Gynecology Flashcards
Painless genital ulcer with skin rash
2ry Syphilis
Post operative fever cause’s
2-3 days = atelectasis or pneumonia/ 3-5 days = UTI / 5-7= DVT / >7 = wound infection
Vaccines allowed in pregnancy are
Dtap / influenza
Cottage like discharge = ….
Candida
Hyphea In urine microscopy?
Candida
Ptn with odorless, white-grey vaginal discharge adherent to the vaginal wall, under microscope there are spores, diagnosis
Candida
Budding yeast cells, pseudohyphea in vaginal discharge = …..treated by ………
Candida / Fluconazole
………..is ass. With miscarriage
Rubella
Painful genital ulcer + conjunctivitis + rash =
Gonorrhea
Mother with hepatitis B delivered a baby 12 hours ago, what to give the baby
HBV vaccine with IG
Ptn with fishy smell, itchy discharge, treatment?
Oral metronidazole is the best for bacterial vaginosis
Bacterial vaginosis sample under microscope =
Granular epithelial cells
Pic of clue cells, diagnosis
Bacterial vaginosis
Female with vaginal discharge under microscope shows motile flagella, what to give the husband?
Metronidazole ( because of trichomonas infection )
Female with cheesy discharge, what to give the husband?
Nothing
Pregnant lady complain of foul smelling discharge, treatment
Metronidazole
Pregnant lady her water broke but she had history of herpes, what to do
Speculum exam
Ptn with dysparenuria and postcoital spotting, where is the source
Cervix-uterus
At what age you should start cervical Cancer screening?
21
Pregnant woman at 26week with large genital warts, how to treat
Cryotherapy
Pic of female genital warts, history of multiple sexual partners, organism
Condylomata lata
Organism to cause warts =
HPV 6-11
Pap smear screening every…..years
3 years
Pap smear shows ASCUS , WHATS NEXT?
Colposcopy
Treatment of mastitis
Amoxicillin
Campylobacter jejuni treatment?
Azithromycin
Treatment of C .difficile?
Oral vancomycin
Ptn with familia Mediterranean fever, which drug to avoid ?
Amoxicillin
Pregnant at 35 weeks complaining of headache, abdominal pain ? Management
Give magnesium sulfate and admit for delivery
Pregnant with hyperthyroidism on carbimazole 15mg , but still not controlled?
Increase dose to 20
Pregnant with hyperthyroidism, what to give?
Propylthiouracil
True or false , smoking affects the efficacy of hydroxychloroquine
True
……..is a uterotonic medicine that is CONTRAINDICATED in ptn with asthma
Carboprost F2 alpha
Which medication can help to prevent hypercalciuria that causes stones
Thiazide
20 weeks pregnant ptn with history of preterm delivery , her cervix is 30mm what to do?
Give progesterone
Mom just eat polished rice, expected deficiency?
Vit B1
Ptn presents with sever asthma on salbutamol what to add
ICS
Ptn with irregular cycles anovulatory cycle, how to treat
Progesterone
Pregnant with UTI symptoms what to give
Nitrofurantoin, but if she’s in 3rd trimester give her cephalaxin
Ptn was given IV mgS04 , what can you give to reverse the action
Calcium gluconate
How to treat pregnant ptn with hyperthyroidism?
Depends on the trimester ( if first = propylthiouracil) if 2nd =carbimazole
Bleeding diagnosed with ovulatory dysfunction, treatment
OCP
Types of estrogen : pregnancy =………., childbearing age …….., postmenupause …..
Pregnancy = Esteriol ( E3 ) / childbearing = Estradiol ( E2 ) / post menopause = Estrone ( E1 )
What’s the most important immunoglobulin on breast milk
IgA
HIV mother asking if she can lactate
No she’s can’t
How can a mother with TB lactate?
Via expressed milk
HIV pregnant woman is asking if her baby will be infected?
If the mother is taking her HIV medication, the Chance of passing HIV is less than 1%
Lactating mother has UTI, which antibiotics considered safe to use?
Nitrofurantoin, ciprofloxacin, levofloxacin, ofloxacin, trimethoprime-sulfamethoxazole ( tpm, SMX )
Can mother with hepatitis B lactate
Yes
Female has difficulty breast feeding because there’s no milk, diagnosis
Sheehan syndrome
Lactating female with breast swelling, mass, hotness, or redness around areola, mass , tender, LN enlargement. diagnosis & treatment
Abscess / needle aspiration or incision and drainage +/- antibiotics
How often mammogram should be done for women 55 and above?
Every 2 years
Pregnant with unilateral mobile breast mass? Next
Bilateral US
……….. nipple is Contraindicated for breastfeeding
Cracked nipple
Treatment of cysttosarcoma phyllodes
Wide local excision
Most risk factor for breast cancer is
Age
Lactating mother with inverted nipple with slit, diagnosis
Duct ectasia ( widen and hyperplasia of milk duct that becomes blocked )
When breastfeeding counseling should be done?
Third trimester
If one breast has abscess can she use the other?
Yes
Ptn with BIRAD 3 score on mammogram, what’s next ?
Means it’s probably benign and needs follow up in 6 months
Female in her 40s with high FSH and LH, she’s in risk for
Osteoporosis ( because high FSH= low estrogen )
Ptn on OCP for long time, developed hepatic adenoma, management
Stop OCP
Post menopausal woman wants hormonal replacement therapy
Refuse
Post menopausal woman with urine incontinence , management
First excercise
What’s the most common type of valvular cancer
Sq. Cell carcinoma
How to treat valvular cancer , carcinoma in situ?
Superficial local excision with margins
Treatment for atrophic vaginitis
Estrogen
Female doesn’t want to get pregnant for 2 years what can you offer
Depo Provera injections
Post menopausal woman with history of myomectomy ( fibroid removal ) is present with bleeding , endometrial biopsy shows 20mm thickness, diagnosis
Cancer ( most likely )
What’s the normal endometrial thickness in post menopausal woman
<5 mm
What the normal endometrial thickness during childbearing age
<14mm
PTH with history of breast cancer on tamoxifen( ttt for breast cancer ) , what are you afraid of developing
Endometrial cancer
Ptn on tamoxifen with post menopausal bleeding, next
Biopsy
Ptn with breast cancer and fibroid 8 cm and hypoechoic area, on tamoxifen, presents with vaginal bleeding, diagnosis
Endometrial cancer
Ptn with strawberry cervix with post coital bleeding , diagnosis , treatment
Trichomoniasis, metronidazole
Female with post coital bleeding, how to diagnose
Inspect vagina and cervix
What’s the most likely indicative bleeding for cervical source
Postcoital bleeding
Ptn with postcoital bleeding, speculum exam was done and revealed fumigating mass, what next
Cone biopsy
Ptn complain of urine leaks during intercourse and after urination, diagnosis
Urethral diverticulosis
Ptn with dysuria, dyspareunia with normal urine analysis , without fever?
Urethral diverticulosis
What are medrozyprogestone uses?
Treat amenorrhea / uterine bleeding / prevent endometrial hyperplasia
Case with amenorrhea for 1 year, treatment
Medroxyprogesterone
48 years old female has irregular menses with uterine bleeding , treatment
Medroxyprogesterone
Abdominal hysterectomy complicated by abdominal bleeding, what’s the cause?
Liver hemangioma
Post menopausal woman with endometrial hyperplasia, management
Hysterectomy
Ptn underwent total hysterectomy with oophorectomy, what to give her
Estrogen patch
Female complains of vaginal atrophy, treatment
Topical estrogen
Bleeding in old female is usually from…..
Uterus
Ground glass appearance on US =…..and what does it cause
Endometrioma / it causes infertility
What’s the triad of endometriosis?
Pain with menses, sex and deification
Post menopausal woman with bleeding, management
Endometrial biopsy
Endometriosis is associated with infertility, true or false
True
Nulliparity increase risk of endometrial cancer, true or false
True
Ovarian cancer treatment
Surgery and chemotherapy
Next step after diagnosis malignant phylloid tumor ( type of breast cancer)
Chest CT scan
Healthy woman with FH of breast cancer and ovarian cancer,wants to do screening test, what to choose
BARCA genetic test
Hypoechoic ovarian cyst = ……..cyst
Malignancy
Ca……is elevated in ovarian cancer but it’s not specific
Ca125
Pleural effusion + ascites + benign ovarian tumor indicate what syndrome
Meigs syndrome
Pregnant, jaundice, itching =
Pregnant cholelithiasis
Pregnant with asymptotic mid systolic murmur, diagnosis
Physiologic pregnancy murmur
What’s the most common cause of morbidity in multiple gestation?
Prematurity
What immunoglobulin can cross placenta
IgG
What’s hyperemesis gravidarum?
الوحم
Closed Os, empty sac on US , no passage of tissue, diagnosis , management
Anemberoinic pregnancy / follow up after 4 weeks
Ptn came to the ER with heavy vaginal bleeding during menses ( menhorragea ) how to stop the bleeding?
Give estrogen alone not combined
Ptn with history of multiple D&C which went deeper than it should, now is not having menses anymore, which layer was damaged?
Basiles
Most common cause of recurrent abortion in first trimester
Chromosomal abnormalities, or anatomical pb as septate uterus= 1 trimester or arcuate uterus = 2nd trimester
When to say this is gestational hypertension?
If it occurs after 20 weeks of pregnancy
Eclampsia occurs after 20 weeks of pregnancy and can be caused by gestational hypertension or chronic hypertension, true or false?
True
Pregnant in week 22 with hypertension. Treatment / another Q pregnant (12 weeks) complaining of mild edema in the lower limbs ,mild elevation in BP , there is Trace of protein in the urine. What to give
Methyldopa
Which drugs can be given for sever HTN?
Labetolol, hydralazin
What do you need to diagnose eclampsia
2 readings of HTN + one of these : proteinuria, seizure, headache or visual pb , low platelets, liver dysfunction, other signs of kidney dysfunction, fluid in Lungs,
Most common complication of having HTN in pregnancy
IUGR
What are the test used to detect chromosomal abnormalities in fetus?
Nuchal translucency, chorionic villus sampling (CVS)
Pregnant with DM and now has hypoglycemia, what’s the best rout to give her glucose without causing harm to the baby?
Peripheral venous
Pregnant with repeated vomiting, what will you find in urine
Ketones
Post partum primary hemorrhage is during first…..hours
24 hours
Treatment of postpartum hemorrhage
Oxytocin
PPH not responding to oxytocin and massage what to do
B-lynch suture
Steps to stop PPH =
Oxytocin with massage, if didn’t stop use ergonovine, if fails either do ligation of uterine vessels or hysterectomy
Death from PPH is ….%
25%
PPH with asthma, contraindicated drug is ?
Carpoprost
Ptn with irregular menses, hairsuthism, high LH, normal FSH , high testosterone , how to diagnose
Glucose tolerance test and lipid profile
Obese Ptn with irregular menses, hairsuthism, infertility, diagnosis
Polycystic ovary syndrome
Simple test for Turner syndrome
FSH/LH
Treatment of polycystic ovary syndrome in ptn doesn’t want to get pregnant soon
Combines pills ; estrogen with progesterone
In polycystic ovary, what blood test done for hairsuthism evaluation?
Testosterone
What’s the other name of polycystic ovary
Stein levanthal syndrome
PCOS Ptn wants to get pregnant what to give
Clomiphene
How does PCOS cause endometrial hyperplasia
Because of unopposed estrogen due to lack of ovulation
Best treatment combo for ptn with PCOS who wants to get pregnant
Metformin + wt loss + clomiphene
In Ptn with PCOS what shall you test for
Glucose, Lipid profile
Female with normal breast and coarse pubic hair with high testosterone. Diagnosis
Androgen insensitivity syndrome/ if same symptoms but normal testosterone then it’s Mayer ruktansky syndrome
Ptn with dysmenorrhea, heavy menses, history of fibroid or uterine surgery, history of endometriosis, with bulky uterus on examination and MRI, diagnosis / another Q . Patient with dysmenorrhea, heavy bleeding. shows symmetrical uterine enlargement, what is the diagnosis
Adenomyosis
How to diagnose adenomyosis?
Mainly clinically + MRI
Definitive treatment for adenomyosis
Hysterectomy
Risk factors of adenomyosis
Endometriosis , fibroid , uterine surgery
