Gynecology Flashcards Preview

USMLE Step 3 MTB > Gynecology > Flashcards

Flashcards in Gynecology Deck (25)
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1
Q
  • fibroadenoma
  • fibrocystic disease
  • intraductal papilloma
  • fat necrosis
  • mastitis
A

benign breast disease

2
Q
  • ductal carcinoma in situ (DCIS)
  • lobular carcinoma in situ (LCIS)
  • invasive ductal carcinoma
  • invasive lobular carcinoma
  • inflammatory breast cancer
  • Paget’s disease of breast/nipple
A

malignant breast disease (breast cancer)

3
Q

causes of enlarged uterus

A
  1. pregnancy
  2. leiomyoma
  3. adenomyosis
4
Q

ALL postmenopausal bleeding is what until proven otherwise?

A

endometrial carcinoma

5
Q

when do you start screening for cervical cancer?

A

21 yoa regardless of onset of sexual activity

6
Q

frequency of cervical cancer screening if LESS than 30 yoa?

A

every 3 years w/ cytology ONLY

7
Q

frequency of cervical cancer screening if MORE than 30 yoa?

A

every 3 years w/ cytology ONLY, OR every 5 years w/ cytology AND HPV

8
Q

PAP screening is NOT recommended for?

A
  • greater than 65 yoa w/ recent normal PAP smear

- women w/ total hysterectomy for benign disease

9
Q

management of ASCUS on PAP smear if f/u is CERTAIN

A

repeat PAP smear in 3-6 months AND order HPV DNA typing

10
Q

management of ASCUS on PAP smear if f/u is UNCERTAIN

A

colposcopy and biopsies

11
Q

management of ASCUS if REPEAT PAP smear again shows ASCUS or HPV 16 and 18 are found

A

colposcopy and biopsies

12
Q

give quadrivalent HPV recombinant vaccine (Gardasil) to?

A

all females 8-26 yoa

13
Q

INITIAL w/u for pelvic pain

A
  1. pelvic exam
  2. cervical cultures
  3. ESR
  4. WBC (BC if fever is present)
  5. US
14
Q

cervicitis management

A
  • cervical cultures

- single dose azithromycin PO and ceftriaxone IM

15
Q

acute salpingo-oophoritis management

A
  • cervical cultures
  • single dose doxycycline PO and ceftriaxone IM (outpt)
  • cefotetan or cefoxitin IV and doxycycline IV (inpt)
16
Q

chronic pelvic inflammatory disease treatment

  • infertility
  • dyspareunia
  • h/o ectopic pregnancy or abnormal vaginal bleeding
  • NEGATIVE cervical cultures and labs
  • US = B/L cystic pelvic masses (hydrosalpinges)
A

lysis of tubal adhesions

17
Q

tuboovarian abscess treatment

A
  • cefoxitin and doxycycline IV

- exlap +/- TAH and BSO (total abdominal hysterectomy bilateral salpingo oophorectomy), or percutaneous drainage

18
Q

primary dysmenorrhea treatment

  • crampy lower abd pain
  • N/V, and diarrhea during menstruation
  • excessive endometrial PG F2
A
  • NSAIDs

- combination OCP (2nd line)

19
Q

MCC of secondary dysmenorrhea

A

endometriosis

20
Q

endometriosis treatment

A

continuous PO progesterone

21
Q

secondary amenorrhea w/u

A
  1. B-hCG (pregnancy test)
  2. TSH
  3. prolactin
  4. progesterone challenge test
  5. estrogen-progesterone challenge test
22
Q

LH:FSH ratio in PCOS (polycystic ovarian syndrome)

A

3:1

23
Q

treatment for PCOS

A
  • OCP
  • spironolactone
  • clomiphene
  • metformin
24
Q

when is HRT the answer?

A
  • menopausal vasomotor symptoms (hot flashes)
  • genitourinary atrophy
  • dyspareunia
25
Q

when is HRT NOT the answer?

A
  • treatment of osteoporosis
  • h/o breast or endometrial cancer
  • liver disease
  • active thrombosis
  • unexplained vaginal bleeding