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Flashcards in ICR-GYN Issues Deck (29):
1

Normal vaginal discharge

Clear to white

2

Most common cause of vaginitis

Bacterial 50%, trichomonas 25%, yeast 25%

3

Curdy discharge pH < 4.5, hyphae w/itching/burning

Candida

4

Green-yellow discharge w/irritation

Trichomonas

5

Gray-white odorous discharge w/ pH > 4.5

Bacterial vaginitis

6

A woman presents with pain and pressure like she is sitting on something. She has difficulty voiding (has to put her fingers in the vagina), urinary incontinence and sexual difficulties. How do you treat her?

She has symptoms of pelvic relaxation. You can treat with pessary and surgery.

7

What causes urge incontinence?

Detrusor instability

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8

What causes stress incontinence?

Anatomic loss of support from increased abdominal pressure

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9

What causes overflow incontinence?

Obstruction or loss of neurological control results in a constantly full bladder that dribbles

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10

What drugs can be used to treat urge incontinence?

Anticholinergics, muscarinic receptor antagonists and TCAs (paralyze detrusor)

11

What drugs can be used to treat stress incontinence?

Anticholinergics, estrogen therapy, TCAs, pessary and surgery.

12

What drugs can be used to treat overflow incontinence?

Muscarinic agonists, surgery and behavior modification

13

Gynecologic differential for acute pelvic pain

Ruptured adnexal cysts, hemorrhagic adnexal cysts, ectopic pregnancy and infection

14

Non-gynecologic differential for acute pelvic pain

Appendicitis, diverticulitis, ischemic bowel, bowel obstruction, UTI and kidney stones

15

Differential for chronic pelvic pain

GYN: Endometriosis, pelvic congestion syndrome, degenerating fibroids, adenomyosis, dysmenorrhea and adhesions. Non-GYU: UTI, neurologic, psychiatric and abdominal wall conditions.

16

A 20-30 year old woman presents with dysmenorrhea, dyspareunia, infertility and chronic pelvic pain. Her mother had a similar condition. What is your diagnosis?

Endometriosis

17

Dysmenorrhea treatment

NSAIDs

18

Endometriosis treatment

Progestins, GnRH agonists, surgery

19

Adenomyosis treatment

Like endometriosis

20

Test for GC/Chlamydia, treatment for GC/chlamydia PID?

NAAT. Treat for both conditions (ceftriaxone, azithromycin (1x) or doxycycline (7 days)

21

A patient comes in with pelvic pain, fever, mucopurulent discharge, elevated ESR, elevated CRP. She has a history of GC/chlamydia cervicitis. Laparoscopy is shown below What is your diagnosis?

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Note Fitz-Hugh-Curtis adhesions over the liver, typical of PID.

22

Functional components of the normal menstrual cycle

Hypothalamic-pituitary unit, ovaries and endometrium.

23

Most common cause of abnormal uterine bleeding?

Anovulation. Bleeding disorders in young patients, fibroids, atrophy and pregnancy complications are also common.

24

Bleeding through super tampon with a pad longer than 7 days at normal intervals.

Menorrhagia > 80 mL 

25

Irregular menstrual intervals

Metrorrhagia

26

Bleeding at intervals < 21 days

Polymenorrhea

27

Bleeding at intervals > 40 days

Oligomenorrhea

28

Treatment of acute dysfunctional uterine bleeding

High-dose estrogen followed by progestins. 

29

Treatment for chronic dysfunctional uterine bleeding

Progestins, OCPs, ablation and hysterectomy