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OB/GYN > Cervix, Uterus, and Ovaries > Flashcards

Cervix, Uterus, and Ovaries Flashcards

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1
Q

cervicitis with foamy, greenish discharge and strawberry cervix

A

caused by trichomoniasis

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2
Q

cervicitis with thin, gray discharge with fish smell

A

caused by bacterial vaginosis

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3
Q

cervicities with thick, creamy discharge

A

caused by neisseria gonorrhea

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4
Q

cervicitis with purulent pus like discharge

A

caused by chlamydia trachomatis

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5
Q

cervicitis with white/curd like discharge

A

candidiasis

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6
Q

patient presents with post coital bleeding, dysmenorrhea, dyspareunia, lower abdominal pain, back pain, urgency, frequency, dysuria, puriritis, and vulvular pain. Also has leukorrhea. What is in ddx?

A

cervicitis. ask about discharge if acute condition

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7
Q

problem with cervicitis is it is often asymptomatic. if left untreated, can potentially lead to..

A

PID, chronic pelvic pain, infertility, and ectopic pregnancy

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8
Q

atypical cells of undetermined significance

A

ASCUS cells- abnormal, but not enough to call dysplasia

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9
Q

CIN II of cervical dysplasia

A

abnormal cells in half thickness of cervix lining

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10
Q

CIN III of cervical dysplasia

A

abnormal cells in entire thickness of cervix lining, but has not spread below to surface layer

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11
Q

in what treatments of cervical dysplasia can depth of tx be controlled/not controlled?

A

controlled in laser tx, not controlled in cryotherapy

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12
Q

result of cryotherapy tx in cervical dysplasia

A

damaged cells will shed in heavy watery discharge for 1 month

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13
Q

which tx of cervical dysplasia has lowest recurrence rate?

A

hysterectomy

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14
Q

tx of cervical dysplasia

A

cryotherapy, laser, cone biopsy, LEEP, hysterectomy

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15
Q

F/U of cervical dysplasia

A

CIN I- cytology at 6 months and 12 months OR HPV DNA testing at 12 months. CIN II and III- cytology or colposcopy at 4-6 months x 2 years

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16
Q

cell type affected in cervical cancer

A

squamous cell- 85%. adenocarcinoma on the rise

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17
Q

how to differentiate cervicitis with cervical cancer via symptoms. both may have post coital bleeding, but

A

cervicities- pruritic, cervical cancer- non pruritic

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18
Q

dx of cervical cancer

A

papsmear- vaginal cytology, cervical biopsy or endocervical curettage or conization

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19
Q

prevention of cervical cancer

A

gardasil quadravalent (6/11/16/18) or cervix bivalent HPV vaccine (16/18)

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20
Q

patient presents with heavy, irregular vaginal bleeding and pelvic pressure and pain. US shows fibroid tumor causing enlarged uterus. What other tests to do you?

A

suspect leiomyoma- pregnany test, U/A, Hgb levels,

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21
Q

tx for leiomyoma

A

symptomatic- intermittent ocp or progestrin,, myomectomy, hysterectomy

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22
Q

if preggo with leimyoma, and fibroid tumor greater than 3 cm,

A

increased risk of preterm labor, placental abruption, pelvin pain, and c-section

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23
Q

when do leiomyoma grow and atrophy?

A

responsive to hormones- so rapid growth in estrogen phases (enlarges with menstrual cycle) and atrophies during menopause

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24
Q

leiomyoma tumor made of of…

A

CT and smooth muscle

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25
noncancerous uterine thickening
adenomyoma
26
heavy bleeding and severe cramping with menstrual periods. dx?
maybe its menorrhagia or leiomyoma. do surgical excision- if endometrial tissue in thick uterine lining, consider adenomyoma
27
tx for adenomyoma
lupron or synarel, surgery good when confined to isolated area in muscle wall.
28
dx of adenomyoma
surgical excision- only proven way to truly diagnose
29
first line imaging test for females with abnormal uterine bleeding
transvaginal US
30
sx of cervical or uterine polyps
postcoital bleeding, intermenstrual bleeding, heavy periods, metrorrhagia, leukorrhea
31
how to diagnose cervical/uterine polyps
transvaginal US, microscopic examination, sonohysterography, hysteroscopy
32
most cervical/uterine polyps originate from
endocervix
33
tx of cervical/uterine polyps
excise/cut, leave in place and monitor, laser tx
34
number 1 symptom in endometrial cancer
endometrial cancer
35
most common diagnosed gynecological malignancy is united states
endometrial cancer
36
female 60 years old with abnormal bleeding including post menopausal, pelvic pain and discomfort
suspect endometrial cancer. do biopsy
37
strongest predictor of survival in endometrial cancer
stage 1 depth of myometrial invasion
38
majority of endometrial cancers are what kind of cancers?
primary- adenocarcinoma
39
endometrial cancer tx
total hysterectomy and bilateral salpingo-oophorectomy
40
ovarian cancer- benign or malignant?
most benign, but when malignant, leading cause of death for reproductive tract
41
abdominal pain and bloating, pelvin pain/pressure. no abnormal bleeding. what cancer would you suspect?
ovarian cancer
42
markers in ovarian cancer
CA-125 helps distinguish between benign and malignant, hCG, lactate dehydrogenase, alpha fetoprotein
43
ovarian cancer diagnosis
pelvic US and exam, markers, transvaginal US in high risk females
44
you diagnose malignant ovarian cancer. what are tx options
total hysterectomy and bilateral salphingo-oopherectomy and lymphadenopathy plus post op chemo
45
benign ovarian cancer tx
remove tumor, unilateral oopherectomy may be done
46
patient presents with dyspepsia, bloating, bowel/bladder pressure, dyspareunia, severe acne, deep voice, hirsutism. how to diagnose?
suspect benign ovarian neoplasm- do a pelvic exam. transvaginal US to determine architecture of mass. CBC for WBC to r/o PID. beta-hCG check. UA, serum estrogens and androgens if PCOS workup, CA-125 if post menopausal to differentiate benign vs. malignant pelvic pass, alpha fetoprotein
47
patient presents with painful, tender mass on bimanual exam. Pelvic US shows smooth, thin walled, unilocular cyst less than 10 cm. OCP's will help prevent these from reoccuring. suspect..
follicular cyst
48
US shows complex, grossly yellow, rough edged cyst in ovary
corpus luteum cysst
49
which cyst can present like appendicitis
corpus luteum cyst
50
labs in theca lutein cyst
chorionic gonadotropin elevated, US or PE reveal bilateral, clear straw colored fluid
51
ectocervix vs. endocervix covered by ...
ecto-stratified squamous epithelium. endo - columnar epithelium (mucous secreting)
52
is endo or ectocervix hormone sensitive?
ectocervix
53
ectocervix extends from...
squamocolumnar junction to vaginal fornices
54
classifications of leiomyoma
intramural, intraligamentous, cervical, parasitic, submucous, subserous
55
first line imaging study of choice for evaluation of women with abnormal uterine bleeding
transvaginal ultrasound
56
soft red pedunculated protrusion from the cervical canal at external os, intermenstrual or postcoital bleeding, post douching, post menopause bleeding. . In age 25, nulliparous. previously on tamoxifen.
endometrial polyps (cervical or uterine polyp)
57
how to diagnose endometrial polyp
transvaginal ultrasound, sonohysterography, hysterectomy
58
most common diagnosed gynecologic malignancy in U.S.
endometrial cancer
59
to confirm diagnosis of endometrial cancer-
endometrial tissue biopsy
60
distinguish between type I and II endometrial cancer
I- estrogen dependent. Most of the cases. favorable prognosis. low grade nuclear atypia. II- estrogen INdependent- spontaneous, less well differentiated, worse prognosis than Type I
61
most common type of endometrial carcinoma
adenocarcinoma
62
approx 10% of endometrial cancers=
serous carcinomas
63
endometrial cancer tx
TAH-bso, radiation for metastatic disease
64
strongest predictor of survival in endometrial cancer
stage I depth of myometrial invasion
65
leading cause of death for reproductive tract cancer
ovarian malignant tumors
66
BRCA1 gene mutation. chance of ovarian cancer?
39% lifetime risk
67
malignant ovarian tumor in premenopausal vs. postmenopausal-
25% postmenopause, 10% premenopause
68
abnormal bleeding in ovarian cancer?
NO. vague GI symptoms, pelvic pressure and pain
69
Is CA-125 used for screening in ovarian cancer?
No
70
CA-125 sensitivity and specificity
distinguishes between benign and malignatn pelvic masses. is sensitive, but not very specific (also may be elevated in endometriosis)
71
imaging in ovarian cancer
transvaginal ultrasound for high risk women
72
benign ovarian neoplasm tx
tumor removal/unilateral oophorectomy
73
malignant ovarian cancer tx
complete surgical staging plus abdominal hysterecomy and BSO with omenetomy and selective lymphadenectomy
74
2 types of funcitonal ovarian cysts
follicular and corpus luteum
75
most common functional cyst
follicular cyst
76
what medication increases risk of ovarian cyst formation?
tamoxifen
77
cystectomy/wedge resection for cyst indicated when:
premenopausal cysts more than 5 cm that persist more than 12 weeks, when mass is solid, mass is greater than 10 cm, postemenopausal cyst

OB/GYN (10 decks)

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