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sex and repro > uterine/cervical clinical > Flashcards

uterine/cervical clinical Flashcards

1
Q

increased risk for fibroids?

A

early menarche

increasedBMI

Nulliparous

Heredity

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2
Q

decreased risk

A

postmenopausal

cigarette smoking

pregnancy

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3
Q

types of firboids

A

subserous

submucous

interstitial of the inter

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4
Q

which type of fibroid would present with heavy periods/dysmenorrhea?

A

submucosal pedunculated

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5
Q

which type of fibroid would have little symptoms?

A

pedunculated subserous (pressure)

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6
Q

what would happen is the pedunculated subserous gains blood supply and separates?

A

parasitic fibroid

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7
Q

most common clinical symptom?

A

bleeding and consequent anemia

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8
Q

heavier bleeding due to

A

venous lakes

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9
Q

other symptoms?

A

pelvic discomfort
hydronephrosis
dyspareunia
INFERTILITY: submucosal

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10
Q

pregnancy complications re: placenta?

A

placenta previa

also preterm

fetal malposition

higher C-section rate

neonatal morbidity

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11
Q

on exam?

A

enlarged, non-tender uterus

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12
Q

Diagnosis?

A

pelvic exam

Transvaginal US

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13
Q

management

A

routine pelvic if asymptomatic

Asymptomatic:

  • progestins oral contraceptives
  • GnRH agonists rapidly shrink them (bone loss though, end stage)
  • aromatase inhibitors
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14
Q

treatment by interventional radiologst?

A

uterine artery embolization

magnetic resonance guided focus ultrasound removal

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15
Q

surgical mgmt

A

hysterectomy most common (subtotal just the uterus, complete=uterus and cervix)

myomectomy (removal of the fibroids)

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16
Q

what’s it called when fibroid blocks menstrual blood?

A

Hematometra

cylcic, midline pain, sometimes amenorrhea

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17
Q

menarche, mild menstrual cramps, more painful periods or heavier regular periods

A

Adenomyosis

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18
Q

gold standard for adenomyosis?

A

MRI

but you can use US

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19
Q

tx for adenomyosis

A

NSAIDS, combined contraceptives

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20
Q

3rd most common reason for hysterectomy?

A

Uterine Prolapse

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21
Q

Pelvic floor trauma can cause?

A

Uterine Prolapse

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22
Q

Procidentia?

A

most severe stage of uterine prolapse

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23
Q

tx Uterine prolapse for mild symptoms?

A

Kegel exercises to strengthen the pubococcygeus and levator ani

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24
Q

elderly tx for uterine prolapse

A

Pessary

25
Q

surgical tx for pelvic organ prolapse?

A

Obliterative

Vaginal Hysterectomy

26
Q

abnormal bleeding is outside what range?

A

3-7 days

27
Q

menorrhagia

A

greater than 7 days

28
Q

metrorrhagia

A

intermenstrual (breakthrough) bleeding

29
Q

Menometrorrhagia

A

prolonged uterine bleeding occurring at irregular intervals

30
Q

Hypomenorrhea

A

less than 3 days

31
Q

Oligomenorrhea

A

longer than 35 days cycle length

32
Q

polymenorrhea

A

shorter than 24cycle length

33
Q

Causes of abnormal uterine bleeding

A 
Polyp/Pregnancy
Adenomysosis
Leiomyoma
Malignancy and Hyperplasia
PCOS
Fibroid

PALM(H)

34
Q

causes of AUB: nonstructural

A 
Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet classified

COEIN

35
Q

AUB dx

A

rule out cancer

36
Q

what drugs can cause AUB?

A

contraceptives and HRT

37
Q

NSAIDs block ________ which helps with menorrhagia

A

prostaglandins

38
Q

what will decrease flow by 40-70%

A

Hormonal contraceptive pills

Levonorgestrel-containing device

other progestins (depo shot)

39
Q

surgery for AUB

A

endometrial destruction (outpatient) only for those with predictable bleeding (otherwise rule out cancer)

hysterectomy most effective

40
Q

squamocolumnar junction separates

A

stratified squamous epithelium of the cervix and mucin secreting columnar epithelium of endocervix

41
Q

squamous metaplasia is a conversion of exposed columnar epithelium into squamous epithelium/metaplasia because of what process?

A

lowering of the pH of the vagina via glyocgenation of the epithelium of the lower Gen tract

42
Q

CIN chance of invasion?

A

12%

43
Q

Risk factors for CIN

A

Early coitarche
multiple partners
smoking
Immunosuppression

44
Q

warning for CIN

A

postcoital bleeding

discharge

45
Q

bivalent vaccine

A

16,18

46
Q

quadrivalent

A

16,18,6,11

47
Q

9 valent

A

+31,33,45,52,58

48
Q

pap smear more sensitive or specific?

A

more specific

49
Q

what happens if you add HPV to your pap cytology?

A

sensitivity increases

50
Q

what are you scraping with a pap

A

transformation zone

51
Q

21-29 screened?

A

every 3 years

52
Q

30-65 cotesting

A

every 5 years

53
Q

TOTAL hysterectomy screening?

A

no screening

54
Q

do you continue to screen those with dx?

A

yes, for vaginal spread

55
Q

how are epithelial cell abnormalities managed in HPV positive?

A

tx’d as low grade lesion

56
Q

imcompetent cervix

A

silent cervical dilation without uterine contractions risk factors including LEEP or cone biopsy

57
Q

dx for incompetent cervix dx

A

transvag US

58
Q

what happens if someone has an incompetent cervix and they get pregnant?

A

screen for that at 16 weeks and then you can suture it and remove before labor .÷

sex and repro (9 decks)

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