Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MS3 > Step studying 5 > Flashcards

Step studying 5 Flashcards

1
Q

What are the epithelial cell ovarian tumors

A

Serous, mucinous, endoemetriod, and brenner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for epithelial cell ovarian tumors

A

♣ Pathology of epithelial tumors = endothelial trauma aka ovulation
• So risk increases with age and nulli/low parity

♣ Associated with BRCA1, BRCA2, and HNPCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation and prognosis of epithelial cell ovarian tumors

A

Are malignant
♣ Usually present as stage IIIb or worse due to asymptomatic
♣ Advanced disease often present with renal failure, small bowel obstruction, or ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tx of epithelial cell ovarian tumors

A

TAH + BSO + Chemo (Paclitaxel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the ovarian germ cell tumors

A

Teratoma, Dysgerminoma, Endodermal sinus tumor, Choriocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of germ cell ovarian tumors

A
  • Are non-malignant

- Usually present in teenage girls as an adnexal mass and weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx of ovarian germ cell tumors

A

Unilateral salpingoophorectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tx of choriocarcinoma

A
  • Surgical = TAH, debulking

* Medical = MAC (Methotrexate, Actinomycin D, Cyclophosphamide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 types of vulvar cancer and their presentation

A
  • SCC = black and itchy lesion
  • Melanoma = black and itchy lesion
  • Paget’s = RED and itchy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx of 3 types of vulvar cancer

A
  • SCC = vulvectomy and lymph node dissection
  • Melanoma = vuvlectomy and lymph node dissection
  • Paget’s = (less aggressive cancer) wide local excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of simple ovarian cyst

A

• <3 cm = nothing
• <10 cm = repeat imaging
o If it grows or does not resolve, then remove

• Wrong treatments:
o Aspiration
o OCPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx of complex ovarian cysts

A

• >10 cm = remove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx of endometriosis

A

NSAIDs, OCPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnosis of endometrioma

A

Diagnostic laparascopy with visualization of chocolate cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tx of ectopic pregnancy

A

Methotrexate only okay very early on in pregnancy (b-hCG <5,000, gestational sac <3cm, no cardiac activity)

Otherwise tx is surgery

  • Salpingostomy if no rupture
  • Salpingectomy if rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnosis of ovarian torsion

A

US with doppler to see decreased flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diagnosis of tuboovarian abscess

A

It is a subtype of pelvic inflammatory disease

  • Will have tenderness at CMT, adnexal, or uterine
  • US for diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx of tuboovarian abscess

A

• Cefoxitin + Doxycycline + Metronidazole
• Clindamycin + Gentamycin
♣ Surgery in worst case scenario

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you calculate corrected sodium in a patient who is hyponatremic in the setting of hyperglycemia

A

Observed sodium + 2 for every 100 that glucose is over 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tx of endometriosis

A

NSAID + OCP

- Laparatoscopy if above tx is unsuccessful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Medication tx of agitation in the elderly

A

Low dose Haloperidol

22
Q

Adverse effects of oxytocin

A
  • Hyponatremia (oxytocin is produced by posterior pituitary and has similar structure to ADH and can lead to water retention and thus hyponatremia
  • Tachysystole
  • Hypotension
23
Q

What do you do when b-hCG is below discriminatory zone and you can’t visualize anything on US

A

• Can check quant again in 48 hours if it is not yet at discriminatory zone
o Normal IUP should double b-hCG in 48 hours
o Ectopic pregnancy will have a slower rise in b-hCG (will not double)

24
Q

What are the causes of abnormal uterine bleeding

A

PALM COEIN

Polyps
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovarian dysfunction
Endometrium
Iatrogenic (IUD)
Not yet classified
25
Q

Tx of fibroids

A

• OCP/IUD +/- NSAIDs for pain

26
Q

Surgery options for fibroids

A
  • Leuprolide to shrink prior to surgery
  • Myomectomy if want to maintain fertility
  • TAH if she doesn’t want kids
27
Q

Describe pathogenesis of PCOS

A

o Increases LH = stimulation of theca cells = increased androgen production by theca cells = increased peripheral conversion of androgens into estrone in adipose tissue = decreased FSH (negative feedback) = decreased stimulation of granulosa cells = degeneration of follicles cystic follicles

28
Q

Diagnosis of PCOS

A 
Diagnostic criteria (1 + 2 or 3):
(1) Oligo- or anovulation
(2) Hyperandrogenism
♣	Elevated DHEAS
♣	Elevated Testosterone
♣	LH:FSH > 3:1
(3) Polycystic ovaries on US
29
Q

Describe how Kallman syndrome causes amenorrhea

A

♣ Defective migration of GnRH-releasing neuron (problem at level of the hypothalamus)
• No GnRH to stimulate FSH or LH

30
Q

What will you seen in Kallman syndrome in terms of:

  • Internal sex organs
  • External sex organs
  • Secondary sex characteristics
A

♣ Will have uterus and fallopian tubes but no secondary sex characteristics

31
Q

Tx of Kallmans

A

♣ Tx: give estrogen and progesterone

32
Q

Describe how craniopharyngeoma causes amenorrhea

A

♣ Problem is at the level of the anterior pituitary

• No FSH or LH being produced

33
Q

What will you seen in Craniopharyngioma in terms of:

  • Internal sex organs
  • External sex organs
  • Secondary sex characteristics
A

♣ Will have uterus and fallopian tubes but no secondary sex characteristics

34
Q

Tx of craniopharyngeoma

A

♣ Tx: give estrogen and progesterone + resection

35
Q

Describe how Mullerian agenesis causes amenorrhea

A

♣ Recall that Mullerian ducts create the upper 3rd of vagina, uterus, and tubes

36
Q

What will you seen in Mullerian agenesis in terms of:

  • Internal sex organs
  • External sex organs
  • Secondary sex characteristics
A

♣ Normal female (XX)
• No uterus
• Normal female external genitalia
• Female secondary sex characteristics

• Patient will still have ovaries which can produce estrogen and progesterone, and will develop secondary sex characteristics

37
Q

Tx of mullerian agenesis

A

• Elevate the vagina and she can live a normal life but infertile

38
Q

How does Androgen insensitivity syndrome cause amenorrhea

A

♣ Patient has all male sex characteristics including testes, but testosterone produced by testes is not recognized by the body

39
Q

What will you seen in Androgen insensitivity syndrome in terms of:

  • Internal sex organs
  • External sex organs
  • Secondary sex characteristics
A

♣ Karyotypically male (XY)
• Internal sex organs are male (+testes)
• External sex organs are female (+vulva, vagina, clitoris)
• Female secondary sex characteristics

Conversion of testosterone to estrogen allows for secondary female characteristics to still develop

40
Q

Management of androgen insensitivity syndrome

A

• Elevate vagina
• Need to perform orchiectomy because undescended testes are at increased risk of testicular cancer
o Wait til after puberty so that testosterone can be produced and turn into estrogen for secondary sex characteristics

41
Q

What will you seen in Turner syndrome in terms of:

  • Internal sex organs
  • External sex organs
  • Secondary sex characteristics
A

♣ Will have elevated LH and FSH in attempt to stimulate nonexistent ovaries
♣ Since there are no ovaries to create estrogen and progesterone, there will be no secondary female sex characteristics

42
Q

Describe how hypothyroidism causes amenorrhea

A

♣ Low T3/T4 increases TRH (produced by hypothalamus) = increased TRH stimulates the anterior pituitary to produce prolactin = high prolactin inhibits GnRH = low GnRH causes low FSH and LH

43
Q

First tests that should be ordered for secondary amenorrhea

A

UPT, TSH, Prolactin

44
Q

If initial tests for secondary amenorrhea are normal, what is next step

A

Start from endometrium and work your way up

–> Progesterone challenge

45
Q

Describe results of progesterone challenge

A

♣ If she bleeds in response progesterone, problem is anovulation
• Most likely due to PCOS
♣ If she does not bleed, try estrogen + progesterone

46
Q

Describe results of estrogen + progesterone

A

♣ If she still does not bleed, problem is endometrial
• Asherman’s, ablation
♣ If she bleeds, then the problem is due to signaling

47
Q

Next test after P + E if she bled, and interpret results

A

FSH/LH
♣ High FSH/LH means problem is with ovary
♣ Low/normal FSH/LH means problem is with pituitary or hypothalamus

48
Q

Next step if she had high FSH/LH

A 
Problem of ovary
•	US to see if follicles are present
o	+Follicles 
♣	Dx = Resistant ovarian syndrome (aka Savage syndrome)
♣	Tx = hormone replacement 
o	–Follicle
♣	<40 y/o = premature ovarian failure
♣	>40 y/o = menopause
49
Q

Next step if she had low FSH/LH

A

o MRI to evaluate anterior pituitary
♣ +MRI = anterior pituitary problem
♣ -MRI = hypothalamic problem

50
Q

What lab value might you see in menopaus

A

Increased FSH - Body pump out more FSH in response to decreased estrogen

51
Q

Tx of hot flashes

A

SSRI - Venlafaxine

MS3 (88 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions