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Clin Med > Women's Health > Flashcards

Women's Health Flashcards

1
Q

What disorder commonly occurs from breastfeeding?

A

Mastitis

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2
Q

What are the signs/symptoms of mastitis?

A

Sudden onset of pain
Inflammation
Induration
Tenderness
Warmth

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3
Q

What is the treatment for mastitis?

A

No MRSA or abscess: dicloxacillin 500mg QID or Keflex 500mg QID
MRSA: bactrim 1-2 tabs PO BID or clindamycin 300mg TID
Warm compress & keep breastfeeding

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4
Q

What is galactorrhea?

A

Milk production when not breastfeeding

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5
Q

What things can cause galactorrhea?

A

Chronic breast stimulation
Steroids
Hormones
Pituitary tumor
Idiopathic

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6
Q

What are signs/symptoms of galactorrhea?

A

Milky discharge from nipples
Discharge has evidence of fat droplets on analysis

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7
Q

How do you treat galactorrhea?

A

Stop offending agent
Treat cause

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8
Q

What are the signs/symptoms of intraductal papilloma?

A

Bloody, serous discharge from the nipple

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9
Q

What diagnostic test is used in intraductal papilloma?

A

Ductogram

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10
Q

What is the treatment for an intraductal papilloma?

A

Excision of the duct

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11
Q

What is polythelia?

A

Accessory or supernumerary nipple that develop along the “milk line”

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12
Q

What is the most common benign breast tumor?

A

Fibroadenoma

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13
Q

What are signs/symptoms of a fibroadenoma?

A

Sharply circumscribed, freely mobile, “rubbery” lump

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14
Q

What are the signs/symptoms of breast cancer?

A

Hard, non-mobile mass
Skin retraction
Nipple retraction
Peau d’orange
Commonly in the upper outer quadrant

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15
Q

What is the most common type of breast cancer?

A

Ductal

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16
Q

What is the treatment for breast cancer?

A

Surgery (mastectomy, lumpectomy)
Radiation
Chemo
SERMs
Aromatase inhibitors
PD-L1 inhibitor

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17
Q

What tool can be used to assess risk of breast cancer?

A

Gail Model

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18
Q

What are the genes that are looked at when assessing genetic predisposition to breast cancer?

A

BRCA1 & BRCA2

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19
Q

Most breast cancer occurs in women with what type of risk factors?

A

Most occurs in women with no known risk factors

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20
Q

What is the 1st line diagnostic test for abnormal uterine bleeding?

A

Transvaginal ultrasound

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21
Q

What is the definitive treatment for abnormal uterine bleeding?

A

Hysterectomy

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22
Q

What are the definitions of amenorrhea, oligomenorrhea, menorrhagia, and dysfunctional uterine bleeding?

A

Amenorrhea: absence of bleeding for > 3 cycles
Oligomenorrhea: > 35 days between cycles
Menorrhagia: excessive volume or > 7 days
Dysfunctional: anovulatory bleeding

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23
Q

What are the normal ranges for a menstrual period (frequency, regularity, duration, volume)?

A

Frequency: 24-35 days
Regularity: 2-20 day monthly variance in 1 year
Duration: 4.5-8 days
Volume: 5-80mL

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24
Q

What procedure should be performed on all pts > 45 yo with abnormal bleeding?

A

Endometrial biopsy

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25
Q

What does PALM COEIN stand for?

A

Reasons for abnormal uterine bleeding
P: endometrial polyp
A: adenomyosis
L: leiomyoma (uterine fibroids)
M: endometrial cancer (malignancy)

C: coagulopathy
O: ovulation disorders
E: endometrial disorders
I: iatrogenic
N: not otherwise classified

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26
Q

What are the signs/symptoms of leiomyoma (uterine fibroids)?

A

Heavy or prolonged menstrual periods
Pelvic pain or “pressure”
Enlarged or irregularly contoured uterus on PE

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27
Q

What are the signs/symptoms of endometrial cancer?

A

Postmenopausal bleeding (most common)
Abdominal bloating/fullness/distention
Back pain
Dyspareunia

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28
Q

What is the mainstay treatment for endometrial cancer?

A

Total hysterectomy with bilateral salpingo-oophorectomy

29
Q

Dysmenorrhea (painful menstruation) can either be _____ or ______

A

Primary; secondary

30
Q

What are signs/symptoms of dysmenorrhea?

A

Primary: cramping pain w/every menstrual cycle
Secondary: progressive worsening of pelvic pain

31
Q

What is the 1st line treatment for dysmenorrhea?

A

NSAIDs (ibuprofen or naproxen)

32
Q

What is the definition of premenstrual syndrome?

A

Emotional and/or physical symptoms occurring 1-2 weeks prior to menstruation & resolving 1-3 days after the onset of menstruation

33
Q

Lifestyle mods can help alleviate PMS symptoms, but what is the 1st line treatment for PMS with predominantly emotional issues?

A

SSRIs

34
Q

What typically causes cervical dysplasia?

A

HPV (16 & 18 commonly)

35
Q

What is the gold standard diagnostic test for cervical dysplasia?

A

Colposcopy

36
Q

What is the Bethesda classification?

A

A system/tool that describes pap smears to guide treatment (tells what kind of dysplastic cells are present)

37
Q

What is the treatment for cervical dysplasia?

A

ASC-US: repeat pap/HPV in 1 yr, colp if needed
LSIL: repeat pap in 1 yr, colp if needed
ASC-H: colposcopy
HSIL: colposcopy or excisional tx
Post-menopause: vaginal estrogen & repeat pap

38
Q

What is the most common symptom of cervical cancer?

A

Post-coital bleeding

39
Q

What is the gold standard diagnostic test for cervical cancer?

A

Colposcopy

40
Q

What is used for staging cervical cancer?

A

FIGO

41
Q

What is the treatment for cervical cancer?

A

Prevention w/routine pap smears, HPV vaccine, condom use
Simple hysterectomy (for stage IA1 only)
Total hysterectomy
Conservative surgery (if fertility desired)
> IA1 needs lymph node dissection & radical hysterectomy

42
Q

What is the definition of menopause?

A

Permanent cessation of menses for 12 consecutive months

43
Q

What are the signs/symptoms of menopause?

A

Vasomotor: hot flashes, night sweats, palpitations
Urogenital: vaginal atrophy
Psych: irritability, anxiety, depression

44
Q

What test for menopause supports a diagnosis, but it not usually done?

A

FSH (> 40 supports dx)

45
Q

What should post-menopausal women be screened for starting at age 65?

A

Osteoporosis w/DEXA scan

46
Q

What is the treatment for menopause?

A

Hormone replacement (estrogen)
SERMs (raloxifene, bazedoxifene)
Non-hormone tx (SSRIs, gabapentin)
Osteoporosis specific (bisphosphonates, Vit D, calcium)
Non-prescription tx (Vit E, omega-3 fatty acids)

47
Q

What are the stages of menopause?

A

Premenopause: no symptoms, still have period
Perimenopause: symptoms of hormone change, can last 4 years & can still get pregnant
Menopause: no period for 12 months
Postmenopause: over 1 year since last period, stay in this stage for remainder of life

48
Q

What risks of treatment of menopause should the pt be made aware of?

A

Hormones increase risk of cancer, stroke, embolism, CAD
SERMs have risk of thromboembolism & stroke

49
Q

What disorder is asymptomatic early and majority has mets once there are symptoms?

A

Ovarian cancer

50
Q

What is the 1st line diagnostic test for ovarian and fallopian tube cancer?

A

Transvaginal ultrasound

51
Q

What is the treatment for ovarian and fallopian tube cancer?

A

Refer to GYN oncologist
Surgery
Chemo

52
Q

What procedure can be performed to prevent ovarian cancer in pts with a known BRCA gene?

A

Bilateral salpingo-oophorectomy

53
Q

What are the 2 subtypes of vulvar and vaginal cancer?

A

Vulvar intraepithelial neoplasia from HPV infection
Vulvar non-neoplastic epithelial disorder from chronic skin inflammation

54
Q

What is the most frequent sign/symptom of vulvar cancer?

A

Chronic vulvar or vaginal itching

55
Q

What is the gold standard treatment for vulvar and vaginal cancer?

A

Surgical resection

56
Q

What is the most common chronic vulvar condition?

A

Vulvar lichen sclerosus

57
Q

What are the signs/symptoms of vulvar lichen sclerosus?

A

Erythema & edema
Development of white plaques
Intense itching
“Cigarette paper” appearance

58
Q

What is the treatment for vulvar lichen sclerosus?

A

Stop itch-scratch cycle
Vulvar hygiene
Oral antihistamine
High-potency topical steroids

59
Q

Vulvar lichen sclerosus often gets mistaken for what in females that are prepubertal?

A

Sexual abuse

60
Q

What is the length of time it takes vulvar epithelium to heal?

A

At least 6 weeks

61
Q

What is the treatment for a Bartholin’s cyst/abscess?

A

Stab incision & place Word cath
I&D w/o Word cath
GYN follow up in 5-7 days

62
Q

What are the 6 P’s of vulvovaginal lichen planus?

A

Pruritus
Polygonal
Planar
Purple
Papules
Plaques

63
Q

What are signs/symptoms of bacterial vaginosis?

A

Thin, white, homogenous discharge
“Fishy smell”

64
Q

What criteria is used to diagnose bacterial vaginosis?

A

Amsel’s criteria (must have 3 of 4)

65
Q

What is Amsel’s criteria?

A

Thin, homogenous, white, non-inflammatory adherent discharge
Clue cells on microscopic exam
Vaginal pH > or = 4.5
Positive “whiff” test (fishy odor after KOH)

66
Q

What is the treatment for bacterial vaginosis?

A

Metronidazole (flagyl) 500mg PO BID x 7 days OR
MetroGel 0.75% 1 applicator 5g intravaginal QD x 5 days OR
2% clindamycin cream 1 applicator 5g intravaginal QHS x 7 days

67
Q

What is characterized by perivaginal itching/burning, redness, and thick, white, curd-like discharge that adheres to the vaginal walls?

A

Vaginal candidiasis (yeast infection)

68
Q

What is the treatment for vaginal candidiasis (yeast infection)?

A

Oral or intravaginal antifungals
Butoconazole 2% 5g 1 dose OR
Clotrimazole 500mg x 1 dose OR
Fluconazole (diflucan) 150mg PO x 1 dose OR
Nystatin vaginal suppository QD x 14 days

Clin Med (15 decks)

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