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Flashcardlet > Womens Health > Flashcards

Womens Health Flashcards

1
Q

The long term sequel are of chronic anovulation includes unopposed estrogen stimulation of the endometrium putting with PCOS women at 3xs risk for

A

Endometrial cancer

Also associated with increased lipid abnormalities

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2
Q

All women diagnosed with PCOS must be screened for

A

Diabetes

Hyperlipidemia

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3
Q

Treatment of women with PCOS should address 4 areas

A

1) chronic anovulation
2) androgen excess
3) insulin resistance
4) lipid abnormalities

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4
Q

First line of therapy for PCOS

A

Biguanide Metformin

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5
Q

PCOS patients suffering from infertility should be treated with🤔

A

Clomiphene ovulation induction

Combined oral contraceptive pills are an ideal first line treatment in patients who also desire conception

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6
Q

Dysrythmia almost universally associated with patients with anorexia nervosa

A

Sinus bradycardia

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7
Q

Regional analgesia in laboring patients increases the risk of?

A

Vacuum or forceps assisted delivery

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8
Q

Patients with diarrhea predominant OR MIXED presentation IBS should be tested for?

A

Celiac disease

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9
Q

A diagnosis of migraine with aura is considered an unacceptable risk for

A

Combined Oral contraceptives

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10
Q

Sevelamer is a synthetic agent of phosphate binders class works by?

A

Blocking intestinal absorption of phosphate, which lowers parathyroid hormone secretion

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11
Q

Uricosuric acid, cystine, calcium oxalate stones tend to form in?

A

Acidic urine

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12
Q

In patients with hyperthyroidism to avoid worsening of orbitopathy recommended treatment?

A

Treat with methimazole prior to radioactive iodine ablation

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13
Q

Treatment that leads to most effective weight reduction and long term management in morbidly obese

A

Bariatric surgery

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14
Q

The major source of serum BNP

A

The cardiac ventricles

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15
Q

Condition characterized by chronic anovulation and hyperandrogenism

A

PCOS

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16
Q

In women 30-65 years old, screening for cervical cancer with cervical cytology and HPV testing is recommended every

A

5 years

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17
Q

Anovulatory amenorrhea is abnormal uterine bleeding that typically results from

A

Endocrinopathy i.e.; PCOS

Mechanism of abnormal bleeding related to unopposed estrogen

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18
Q

Imaging recommended to evaluate the uterus in patient with history of abnormal uterine bleeding

A

Transvaginal US MORE ADVANCED IMAGINGthen
Saline infusion sonohysterography
Or
Hysteroscopy

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19
Q

Endometrium that is too thin because of heavy continuous bleeding. What is treatment?

A

estrogen followed by progestin

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20
Q

Treatment too thick endometrium

Goal of therapy?

A

Treat with Progestins or OCPs to reduce thickness of the endometrium

21
Q

Abnormal uterine bleeding emergency management

A

IV conjugated estrogen- 25mg q 4hours until bleeding slows

Oral conjugated estrogen 10 mg/ day

22
Q

Determination of adequate estrogen in amenorrhea is established by?

A

Progestin challenge test

5-10 mg medroxyprogesterone acetate po q day X 10 days

ANY. Bleeding within 2-7 days is positive

23
Q

Anovulatory amenorrhea is amenorrhea in women with adequate estrogen (+ progestin challenge) occurs because

A

Progesterone is NOT being adequately produced in the LUTEAL phase

Treat with progestin 10 mg q day 7-10 days every month or OCPs

24
Q

Amenorrhea with nL TSH, Prolactin, and NEGATIVE withdrawal bleed with progestin challenge ➡️ no bleed with both estrogen and progestin challenge

A

Outflow tract obstruction

25
Q

Management of PCOS

HIRSUTISM?

A

OCPs
Spironolactone
Fin astride

26
Q

Management of PCOS

Insulin resistance?

A

Metformin

27
Q

Management PCOS
Infertility
Meds that promote ovulation induction?

A

Clomiphene
Metformin
Pioglitazone

28
Q

Management of PCOS

Oligomennorhea and amenorrhea?

A

OCPs

Monthly progesterone

29
Q

First test when evaluating premenopausal bleeding?

A

Endometrial biopsy

30
Q

Single most important histological finding on endometrial biopsy

A

Cytological atypia

31
Q

Management In reproductive women with Cytological atypia on EMB

A

High dose progestins, megace (megestrol) or depo provera for 3 months then rebiopsy

32
Q

Management in reproductive women with no Cytological atypia but simple endometrial hyperplasia with abnormal bleeding

A

Progestin withdrawal for 6 months then rebiopsy

MPA (provera), megestrol (megace), levonorgestrel IUS (mirena- induces amenorrhea and may cause atrophy) or sequential HRT - prevents hyperplasia but no contraception

33
Q

Irregular bleeding is common after HRT is initiated and improves within

A

6-12 months for most women

34
Q

Preferred treatment for vaginal dryness/ atrophy of the vagina

A

Vaginal estradiol ring worn for 90 days

35
Q

52 year old currently takes no meds refuses estrogen replacement therapy. What is considered most effective in relieving her menopausal symptoms?

A

Venlafaxine ( Effexor)

36
Q

All pregnant women should be screened for anemia? What level of Hgb is considered iron deficiency anemia in first trimester?

A

First trimester- Hgb

37
Q

USPSTF recommends ALL pregnant women be screened for

A

HIV
Hepatitis B
Syphilis

38
Q

USPSTF recommends ALL pregnant women less than 25yo and with high risk sexual behaviors (>1sexual partner) be screened for

A

Chlamydia and gonorrhea

39
Q

When should women with active recurrent genital herpes should be offered suppressive viral therapy at or beyond

A

36 weeks of gestation

Acyclovir 400 mg tid
Valcyclovir 500mg po bid daily

40
Q

How long must OCPs be taken before they become effective

A

1 month

41
Q

The imaging study for evaluation of pelvic mass is?

A

Ultrasound

42
Q

The most common class of organisms associated with BV

A

Anaerobic bacteria

43
Q

Women with ASC-US who test positive for high risk HPV SHOULD UNDERGO

A

Colposcopy

44
Q

HPV types associated with genital warts

A

6&11

45
Q

Which part of the cervix is most vulnerable today’s plastic changes

A

The squamocolumnar junction

46
Q

Indications for estrogen therapy/ estrogen combined with daily or cyclic progestin/progesterone therapy

A

1) treatment mod- severe vasomotor symptoms
2) treatment mod to severe vulvar and vaginal atrophy
3) prevention of post menopausal osteoporosis

47
Q

USPSTF recommends biennial (every other year) mammography for women ages

A

50-74

Stop screening at age 75

48
Q

The American cancer society recommends along with mammography that screening breast MRIs be performed in 5 groups. What are the 5 groups?

A

Women BRCA1&2 gene mutations
Women 1st degree relatives w/BRCA1&2 gene mut who have not had genetic testing
Women who underwent radiation to chest aged 10-30 for hodgkins
Women lifetime risk
Women known hereditary breast cancer syndrome

49
Q

What is the preferred initial test for a patient with painless post menopausal bleeding

A

Transvaginal ultrasonography

Flashcardlet (18 decks)

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