UWorld: Step 2 CK - "Obstetrics & Gynecology" Flashcards
In what age groups is the HPV vaccine indicated?
- Women: 11 - 26
* Men: 11 - 21 (26 if they are MSM)
How should an asymptomatic Bartholin cyst be treated?
Observation (many times they resolve on their own)
If they are infected (abscesses), then incision and drainage can be curative.
What should you do in the case of a Pap test showing high-grade dysplasia?
Immediate colposcopy
In addition to PID, N. gonorrhoeae can cause ____________.
pharyngitis (look for cervical lymphadenopathy)
Both tamoxifen and raloxifene can cause what side effects?
Hot flashes and clots
The first-line choice for evaluating the endometrium is _______________.
endometrial biopsy
True or false: endometriosis can present with dyspareunia.
True
How can you use the timing of pain to distinguish between primary dysmenorrhea and endometriosis?
Endometriosis pain peaks before bleeding while dysmenorrhea peaks during bleeding.
Uterine fibroids are also called _______________.
leiomyomata uteri or leiomyoma
What patient characteristic can help you distinguish leiomyoma from leiomyosarcoma?
Age
Fibroids are more common in younger women.
What neoplasm can cause bloody discharge?
Intraductal papilloma
True or false: biopsies are needed to evaluate ovarian masses.
False
If they are malignant, then the cancer could seed the abdomen during a biopsy.
Ovarian torsion shows __________ on doppler flow.
absence of movement
After an ultrasound has shown the absence of flow on a suspected case of ovarian torsion, the next step is to ______________.
do urgent laparoscopy
One of the most common complications of cervical conization is _____________.
cervical stenosis (impeded menstrual flow and dysmenorrhea)
Lichen sclerosis is diagnosed by ______________.
vulvar punch biopsy
_______________ occurs more frequently in those with lichen sclerosis.
Squamous cell carcinoma
True or false: topical estrogen is used to treat lichen sclerosis.
False.
Corticosteroids are treatment.
Lichen sclerosis typically spares _________.
the vagina itself (it surrounds the labia majora)
HELLP is a ______________________ syndrome.
systemic inflammatory disorder with platelet consumption
The consumption of platelets causes congestion of the liver with swelling and hepatocellular destruction.
Cystic teratomas can show ______________ on ultrasound.
calcifications and hyperechoic nodules
Teratomas are also called ___________.
dermoid cysts
What is dyschezia?
Pain with defecation (in the context of OB/GYN, suggestive of endometriosis)
In a menstrual cycle, “day 1” is the day that ____________.
bleeding starts
The most effective form of emergency contraception is _____________.
copper IUDs
What are some indications for endometrial biopsy by age?
- Older than 45: postmenopausal bleeding or AUB
* Younger than 45: AUB with either excess estrogen exposure, anovulation, or failed medical management
What is ACOG’s recommendation for alcohol intake for women?
Less than 7 drinks per week
More than this increases risk of breast cancer.
Which women should get genetic testing?
Those who have had breast cancer before age 50, have a first-degree relative who had breast cancer before age 50, or ovarian cancer at any age.
When should you do laparoscopy in a patient with endometriosis?
- When NSAIDs and OCPs have failed
- Infertility with a desire to have children
- Concern for concomitant malignancy
How can you further evaluate a woman with suspected infertility due to past PID?
Hysterosalpingogram
All sexually active women younger than 25 should be tested for ________________.
chlamydia and gonorrhea; many cases are asymptomatic, so testing can catch underlying infections
True or false: combined OCPs increase risk of endometrial cancer.
False. They actually lower the risk because the progesterone promotes differentiation and stabilization rather than uncontrolled growth.
The most common symptoms of vaginal cancer are _______________.
vaginal bleeding and malodorous discharge
What are the two diagnostic tests done to evaluated ovarian masses?
TVU and CA-125
If the US does not show suspicious features and the CA-125 is normal, then the patient can be managed with observation. If either test is abnormal, however, laparoscopy is indicated.
Atrophic vaginitis can present with what kind of incontinence?
Mixed
Normal breast milk is what color?
Brownish-gray
How should genital HSV in a pregnant woman be managed?
- Administer acyclovir or valacyclovir to women with a history of HSV beginning at 36 weeks gestation.
- If a woman is in labor and has active genital lesions, then a c-section is indicated.
Explain the two phases of gestational diabetes treatment.
- First, recommend dietary changes, specifically no more than three small meals and 2 snacks per day.
- Second, administer insulin, glyburide, or metformin if labs fail to correct with diet.