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MS3 - OB/GYN > Gynecology > Flashcards

Gynecology Flashcards

1
Q

What are the top 3 causes of vulvovaginitis symptoms?

A
  • Bacterial vaginosis (21-29%)
  • Vulvovaginal candidiasis (7-39%)
  • Trichomonas (4-35%)
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2
Q

“Thick white discharge with itching” is the classic presentation for which vulvovaginitis condition?

A

Yeast infection

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3
Q

“Thin white discharge with fishy odor” is the classic presentation for which vulvovaginitis condition?

A

Bacterial vaginosis

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4
Q

“Yellow frothy discharge with increased odor” is the classic presentation for which vulvovaginitis condition?

A

Trichomonas

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5
Q

What is the normal vaginal pH range in a reproductive-aged female?

A

3.8-4.5

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6
Q

What vulvovaginal infection is associated with a pH < 4.5?

A

Yeast

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7
Q

What vulvovaginal infection is associated with a pH > 4.5?

A

BV or Trichomonas

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8
Q

How can lichen sclerosis and lichen planus be distinguished from one another?

A

Lichen sclerosis only involves the vulva whereas lichen planus involves both the vulva and vagina

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9
Q

What are the CDC recommendations for C/G screening?

A
  • < 25 yo: annual screening

- > 25 yo: screen if new/multiple sexual partners or partners with known STD risk

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10
Q

What are the STI screening recommendations for pregnant women?

A

1st Trimester

  • Syphilis
  • C/G
  • HIV
  • Hep B
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11
Q

What are HIV screening recommendations for individuals age 13-64?

A

Screen at least once and repeat annually if high risk

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12
Q

What are STI screening recommendations for men who have sex with men?

A

Annual G/C screen

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13
Q

What are STI screening recommendations for those with a history of injection drug use or unsafe sex?

A

HIV screen annually

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14
Q

What is the most common infectious disease in the United States?

A

Chlamydia

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15
Q

What is the treatment for Chlamydia?

A

Azithromycin + Doxycyclin

+ Ceftriaxone for gonorrhea coverage

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16
Q

What is the treatment for Gonorrhea?

A

Ceftriaxone (+ Azithromycin and Doxycyclin for chlamydia coverage)

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17
Q

HSV-1 usually causes what type of herpes?

A

Oral

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18
Q

HSV-2 usually causes what type of herpes?

A

Genital

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19
Q

What is a common treatment for UTI?

A

Trimethoprim-Sulfamethoxazole

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20
Q

What is the 1st-line therapy for prolapse?

A

Pessary

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21
Q

How is endometriosis defined?

A

The presence of endometrial glands and stroma in any site outside of the uterus

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22
Q

What are the two classic symptoms of endometriosis?

A
  • Dysmenorrhea

- Dyspareunia

23
Q

What is the first-line therapy for the treatment of endomentriosis

A

Oral contraception (OCPs)

24
Q

What is the definition of chronic pelvic pain?

A

Non-cyclic pain that last more than 6 months and localizes to the anatomic pelvis, the anterior abdominal wall at or below the level of the umbilicus AND is of sufficient severity to causes functional disability OR require medical care

25
Q

What are some common gynecologic causes of chronic pelvic pain?

A
  • PID
  • Endometriosis
  • Leiomyomas
26
Q

What are two notable non-gynecologic causes of chronic pelvic pain?

A
  • IBS

- Interstitial cystitis

27
Q

What are the top risk factors for breast cancer?

A
  • Age
  • Personal hx of breast cancer
  • Inherited BRCA 1/2
28
Q

A straining Q-tip angle > 30 degrees from the horizon can be indicative of what?

A

Urethral hyper-mobility

29
Q

What symptoms are classically present in a woman with ovarian torsion?

A
  • Pelvic pain
  • Adnexal mass
  • Nausea/vomiting
30
Q

What is the treatment for ovarian torsion?

A

Surgery immediately!

31
Q

What does LEEP stand for?

A

Loop Electrosurgical Excision Procedure

32
Q

What are some of the complications of LEEP?

A
  • Increased bleeding
  • Cervical stenosis
  • Infection
  • Persistent disease
33
Q

What is the first sign of sexual development progression in a female?

A

Thelarche (Breast buds)

34
Q

What is the minimum body weight range for menarche to begin?

A

85-106 pounds

35
Q

What is the best initial treatment for polycystic ovary syndrome (PCOS)?

A
  • Weight loss

- OCPs (to regulate periods, control androgen levels, and prevent endometrial hyperplasia)

36
Q

What is the best treatment for polycystic ovary syndrome (PCOS) if a women wishes to conceive?

A
  • Clomiphene citrate

- Metformin

37
Q

Why does postpartum telogen effluvium (hair loss) occur?

A

During pregnancy estrogen levels are very high which causes synchrony of hair growth. Therefore, when the estrogen levels decrease after delivery (1-5 months), the hair loss occurs all at the same time rather than in phases under normal estrogen levels.

38
Q

What is the mechanism by which OCPs reduce pain during menstruation?

A

Progesterone in OCPs causes endometrial atrophy. Since prostaglandins are released by the endometrium, less endometrium equals less prostaglandins = less pain

39
Q

A fixed, nodular uterus might describe which condition?

A

Endometriosis

40
Q

What is the first step in working up any female patient over the age of 45 with abnormal uterine bleeding (AUB)?

A

Endometrial biopsy (to rule out endometrial carcinoma)

41
Q

What is the pathogenesis of adenomyosis?

A

Invasion of endometrial glands into the myometrium

42
Q

Which FRAX scores indicate treatment in the setting of osteopenia/osteoporosis?

A
  • 10-year risk of osteoporotic fracture > 20%

- 10-year risk of hip fracture > 3%

43
Q

Why is an anti-mullerian hormone assay helpful in the workup of infertility?

A

In women of older age and AMA, it helps determine the ovarian reserve

44
Q

What are two important timing criteria needed for the diagnosis of PMS or PMDD?

A
  • A symptom-free week during the follicular phase

- Symptoms must be present in the luteal phase

45
Q

Supplementation with which mineral/element has been shown to reduce the physical and emotional symptoms of PMS?

A

Calcium 1,200mg (remember, eating ice cream while on your period makes you feel better!)

46
Q

Which race has a higher incidence of molar pregnancy?

A

Asian

47
Q

Which age distribution is more likely to have a molar pregnancy?

A

Women > 40 or < 20 years old

48
Q

Which type of molar pregnancy has a propensity to develop into a post-molar GTD?

A

Complete mole

49
Q

Should you biopsy a lesion suspicious for choriocarcinoma/metastatic choriocarcinoma?

A

NO!! NEVER!

50
Q

Why should you never biopsy a lesion suspicious for choriocarcinoma/metastatic choriocarcinoma?

A

Because choriocarcinoma is a highly vascular malignancy, so biopsy can cause a rupture. A positive beta-HCG is all you need!

51
Q

Which type of leiyomyoma is most likely to lead to issues with fertility?

A

Submucosal

52
Q

Dermoid cyst of the ovary is a synonym for what?

A

Mature cystic teratoma

53
Q

Mature cystic teratoma can lead to what complication of the ovary?

A

Ovarian torsion

54
Q

What are the most common ovarian neoplasm in women < 30 years old?

A

Germ cell tumor (think germ cell as in “young”)

MS3 - OB/GYN (4 decks)

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