WH Dx 3

Question 1

dyspareunia

Answer 1

vulvovaginal or pelvic pain that is provoked by or exacerbated during sexual contact

Question 2

vulvovaginal or pelvic pain that is provoked by or exacerbated during sexual contact

Answer 2

dyspareunia

Question 3

dyspareunia risk factors
6

Answer 3

1. pelvic floor muscle hypertonia
2. PID
3. depression
4. anxiety
5. hx of sexual abuse
6. < 50 y.o.

Question 4

dyspareunia hallmark sx

Answer 4

pain with genital sexual contact

Question 5

dyspareunia DD
3

Answer 5

1. STD
2. PID
3. endometriosis

Question 6

dyspareunia education

Answer 6

This is pain with intercourse. This can be caused by a number of things like anatomy changes, infection, hormones, trauma, and inflammation. Some self-help options can include lubricants, relaxation techniques, and breathing exercises

Question 7

dyspareunia meds

Answer 7

NSAIDs

Question 8

dyspareunia test

Answer 8

no lab or imaging test; can r/o other conditions like STDs and UTI

Question 9

dyspareunia f/u

Answer 9

Refer to pain specialist if appropriate, pelvic floor PT, and sex therapist. Come back in 3 months

Question 10

dyspareunia red flags
5

Answer 10

1. worsening symptoms
2. change in menstrual period
3. change in discharge
4. bleeding or spotting between periods
5. signs of abuse

Question 11

endometriosis

Answer 11

endometrial tissue grows outside the uterine cavity

Question 12

endometriosis - patients classically present during when with what

Answer 12

their reproductive years with sx of pelvic pain, infertility, ovarian mass

Question 13

endometriosis peak age

Answer 13

25-35

Question 14

endometriosis s/sx
8

Answer 14

1. chronic abdominal pain
2. pelvic pain or pressure
3. severe dysmenorrhea
4. dyspareunia
5. heavy menstrual bleeding
6. infertility
7. low back pain
8. chronic fatigue

Question 15

endometriosis bowel and bladder

Answer 15

can cause bowel and bladder dysfunction -
pain
urgency
frequency

Question 16

endometriosis physical exam findings
4

Answer 16

1. focal tenderness on vaginal exam
2. nodules in posterior fornix
3. adnexal masses
4. immobility or lateral placement of cervix or uterus

Question 17

chronic abdominal pain, pelvic pain, pressure, severe dysmenorrhea

Answer 17

endometriosis

Question 18

pelvic pain, infertility, and ovarian mass

Answer 18

endometriosis

Question 19

tenderness on vaginal exam, immobility or lateral placement of cervix

Answer 19

endometriosis

Question 20

endometriosis DD
3

Answer 20

dysmenorrhea
PID
Uterine malignancy

Question 21

endometriosis education
4

Answer 21

1. In this condition, the cells that normally grow within the uterine lining, grow outside of it.
2. This leads to inflammation inside the body.
3. This causes a lot of symptoms and fertility issues.
4. Avoid fatty food, red meats, caffeine and alcohol.

Question 22

endometriosis meds
2

Answer 22

1. NSAID for pain
2. Oral contraceptives

Question 23

endometriosis test
2

Answer 23

A TVUS is recommended.
The only definite dx is through a laparoscopy which is a biopsy.

Question 24

endometriosis f/u

Answer 24

4-6 weeks to determine effectiveness of treatment

Question 25

endometriosis red flags 4

Answer 25

1. worsening sx 2. increased pelvic pain 3. increased bleeding 4. GI or GU concerns

Question 26

fibroadenoma

Answer 26

benign breast mass

Question 27

benign breast mass

Answer 27

fibroadenoma

Question 28

fibroadenoma is most common in who

Answer 28

women 30-40

Question 29

fibroadenoma risk factors 2

Answer 29

1. hormone replacement therapy 2. family history of breast cancer

Question 30

fibroadenoma physical exam findings

Answer 30

benign solid mass, painless, firm, and mobile

Question 31

breast mass that is painless and mobile

Answer 31

fibroadenoma

Question 32

breast mass that is painless and immobile

Answer 32

possible breast cancer

Question 33

fibroadenoma DD 2

Answer 33

breast cyst breast carcinoma

Question 34

fibroadenoma education 2

Answer 34

these are typically benign masses perform a self-breast exam monthly to monitor this mass

Question 35

fibroadenoma medication

Answer 35

none - may need surgical intervention if bothersom

Question 36

fibroadenoma test 3

Answer 36

1. < 30 breast US to determine solid from cystic masses 2. > 35 then a mammogram or US can be performed 3. definitive test is a breast tissue biopsy

Question 37

fibroadenoma f/u

Answer 37

every 6 months until stable and then yearly

Question 38

fibroadenoma red flags 3

Answer 38

1. worsening of symptoms 2. mass begins to proliferate 3. new breast changes such as changes to your skin, nipples, discharge or more

Question 39

Infertility

Answer 39

failure to achieve successful pregnancy after 12 months or more of regular, unprotected sex

Question 40

failure to achieve successful pregnancy after 12 months or more of regular, unprotected sex

Answer 40

infertility

Question 41

Infertility evaluation and tx should be initiated at what stage for women < 35 and >35

Answer 41

< 35, 12 months >35, 6 months

Question 42

Infertility DD 2

Answer 42

PCOS endometriosis

Question 43

Infertility education 3

Answer 43

1. quit smoking 2. reduce excessive caffeine intake and alcohol intake 3. have appropriate timing and frequency of sex

Question 44

Infertility meds

Answer 44

May involve drug therapies, surgery, and/or procedures such as IVF

Question 45

Infertility tests 4

Answer 45

1. semen analysis 2. assess ovarian reserve (blood test) 3. HSG test to check fallopian tube patency (x ray with contrast) 4. SIS test to assess uterine cavity (saline with US)

Question 46

Infertility f/u

Answer 46

in 4 weeks to discuss lab and imaging results, from here we can make the appropriate referrals

Question 47

Infertility AG 3

Answer 47

1. cervical cancer screening 2. STD screening 3. get vaccinated

Question 48

Infertility red flags 4

Answer 48

1. irregular cycle 2. upper body weight gain 3. growing abnormal facial hair 4. increase in acne