Womens health Flashcards
1
Q
The secretory phase of the menstrual cycle (day 14-28) is dominated by what hormone?
A
Progesterone
2
Q
Is a nulliparous or multiparous woman more likely to get preeclampsia?
A
Nulliparity is a risk factor for preeclampsia
3
Q
Wince a genetic cause is the number one reason for primary amenorrhea, what is one very important test?
A
Karyotype
4
Q
Purulent cervical discharge should make you think of what diagnosis?
A
Neisseria gonorrheoeae
5
Q
A description of a young girl with a web neck or wide shield chest should make you think of what diagnosis?
A
Turners syndrome
6
Q
A cervical biopsy comes back as CIN1. What is the next step?
A
Repeat pap smear in 6 months and repeat colposcopy in 12 months
7
Q
What is the most common cause of secondary amenorrhea
A
Pregnancy
8
Q
What three labs should you order if you are considering secondary amenorrhea?
A
Beta- HCG, TSH, prolactin
9
Q
Define premature birth
A
Delivery before 37 weeks
10
Q
A unilateral, single, mobile, firm, contender solid breast mass should make you think of what diagnosis?
A
Fibroadenoma
11
Q
Define metorrhagia
A
Bleeding between menstrual cycles
12
Q
Postmenopausal bleeding is immediately believed to be what diagnosis?
A
Endometrial cancer until proven otherwise
13
Q
During what portion of the menstrual cycle does PMS occur?
A
By definition it is in the second half of menstruation and should receive the symptoms
14
Q
How do you treat bacterial vaginosis?
A
Metronidazole x7 days
15
Q
What location within the pelvis is endometriosis most commonly found?
A
On an ovary
16
Q
What lab test is the gold standard for chalmydia?
A
Nucleic acid amplification test
17
Q
How do you definitely diagnose endometriosis?
A
Exploratory laparoscopy
18
Q
Are fibrocystic breast masses usually bilateral or unilateral?
A
Bilateral
19
Q
What is the most common uterine tumor?
A
Leiomyoma, also known as fibroids
20
Q
Which ethnic background is at an increased risk of fibroids?
A
African americans are 5x more likely to have fibroids compared to caucasian women
21
Q
How do you treat vaginal candida?
A
Fluconazole po 1 dose or azole cream x1 week
22
Q
What is the first step of treatment for endometrial cancer?
A
Total hysterectomy and bilateral salpingo-oophorectomy
23
Q
If you see the term chocolate cyst, it should make you think of what diagnosis?
A
Endometrioma
24
Q
A surge in what hormone leads to ovulation?
A
Lutenizing hormone
25
A patient presents with irregular menses, hirsutism, and infertility. What is the most likely diagnosis?
Polycystic ovarian syndrome
26
What endocrine issue is associated with PCOS?
Insulin insensitivity
27
You have a patient with PCOS who would like to get pregnant. What are two medications you may start her on?
Metformin and clomid
28
What is the medical treatment for an early ectopic pregnancy?
Methotrexate
29
An ovarian cyst that contains hair and teeth should make you think of what diagnosis?
Teratoma
30
What is the mean age for ovarian cancer?
63, you will need to think of this with an older patient with vague abdominal symptoms
31
Define the second stage of labor
Fully dilated to delivery
32
A 66 year old female patient presents with bouts of nausea, weight loss, and vague abdominal pain, what is the most likely diagnosis?
Ovarian cancer
33
When is it recommended to begin pap smears?
Beginning at age 21 regardless of sexual history
34
A cervical biopsy comes back as CIN2 or CIN3. What is your next step?
Excision - LEEP, cold knife (worry about incompetent cervix), cryotherapy
35
List 2 risk factors for cervical cancer
Multiple sexual partners, smoking
36
How much time has to pass before diagnosing secondary amenorrhea?
If cycles have been normal 3 months, if cycles have been irregular 6 months
37
What is a cystocele?
A herniation of the bladder into the vagina
38
What is the treatment for turners syndrome?
Cyclical estrogen and progesterone
39
What are the 3 treatments for uterine prolapse?
Pessary, Kegel's maneuver, surgical repair
40
What is the most common organism to cause mastitis?
Staph aureus
41
At approximately how many weeks pregnant is the uterus at the level of the umbilicus?
20 weeks
42
What is the most common cause of postpartum hemorrhage?
Uterine atony
43
Define missed abortion
No vaginal bleeding, cervix is closed, no products of conception are still inside
44
At what age is primary amenorrhea diagnosed?
Age 14 if no secondary sex characteristics. Age 16 if some secondary development
45
What is the first line treatment for mastitis?
Dicloxacillin is first line, cephalexin or erythromycin are second line
46
Should a breast feeding mother stop breast feeding if she develops mastitis?
Mastitis is not a reason to stop breast feeding, but a breast abscess is
47
A physical examination revealing a retroverted uterus or uterosacral ligament modularity should make you think of what diagnosis?
Endometriosis
48
At how many weeks of pregnancy can amniocentesis done?
15-20 weeks
49
List four risk factors of breast cancer?
BRCA1 or BRCA2 positive, unstopped estrogen, nulliparity, early medicine, late menopause
50
What is the average age of menopause?
51
51
Cottage cheese discharge should make you think of what diagnosis?
Vaginal candidiasis
52
The follicular phase of menstruation is dominated by what hormone?
Estrogen
53
How much weight should a woman gain during pregnancy
20-35 pounds
54
Thin, sticky, malodorous vaginal discharge should make you think of what diagnosis?
Bacterial vaginitis
55
List 2 medications commonly used for hypertension in pregnancy?
Methyldopa and labetalol
56
Vaginal infection with motile flagellated protozoa should make you think of what diagnosis?
Trichomonas vaginitis
57
Classic triad for pre-eclampsia?
HTN, edema, and proteinuria
58
Why is ovarian cancer so hard to diagnose?
There are no good markers and the symptoms are very vague
59
What are two important things you need to tell your patients before putting them on metronidazole?
Stay out of the sun and avoid alcohol
60
Define inevitable abortion
Vaginal bleeding, cervix is open, products of conception inside
61
How is the first day of the menstrual cycle defined
The first day of menstrual bleeding is the first day of the cycle
62
Karyotype for a patient with turners syndrome?
(45, X) they are missing one sex chromosome
63
Give the definition for preterm labor
Contractions that open the cervix before 37 weeks
64
A patient presents with mucopurlent discharge and cervical motion tenderness, what is the most likely diagnosis?
Chlamydia cervicitis
65
Which four human papillomaviruses are linked to cervical cancer?
HPV 16, 18, 31, and 33
66
Clue cells should make you think of which diagnosis?
Bacterial vaginosis
67
What is the hallmark physical exam finding for placenta previa?
Trick question - NEVER do a physical exam on someone with presumed placenta previa.
68
What medium do you need to grow out Neisseria gonorrhoeae?
Thayer-martin
69
What age range is the HPV vaccination recommended for?
9 to 26 years old
70
A patient with primary amenorrhea and a low FSH should make you think of what diagnosis?
Hypothalamic pituitary insuf ciency
71
What characteristic of pelvic inflammatory disease will help to differentiate it in a question from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst?
It will be bilateral pain. Most other common abdominal complaints have unilateral pain.
72
List 2 risk factors for ovarian cancer
BRCA1, family history, nulliparity, late menopause, Caucasian, Asian
73
Define abortion
Delivery of uterine contents before 20 weeks.
74
Does mastitis tend to be unilateral or bilateral?
Unilateral and only in one quadrant
75
Define full-term
Delivery at 37-42 weeks
76
When does quickening occur?
Nulliparous 18-20 weeks, multiparous 14-16 weeks
77
3 risk factors for placental abruption
HTN, smoking, AMA, cocaine use, PROM
78
Treatment for ovarian cancer
Total hysterectomy and bilateral salpingo-oophorectomy. Then chemo and radiation.
79
Bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. It can be observed as early as 6 to 8 weeks after conception, and its presence is an early sign of pregnancy.
Chadwicks sign
80
At approximately how many weeks pregnant is the uterus at the level of the symphysis pubis?
12 weeks
81
A snowstorm appearance on ultrasound should make you think of what diagnosis?
Hydatidform mole
82
What medication can be used to control bleeding due to uterine atony?
Oxytocin
83
What is the term for when the placenta has implanted directly over the cervical os?
Placenta previa
84
At how many weeks of pregnancy can chorionic villus sampling (a test made in early pregnancy to detect congenital abnormalities in the fetus) be done?
10-13 weeks
85
Why is folic acid given as a prenatal vitamin?
Low folic acid can lead to neural tube defects.
86
Most common endometrial cancer?
75% are adenocarcinomas
87
A strawberry cervix with copious yellow/green discharge should make you think of what diagnosis?
Trichomonas vaginitis
88
What is the #1 cause of septic arthritis in sexually active young adults
Neisseria gonorrhoeae
89
How many days after conception is beta HCG positive?
8
90
If the pap smear results come back anything other than negative or ASCUS what is your next step?
Colposcopy and biopsy
91
List 3 risk factors for ectopic pregnancy
Previous ectopic, scarred tubes (hx of PID or salpingitis), IUD
92
Grape-like vesicles or a sack of grapes on ultrasound should make you think of what diagnosis?
Hydatidiform moles
93
What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor?
Betamethasone
94
What are two tocolytic medications you should be aware of?
Magnesium sulfate and calcium channel blockers
95
A woman presents to the ER concerned she is in preterm labor. What treatment should you begin before even getting any imaging or lab results?
Give IV uids (most often the patient is suffereing from dehydration).
96
The pap smear results on a 23 year old patient come back as atypical squamous cell uncertain signi cance (ASCUS). What is your next step?
Repeat pap smear in 12 months although HPV test is acceptable.
97
What are three ways you can check for ruptured membranes?
Ferning pattern on a slide, visualize leakage from the cervix, pooling in the vagina
98
What is the normal range of fetal heart rate?
120-160
99
Define menorrhagia
Heavy prolonged menstruation
100
What Rh combination for mom and dad might
| cause the mother to create antiboides against the baby’s red blood cells?
Mom Rh-negative and dad Rh- positive
101
At what point during pregnancy is RhoGAM given if it is needed?
28 weeks
102
Define complete abortion
Vaginal bleeding, cervix open, products of conception have passed
103
Gestational diabetes puts mom and baby at increased risk of for what three things?
Preeclampsia, macrosomia (traumatic birth), slowing in fetal lung development
104
Which is associated with painful third trimester bleeding placental abruption or placenta previa?
Placental abruption
105
What are the three causes for a postpartum hemorrhage?
Uterine atony, genital laceration, retained placenta
106
Define the third stage of labor
Delivery of baby to delivery of placenta
107
What medications are used to treat post partum metritis
Clindamycin and gentamycin
108
What organism is the most common sexually transmitted bacteria
Chlamydia
109
Interference with work or school is part of which diagnosis, premenstrual syndrome or premenstrual dysphoric disorder?
Premenstrual dysphoric disorder
110
Which reproductive cancer carries the highest rates of death in women?
Ovarian cancer
111
What is the most common infection following a c section
Metritis
112
How do you treat a trichomonas infection
Metronidazole
113
Define incomplete abortion
Vaginal bleeding, cervix is open, products of conception partially passed
114
What is the most common site of an ectopic pregnancy?
Within a fallopian tube
115
Early on in pregnancy serial beta HCG should double over what time period?
Every 48-72 hours
116
Define procidentia
Uterine prolapse beyond the introitus
117
What is the more popular term for Stein-Leventhal syndrome?
PCOS
118
What is the formula for calculating estimated date of con nement or due date?
First day of last menstrual period + 7 days - 3 months
119
What are the ve components of the biophysical pro le as part of antepartum testing?
A non-stress test, fetal breathing, two gross body movements, fetal tone, amniotic uid index
120
Define the first stage of labor
Onset of contractions to full dilation of the cervix
121
A rope like breast mass should make you think of what diagnosis
Fibrocystic breast mass
