GYN

Question 1

Amsel Criteria

Answer 1

pH over 4.5, clue cells, positive whiff test, thin gray discharge

Question 2

Which diagnosis? Polygonal ivory papules of vulvar and perianal areas, waxy sheen on labia minora and clitoris, hypopigmentation; progresses to fissures/erosions, mucosal edema, and surface vascular changes

Answer 2

Lichen sclerosis

Question 3

Which diagnosis? Itching, pruritis, contact bleeding, pain, dyspareunia, lacy reticular pattern of labia and perineum, possible scarring or erosions

Answer 3

Lichen planus

Question 4

Which diagnosis? Severe vulvar pruritis (can be worse at night), thick/enlarged labia possibly with edema, associated with chronic scratching/rubbing

Answer 4

Lichen simplex chronicus

Question 5

Which vulvar infection necessitates treatment of sexual partner as well?

Answer 5

Trichomoniasis

Question 6

Which diagnosis? Severe pain on vestibular touch and attempted vaginal entry, including tenderness to pressure

Answer 6

Vestibulodynia

Question 7

Most prevalent STI in the US

Answer 7

HSV

Question 8

Which diagnosis? Firm, small umbilicated dome-shaped papules on vulva

Answer 8

Molluscum Contagiosum

Question 9

Management of tuba-ovarian abscess

Answer 9

Abx

Question 10

Which diagnosis? Perihepatitis caused by purulent tubal discharge ascending to the RUQ

Answer 10

Fitz-Hugh-Curtis Syndrome

Question 11

Which diagnosis? Soft painful ulcer on vulva

Answer 11

Chancroid

Question 12

Which diagnosis? “School of fish” appearance on gram stain

Answer 12

Chancroid

Question 13

Which diagnosis? Pink/skin-colored lesions that range from papular to exophytic; pruritis and bleeding possible

Answer 13

Condyloma accumniata (HPV)

Question 14

Which diagnosis? painless papule or shallow ulcer/erosion followed by development of inguinal buboes and groove sign

Answer 14

Lymphogranuloma venereum (chlamydia trachomatis)

Question 15

Which diagnosis? Large beefy-red painless ulcerations, “Donovan bodies” on microscopy

Answer 15

Granuloma Inguinale/Klebsiella granulomatis

Question 16

Which diagnosis? Pain/fullness/heaviness of variable intensity and duration, worse premenstrually and during pregnancy, aggravated by standing, fatigue, and coitus

Answer 16

Pelvic congestion syndrome

Question 17

Which diagnosis? Cyclical mastalgia worst before menstruation, engorged breasts, possibly serous or green discharge

Answer 17

Fibrocystic breast changes

Question 18

Which diagnosis? serosanguineous nipple discharge in absence of breast mass

Answer 18

Intraductal papilloma

Question 19

Which diagnosis? red, edematous, tender indurated breast in a non-lactating female

Answer 19

Inflammatory breast cancer

Question 20

Delayed puberty definition

Answer 20

No secondary sex characteristics at age 14

Question 21

Which diagnosis/tx? Premature menses before breast and hair development

Answer 21

McCune-Albright Syndrome (Continuous GnRH therapy)

Question 22

Which diagnosis/tx? Premature adrenarche, may have ambiguous genitalia at birth

Answer 22

CAH (steroid replacement)

Question 23

Which diagnosis? Absent uterus, normal secondary sex characteristics

Answer 23

Mullerian Agenesis

Question 24

Which diagnosis/tx? Absent uterus, normal breast development, axillary/pubic hair absent

Answer 24

Androgen Insensitivity Syndrome (46,XY), Gonadectomy

Question 25

Most common cause of amenorrhea

Answer 25

Pregnancy

Question 26

FSH:LH ratio in premature ovarian failure

Answer 26

Greater than 1.0

Question 27

Which diagnosis/tx? Intrauterine synechiae or adhesions result from trauma to the basal layer of the endometrium, may result in amenorrhea

Answer 27

Asherman Syndrome (Operative hysteroscopy w/IUD placement)

Question 28

PCOS hormone ratio

Answer 28

Elevated LH:FSH ratio

Question 29

PCOS increases risk for ____ cancer

Answer 29

endometrial

Question 30

Which diagnosis/tx? Hirsutism, amenorrhea, acanthosis nigricans

Answer 30

PCOS/OCPs

Question 31

Labs for Hirsutism (7)

Answer 31

FSH, LH, DHEA-S, Testosterone, 17-hydroxyprogesterone, PRL, TSH

Question 32

Which diagnosis? most common in women 20-40, rapid onset hirsutism and virilizing signs (acne, amenorrhea, clitoral hypertrophy, deepening of voice)

Answer 32

Sertoli-Leydig Cell tumor

Question 33

PALM-COEIN

Answer 33

Polyp, Adenomyosis, Leiomyoma, Malignancy, Coagulopathy, Ovulatory Dysfunction, Endometrial Dysfunction, Iatrogenic, Not Classified

Question 34

Workup for heavy menses

Answer 34

Pregnancy test, Pelvic US, Endometrial biopsy

Question 35

Most common cause of post-menopausal uterine bleeding

Answer 35

Atrophic endometrium

Question 36

Ddx for dysmenorrhea (5)

Answer 36

Adenomyosis, Leiomyomas, Endometriosis, PID, Primary

Question 37

Management of Adenomyosis (4)

Answer 37

GnRH agonists, Endometrial Ablation, IUD, Hysterectomy

Question 38

Management of Endometriosis (5)

Answer 38

NSAIDs, OCPs, GnRH agonists, Danazol, Laparoscopy

Question 39

Causes of Infertility (5)

Answer 39

Ovarian Factor, Uterine Factor, Tubal Factor, Male Factor, Peritoneal Factor

Question 40

Diagnostic test for tubal disease

Answer 40

HSG

Question 41

Demographic at highest risk for GTD

Answer 41

Asian

Question 42

Which diagnosis? Vaginal bleeding, uterine size greater than dates (25-50% of cases)

Answer 42

Molar pregnancy

Question 43

Management of Molar Pregnancy (3)

Answer 43

Suction curettage, Follow hCG levels, screen for metastasis (CT CAP/MRI Brain)

Question 44

Diagnosis of choriocarcinoma

Answer 44

hCG level

Question 45

Leading cause of injury-related death in pregnant women

Answer 45

Homicide

Question 46

Which diagnosis? Tissue paper, crinkled skin with fragile, thinned, and atrophic appearance

Answer 46

Lichen sclerosis

Question 47

Which diagnosis? White plaque-like lesions, poorly defined erythema

Answer 47

Paget Disease

Question 48

Treatment of leiomyomas (5)

Answer 48

Contraceptives, GnRH agonists, Myomectomy, Hysterectomy, Uterine Artery Embolization

Question 49

Most common cause of hysterectomy

Answer 49

Leiomyomas

Question 50

Most common gynecologic malignancy

Answer 50

Endometrial Cancer

Question 51

Screening for endometrial cancer metastasis

Answer 51

CXR

Question 52

Which diagnosis? Uniloculated ovarian cyst, without evidence of blood, soft tissue, or excrescences in a women of child-bearing age

Answer 52

Functional Ovarian Cyst

Question 53

Most common ovarian epithelial tumor

Answer 53

Serous cystadenoma

Question 54

Most common category of malignant ovarian tumors

Answer 54

Epithelial

Question 55

Most common ovarian tumor in all ages

Answer 55

Dermoid cyst/Benign cystic teratoma (most common in reproductive years

Question 56

Granuloma cell tumors may cause _____.

Answer 56

Endometrial hyperplasia