Uterine/Cervix

Question 1

While doing a pap you note a yellowish, translucent, raised pearl-like lesion on the ectocervix – dx? Tx?

Answer 1

Nabothian cyst; benign

Question 2

What is a leiomyoma?

Answer 2

uterine fibroid

Question 3

If a patient has menorrhagia, metorrhagia, and intermenstrual bleeding, and on palpation you note a firm/enlarged uterine mass – dx? How do you confirm? Tx?

Answer 3

Leiomyoma
U/S
Tx: observe; if symptomatic myomectomy or hysterectomy

Question 4

If a pt presents with bilateral, lower abdominal pain with N, HA, and LBP. On exam you elicit a positive chandelier sign – dx? How do you confirm? How do you tx?

Answer 4

Pelvic inflammatory disease
Need to swab or DNA probe for gonorrhea & chlamydia; may need U/S to look for mass
Tx: Abx outpatient, if severe treat inpatient with IV
Treat partners

Question 5

What is the most common cause of PID?

Answer 5

Gonorrhea & chlamydia

Question 6

What is endometriosis?

Answer 6

endometrial tissue found on the outside of the endometrial cavity

Question 7

How does a pt present with endometriosis? Dx? Tx?

Answer 7

dysmenorrhea, pelvic pain, dyschezia (difficulty passing bowel), and infertility
Dx – U/S
Tx – NSAIDs, OCPs, possible surgery

Question 8

If a pt has purulent vaginal discharge, with some postcoital bleeding, dx? What are they at risk for?

Answer 8

Cervicitis (caused by G&C, candida, trich, or vaginosis)

At risk for PID

Question 9

Pt presents with fever, elevated WBC, lower abdominal pain, and vaginal discharge – dx?

Answer 9

Tubo-ovarian abscess – possible rupture if becoming septic

Question 10

What is a late complication of PID?

Answer 10

Tubo-ovarian abscess

Question 11

Where does a tubo-ovaria abscess form? What causes it? Dx & TX?

Answer 11

Forms in fallopian tube

  - Caused by C&G
  - Dx via imaging
  - Tx 24 hours inpatient abx, may require surgery

Question 12

What is the MC type of ovarian cyst? What causes it?

Answer 12

follicular cyst; results from a failure to ovulate

Question 13

What type of ovarian cyst would occur AFTER ovulation?

Answer 13

corpus luteum cyst

Question 14

What type of ovarian cyst can result in a false pregnancy?

Answer 14

theca-lutein cyst

Question 15

If endometriosis involves an ovary and forms a cyst/tumor – what is it?

Answer 15

Endometrioma

Question 16

What is chocolate cyst?

Answer 16

Endometrioma (filled with old blood)

Question 17

How do we manage ovarian cysts?

Answer 17

if it’s fluid filled – monitor with U/S
If not fluid filled – remove
If >6cm – remove b/c of risk of TORSION

Question 18

How can we prevent cysts?

Answer 18

OCP’s