Gynecology Flashcards
(275 cards)
0
Q
Regulation by gonadal sex of the differentiation of the genital apparatus
A
Phenotypic or genital sex
1
Q
Established by genetic inheritance at the moment of fertilization
A
Chromosomal sex
2
Q
Establishment of gender role, role gender identity or sexual orientation
A
Psychological sex
3
Q
Single most consistent determinant of maleness
A
Presence of y chromosome
4
Q
Responsible for sex determination
A
SRY gene
5
Q
One of the 2 copies of x chromosome present in females is inactivated
A
Lyon hypothesis
6
Q
Tests to determine genetic sex
A
Sex chromatin test, hair root test, karyotyping
7
Q
Cells that secrete anti mullerian hormone
A
Sertoli cells
8
Q
Enlarges to become testis
A
Embryonic medulla
9
Q
Proliferates to become the ovaries
A
Embryonic cortex
10
Q
Mesonephric dcg
A
Wolffian ducts
11
Q
Paramesonephric ducts
A
Mullerian ducts
12
Q
Responsible for differentiation of wolffian ducts
A
Testosterone
13
Q
Induces dissolution of mullerian ducts
A
MIF
14
Q
Forms the testis
A
Medulla
15
Q
Forms the ovaries
A
Cortex
16
Q
Dubbed as gay gene
A
Xq28 of X chromosome
17
Q
Part of brain larger in homosexual males
A
Suprachiasmatic
18
Q
47 xxy
A
Klinefelter
19
Q
Most common gynecologic problem in the prepubertal female
A
Vulvovaginitis
20
Q
Translucent vertical line at the midline
A
Adhesive vulvitis
21
Q
Management for adhesive vulvitis
A
Topical estrogen cream, BID for 3 weeks
22
Q
Figure of 8 or hour glass; parchment like appearance of skin
A
Lichen sclerosus
23
Q
Mgmt for lichen sclerosus
A
Sitz bath, avoid trauma; CLOBETASOL
24
Precocious puberty is defined by the onset of secondary sexual characteristics at what age
Before 8 in girls and 9 in boys
25
Managment for incomplete isosexual precocious puberty
Conservative management
26
Premature thelarche is associated with
Extremely low birthweights
27
Pseudo precocious puberty is due to
Granulosa cell tumor, mc cune albright syndrome
28
Tx for idiopathic precocious puberty
GnRH
29
Management for McCune albright syndrome
Aromatase inhibitor
30
3ps of mc cune albright
Precious puberty, pigmentation, polyostotic fibrous dysplasia (due to somatic mutation of neural crest cells)
31
Most useful diagnostic tool for premenstrual syndrome
Symtpom diary
32
What are the indications for endometrial biopsy for AUB
>35yrs old, obesity, HPN, DM
33
Ovulatory DUB is due to what
Prostaglandin and fibrinolytic system
34
Medical managment for DUB
CEE 10mg/day in 4 divided doses;
35
Tx of choice for anovulatory DUB
Progestin
36
Androgenic steroid used for DUB
Danazol 200-400mg/day
37
Inhibits ovarian steroid production
Leuprolide- GnRH agonist
38
Definitive management for DUB
Hysterectomy
39
Primary dysmenorrhea is due to increased levels of
Protaglandin F2a
40
First line for primary dysme
NSAID
41
Isolated gonadotropin deficiency associated with anosmia
Kallman syndrome
42
Management for Turner syndrome
Estrogen therapy; cyclic progesterone- endometrial hyperplasia
43
Failure of ovaries to respond to FSH and LH secondary to receptor defect
Savage syndrome
44
Cessation of ovarian function in patients <40 yo
Premature ovarian failure
45
Management for mayer rokitansky kuster hauser syndrome
Neovagina creation
46
Management for androgen insensitivity
Gonad removal at 18yo; neovagina creation
47
Incision for imperforate hymen
Cruciate incision
48
Hematocolpos
Transvaginal septum
49
Hirsutism, amenorhea, obesity
Stein leventhal syndrome (PCOS)
50
Pituitary cell destruction as a result of a hypotensive episode during pregnancy
Sheehan's syndrome
51
Pituitary cell destruction unrelated to pregnancy
Simmond's disease
52
Management for premature ovarian failure
Irradiation, chemotherapy, autoimmunity
53
Intrauterine adhesions due to curettage
Asherman syndrome
54
Anovulation can be caused by
Hypothyroidism and prolactinoma
55
Menopause characterisitcs
51 yo; 12 mos after last; 3 mos with elevated FSH and LH
56
Menopause is earlier by how many yrs in smokers
2
57
Coverts androstenedione to estrone
Aromatas
58
Pathognomonic sign of menopause
Hot flushes/ flashes
59
Mgmt for hot flushes
Estrogen
60
Most accurate method to measure bone density
Dual energy xray DEXA
61
Risks regarding ERT
Heart, breast, stroke
62
Duration of ERT
6-12 mos, not >4 yrs
63
Prevents endometrial hyperplasia
Progrsin
64
Selective receptor modulator
Raloxifene
65
Herniation of the Pouch of Douglas
Enterovele
66
Grade: cervix descends halfway to the introitus
I
67
Grade: cervix descends to the introitus
II
68
Grade: cervix extends outside introitus
III
69
Grade: providential
IV
70
Pelvic strengthening exercise:
Keel's maneuver
71
Endopelvic fascial reinforcement
Kelly placation
72
Obliteretion of vaginal canal
Colpocleisis/ effort procedure
73
Urethrovesicular suspension via abdominal apporach
Burch/ marshallarchetti krantz procedure
74
Elevation of bladder neck and urethra via vaginal and abdominal approaches
Sling procedure
75
Mgmt for rectocele
Posterior repair
76
Mgmt enterocele
Moschvitz repair
77
Mgmt for PCOS
OCP
78
Mgmt for late onset congenital adrenal hyperplasia
Glucocorticoid
79
Management for hair follicle and androgen sensitivity
Spironolactone
80
Double cervix, double vagina
Bicollis
81
Mucous retention cyst of endocervical columnar cells occuring when a cleft has been covered by squamous metaplasia
Nabothian cyst
82
Most common cervical cyst
Nanothiam cust
83
Cervical polyp
Most common lesion of the cervix
84
HPV types related with cervical CA
16,18,31,33
85
Mainstay tx for menopause
Estrogen replacement therapy
86
Example of a selective receptor modulator
Raloxifen
87
Pelvic strengthening exercise
Keel's maneuver
88
Drugs for ovulation induction
Clomiphene citrate, metformin, hMG, GnRH
89
75% of ovarian masses in women
Functional cyst
90
Most common cause of complex adnexal mass
Benign cystic teratoma
91
Most common cause of a pelvic mass
Pregnancy
92
HONEYCOMB, straw colored fluid, multicystic, bilateral
Theca lutein cyst
93
Functional cysts include
Follicular, corpus luteum, theca lutein
94
Rpt ultrasound for follicular cyst and corpus luteum cyst are done when?
6-8 weeks
95
Management for premenaechal cyst >2cm
Ex lap
96
Most frequent ovarian epithelial tumor
Serous cystadenoma
97
Resembles cells of endocervix or intestinal epithelium
Mucinous cystadenoma
98
Transitional tumor: coffee bean appearing nucleus
Brenner tumor
99
Most common neoplasm in prupubertal female
Benign cystic teratoma
100
Most common benign solid tumor of the ovary
Fibroma
101
Ovarian fibroma, ascites, hydothorax
Meig's syndrome
102
Most common cause of gynecological cancer death
Malignant ovarian tumor
103
Gene associated with increased risk for ovarian CA
BRCA 1 gene
104
Most common ovarian carcinoma
Epithelial
105
Most frequent ovarian eptihelial tumor
Serous
106
Epithelial cells filled with mucin
Mucinous tumors
107
Hobnail cells
Clear cell
108
Resembles transitional cells of urinary bladder
Brenner
109
Epithelial cells resembling endometrium
Endometrioid
110
75% of patients with epithelial ovarian tumors present at what stage
III or stage IV
111
Phase 1 of epithelial CA managment
Debulking
112
Phase of 2 epithelial cancer management
Post op chemotherapy: carboplatin and taxol
113
Follow up for CA 125
Q 3mos for 2 yrs then q6mos for the next 2 yrs
114
Management for stage1a ovarian epithelial CA in young women who desire fertility
Unilateral salpingooophorecrony
115
Most germ cell tumors are? Benign/malignant
Benign
116
Most malignant germ cell tumors are what type?
Dysgerminoma
117
Most frequent germ cell tumor overall
Dermoid cyst
118
Most common ovarian neoplasm in women <30 yo
Germ cell tumor
119
Analogous to seminoma of testes
Dysgerminoma
120
Numerous hyaline droplets in yolk sac tumors
Schiller duval
121
Schiller duval bodies
Yolk sac tumor
122
Hemorrhagic highly malignant cytotrophoblast and syncytiotrophoblast
Choriocarcinoma
123
Mgmt for germ cell tumor
Benign- ovarian cystectony; malgnant- unilateral salpingo- oophorectony; post child bearing- TAHBSO
124
Sex cord stromal tumors
Granulosa theca cell and sertoli leydig cell
125
Resembles fetal testes
Sertoli leydig cell tumor
126
Coffee bean nuclei; call exner bodies
Granulosa cell tumor
127
Mgmnt fo sex cord stromal tumors
Young: unilateral salpingooophorectony; post menopausal: TAHBSO
128
Nipple projections in dermoid
Tubercle of rokitansky
129
Tumor marker for dysgerminoma
LDH
130
Tumor marker for endodermwl sinus tumor
Yolk sac tumors- AFP
131
Tumor marker for choriocarcinoma
HCG
132
Tummor marker for immature teratoma
AFP
133
Mgmt for labial fusion
Cortisol+ surgery
134
Mgmt for imperforate hymen
Cruciate incision
135
Dx of transverse vaginal septum
Ultrasound and MRI
136
Failure of urogenital sinus to contribute to the lower portion of the vagina leads to
Vaginal atresia
137
Mgmt for vaginal atresia
Vaginal pull through
138
Absence of vagina, hypoplasia of cervix, uterus and fallopian tubes
Mayer rokitansky kuster hauser
139
Mgmt for vaginal agenesis
Mc indole procedure; Serial vaginal dilators;
140
Mgmt for lichen simplex chronicus
Medium potency topical steroids BID 4-6X / week
141
Pruritic, polygonal, papules in external genitalia
Lichen planus
142
Mgmt for lichen planus
Vaginal hydrocortisone suppositories; adhesions/ surgical excision or vaginal dilators; postmenopausal atrophy: vaginal estrogen
143
Palpable red glandular spots and patches in the upper 1/3 of the vagina on the anterior wall
Vaginal adenosis
144
Vaginal adenosis is due to exposure to what
DES
145
Most common tumor in the vulva
Epidermal inclusion cyst
146
Occlusion of pilosebaceous duct
Epidermal inclusion cyst
147
Mgmt for epidermal inclusion cyst
Incision and drainage; complete excision
148
Tumor formed due to accumulation within the cyst
Sebaceous cyt
149
Mgmt for sebaceous cyst
Incision and drainage
150
Microcystic disease
Fox Fordyce disease
151
Due to occlusion of apocrine glands in the mons pubis and labia minora
Hidradenitis suppurativa
152
Mgmt for hidradenitis supparativa
Wide local excision, incision and drainage, antibiotics
153
Chronic inflammation of the paraurethral gland causing obstruction of the duct
Skene's gland cyst
154
Mgmt for bartholin's gland duct cyst and abscess
Biopsy in>40 yo; no tx for 1-2 cm; sitz bath, word catheter placement ;4-6 weeks; masupialization, antibiotics for N gonorrhoeae
155
Also called dysontogenic cyst
Gartner's duct cyst
156
Remnants of the mesonephric ducts of the wolffian system
Gartner's duct cyst
157
Mgmt for gartner's duct cyst
Excision, IVP and cystoscopy; vasopressin
158
Most common benign solid tumor of the vulva
Fibroma
159
Small fleshy outgrowth in the distal edge of urethral meatus
Urethral caruncle and prolapse
160
Mgmt of urethral caruncle:
Biopsy; oral topical estrogen; avoid irritation
161
Mass of anterior vaginal wall from the posterior urethra
Urethral diverticulum
162
Dysuria, dyspareunia, dribbling of urine
Urethral diverticulun
163
Mgmt for urethral diverticulum
Voiding cystourehtrograpjy; cystourethroscopy
164
Mgmt for squamous cell hyperplasia
Medium potency topical steroid BID 4-6 weeks
165
Risk factor for Vulvar intraepithelial neoplasia
HPV infectiom 16 and 18
166
Mgmt for VIN
Vulvectomy, vulvar skinning; vaporization by laser
167
Mgmt for vulvar carcinoma
Stage I-III: wide radical vulvar excision and bilateral inguinal femoral node dissection
168
Gold standard for determining sex
Karyotyping
168
When do the testes descend through the inguinal ring?
7-9th mo
168
The internal genitalia come from w/c structures
Wolffian and mullerian ducts
169
Analagen of external genitalia include
Genital swelling/ labioscrotal swellig; urogenital sinus; genital tubercle; genital or urethral folds
170
Results when phenotype and geotype do match
Pseudohermaphrodites
171
Grayish-white discharge 6-12 mos before menarche due to desquamation of vaginal epithelium
Physiologic discharge of puberty
172
Most common foreign body seen
Tissue paper
173
Most common cause of accidental genital trauma
Straddle injury(most common)
174
Management of genital warts in children
Laser therapy under inhalation anesthesia
175
Most common cause of peripheral precocious puberty
Granulosa cell tumor
176
Used to differentiate bn central and peripheral precocious puberty
GnRH stimulation test
177
Management for McCune Albright syndrome
Aromatase inhibitor
178
Management for idiopathic pecious puberty
GnRH
179
Management for premenstrual syndrome
Spironolactone, bromocriptine, SSRI, TAHBSO
180
Norma freq, duration and volume of menstrual cycle
21-35 days, 4-7 days, 30-80 ml
181
Excessive or prolonged menstruation
Menorrhagja
182
Scanty menstruation; very light flow
Hypomenorrhea
183
Menstruation occuring every >35 days
Oligomenorrhea
184
Bleeding bn normal menses
Metrorrhagia
185
Excessive or prolonged bleeding
Menometorrhagja
186
2 types of DUB
Ovulatory and anovulatory
187
Definitive management for DUB
Hysterectomy
188
Tx of choice for anovulatory DUB
Progestins
189
Indicated for DUB cases with acute bleeding who do not respond to Iv estrogen or women with significant hypovolemia
D and C
190
25% of women with breasts and uterus have
Prolactinomas or hyperprolactinemia
191
Initial hormonal changes signaling onset of menopause
Decrease inhibin and fah
192
Marker of production of ovary
Testoserone
193
Marker of production of adrenal gland
DHEAS
194
Marker of production of peripheral conversion
3a diol G
195
Elevated in androgen producing tumors
DHEAS
196
Elevated in late onset CAH
17-OHP
197
Elevated in cushing's disease
Glucocoricoid and androgen
198
Usual fecundability rate
20%
199
Direct injection of a single sperm into an oocyte
Intracytoplasmic sperm injection
200
Sperm is added to oocytes in culture medium
In vitro fertilization
201
Most common presenting symptomnof vaginitis
Vaginal discharge
202
Fishy odor
Bacterial vaginosis
203
Clue cells
Bacterial vaginosis
204
Mgmt for vaginosis
Metronidazole
205
Mgmt fir candiasis
Fluconazole
206
Mgmt for trichomoniasis
Metronidazole
207
Management for enterobiasis
Pyrantel pamoate
208
Microscopy of enterobiasis
D shaped eggs
209
Microscopy for trichomonas
Trichimonads
210
Strawberry cervix
Trichomoniasis
211
Most common cause of PID
Gonorrhea
212
Severe cervical motion tenderness
Chandelier sign
213
Management for tubo ovarian abscess
Clindamycin and gentamycin
214
Gram negative diplococci and numerous WBC
Neisseria gonorrhea
215
definitive diagnosis for PID
Endometrial biopsy, TVS/ MRI,laparoscopic
216
TVS or MRI showing thickened, fluid filled tubes, with or without free pelvic fluid or tubo ovarian complex
Acute PID
217
Management for cervical stenosis
Gentle dilatation
218
Examples of ablative therapy for CIN II-III
Cryotherapy, CO2 laser ablation, Loop electrosurgical excision, Cold knife conization
219
HPV 6,11 causes what
Genital warts
220
Most common cervical CA tumor type
Squamous
221
Most common symptom of cervical CA
Vaginal bleeding
222
Stage of cervical CA confined to cervix
I
223
Stage of cervical CA invading the uteus
II
224
Stage if cervical CA extending to the pelvic wall
III
225
Stage of cervical CA that extends beyond the true pelvics
IV
226
Management for stage IA and IIA
Extrafascial hysterectomy
227
Management for highly advanced cervical CA
Chemoradiatiob
228
Most common cause of death of cervical CA
Uremia
229
Most common Mullerian anomaly
Category V. Septate uterus
230
Most common type of myoma
Intramural
231
Myoma associated with prolonged bleeding
Submucosal
232
Most common symptom of myoma
AUB
233
Most common symptom of endometrial polyp
Metorrhagia
234
Presence and growth of glands and stroma of the lining of the uterusnin aberrant location
Endometriosis
235
Theories in endometriosis
Metastatic theory(retrograde menstruation- most wideley accepted); metaplastic theory
236
Adenomyosis is growth of endometrial glands and stroma where
Uterine myometrium with a depth of at least 2.5
237
Most common site for adenomyosis
Ovaries
238
Chocolate cysts or powder burn lesions in the pelvis
Adenomyosis
239
3 cardinal features of adenonyosis
Gland, stroma, hemorrhage
240
Mid 30s, nulliparous, infertile, secondary dysme,pelvic pain
Adenomyosis
241
Classic symtpom of adenomyosis
Dysmenorrhea and menorrhagis
242
Laparosxopy
Diagnosis of endometriosis is via
243
Most common sx of endrometrial hyperplasia
Bleeding (long periods of oligomenorrhea/amenorrhea followed by irregular excessive uterine bleeding)
244
Most important determinant of pre malginant potential(endometrial hyperplasia)
Cytologic atypia
245
Most common cause of post menopausal bleeding
Endometrial atrophy
246
Most common gynecologic malignancy
Endometrial cancer
247
Most common site of mets in endometrial cancer
Lungs
248
Most common subtype of endometrial CA
Endometrioid
249
basic tx for endometrial CA
Tahbso, node sampling, peritoneal washing
250
Most common cause of simple cystic adnexal mass in reproductive years
Functional cyst
251
Most common cause of complex adnexal mass
Benign cystic teratoma
252
Persistence of dominant follicle
Follicular cyst
253
Arise from prolonged or excessive stimulation by endo/exogenous gonadotrophins
Theca lutein cysts
254
Management for adnexal mass during reproductive years
8cm ex lap
255
Typical size of malignant pelvic masses
>8cm
256
Ovarian CA types
EGS(epithelial, germ cell, stromal)
257
Epithelial ovarian tumors that resemble fallopian tubes
Serous tumors
258
Epithelial ovarian tumor that resembles cells of the GIT
Mucinous
259
Hobnail cells are found in
Clear cell CA
260
Analogous to seminoma of the testes
Dysgerminoma
261
Schiller Duval bodies are found in
Yolk sac tumors
262
Malignant germ cell tumors:
Dysgerminoma, endodermal sinus/yolk sac tumor, choriocarcinoma, immature teratoma
263
Sex cord stromal tumors include
Granulosa theca cell and sertoli leydig cell tumors
264
Failure of mullerian tubercle to canalize
Transverse vaginal septum
265
Failure of the urogenital sins to contribute to lower portion of vagina
Agenesis of lower vagina
266
Liquefaction degeneration at the basal layer; well defined band like infiltrate below the basal layer
Lichen planus
267
Related to exposure to DES in utero
Vaginal adenosis
268
Most common symptom of vulvar intraepithelial neoplasia
Itching
269
Risk factor for VIN
HPV 16 and 18
270
Most common sx of vulvar CA
Itching
271
Most common type of vulvar CA
Squamous
272
Mngmt for stage I to stage III Vulvar Ca
Wide radical vulvar excision and bilateral inguinal femoral node dissedtion
