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Reproductive Medicine > Exam #2 > Flashcards

Exam #2 Flashcards

1
Q

Testicular torsion can manifest as an absence or weakness of the ________ __________

A

Scrotal ligament

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2
Q

Prostate cancer is most commonly found in the __________ ____________ of the prostate

A

Peripheral zone

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3
Q

Tx of balanitis/posthitis

A

Lotrimin
+/- topical steroid
DM control
Hygiene

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4
Q

Tx for phimosis

A

Child: give topical steroid after 4 y/o
Circumcision for refractory
Adults: Nystatin +/- topical steroid

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5
Q

Most common etiology of urethritis

A

STI
Chlamydial most common
Also gonococcal

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6
Q

Tx for urethritis

A

Ceftriaxone/Cipro + Azithro/Doxy

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7
Q

Risk factors for erectile dysfunction

A

DM, HTN, CAD, HLD, smoking, surgery

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8
Q

Penile condylomas

A

Warts; HPV related; check the anus as well

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9
Q

Causes of primary hypogonadism

A

Testicular failure

Mumps orchitis

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10
Q

Causes of secondary hypogonadism

A

Age-related (ADAM)

Chronic opiates

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11
Q

What diagnostic study is appropriate if testosterone levels are found to be < 100 ng/dL?

A

DEXA Scan

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12
Q

What testosterone level is defined as hypogonadism?

A

150-200 ng/dL

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13
Q

Risks associated with exogenous testosterone treatment

A

Infertility
Prostate CA
CV Events

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14
Q

Follow up/monitoring after starting a patient on exogenous testosterone

A

PSA; H and H; testosterone; urinary ROS; DRE

3, 6, 12 mo after initiating tx, then annually thereafter

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15
Q

Tx for cryptorchidism

A

Hormonal manipulation (GnRH injections)

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16
Q

The testis are actually absent in ____% of cryptorchidism cases

A

20%

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17
Q

Risk factors for cryptorchidism

A

Twins, low birth weight, preterm delivery, fam hx, prune belly syndrome

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18
Q

Complications of cryptorchidism

A

CA risk (even in contralateral)
Decreased fertility
Torsion risk is 10x higher

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19
Q

Negative cremaster sign, negative Prehn’s sign

A

Testicular torsion

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20
Q

Positive Prehn’s sign

A

Epididymitis

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21
Q

Most common etiologies of epididymitis

A

< 35 y/o = chlamydia, gonorrhea

> 35 y/o = E. coli

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22
Q

Most common etiology of orchitis

A

Viral mumps in children

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23
Q

_________ __________ (stratified epithelium) comprises 30% of the prostate

A

Glandular tissue

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24
Q

70% of prostate adenocarcinomas arise from the _________ ________

A

Peripheral zone

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25
Tx for BPH
Non-selective alpha blockers (-zosin) Selective alpha blockers (-dosin, -losin) 5-alpha reductase inhibitors (-steride) Antimuscarinics (oxybutynin)
26
Risk factors for BPH
``` UTI Prostatitis Neurologic disease (CVA/TIA, Parkinson's MS) Dietary indiscretion (caffeine, alcohol) DM OSA (snoring) Advanced cancer of the prostate (rare) ```
27
Enzyme that liquefies ejaculate | Allows sperm to swim freely
PSA (prostate specific antigen)
28
Etiologies of UTI
E. coli (80%) | Staph, Klebsiella, Proteus
29
Etiologies of pyelonephritis
E. coli | Proteus, pseudomonas, klebsiella
30
Treatment of pyelonephritis
IV ABX, good hydration, blood glucose monitoring
31
90% of kidney stones < _______ will pass spontaneously
4 mm
32
Instructions for use of diaphragm for sexual intercourse
Must be used with spermicide | Should be left in place for at least 6 hours after intercourse
33
Instructions for use of cervical cap
Must be used with spermicide Should be left in place for 6-8 hours after intercourse Can be left in place up to 48 hours
34
Three actions of estrogen/progestin contraceptives
1. Suppression of ovulation 2. Thinning of the endometrium 3. Thickening of cervical mucus
35
Risks associated with estrogen/progestin contraceptives
``` MI Ischemic stroke HTN Venous thromboembolism (increased with obesity, 40+) Hepatic adenoma ```
36
Contraindications to estrogen/progestin contraceptives
``` Smoker over age 35 Uncontrolled HTN Hx of stroke or ischemic heart dz Hx of VTE Inherited thrombophilia SLE Migraine with aura Breast CA Cirrhosis Liver tumor ```
37
Side effects of estrogen/progestin contraceptives
``` Breakthrough bleeding (most common) Amenorrhea Bloating Nausea Breast tenderness Weight gain HA ```
38
Mode of Action for Progestin Only Contraceptives
Thickens cervical mucus Thinning of endometrium Variable suppression of ovulation
39
Contraindications for progestin only contraceptives
Breast CA Undiagnosed abnormal uterine bleeding Active liver dz
40
Side effects for progestin only contraceptives
Irregular bleeding | Amenorrhea
41
Sx of bacterial vaginosis
Asymptomatic Watery, white/grey discharge No pruritus, urinary sx, or pain Foul "fishy" odor, esp. after menses or sex
42
Treatment for BV
``` Metronidazole Metrogel Clindamycin Clindesse Tinidazole ```
43
Sx of trichomonas vaginalis
``` Asymptomatic Copious yellow/grey/green frothy discharge Possibly mixed with blood Malodorous Vulvar pruritus and dysuria ```
44
Signs on exam of trichomonas vaginalis
Vulvar/vaginal erythema and inflammation pH > 4.5 Strawberry cervix Wet prep with high WBCs and motile trichomonas (flagella)
45
Tx of Trichmonas vaginalis
Metronidazole Tinidazole CDC recommend repeat testing with NAAT 2 wk-3 mo
46
CDC recommendations for GC/Chlamydia Testing
Routine annual screening of all females sexually active < 25 y/o Routine screening of all pregnant women in 1st trimester Routine annual screening of all sexually active women > 25 y/o with risk factors
47
Tx of gonorrhea
Ceftriaxone plus Azithromycin/Doxycycline
48
Sx of vulvovaginal candidiasis
Vulvovaginal pruritus Vulvovaginal burning Thick white odorless "cottage cheese" discharge
49
_________ __________ most common disorder seen with pregnancy loss
Uterine septum
50
DDx of an enlarged uterus
``` Pregnancy Uterine adenomyosis Leiomyoma uteri Hematometra (cervical stenosis/vaginal septum) Malignancy ```
51
Presence of endometrial glands and stroma in the myometrium
Benign Adenomyosis
52
Benign tumors of smooth muscle origin (arise in myometrium). Most common solid pelvic tumor in women
Leiomyomata Uteri
53
Most frequent indication for benign hysterectomy
Leiomyomata Uteri
54
Overgrowth of proliferative endometrium resulting rom protracted E stimulation in the absence of P
Endometrial hyperplasia
55
Unopposed E
Endometrial hyperplasia
56
Classically associated with inability to smell
Kallmann Syndrome | GnRH deficiency: will present as primary amenorrhea
57
Medications that can cause secondary amenorrhea
Hormonal contraceptives Progestin IUD Metoclopramide (Reglan): causes hyperprolactinemia Antipsychotic drugs (Thorazine, Haldol, Risperdal): causes hyperprolactinemia
58
Irregular bleeding, especially between menses
Metorrhagia
59
Excessive and irregular uterine bleeding
Menometorrhagia
60
Cycle length less than 24 days
Polymenorrhea
61
Simple epithelial-lined cyst or fibroid adjacent to the ovary, usually within the broad ligament
Paraovarian cyst or fibroid
62
Types of Ovarian Cancers
Epithelial tumors (90%) - serous adenocarcinoma most frequent subtype Stromal tumors Germinal tumors
63
Risk factors for ovarian cancers
Age, genetics (BRCA 1/2, Lynch 2 syndrome), early menarche, late menopause, nulliparity, infertility, endometriosis, PCOS, smoking, obesity
64
Protective factors for ovarian cancers
``` Oral contraceptive use Multiparity Breastfeeding Tubal ligation Salpingo-oophorectomy Hysterectomy ```

Reproductive Medicine (3 decks)

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