GYN pretest

Question 1

who should have DEXAs?

Answer 1

postmenopausal not on HRT or women over 65

Question 2

parabasal cells on pap mean what?

Answer 2

postmenopausal –> they lack estrogen

Question 3

vaginal cysts

Answer 3

gartner duct– embryonic origin of mesonephric duct, on lateral wall, small and benign

inclusion cyst–from burth trauma or surgery

bartholin –> on the labia,

Question 4

cervical cancer will spread first to which nodes?

Answer 4

paracervical

Question 5

how often are cystic teratomas (dermoid cysts) bilat?

Answer 5

10%

Question 6

how do you classify microinvasive CIN?

Answer 6

not >3mm into BM and not >7mm lateral spread

Question 7

how does vulvar carcinoma spread throuhg nodes?

Answer 7

SUPERFICIAL inguinal –> deep iliac –> external iliac

Question 8

characterize syphillis in stages

Answer 8

1) chancre
2) dissemination –> maculopapular rash on palms and soles
3) tertiary –> optic atrophy, tabes dorsaliz, AA, gumas

Question 9

an indication for cone biopsy?

Answer 9

when colpo is not in proportion of scary pap

Question 10

go to treatment for vulvodynia

Answer 10

avoid anything touch vagina

topical lidocaine, estrogen creams

Question 11

what are clue cells?

Answer 11

vaginal epithelial cells with bacteria on them

Question 12

how can fibroids contribute to PPH?

Answer 12

uterine distortion that prevents appropriate contraction

Question 13

how would you medically treat a pt with endometriosis who wanted to get pregnant?

Answer 13

GnRH agonist –> after suppression effects are over, no problems getting pregnant

Danazol= “pseudomenopause”, causes endometrial atrophy

Question 14

what structure in the male secretes MIF?

Answer 14

testes –> so no testes= no MIF= uterus in a phenotypical male

46xy

Question 15

primary ammenorrhea with absent uterus?

Answer 15

mullerian agenisis (46xx)

Question 16

order to primary amenorrhea (GMAT)

Answer 16

gondal dysgenesis > mullerian agen 46xx > testicular feminization 46xy

Question 17

most effective treatment for PMS?

Answer 17

SSRI

Question 18

hair growth is caused by _______ not _________

Answer 18

androgens! not estrogen, which does about everything else in pubrty and development

Question 19

for fertility, when should a hysterosalpingogram be done?

Answer 19

mid follicular, day 8ish

Question 20

how do you check progesterone levels to see if ovulation is appropriate?

Answer 20

serial levels from day 14-21

Question 21

you see an atrophic endometrial stripe in someone with acute uterine bleeding… what do you do

Answer 21

ESTROGEN will rebuild endometrium and stimulate clotting at capillary level

Question 22

stress incont

Answer 22

MOST COMMON
intravesical pressure exceeds max urethral pressure—> aka incompetence of urethral sphincter with normal ureththral pressure profile
**no destrusor activity proceeding leakage

***25% of women will ahve for a few months after vaginal birth

Question 23

urge incont. Whats the first line treatment? Next line?

Answer 23

second most common, inc with inc AGE!!
-bladder leaks due to uninhibited detrusor contraction >15cmH20 and urethral relaxation

tx= bladder training, dec xs fluids/ caffiene. Next line is oxybutinin (anticholinergic)

Question 24

functional incont

Answer 24

pt cannot reach toilet in time to due to physical/cognitive/psych limitations

Question 25

urethral diverticula

Answer 25

present with dribbling incont after voiding

• suburethral mass palpated in vaginal exam
• dyspareunia

Question 26

what imaging test is CI in patients with high Cr?

Answer 26

CT with contrast

Question 27

what volumes do you feel fullness, urge, max capacity?

Answer 27

100
350
450

Question 28

oxybutinin treats:

Answer 28

detrusor insability

Question 29

define: cystocele, rectocele, enterocele

Answer 29

cystocele: prolapse of ANTERIOR wall of vagina
rectocele: prolapse of POSTERIOR wall of vainga
enterocele: prolapse of bowel wall

up and beyond hymenal ring

Question 30

procedentia, risk factors

Answer 30

CERVIX come out beyond vagina

• parity
• menopause
• pelvic surgery
• intraabd pressure

Question 31

first line therapy for prolapse among most urogyns?

Answer 31

pessary

Question 32

colpocleisis

Answer 32

complete obliteration of vaginal lumen

***only in women who will NOT be sexuall active

Question 33

outpatient procedure for strss incont?

Answer 33

urethral sling

Question 34

how do you manage uterine/ vaginal vault prolapse? esp in old ladies or medically complicated?

Answer 34

probably go for a pessary because they are not a surgical candidate

If she has uterine prolapse and no sx, then don’t treat!

Question 35

how should you manage someone with persistent UTI sx despite treatment?

Answer 35

follow up urine culture to look for resistant organisms