STI w/ normal pH
candidiasis
strawberry cervix
Trichomoniasis
clue cells on microscopy
BV
2 big complications of PID
infertility & Fitz-Hugh-Curtis syndrome
4 stages of herpes
primary: genital lesion w/o Abs
nonprimary 1st episode: opposite Ab in serology (Type 1 Ab w/ genital lesions)
recurrent: had type 1, keep getting type 1
asymp. viral shedding
RUQ pain, adhesions, or pain w/ breathing
Fitz-Hugh-Curtis syndrome
related to PID
which types of HPV account for 70% of cervical cancer
16 & 18
syphilis diagnosis?
bacteria visible w/ Darkfield microscopy (VDRL panel)
post-partum amenorrhea resulting from postpartum pituitary necrosis secondary to severe hemorrhage & hypotension
Sheehan’s syndrome
related to D&C or uterine infection
Asherman’s Syndrome- secondary amenorrhea cause
diagnostic test for secondary amenorrhea? and what do you look for
progestin challenge test
withdrawl bleeding- if no bleeding after 2 weeks –> pregnancy, hypoestrogenism, uterine defect
PMS symptoms have to occur when?
luteal phase
gold standard for tx PMDD?
SSRIs
PMDD diagnosis criteria?
5 or more sx during the luteal phase
average age of menopause?
51.5
menopause official diagnosis
12 mo. of amenorrhea after final menstrual period
multiple dilated ducts in the subareolar space. Discharge may be clear, milky, or green-brown
Duct Ectasia
duct ectasia tx
duct excision
most common cause of nipple discharge
duct ectasia
most common lesion to cause serous or serosanguineous d/c
and what do you do
Intraductal papilloma
excise the involved duct (it could be invasive papillary carcinoma)
bilateral milky nipple d/c in non-lactating pt
pituitary adenoma
frequent cause of mastitis
mastitis tx
staph
antibiotics, incision & drainage, pain mgmt
firm, mobile, slightly tender mass, well-defined borders
how do you evaluate and treat
breast cyst
u/s
aspiration- diagnostic & therapeutic
palpable 1-3 cm mass, may have cyclical tenderness
change in size w/ menstrual cycle
fibroadenoma
excise if symptomatic or planning a pregnancy
rapidly growing, similar to fibroadenomas
Phyllodes tumor
cutaneous nipple abn- eczematous changes
Paget’s disease- can be an early sign of breast CA
clustered pleomorphic calcifications on mammogram
DCIS
first line tx osteoporosis
bisphosphonates- (risendronate sodium)
unless they have breast CA- then its SERM (raloxifine)
mastitis that doesn’t improve w/ tx is concerning for?
inflammatory breast CA
tx PID
Ceftriaxone IM
Doxycycline x 14 days
Metronidazole x 14 days
trich tx
metronidazole
chlamydia tx
doxycycline x 14 days or 1 dose zithromax
gonorrhea tx
Ceftriaxone IM
azithromycin/doxy to cover chlamydia too
syphilis tx
Benzathine PCN G, IM
best imaging for evaluating DCIS
MRI
tx for unilateral nipple discharge
excisional biopsy of offending duct & any mass/lesion
refer to specialist
