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REPRO II Exam 2 > Dunn OB/GYN VIII > Flashcards

Dunn OB/GYN VIII Flashcards

1
Q

ASCUS

A

atypical squamous cells of undetermined significance

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2
Q

ASC-H

A

atypical sqamous - high grade

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3
Q

AGUS

A

atypical glandular undetermined significanse

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4
Q

LSIL

A

low grade squamous intraepithelial

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5
Q

HSIL

A

high grade squamous intraepithelial lesion

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6
Q

workup for abnormal pap

A

age
degree of abnormality
risk factors

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7
Q

risk factors for abnormal pap

A 
no recent pap
smoking
age 1st intercourse
number of partners
immunocompromised
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8
Q

colposcopy

A

look at cervix through microscope

gives histology

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9
Q

mild dysplasia

A

CIN I

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10
Q

moderate dysplasia

A

CIN II

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11
Q

severe dysplasia, CIS

A

CIN III

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12
Q

CIN

A

cervical intraepithelial neoplasia

1-3 and invasive cancer

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13
Q

CIN I

A

10% progress

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14
Q

CIN II

A

30-40% progress

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15
Q

CIN III

A

all need treatment**

also - invasive cancer need treatment

tx - excision

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16
Q

cervical cancer spread

A

lymph nodes

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17
Q

tx of cervical cancer

A 
follow up pap
destroy
excision
hysterectomy
radical hysterectomy (top third vagina and nodes)
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18
Q

indication for conization

A

CIN II and III

endocervical disease on colposcopy

inadequate colposcopy

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19
Q

who doesn’t get pap smears

A

get screened - no cervical cancer- can screen for it

low SES
minorities
foreign born
living in US < 10 years
no health care
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20
Q

CIN 2 and 3

A

10-13 years to invasive cancer

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21
Q

cervical cancer incidence and death rates

A

in US

-has gone down

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22
Q

major factor for cervical cancer

A

no screening

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23
Q

paps and eduation

A

more educated - get more paps

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24
Q

cervical cancer screening

A

should begin at age 21 - if sexually active**

<21yo no screening regardless of sex onset

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25
Q

highest incidence cervical cancer

A

30-65yo

26
Q

adolescents

A

STI screen - urine

no paps

27
Q

age 21-29

A

cytology alone every 3 years
HPV - not for screening

HPV test - expensive
pap - cheap

28
Q

avoid HPV test

A

age 20-29

29
Q

age 30-64

A

recommend cotesting

cytology and HPV testing every 5 years**

bc more CIN III this age grop

30
Q

high risk HPV

A

colposcopy

31
Q

adequate negative screening

A

3 paps

2 HPV

32
Q

history of abnormal pap

A

still need to check after hysterectomy

33
Q

standards for paps

A

21-65yo

cotesting >30yo (with HPV test)

34
Q

biggest gain in reducing cervical cancer

A

screening women who don’t screen

35
Q

47yo F G4P3

  • continued bleeding
  • > 3 days per day
  • menses more frequent and longer last year
  • severe cramping
  • smoker
  • fam hx ovarian cancer, asthma
  • underweight
  • low BP
  • looks ill
A

abnormal uterine bleeding

hCG negative
U/S - 6cm mass in fundus normal ovaries

leiomyoma with myxoid degeneration**

36
Q

smoking

A

reduces risk for endometrial cancer

-decreases circulating estrogen

37
Q

PALM-COEIN

A

abnormal uterine bleeding
-nonpregnant

polyp
adenomyosis
leiomyoma
malignancy and hyperplasia

coagulopathy
ovulatory dysfunction
endometrial
iatrogenic
not yet classified
38
Q

post menopausal abnormal uterine bleeding

A

rule out cancer**

39
Q

acute bleeding in ER

A

IV estrogen
high dose progesterone
OCPs

40
Q

endometrial polyp

A

common cause of perimenopausal and early postmenopausal uterine bleeding

generally benign
hyperplastic growth of glands

growth - stimulated by estrogen or tamoxifen**

41
Q

uterine leiomyoma

A

most common benign tumor in females

malignant variant - leiomyosarcoma

subtypes - pedunculated, subserosal, submucosal, intramural

42
Q

most common benign neoplasia of femal genitals

A

fibroids

smooth m and CT growth

E/P sensitive**

43
Q

E/P sensitive

A

fibroids - uterine leiomyoma

44
Q

complications of fibroids

A

torsions/infertility

45
Q

adenomyosis

A

noncyclical pain
menorrhagia
enlarged uterus no adnexal tenderness

endometrium grows into myometrium

46
Q

tx for adenomyosis

A 
NSAIDs
OCPs
progestins
ablation
hysterectomy
47
Q

stimulated by estrogen

A

fibroid of uterus

-uterine leiomyoma

48
Q

leading cause of hysterectomy in US

A

fibroids

49
Q

risk fx for fibroids

A 
AAs
early menarche (10yo)
obesity
red meat, beer
HTN
50
Q

tx of fibroids

A

expectant management

control bleeding - OCPs
GnRH agonist
myomectomy, hysterectomy

51
Q

myxoid degeneration

A

large leiomyoma that outrgrows blood supply

also have cystic, red carneous, and hyaline degeneration

52
Q

postmenopausal bleeding

A

usually painless

pain - stenotic cervix, severe/rapid bleeding, infection, torsion, tumor

53
Q

atrophic endometrium

A

thin uterus that tears and bleeds

most common cause of postmenopausal bleeding

54
Q

atrophic endometrium

A

hypoestrogen

pale, dry vagina smooth and shiny with loss of most rugation**

55
Q

endometrial hyperplasia

A

increased gland:stroma

tends to be estrogen dependent

needs a biopsy

can have endogenous estrogen production - ovarian/adrenal tumor

also with exogenous estrogen

56
Q

at risk for endometrial cancer

A

obese - more estrogen

57
Q

most common genital cancer women over 45yo

A

adenocarcinoma of endometrium

58
Q

tx of atrophy

A

vaginal estrogen therapy

59
Q

tx of endometrial hyperplasia

A

cyclic progestin therapy

60
Q

tx of endometrial hyperplasia with atypia

A

hysterectomy

REPRO II Exam 2 (21 decks)

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