is a ruptured corpus luteum cyst managed?

A

Observation unless there is significant intraperitoneal bleeding.

79
Q

What is the most common complication of ovarian dermoid cysts?

A

Torsion.

80
Q

What is Meigs syndrome?

A

Ovarian fibroma associated with ascites and pleural effusion.

81
Q

How is an endometrioma diagnosed?

A

Ultrasound showing a thick-walled cyst with homogenous echolucency.

82
Q

What is the first-line imaging modality for benign gynecologic lesions?

A

Ultrasound.

83
Q

What is the hallmark finding of lichenification in chronic vulvar pruritus?

A

Thickened skin with exaggerated markings.

84
Q

Why are minimally invasive surgeries preferred for leiomyomas?

A

They reduce recovery time and preserve fertility.

85
Q

What is the hallmark symptom of adenomyosis?

A

Secondary dysmenorrhea.

86
Q

What is the treatment for paratubal cysts causing torsion?

A

Excision of the cyst.

87
Q

A 55-year-old woman presents with a pigmented lesion on her vulva that has grown irregular in shape over the past year. What is the likely diagnosis, and what is the next step?

A

Melanoma. The next step is excision with a 0.5–1 cm margin and biopsy.

88
Q

A 35-year-old woman reports a slow-growing, painless mass on her labia majora that started as a small pimple two years ago. What is the most appropriate management?

A

Excision of the fibroma.

89
Q

A 25-year-old cyclist presents with severe pain and swelling in her vulva after a fall. What is the best course of action?

A

Conservative management with ice packs and compression.

90
Q

A postmenopausal woman complains of intense vulvar itching that has persisted for months. What is the most likely diagnosis, and how should it be treated?

A

Lichen simplex chronicus. Treat with topical steroids and address any underlying causes.

91
Q

A 28-year-old woman presents with vaginal bleeding and pain after intercourse. What is the next step in management?

A

Suturing under anesthesia and evaluation for urinary or GI injury.

92
Q

A newlywed reports painful intercourse due to involuntary vaginal muscle contractions. What is the diagnosis, and what initial steps should be taken?

A

Vaginismus. Initial steps include pelvic floor therapy and counseling.

93
Q

A 30-year-old woman presents with profuse vaginal bleeding following a mechanical dilation procedure for D&C. How should this be managed?

A

Inspect and repair the laceration under visualization.

94
Q

A 45-year-old woman with a history of loop electrosurgical excision presents with secondary amenorrhea and cyclic pelvic pain. What is the likely diagnosis and management?

A

Cervical stenosis. Management involves cervical dilation under ultrasound guidance.

95
Q

A 42-year-old woman reports intermenstrual spotting and postcoital bleeding. What is the most appropriate diagnostic and therapeutic procedure?

A

Hysteroscopy with dilation and curettage.

96
Q

A 14-year-old girl presents with cyclic pelvic pain but no menses. What is the likely diagnosis and treatment?

A

Hematometra due to an imperforate hymen. Treatment involves surgical incision and drainage.

97
Q

A 35-year-old woman presents with heavy menstrual bleeding and pelvic pain. What is the best management approach?

A

Myomectomy if the patient desires future fertility; otherwise, consider medical management or hysterectomy.

98
Q

A 32-year-old woman with a history of infertility is diagnosed with a submucosal leiomyoma distorting the endometrial cavity. What is the best management option?

A

Hysteroscopic resection of the submucosal leiomyoma.

99
Q

A 38-year-old woman complains of progressively worsening dysmenorrhea and heavy menstrual bleeding. What is the likely diagnosis and definitive treatment?

A

Adenomyosis. The definitive treatment is hysterectomy.

100
Q

A 45-year-old woman undergoing evaluation for infertility is incidentally found to have a 5 cm paratubal cyst near the fimbrial end. What is the most appropriate management?

A

Surgical excision if symptomatic or large; otherwise, observation.

101
Q

A 30-year-old pregnant woman presents with acute pelvic pain.

A

Further evaluation is needed to determine the cause.

102
Q

What is the likely diagnosis for a diffusely enlarged, tender uterus with thickened myometrium?

A

Adenomyosis. The definitive treatment is hysterectomy.

103
Q

What is the most appropriate management for a 5 cm paratubal cyst found incidentally in a 45-year-old woman?

A

Surgical excision if symptomatic or large; otherwise, observation.

104
Q

What is the best treatment for an 8 cm ovarian mass and a twisted fallopian tube in a pregnant woman?

A

Laparoscopic untwisting and cystectomy.

105
Q

What is the most appropriate next step for a 4 cm simple ovarian cyst found in a 25-year-old asymptomatic woman?

A

Observation with repeat ultrasound in 6 weeks.

106
Q

What is the likely diagnosis for sudden-onset unilateral pelvic pain with free fluid and a complex adnexal mass?

A

Ruptured corpus luteum cyst. Manage conservatively unless hemodynamically unstable.

107
Q

What is the likely diagnosis for a 7 cm unilocular cyst with calcifications found incidentally in a 35-year-old woman?

A

Dermoid cyst (mature teratoma). Treatment is cystectomy.

108
Q

What is the likely diagnosis and management for a 6 cm homogenous cyst with ‘ground-glass’ echogenicity in a woman with infertility?

A

Endometrioma. Management includes medical therapy or surgical excision if symptomatic.

109
Q

What is the diagnosis and management for a woman with acute pelvic pain and reduced blood flow to the right ovary?

A

Ovarian torsion. Immediate laparoscopic detorsion is needed.

0 - OB2 (13 decks)

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