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Clerkship Prep > Womens Reproductive Health > Flashcards

Womens Reproductive Health Flashcards

1
Q

After age 60 is hypertension more common in men or women

A

Women

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2
Q

Is T2DM higher in men or women

A

Women

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3
Q

PCOS involves a triad of:

A

Insulin resistance, anovulation, and increased androgens

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4
Q

Autoimmune disorders are more common in

A

Women

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5
Q

What percentage of pregnancies are planned

A

Less than half

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6
Q

How often should the average women get a Pap test?

A

Every 3 years

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7
Q

The most common gyne malignancy is

A

Uterine cancer

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8
Q

Highest risk for uterine cancer is in

A

Obese, low parity women

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9
Q

MB Breast Screening Program recommends mammograms starting at age

A

50

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10
Q

50-69YO women should have a mammogram how often?

A

Every 2-3 years

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11
Q

What age do paps start in MB?

A

21

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12
Q

Cervical cancer is seen in women

A

20+

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13
Q

Commonest causes of mortality for a 19YO woman

A

Accidents and complications from HIV, followed by suicide

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14
Q

Which vaccination can reduce a woman’s risk of cervical cancer?

A

HPV vaccine

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15
Q

Uterine cancer presents with

A

Abnormal bleeding

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16
Q

Elevated risks in older mothers are

A

Genetic abnormalities, miscarriage, infertility, hypertension, gestational diabetes

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17
Q

A 60 YO woman should get a mammogram every

A

2-3 years

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18
Q

What nerve provides motor and sensory innervation to the perineal structures?

A

Pudendal nerve (S2-S4)

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19
Q

Pessaries are

A

Prosthetic devices used to prop up the vagina by providing intravaginal support

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20
Q

Large uterine fibroids may cause what sx

A

Pelvic pain, difficulties with micturition and defecation, backache and pain in the leg

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21
Q

Where does the distal ureter course in relation to the uterine artery?

A

Ureter under the artery - water under the bridge

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22
Q

Ovarian torsion presents as

A

Severe, constant, unilateral pelvic pain

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23
Q

Diagnosing suspected ovarian torsion

A

Diagnostic laparoscopy

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24
Q

Atypical endometrial hyperplasia can be a precursor to

A

Endometrial cancer

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25
Q

Most cases of endometrial cancers are due to

A

Prolonged unopposed estrogen exposure

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26
Q

Chronic HPV infection is a risk factor for

A

Cervical adenocarcinoma

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27
Q

Diethylstilbestrol exposure in utero increases risk of

A

Clear cell carcinoma of the cervix and vagina

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28
Q

Cervical Leiomyoma presents as

A

Protruding cervical mass with heavy bleeding

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29
Q

Uterine leiomyoma presents with

A

Bulk symptoms and heavy bleeding

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30
Q

Choriocarcinoma typically presents with

A

Vaginal bleeding, elevated B-hCG levels, enlarged uterus

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31
Q

Complete mullerian agenesis presents as

A

Amenorrhea and a blind vaginal pouch due to congenital absence of the uterus and cervix

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32
Q

Foreign body in the vagina can present as

A

Abdo pain, foul smell, discharge, bleeding

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33
Q

Sarcoma botryoides (a form of rhabdomyosarcoma) presents during infancy as

A

Polypoid of grapelike mass protruding from the vagina, associated with vaginal discharge and bleeding

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34
Q

Imperforate hymen usually presents as

A

Pubertal patients with cyclical abdo pain, amenorrhea, and hematocolpos

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35
Q

Treatment of a symptomatic bartholins duct cyst

A

Incision and drainage with possible word catheter placement

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36
Q

Which HPV strains cause condylomata accuminata

A

11 and 16

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37
Q

Cluster headache onset is often during

A

Sleep

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38
Q

Location of cluster headache

A

Behind one eye

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39
Q

Tension headache location

A

Bilateral band around the head

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40
Q

Duration of cluster headache

A

Less than 2 hrs, multiple times followed by remission

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41
Q

Corneal edema/cloudiness, fixed mid dilated pupil, conjunctival redness is a signs of

A

Acute angle closure glaucoma

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42
Q

Florescein staining of the eye is usually performed to detect

A

Corneal abrasions or herpetic keratitis

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43
Q

HPV vaccine indications

A

All female and male patients age 11-26

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44
Q

Signs of acute inhalant intoxication

A

Transient euphoria and loss of conciousness

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45
Q

Chronic abuse of nitrous oxide can result in

A

B12 deficiency and polyneuropathy

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46
Q

What acid base disturbance can result due to hypoventilation?

A

Respiratory acidosis

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47
Q

What type of contraception is preferred in postpartum breastfeeding mothers

A

Progestin only

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48
Q

Bilateral nipple discharge workup

A

Pregnancy test, galactorrhea evaluation

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49
Q

Unilateral nipple discharge workup

A

Ultrasound +/- mammogram

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50
Q

Workup for galactorrhea

A

Prolactin and TSH levels, pregnancy test

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51
Q

Thelarche is

A

The onset of breast development

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52
Q

The first sign of puberty in most girls is

A

Thelarche

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53
Q

Adrenarche is the onset of

A

Body odor, pubic hair, etc

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54
Q

Treatment for asymptomatic pelvic organ prolapse

A

Reassurance and observation

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55
Q

Obesity is a major risk factor for endometrial hyperplasia because

A

Adipose tissue increases peripheral conversation of androgens to estrone - increased estrogen levels and causing unopposed uterine exposure

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56
Q

Ideal contraception in hypertensive patient

A

Copper containing IUD

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57
Q

Chronically elevated estrone levels can have what effect on menstrual cycle

A

Anovulation and abnormal uterine bleeding

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58
Q

What effect do copper IUDs have on periods?

A

They usually get heavier and more painful

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59
Q

Primary dysmenorrhea is due to

A

Excessive prostaglandin production

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60
Q

First line treatment for primary dysmenorrhea is

A

NSAIDs

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61
Q

Leiomyomata uteri is also known as

A

Uterine fibroids

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62
Q

Uterine fibroids are located in

A

Uterine myometrium

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63
Q

Chlamydia treatment

A

Doxycycline

64
Q

Gonorrhea treatment

A

Ceftriaxone

65
Q

Screening for intimate partner violence should occur for who

A

All women of childbearing age

66
Q

A female fetus gets masculinization by abnormal levels of testosterone in

A

Congenital adrenal hyperplasia

67
Q

Effects of in utero estrogen exposure will wane by what age?

A

6 months

68
Q

Protruding vaginal mass after delivery, with mother in shock but not overtly bleeding may indicate

A

Vaginal hematoma (uterine artery)

69
Q

Follicular, lutein, and polycystic sclerotic ovaries are all what type of conditions?

A

Functional, benign

70
Q

A cyst that produces estrogen

A

Follicular cyst

71
Q

A cyst that produces progestin

A

Lutein cyst (can delay menses)

72
Q

Theca lutein cysts are associated with high levels of

A

B HCG

73
Q

Dysmenorrhea

A

Painful periods

74
Q

Menstrual cycle normal length

A

24-38 days

75
Q

Duration of menstrual flow normal

A

4.5-8 days

76
Q

Normal volume of blood loss in menstruation

A

5-80mL

77
Q

FSH high, estrogen low

A

Primary ovarian insufficiency

78
Q

Significant hypotension from maternal blood loss lowering the BP and causing necrosis in the anterior pituitary gland

A

Sheehans syndrome

79
Q

Low estrogen differential

A

POI, thyroid, prolactin, tumour

80
Q

Medical management patient with fibroids

A

Progestin only (controls bleeding), combined HC, GnRH (instant menopause)

81
Q

Tumour markers in gyne malignancies

A

CA125, CEA, LDH, AFP, BHCG

82
Q

TAH BSO

A

Total hysterectomy and bilateral salpingoophorectomy

83
Q

PALM and COIEN for abnormal bleeding

A

Polyp, adenomyosis, leiomyoma, malignancy
Coagulopathy, ovulatory issue, endometrial, iatrogenic, not yet classified

84
Q

Endometrial tissue invading myometrium, bulky painful heavy uterus with heavy bleeding

A

Adenomyosis

85
Q

Medical treatment of adenomyosis

A

Levonorgestrel containing IUD

86
Q

Contraindications to OCPs

A

Stroke risk with pseudo tumour cerebri or migraines with aura

87
Q

Treating lichen sclerosis

A

Steroid cream, maybe estrogen therapy

88
Q

A tumour that has bone in it

A

Dermoid cyst

89
Q

Total vs subtotal hysterectomy

A

Whether the patient keeps their cervix or not

90
Q

Dermoid cysts arise from what type of cell

A

Primordial germ cell - all three germ layers

91
Q

Treating condyloma accuminata

A

Laser, cryotherapy, podophyllin

92
Q

How long after puberty does menarche occur

A

2 years after

93
Q

Ca125 is a tumour marker for

A

Ovarian cancer

94
Q

VIN in young women

A

Usual VIN, warty or basaloid

95
Q

VIN in older women

A

Differentiated (d vin)

96
Q

Vulvar cancer can spread via lymph to

A

Inguinal nodes

97
Q

Vulvar cancer can spread via blood to

A

Lung, liver, bone

98
Q

Cervical cancer types

A
  1. Squamous cell carcinoma, 2. Adenocarcinoma
99
Q

Mucopurulent cervicitis can be caused by

A

Gonorrhea, chlamydia

100
Q

Profuse, frothy vaginal discharge

A

Trichomonas

101
Q

Pruritic discharge, not STI

A

Candida

102
Q

Foul and fishy discharge

A

BV

103
Q

Treating for gonorrhea and chlamydia

A

Oral cefixime and azithromycin

104
Q

Treating pelvic inflammatory disease

A

Ceftriaxone, doxycycline, metronidazole

105
Q

Treating BV

A

Metranidazole

106
Q

Treating syphilis

A

Benz G

107
Q

Treating candidiasis

A

Topical azole, fluconazole PO

108
Q

Treating lymphogranulonum venereum

A

Oral doxycycline

109
Q

Bicillin (Benzathine penicillin G) treats

A

Syphilis

110
Q

Most ectopic pregnancies are located in the

A

Ampulla

111
Q

Rh negative women with pregnancy require

A

Rh immune globulin AKA WinRho, RhoGAM

112
Q

Longer lifetime estrogen exposure increases risks of

A

Breast cancer

113
Q

Mammography is recommended

A

Every 2-3 years for women 50-74

114
Q

Signs of breast cancer

A

Mass, nodes in armpits, nipple changes

115
Q

Estrogen ad progesterone receptor positive tumours in breast

A

Better prognosis (endocrine therapy)

116
Q

HER2 status is associated with what prognosis

A

Poor prognosis

117
Q

Treat HER2 cancers with

A

Trastuzumab

118
Q

Treat ER PR positive breast cancers with

A

Aromatase inhibitors and CDK4/6 inhibitors

119
Q

Treat triple negative breast cancers with

A

Chemotherapy

120
Q

Cystocele

A

Bulging of bladder into the upper anterior vaginal wall

121
Q

Rectocele

A

Weakness in the rectovaginal septum, bulging or descent toward posterior vaginal wall

122
Q

Enterocele

A

Bulding of the rectum into the pouch of Douglas (usually with loops of bowel)

123
Q

The baden walker system is used to grade

A

The clinical severity of pelvic prolapse in women

124
Q

Stress incontinence

A

Occurs with increased intraabdominal pressure

125
Q

Urgency incontinence

A

Urge with voiding, like you might not make it, caused by involuntary detrusor muscle over activity

126
Q

Overflow incontinence defn

A

Continuous leakage with residual urine after emptying, due to detrusor under activity or bladder outlet obstruction

127
Q

Treating mastalgia

A

NSAIDS - oral vs topical

128
Q

Lactating vs non lactating mastitis treatment

A

Lactating - cloxacillin, non lactating - Amox clav

129
Q

Post menopause, ovaries secrete mostly

A

Andosenedione and testosterone

130
Q

Key feature of perimenopause

A

Menstrual irregularity

131
Q

Contraindications for menopausal estrogen therapy

A

Unexplained vaginal bleeding, acute liver dysfunction, estrogen dependent cancer, coronary heart disease, previous stroke

132
Q

Unilateral spontaneous bloody nipple discharge with mass workup for

A

Malignancy

133
Q

What workup should a patient have prior to starting Trastuzumab

A

Echocardiogram to assess baseline function (to compare further reassessments to)

134
Q

Common side effects of cisplatin and carboplatin

A

Ototoxicity

135
Q

What workup should be obtained before using aromotase inhibitors (anastrozole, letrozole)

A

Baseline bone density scans

136
Q

Tamoxifen increases the risk of

A

VTE

137
Q

Bleomycin can cause

A

Pulmonary fibrosis

138
Q

Trastuzumab risky side effect

A

Cardiotoxicity

139
Q

No cervical change for more than 4 hrs with adequate contractions

A

C section

140
Q

Adequate contractions are defined as more than

A

200mV units in ten minute interval

141
Q

Vaginal delivery is contraindicated in patients with

A

Classical vertical cesarean delivery or abdominal myomectomy with uterine cavity entry

142
Q

Intrauterine infusion to decreased cord compression and resolve variable decels

A

Amnioinfusion

143
Q

Amnioinfusion is contraindicated in

A

Previous uterine surgery

144
Q

Terbutaline is a

A

Tocolytic

145
Q

Laboring patients at high risk of uterine rupture require

A

Laparotomy and cesarean delivery

146
Q

What shot should all pregnant patients get

A

Flu shot

147
Q

Normal internal genitalia, external virilization, undetectable serum estrogen in female is

A

Aromatase deficiency

148
Q

Ambiguous external genitalia, normal internal female organs, electrolyte abnormalities

A

Congenital adrenal hyperplasia (21hydroxylase deficiency)

149
Q

Hypogonadotropic hypogonadism with anosmia and low LH/FSH

A

Kallmans syndrome

150
Q

Cafe au lair, polyostotic fibrous dysplasia, and autonomous endocrine hyper function (precocious puberty)

A

Mccune Albright syndrome

151
Q

Cervical insufficiency clinical features

A

More than 2 prior painless second trimester losses, painless cervical dilation

152
Q

Treatment for cervical insufficiency is

A

Cerclage placement

153
Q

Thrombosis of the deep pelvic or ovarian veins, that becomes infected

A

Septic pelvic thrombophlebitis

154
Q

Management of cervical intraepithelial neoplasia 3 in non pregnant women

A

LEEP, cold knife conization, cryoablation

155
Q

Mechanism of hypertension caused by some OCPs

A

Increased angiotensinogen synthesis by estrogen during hepatic first pass metabolism

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