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Elaina: PANCE review > Women's Health > Flashcards

Women's Health Flashcards

1
Q

motile protozoa on wetmount

A

trichomonas vaginalis

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2
Q

treatment of condylomata acuminata

A

electrocautery, liquid nitrogen, or imiquimod

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3
Q

etiology of condylomata acuminata

A

HPV

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4
Q

green, frothy discharge

A

trichomoniasis

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5
Q

the name for a painful genital ulcer with inguinal lymphadenitis

A

chancroid

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6
Q

what bacteria causes chancroid?

A

haemophilus ducreyi

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7
Q

treatment of chancroid?

A

azithromycin and ceftriaxone

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8
Q

thin, grey fishy smelling discharge usually means?

A

bacterial vaginosis

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9
Q

treatment of BOTH trichomoniasis and bacterial vaginosis?

A

metronidazole

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10
Q

treatment of choice for N. gonorrhea?

A

ceftriaxone

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11
Q

treatment of choice for chlamydia?

A

macrolide (azithromycin) or doxycycline

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12
Q

tzanck smear is the diagnostic of choice for what?

A

herpes simplex

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13
Q

treponema pallidum causes what?

A

syphillis

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14
Q

hallmarks of primary, secondary, and tertiary symphilis?

A

1) painless chancre
2) rash on palms and soles
3) latent; irreversible brain/heart effects

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15
Q

diagnosis and treatment of syphilis?

A 
DX = RPR, VDRL
TX = PCN
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16
Q

treatment of dysmenorrhea?

A

NSAIDS, oral contraceptives

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17
Q

treatment of painful periods secondary to endometriosis?

A

danzol and GNRH agonists (leuprorelin ie lupron)

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18
Q

which cancer is associated with DES exposure?

A

vaginal clear cell carcinoma

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19
Q

which HPV strains are associated with cervical cancer?

A

16, 18, 31, 33

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20
Q

early age of first sex, multiple partners, and smoking are risk factors for which GYN cancer?

A

cervical

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21
Q

abnormal post-menopausal bleeding should raise concern for what?

A

endometrial cancer

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22
Q

most common type of endometrial cancer?

A

adenocarcinoma

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23
Q

which type of GYN cancer is often caught late, and produces signs of abdominal fullness and GI discomfort?

A

ovarian cancer

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24
Q

what is the tumor marker for ovarian cancer?

A

CA-125

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25
Q

95 percent of ectopic pregnancies occur where?

A

fallopian tubes

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26
Q

greatest risk factor for ectopic pregnancy?

A

prior ectopic

also: PID, IUD

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27
Q

what causes hyperemesis gravidarum?

A

increasing estrogens

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28
Q

biggest complication of gestational diabetes?

A

fetal macrosomnia

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29
Q

treatment of choice of gestational diabetes?

A

insulin

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30
Q

between what weeks do we give an oral glucose tolerance test for test for gestational diabetes?

A

between 24-26 weeks

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31
Q

HTN + proteinuria + edema = what?

A

preeclampsia

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32
Q

what is the acronym for the complication of preeclampsia?

A

HELLP

hemolysis, elevated LFTs, low platelets

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33
Q

pre-eclampsia + seizures = what?

how do we treat?

A

eclampsia (may also show hyperreflexia)

treat with magnesium sulfate and delivery

34
Q

PAINFUL third trimester bleeding is often due to?

A

abruptio placenta

think in coke heads

35
Q

PAINLESS third trimester bleeding is often due to?

A

placenta previa

36
Q

treatment of abruptio placenta and placenta previa?

A

delivery usually by c-section

37
Q

WHEN and to whom do we give 300 ug of rhogam to during pregnancy?

A

give to Rh negative women at 28 weeks gestation and within 72 hours of delivery

38
Q

why do we give rhogam to Rh negative women?

A

to prevent hydrops fetalis

39
Q

days 1-14 of the menstrual cycle are also known as the _____ phase

A

follicular/proliferative phase

40
Q

the follicular/proliferative phase are under the influence of which hormone?

A

estrogen increases to proliferate endometrium and peaks at ovulation

41
Q

____ and ____ are the hormones that increase at ovulation

A

FSH and LH increase at ovulation

42
Q

the luteal and secretory phase are days ___ through ___ are are influenced by _____

A

days 14-28; influenced heavily by progesterone

43
Q

progesterone is released in large amounts by what during the luteal and secretory phase?

A

progesterone released in large amounts from the corpus luteum

44
Q

what are the two circumstances under which we can diagnose primary amenorrhea?

A

1) age 14 without secondary sex characteristics

2) age 16 with secondary sex characteristics

45
Q

what does it mean if a progesterone challenge is positive (bleeding occurs) when working up secondary amenorrhea?

A

she has estrogen present but is not ovulating (anovulatory)

46
Q

what does it mean if a progesterone challenge is negative (no bleeding) when working up secondary amenorrhea?

A

patient has very low estrogen levels OR there is a problem with the outflow tract (adhesions, scarring)

47
Q

what are two major non-sex hormones released by the pituitary that should be evaluated when working up amenorrhea?

A

prolactin (high prolactin inhibits ovulation)

TSH (hypothyroid = hyperprolactinemia = amenorrhea)

48
Q

positive chandeleir sign should make you think what? how do we treat?

A

PID – treat with ceftriaxone and doxy for 14 days (or azithromycin)

49
Q

obesity, infertility, insulin resistance, and hirsutism should make you think what?

A

PCOS

50
Q

treatment of PCOS?

A

weight loss, metformin, spironolactone, oral contraceptives

51
Q

PCOS is caused by an excess of what hormone?

A

androgen

52
Q

patients with PCOS are at increased risk for what?

A

breast and ovarian cancer

53
Q

menopause is defined as ____ months of amenorrhea, or an FSH greater than what?

A

12 months of amenorrhea

FSH greater than 40

54
Q

what is the number one benign neoplasm of the female genital tract?

A

leiomyoma (fibroid tumor)

55
Q

how does a leiomyoma (fibroid) usually present?

A

heavy menstrual flow

56
Q

diagnosis and treatment of fibroids?

A 
dx = ultrasound
tx = surgery, GNRH agonists, OCPS
57
Q

HCG levels ____ every ____ hours

A

HCG levels double every 48 hours

58
Q

when do HCG levels peak? when do they fall off?

A

peak at 50-75 days

decrease in 2nd and 3rd trimester

59
Q

when can you detect doppler heart tones in a fetus?

A

10 weeks

60
Q

at 12 weeks, where is the fundal height palpated?

A

pubic symphysis

61
Q

at 20 weeks, where is the fundal height palpated?

A

umbilicus

62
Q

what is chadwick sign? when is it detected?

A

cervical cyanosis at 37 weeks

63
Q

what is hagar sign? when is it detected?

A

cervical softening at 37 weeks

64
Q

at the 16-20 week apppointment, a ____ level should be obtained. why?

A

AFP (alpha fetoprotein)

the amount of AFP levels in a pregnant woman can help see whether a baby has problems with spina bifida or ancephaly

65
Q

at 28 weeks, what test should be ordered on a pregnant woman?

A

glucose tolerance test

66
Q

at 28-30 weeks, what should be given if needed?

A

rhogam

67
Q

at 33-37 weeks, what should we culture for?

A

group B strep

68
Q

a heart rate between ____ and ___ with good accelerations (up to ____ BPM) in 20 minutes is what we look for when monitoring fetal hearttones

A

heartrate between 120-160 BPM

accelerations up to 15 bpm from baseline in 20 minutes are GOOD

69
Q

what is the most common breast mass in young women (age 20-30)

A

fibroadenoma (round, rubbery)

70
Q

how should you work up a suspected fibroadenoma?

A

fine needle aspiration to r/o malignancy

71
Q

painful and tender breast lumps increasing in discomfort with menses should make you think what?

A

fibrocystic disease

72
Q

chocolate cysts and retroflexed uterus should make you think what?

A

endometriosis

73
Q

what is the most common type of breast cancer?

A

infiltrating ductal carcinoma

74
Q

early menarche, late menopause, nulliparty are risk factors for what?

A

GYN cancers esp breast

75
Q

where is the most common site for breast cancers to appear?

A

upper outer quadrant

76
Q

why do we use ultrasound rather than mammogram when working up breast lumps in patients under 30?

A

our breasts are more dense and it is hard to pick up images on mammogram

77
Q

when should we start recommending annual mammogram?

A

40

78
Q

when do we start pap smears? how often?

A

start at 21, do every 3 years under new recommendations

79
Q

what are the 4 stages of delivery?

A

1 = onset of true contractions to full dilation (10 cm)

2= full dilation to delivery

3 = expulsion of placenta

4 = hour after delivery

80
Q

premature rupture of membranes before onset of labor increases risk of what? how should you proceed?

A

increases risk of infection

deliver within 24 hours

81
Q

delivery by c-section or when premature rupture of membranes persist for more than 24 hours put you at risk for what?

A

endometritis

sx = fever, uterine tenderness

dx = WBC over 20k

82
Q

what is the most common pathogen associated with endometritis? how do we treat?

A

often due to anaerobic strep

tx with ABX (clindamycin and gentamicin)

Elaina: PANCE review (3 decks)

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