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GYN 2 Flashcards

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1
Q

What is milky nipple discharge a sign of?

A

galactorrhea, can be normal, drug related, thyroid related, or due to prolactinoma

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2
Q

What is bloody nipple discharge a sign of?

A

intraductal papilloma

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3
Q

What is greenish/brown nipple discharge a sign of?

A

mammary duct ectasia

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4
Q

What is purulent nipple discharge a sign of?

A

acute mastitis

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5
Q

What is the most common “painful” breast mass for women less than 50?

A

fibrocystic changes

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6
Q

What is the most common breast mass?

A

fibroadenoma

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7
Q

Who is intraductal papilloma commonly found in?

A

perimenopausal and menopausal patients

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8
Q

What are the characteristics of mastitis?

A

sudden onset of fever, localized pain, and swelling

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9
Q

What is the most common cause of mastiti?

A

staphylococcus aureus

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10
Q

When do the most aggressive breast cancers occur?

A

less than 40 years old

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11
Q

When do most breast cancer cases occur?

A

greater than 50 years old

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12
Q

What gene is associated with nearly half of early-onset breast cancer?

A

BRCA 1

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13
Q

What are the 3 categories of breast cancer malignancies?

A

ductal, nipple, lobular

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14
Q

What is the most common breast cancer?

A

invasive ductal carcinoma

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15
Q

What is the most common organism to cause bacterial vaginosis?

A

gardnerella vaginalis

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16
Q

What is the color of the discharge of candidiasis?

A

thick, “cottage cheese” curdy, white

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17
Q

What is the pH of candidiasis?

A

<4.5

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18
Q

Is the amine odor with KOH of candidiasis positive or negative?

A

negative

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19
Q

What does the wet mount of candidiasis show?

A

WBC, spores, pseudohyphae

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20
Q

What is the color of the discharge of trichomoniasis?

A

frothy, green/yellow discharge

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21
Q

What is the pH of trichomoniasis?

A

> 5

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22
Q

Is the amine odor with KOH of trichomoniasis positive or negative?

A

positive

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23
Q

What does the wet mount of trichomoniasis show?

A

WBC, motile trichomonads

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24
Q

What does the cervix look like with trichomoniasis?

A

petechia or strawberry patches

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25
What is the color of the discharge of bacterial vaginosis?
thin, white/grey discharge
26
What is the pH of bacterial vaginosis?
>4.5
27
Is the amine odor with KOH of bacterial vaginosis positive or negative?
positive - "fishy smell"
28
What does the wet mount of bacterial vaginosis show?
few WBCs, clue cells
29
What is the most common complaint for someone with vulvar cancer?
vulvar pruritus
30
What is the tx for Bartholin abscess?
I and D followed by insertion of a word catheter and abx
31
What are some risk factors of breast cancer?
- Age >50 - 1st-degree relatives - Radiation exposure
32
What is the name of the cancer that is located on the nipple?
Paget disease (ductal carcinoma in-situ)
33
What does Paget disease present as?
- Eczematous lesions | - orange peel appearance
34
Almost all lobular (invasive lobular carcinoma) are what?
- Estrogen receptor + | - Multifocal and bilateral
35
What are the diagnostic studies used for breast cancer?
- Mammogram - FNA - Core needle bx - Excisional bx: GOLD standard
36
What is the tx for breast cancer?
- Radical Mastectomy - Modified radial mastectomy - Lumpectomy - Chemotherapy
37
Vulva cancer occurs at what age?
Postmenopausal women: 70-80 yo
38
What is the MC cell that makes up vulva cancer?
- SCC | - most develop through VIN
39
Where is melanoma found in pts with vulva cancer?
- Clitoris | - Labia minora
40
Where does adenocarcinoma start?
Bartholin glands
41
What are the characteristics of vulva cancer?
Red or white ulcerative or exophytic lesions
42
Most lesions are located where in regards to vulva cancer?
posterior 2/3 of labia
43
What are the dx and tx options for vulva cancer?
- Dx: biopsy of multiple sites | - Tx: laser, excision, vulvectomy
44
What is the age risk factor for vaginal cancer?
> 55 yo
45
What is the MC cell found in vaginal cancer and where is it MC'ly found?
- Squamous cell - secondary to cervical or vulvar cancers | - upper 1/3 of vagina
46
What is VAIN 1 classified as and how would you tx?
Basal epithelial | - monitor, no therapy
47
What is VAIN 2 classified as and how would you tx?
2/3 vaginal epithelium | - topical chemo (5-FU cream)
48
What is VAIN 3 classified as and how would you tx?
> 2/3 vaginal epithelium | - laser ablation, local excision, intracavitary radiation, topical chemo (5-FU) or partial/total vaginectomy
49
What are the risk factors for cervical ca?
- 1st intercourse < 18 yo - Multiple partners - Infrequent/ abnormal paps
50
What are the HPV types responsible for cervical cancers? Of those which two are MC?
16, 18, 31, 45 | - 16 and 18 are MC
51
What is the pap test report for CIN 1?
Mild cervical dysplasia
52
What is the pap test report for CIN 2?
Moderate to marked cervical dysplasia
53
What is the pap test report for CIN 3?
Severe dysplasia to carcinoma in-situ
54
What are the Dx test for cervical cancer?
- Pap - HPV DNA - Colposcopy
55
What are the Tx options for cervical cancer?
- Cryo - Laser ablation - LEEP - Cold knife conization
56
What would you expect to find on an exam in a pt with fibrocystic breasts?
- Lumpy, thick, firm - Not able to feel clear margins - Able to move tissue.
57
What may a pt present with if they have fibrocystic breasts?
- Non-bloody, green, or brown nipple discharge. - Fluctuance in size - Rapid appearance or disappearance of lesions
58
What are the Dx for fibrocystic breasts?
- Bx: diagnosis often rest on this pathology - US - mammo: not indicated <30
59
What is the tx for fibrocystic breasts?
- Reassurance- NO potential for malignancy - limit caffeine consumption - BC pills
60
Fibroadenoma is MC'ly found in who?
Younger women | - if found in older women they are calcified
61
What is the cause of Fibroadenoma?
- Hormonal response: estrogen sensitive - Changes in size with pregnancy - Regresses w/ menopause
62
What are come clinical findings of an Fibroadenoma?
- Round, firm, discrete, relatively movable | - Non-tender: 1-5cm mass
63
What are the dx test for Fibroadenoma?
- US: well-defined mass with benign features | - Core Needle Biopsy: confirm dx
64
What are some clinical finding in a pt with Intraductal papilloma?
- Bloody, serous, or turbid nipple discharge | - May stain bra
65
What is the Dx for intraductal papilloma?
- Mammogram &/or Ultrasound | - Ductography: identify intraductal filling defect
66
What is the Tx for intraductal papilloma?
Excision of involved duct
67
Galactorrhea is a milky d/c that occurs in who?
In women who aren't pregnant or breast feeding
68
What are the causes of Galactorrhea?
- Physiologic - Neoplastic - Hypothalamic- Pituitary - Medications (SSRIs, TCAs)
69
What are the dx test for Galactorrhea?
- Serum pregnancy test - Prolactin level - Renal function test - TSH - Official visual field test - MRI
70
What is the tx for Galactorrhea?
Treat underlying cause
71
When should you suspect an abscess in a pt with mastitis?
If sxs cont. after starting pt on antibiotics
72
If pt has mastitis and abscess is present what may you note on PE?
Fluctuant mass with palpation
73
What is the the tx for BV?
- Metronidazole | - Clindamycin
74
What are the risk factors for candidiasis?
- DM - Obesity - Pregnancy - Immunosuppressed - Oral contraceptives or corticosteroids - Broad spec antibiotics
75
What is the tx for candidiasis?
- “azoles “: topical, suppository, or oral
76
What is Trichomonas associated with?
- PID - Endometriosis - Infertility - Ectopic Pregnancy - Premature birth
77
What is the tx for Trichomonas?
- Metronidazole - Tinidozole - Treat sexual partners - Undergo other STI testing

OBGYN (5 decks)

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