Gyne from notes

Question 1

Dx tests in primary amenorrhea

Answer 1

Hx, pe, preg test, TSH, PRL, progesterone challenge, FSH/LH (high = ov fail, low = hypothal fail)

Question 2

amenorrhea criteria

Answer 2

no menstruation by 14 with no 2ndary sex char, or by 16 if char

Question 3

amenorrhea causes

Answer 3

hypothal, pituitary, ovarian, outflow tract, endocrine, AIS, drugs

Question 4

anovulatory bleeds char

Answer 4

unpredictable, variable, sex steroids irreg; chronic unopposed E causes thick endo, necrosis, shedding

Question 5

anov bleed causes

Answer 5

PCOS, thyroid, PRL, tumour

Question 6

ov bleed char

Answer 6

cyclic, heavy, prolonged

Question 7

ov bleed causes

Answer 7

physical lesion, hemostatic, PG, infection, dysfxnal CL, atrophic endo

Question 8

dysmenorrhea tx

Answer 8

pg synthetase inhib, ocp

Question 9

endometriosis triad

Answer 9

dysmenorrhea, dyspareunia, dyschezia

Question 10

endometriosis tx

Answer 10

NSAIDS, pseudopreg - OCP, depoprovera; pseudomenopause - danazol (androgen), leuprolide (GnRH ag)

Question 11

PCOS path

Answer 11

low FSH, high LH –> ov secretion of androgens –> hirsut, obesity –> high E –> high LH, low FSH –> anov –> oligomen, infert

Question 12

PCOS dx: 2/3 of

Answer 12

1. oligomenorrhea/irreg x 6 mo
2. hyperandrogenism
3. polycystic ovaries on US
   LH: FSH > 2:1

Question 13

PCOS tx

Answer 13

OCP, lifestyle, metformin, finasteride

infert - clomid, hMG, lhrh, fsh, metformin

Question 14

incontinence drugs

Answer 14

anticholinergics - oxybutinin = ditropan, tolteridone = detrol

Question 15

bacterial vaginosis bugs

Answer 15

gardnerella/anaerobes

Question 16

bact vag dx

Answer 16

ph >6, KOH whiff test, clue cells, gray watery dc

Question 17

bact vag tx

Answer 17

metronidazole, clinda - topical

Question 18

yeast infection dx

Answer 18

yellow thick clumpy dc, ph <6

Question 19

yeast infection tx

Answer 19

diflucan

Question 20

trichomonas

Answer 20

Ph 6 N, high WBC/PMNs, flagellated organisms, grey frothy dc, petechiae

Question 21

trichomonas tx

Answer 21

oral flagyl

Question 22

chancroid

Answer 22

painful ulcers

Question 23

syphilis s&s

Answer 23

painless ulcers, LA, rash palms and soles, condylomata

late: neuro, cv

Question 24

PCOS long term problems

Answer 24

lipids, t2dm, infert, obesity, sleep apnea

Question 25

atrophic vaginitis

Answer 25

postmenopausal, dyspareunia, post coital spotting, thin tissues; treatment is topical E

Question 26

chlamydia tx

Answer 26

obligate intracell | tx : doxy, azithro

Question 27

gonorrhea tx

Answer 27

gram neg, intracell diplococci tx : ceftriaxone, cefixime, cipro if preg - ceph/spectinomycin

Question 28

HPV

Answer 28

6, 11: anogenital warts | 16, 18: oncogenic hsil

Question 29

HSV dx

Answer 29

cytologic smear - multinuc giant cells, acidophilic inclusion bodies, serology for HSV 1/2, HSV DNA PCR tx: acyclovir

Question 30

syph dx and tx

Answer 30

dx: spirochetes, non-treponemal screen, anti trep ab test tx: benzothene penicillin

Question 31

PID tx

Answer 31

cefoxitin + doxycycline (foxi doxy) | or clinda and genta

Question 32

TSS

Answer 32

staph aureus | tx: pencillinase resistant abx - clox