Female Path part 2

Question 1

Suppresses GnRH, FSH/LH & lowers Gonadotropin levels to inhibit ovulation

Answer 1

Progestin implant/ injection

Combined OCP

Question 2

prevent pregnancy by thickening cervical mucus, which prevents sperm from accessing the uterus.
Still get period

Answer 2

The progestin-only pill (due to low dosage/potency) and levonorgestrel intrauterine device (IUD)

Question 3

releases copper ions that elicit an inflammatory reaction in the uterus that is toxic to sperm and prevents fertilization.

Answer 3

copper IUD

Question 4

Sensory Perenial region

External urethral and anal sphincters

Answer 4

Pudendal n

Question 5

S2-S4

Answer 5

Pudendal n

Question 6

Sensory suprapubic

Answer 6

iliohypogastric n

Question 7

Sensory of scrotum/ Labia Majora and upper medial thigh

Answer 7

Genitofemoral n

Question 8

Important landmarks for a ___ nerve block include the ischial spines and sacrospinous ligament.

Answer 8

pudendal

Question 9

Injury from abdominal retractors during laparotomy can lead to labial/scrotal anesthesia.

Answer 9

Genitofemoral nerve

courses along the anterior surface of the psoas muscle.

Question 10

Injury during closure of suprapubic skin incisions (cesarean section) can result in burning pain and paresthesias.

Answer 10

iliohypogastric nerve

Question 11

Injury during hip surgery can impair hip extension.

Answer 11

inferior gluteal nerve (gluteus maximus)

Question 12

The uterine arteries, the major blood supply to the uterus, are branches of the ____ arteries.

Answer 12

internal iliac

Question 13

Bilateral ligation of the internal iliac arteries should stop ___ blood flow and post-partum hemorrhage

Answer 13

uterine

Question 14

A midline episiotomy is a vertical incision from the posterior vaginal opening to the perineal body. It transects the

Answer 14

Perineal body

Question 15

Ovulation is then induced by administration of human chorionic gonadotropin, which mimics the ___ surge.

Answer 15

LH

Question 16

Menotropin (human menopausal gonadotrophin) therapy mimics ___ and triggers the formation of a dominant ovarian follicle.

Answer 16

FSH

Question 17

Following ovulation, the granulosa and theca cells of the ovarian follicle luteinize to form the ____; this secretes relatively high levels of progesterone

Answer 17

corpus luteum

Question 18

stimulates the endometrium to transform from proliferative to secretory to become a hospitable environment for implantation.

Answer 18

Progesterone

Question 19

Primary lymph node drainage of Uterus

Answer 19

External iliac

Question 20

Primary lymph node drainage of the Vagina

Answer 20

Proximal: internal iliac
Distal: inguinofemoral

Question 21

Primary lymph node drainage of Cervix

Answer 21

Internal iliac

Question 22

Primary lymph node drainage of Vulva

Answer 22

Inguinofemoral

Question 23

Primary lymph node drainage of

Answer 23

Paraaortic

Question 24

The discharge is grayish-white and fishy smelling.

Answer 24

Gardnerella Vaginalis

Question 25

amide odor with KOH wet mount

Answer 25

Gardnerella Vaginalis

Question 26

squamous epithelial cells with adherent bacteria

Answer 26

Gardnerella Vaginalis | clue cells

Question 27

Treatment is with metronidazole or clindamycin

Answer 27

Gardnerella Vaginalis | Bacterial Vaginosis

Question 28

A wet mount shows leukocytes and pear-shaped organisms (flagellated trophozoites). 

Answer 28

Trichomoniasis Vaginalis

Question 29

Presents with vulvovaginal erythema and frothy, yellow-green vaginal discharge; patients with cervicitis classically have a cervix with punctate hemorrhage (ie, strawberry cervix).

Answer 29

Trichomoniasis Vaginalis

Question 30

A third-generation cephalosporin will treat the gonococcal infection, and further treatment with _____ is required to treat the chlamydia

Answer 30

azithromycin or doxycycline

Question 31

HPV is a _____, NON-enveloped DNA virus that has a predilection for squamous epithelium of the skin and vagina/cervix.

Answer 31

double-stranded

Question 32

A koilocyte is an immature squamous cell with dense, irregularly (dusky) staining cytoplasm and perinuclear clearing, resulting in a halo.

Answer 32

HPV

Question 33

pseudohyphae of budding yeast on a Pap smear.

Answer 33

Candida Albicans (normal flora)

Question 34

Common triggers for Candida vaginitis include the following: ``` Antibiotic use High estrogen levels (eg, pregnancy) Systemic corticosteroid therapy _______ Any other cause of immunosuppression, including HIV ```

Answer 34

Uncontrolled diabetes mellitus

Question 35

Antibiotic use is the most common cause of Candida vaginitis due to reduction of the ____ population, which facilitates Candida overgrowth. 

Answer 35

gram + lactobacilli

Question 36

Elevated pH of vaginal secretions (>4.5) is associated with (2)

Answer 36

Bacterial vaginosis | Trichomonas vaginitis

Question 37

Diagnosis is made via wet mount microscopy, which typically reveals pseudohyphae with budding yeast and true hyphae. 

Answer 37

Candida Albicans

Question 38

Treatment of vulvovaginal candidiasis is with

Answer 38

Fluconazole

Question 39

  Anatomic or functional ____ is almost always necessary for the development of acute pyelonephritis.

Answer 39

vesicoureteral reflux

Question 40

E-Coli (UPEC) cause Cystitis (dysuria) via

Answer 40

Ascending infection | P-pili

Question 41

_____ are pathognomonic for acute pyelonephritis when accompanied by symptoms of acute UTI.

Answer 41

white blood cell casts

Question 42

Sterile pyuria (WBCs, but no bacteria) can be seen with nongonococcal urethritis caused by ____.

Answer 42

Chlamydia | Ureaplasma

Question 43

Use wet mount SALINE microscopy to diagnose

Answer 43

Trichomonas vaginalis | motile protozoa

Question 44

It can cause disulfiram-like effects (eg, abdominal cramps, nausea, headache) when combined with alcohol due to acetaldehyde accumulation.

Answer 44

Metronidazole

Question 45

How to treat Trichomonas vaginalis

Answer 45

Metronidazole | must treat partner as well

Question 46

is caused by weakened pelvic floor muscle support that often occurs due to chronically increased intraabdominal pressure (eg, obesity, chronic cough, prior pregnancies).

Answer 46

Stress urinary incontinence (intermittent, involuntary leakage of urine)

Question 47

Red-inflamed friable cervix with purulent discharge Asymptomatic, or presents with post-coital bleeding. detected by pelvic examination and nucleic acid amplification testing (NAT).

Answer 47

Gonoccal Cervicitis | chalmydia can cause it too

Question 48

Bacterial vaginosis (BV) is most commonly caused by an overgrowth of the facultative ________ Gardnerella vaginalis and loss of normal lactobacilli flora.

Answer 48

anaerobic, gram-variable rod

Question 49

Rotation of the ovary around the ___ ligament results in ovarian torsion. Presents with sudden-onset unilateral pelvic pain and nausea and sometimes vomiting and fever

Answer 49

infundibulopelvic (IP) ligament | suspensory ligament of the ovary

Question 50

The ____ ligaments connect the posterior aspect of the uterus to the anterior portion of the sacrum.  These ligaments hold the uterus in an anteverted or retroverted position; loss of this support contributes to uterine PROLAPSE into the vagina. 

Answer 50

uterosacral

Question 51

Teenager with ammenorhea Examination shows fully developed secondary sexual characteristics.  Pelvic ultrasound shows a shortened vaginal canal with a rudimentary uterus.

Answer 51

Mullerian Agenesis