Dunn OB/GYN VII

Question 1

gravidity

Answer 1

how many pregnancies

Question 2

parity

Answer 2

how many deliveries

Question 3

TPAL

Answer 3

term, preterm, abortion, living kid

Question 4

LMP

Answer 4

first day of last menstrual period

Question 5

dating of pregnancy

Answer 5

most accurate - first trimester ultrasound

Question 6

gyn hx questions

Answer 6

age at menarche
age 1st intercourse
pap smears
STI history
HPV vaccine
use of contraception
age of maternal menopause
fam hx breast/ovarian cancer
hx endometriosis, fibroids, pelvic organ prolapse (familial)

Question 7

painful menses

Answer 7

dysmenorrhea

Question 8

absence of 3 menstrual periods or no menstruation by age 15

Answer 8

amenorrhea

Question 9

period interval >35 days or 4-9 periods in a year

Answer 9

oligomenorrhea

Question 10

heavy menstruation

Answer 10

menorrhagia

> 80cc

Question 11

bleeding between periods

Answer 11

metrorrhagia

Question 12

heavy bleeding and between menses

Answer 12

menometrorrhagia - MMR

Question 13

painful intercourse

Answer 13

dyspareunia

Question 14

tampon

Answer 14

5cc

Question 15

EGBUS

Answer 15

external genitalia
bartholins gland
urethra
skenes gland

Question 16

72yo urinary incontinence and pelvic prolapse
-G5P5

leaks when cough - stress incontinence

stage 4 prolapse of uterus

Answer 16

tx - hysterectomy - uterus removal

Question 17

cystocele

Answer 17

prolapse of bladder

Question 18

rectocele

Answer 18

prolapse of rectum

Question 19

prolapse staging

Answer 19

1 halfway to hymen
2 to hymen
3 past hymen
4 max descent

Question 20

risk fx for prolapse

Answer 20

postmenopausal
previous pregnancy or vag delivery
difficulty delivery
obesity

Question 21

tx of prolapse

Answer 21

kegel workout
weight loss
estrogn cream
pessary - push things up
bladder sling

Question 22

stress incontinence

Answer 22

most common bladder control problem in women

pressure on bladder - sphincter should close - reflex

pressure not to sphincter - leak urine

Question 23

risk fx stress incontinence

Answer 23

genetics**
age
child birth

Question 24

overactive bladder

Answer 24

urgency (8-10 times a day)

• w/ or w/out urge incontinence
• frequency/nocturia

absence of pathologic or metabolic conditions that might explain these symptoms

diagnosis based on symptoms**

Question 25

urge incontinence

Answer 25

strong need to urinate - don't make it to bathroom in time

Question 26

mixed incontinence

Answer 26

stress and urge

Question 27

cause of incontinence

Answer 27

DIAPPERS ``` delirium infection atrophic urethritis pharm - alpha blocker, cholinergics, etc. psych excessive urine production restricted mobility stool impaction ```

Question 28

women incontinence

Answer 28

1/3 mixed 1/3 urged 1/3 stress

Question 29

diagnosis of overactive bladder

Answer 29

hx, symptoms physical exam urinalysis

Question 30

overactive bladder

Answer 30

can lead to diabling conditions think link to depression

Question 31

falls and fractures

Answer 31

correlation between overactive bladder

Question 32

nocturia

Answer 32

patient has to wake at night 1 or more times to void

Question 33

42yo G2G2 with LMP one week ago - tubal ligation for BC - annual exam - smoker - hypothyroid - last PAP 5 years ago - cervical discharge

Answer 33

do a pap smear -discharge - wet prep - saline and KOH atypical squamous cells - high grade bacterial vaginosis biopsy - CIN III loop conization

Question 34

LGA

Answer 34

>4,000g large for gestational age

Question 35

bacterial vaginosis

Answer 35

no inflammation fishy odor pain and itching - concomitant infection overgrowth of vaginal bacteria -gardnerella loss of lactobacilli - change in pH

Question 36

risk fx bacterial vaginosis

Answer 36

sexual activity | douching - BAD - gets rid of normal flora

Question 37

amsel criteria

Answer 37

for diagnosis of bacterial vaginosis ``` need at least 3 1 - white gray discharge 2 - pH > 4.5 3 - positive whiff test -4 - clue cells ``` gram stain - gold standard - but rarely done PCR based assay

Question 38

stippling of epithelial cells

Answer 38

clue cell gardnerella

Question 39

bacterial vaginosis complications

Answer 39

PID post abortal PID post hysterectomy infections pregnancy - PROM, premature delivery, chorioamnionitis, endometritis**

Question 40

tx of bacterial vaginosis

Answer 40

metrondiazole - avoid alcohol clindamycin tindazole ($$$) asymptomatic - recommended to treat -no partner treatment

Question 41

avoid alcohol with

Answer 41

metrondiazole

Question 42

KOH with hyphae

Answer 42

candida albicans

Question 43

bubbly vaginal fluid

Answer 43

trichomonas vaginalis motile with flagella**

Question 44

koilocytes

Answer 44

HPV infection

Question 45

pap smear

Answer 45

just screening test** normal vs. abnormal abnormalities: high nuclear:cytoplasm ratio abnormal cell structure koilocyte changes (HPV)

Question 46

most common STI

Answer 46

HPV 75% sex active adults in life will be infected 100 types 40 types transmitted sexually

Question 47

most HPV

Answer 47

latent infection no visible lesions diagnosis - DNA hybrid testing

Question 48

DNA testing

Answer 48

performed in evaluation of abnormal pap smear

Question 49

undeveloped countries

Answer 49

lots of cervical cancers bc no screening - paps

Question 50

colposcopy

Answer 50

visualize under microscope

Question 51

warts with HPV

Answer 51

condyloma accuminatum HPV 6 and 11** in men and women immunocompromised more risk

Question 52

cancers with HPV

Answer 52

cervical, vaginal, vulvar

Question 53

transformation zone

Answer 53

cervical cancer and HPV

Question 54

HPV infection clears

Answer 54

spontaneously within 2 years

Question 55

high risk HPV

Answer 55

16, 18, 30 cervical cancer

Question 56

low risk HPV

Answer 56

6, 11 warts

Question 57

gardasil

Answer 57

16, 18, 6, 11 HPV vaccine

Question 58

treating warts

Answer 58

symptoms cosmetic psych freezing, meds, excision, IFN cream