Gynecology Flashcards

Question

Post-partum Hemorrhage Presentation Tx

Answer 1

``` 500c-after vaginal birth 1000cc-after c-section non-surgical: uterine massage oxytocin balloon tamponade ```

Answer 2

``` usually benign young female in her teens Asx, Weight gain Dx: Ultrasound=enormous mass Tx: Cystectomy ```

Answer 3

Small, Consistent, unilocular, anechoic, homogenous <3cm=watch and wait <10cm=repeat imaging

Answer 4

Big, Septations, Loculated, Multi-Echoic heterogenous >10cm=remove

Answer 5

``` Pt: Dysmenorrhea, Dyspareunia, Infertility Dx: U/S=cyst (endometrioma) OCP trial=endometriosis Dx Lap with laser ablation Tx: NSAIDs (pelvic Pain) OCPs ```

Answer 6

``` RF-stricture or PID Pt: Amenorrhea/spotting Abdominal pain UPT (+) Dx: UPT(+) B-HCG >2000 Empty uterus on US Tx: Salpingosotmy if no ruputre salpingectomy if ruptured Methotrexate +/- leucovorin ```

Answer 7

B-HCG <5000 Gestational size <3 cm No fetal heart tones not using folate

Answer 8

``` Abdominal or pelvic pain no other cause + 1 of 3 1. CMT 2. ADT 3. UT possible fever and leukocytosis white cells on a wet prep Dx: U/S abscess Tx: Inpatient IV 1. Cefoxitin+Doxy+MTZ 2. Clindamycin+gentamicin ```

Answer 9

Sneeze and pee No urge or nocturnal symptoms Tx: kegel Surgery

Answer 10

``` (+) Urge and nocturnal symptoms Leaking with contractions Dx: Physical is normal U/A normal decreased cystometry Tx: Oxybutynin ```

Answer 11

``` Caused by inflammation, stones, CA, UTI Frequency, urgency, Dysuria (+) urge no nocturnal symptoms Dx: U/A=WBCs Tx: UTI=ABx Stones=Imaging CA=imaging ```

Answer 12

``` Continuous leak normal function Dx: Physical=fistula Tampon Test Tx: Fistulotomy ```

Answer 13

Foreign body sexual abuse precocious puberty

Answer 14

Pregnancy, Anatomy, AUB, Cervical CA

Answer 15

vaginal atrophy endometrial CA HRT

Answer 16

``` DM, Steroids, Abx Thick white discharge adherent to the vaginal wall no odor Wet prep-hyphae Tx= Topical antifungal oral fluconazole ```

Answer 17

Copious thin white discharge Fishy odor wet prep-clue cells Tx: MTZ

Answer 18

``` Yellow-green discharge Frothy Strawberry Cervix Wet-prep: Flagella, motile Tx: MTZ, treat both partners ```

Answer 19

``` Inflammation of the cervix usually caused by NG/CT (+) CMT, discharge, no PID NG/CT PCR gonorrhea- GNR diplococci Chla-NOS many WBCs Tx=NG=Ceftriaxone CT=Doxyxycline/azithromycin ```

Answer 20

1. Pelvic/abdominal pain 2.no other cause 1 of 3: 1.CMT 2. ADT 3. UT Dx: Transvaginal ultrasound Tx: inpatient- cefoxitin+Doxy Clindamycin+Gentamycin Outpatient- Ceftriaxone+doxy+MTZ

Answer 21

No passage of contents closed cervical os live baby on U/S

Answer 22

No passage of contents Open cervical os Dead baby on U/S

Answer 23

Passage of clots or fetal parts Open cervical os Retained fetal parts on U/S

Answer 24

passage of contents Closed cervical os Nothing on U/S

Answer 25

Polyps Adenomyosis Leiomyomas Malignancy ``` Caogulopathy Ovarian Dysfunction Endometrium Iatrogenic=IUD Not yet Classified ```

Answer 26

``` benign growths that are responsive to estrogen Pt: Asx nodularity Anemia/bleeding Pain, infertility Dx: Transvaginal ultrasound Tx: OCPs=IUD if kids=myomectomy no kids=TAH ```

Answer 27

``` Pt: Fat and hairy Metabolic Syndromes (HTN,DM,HLD) Menometorrhagia Infertility Dx: 1. Anovulation AND 2.Biochemical (DHEAS, increased Testosterone) OR 3. Follicles on U/S Tx: Metformin OCPs Clomiphene Spironolactone ```

Answer 28

Tits (breasts) 8 Pits (axillary) 9 Mits (growth spurt) 10 Lips (menarche) 11

Answer 29

No menarche by 15 | No secondary sex characteristics by 13

Answer 30

``` either a problem with hypothalamus or the anterior pituitary - no FSH/LH Pt: no secondary sex characteristics there are uterus and tubes Dx: decreased FSH/LH MRI differentiates the two diseases Tx: give estrogen and progesterone possible resection if there is a tumor ```

Answer 31

``` (x,x) karyotype Pt: Secondary sexual characteristics with female genitalia no uterus or tubes Dx: Karyotype Normal testosterone, FSH, LH Tx: Elevate the vagina ```

Answer 32

``` (x,y) resistance to testosterone Pt: secondary sexual characteristics external sexual characteristics no uterus or tubes Dx: Karyotype Increased testosterone, normal FSH, LH Tx: elevate vagina after puberty-orchiectomy ```

Answer 33

Webbed neck, Broad spaced nipples, Shield like chest, Coarctation, Bicuspid Aortic Valve secondary sexual characteristics uterus and female genitalia present Dx: Karyotype (x,o) increased FSH and LH U/S-Streak ovaries Tx: Estrogen and progesterone F/U echocardiogram

Answer 34

``` Pregnancy MC Hypothyroidism 2nd MC Prolactin Medications HPO Axis ```

Answer 35

Progesterone Challenge Estrogen & Progesterone FSH & LH MRI

Answer 36

Bleeding indicated PCOS

Answer 37

Check FSH & LH Check FSH/LH ratio increased-ovarian problem normal/decreased-brain do MRI

Answer 38

(-) Fern sign (-) Sperm < 6cm smush test

Answer 39

(+) fern, sperm | > 6cm Smush

Answer 40

``` Hirsuitism Increased testosterone Normal DHEAS Bilateral Ovaries LH/FSH= >3:1 follicles on US Tx: Exercise and weight loss metformin OCPs Clomiphene ```

Answer 41

``` Virilization Very High levels testosterone DHEAS-Normal Unilateral Ovary US shows tumor Tx: Resection ```

Answer 42

``` Virilization Testosterone Normal DHEAS very increased Unilateral Adrenal CT/MRI Adrenal Vein Sampling Tx: Resection Make sure to do the adrenal vein sampling before surgery ```

Answer 43

``` Hirsuitism Testosterone Normal DHEAS elevated Bilateral Adrenals CT/MRI 17-OH progesterone in the urine Tx: Cortisol fludrocortisone ```

Answer 44

``` All get DEXA @ 65 60 if a smoker Bisphosphonates Give vitD and calcium if VitD deficient-50ku promote exercise ```

Gynecology Flashcards

(68 cards)