Lecture 5 Flashcards Preview

ObGyn Lecture > Lecture 5 > Flashcards

Flashcards in Lecture 5 Deck (68):
1

To be diagnosed with PMS, need 1 symptoms in 5 days pre-menses for how many cycles?

3 cycles

2

When are PMDD symptoms absent?

Week post menses

3

What are 4 main somatic symptoms of PMS?

Bloating, mastodynia, HA, swelling

4

What are three affective symptoms of PMS?

Irritable, angry outbursts, moodiness

5

When are symptoms relieved with PMS?

Within 4 days of menses

6

What are some core symptoms of PMDD?

Marked depression, marked anxiety, sudden tearfulness/ sadness, increased interpersonal conflicts or persistent & marked anger or irritability

7

What is the gold standard for treatment of PMDD?

SSRIs

8

What are some common meds for PMS?

NSAIDs, spironolactone (diuretic), ovulation suppression (OCPs, danazol (blocks all hormones- become male like) GnRH agoinst)

9

What are 3 common SSRIs prescribed for PMDD?

Fluoxetine (Prozac), Sertraline (Zoloft), Paraxetine (Paxil)

10

What are some ADRs associated with SSRIs for treatment of PMDD?

GI upset, insomnia, sexual dysfunction, wt gain, increased nervousness

11

What is transition time to non-reproductive years prior to menopause?

Peri-menopause

12

What is the pernmanet cessation of menses. 12 consecutive months w/o menses. Change in follicular phase, luteal phase constant.

Menopause

13

Under what age is premature ovarian failure considered?

Under 40 years old

14

What is the primary hormone in menopause?

Estrone (E1)

15

What hormone becomes higher with menopause?

FSH

16

What does estrone produce?

androstenedione & testosterone

17

What do bisphosphonates do? (ex- alendronate, risedronate)

Inhibit osteoclastic activity

18

What do SERMS (selective estrogen receptor modulator, raloxifene) do?

nhibit bone resorption & turnover.

19

What is a a precaution with bisphosphonates?

Sit up and don't eat for at least 30 minutes after

20

What can St. John's wort work to help?

Vasomotor symptoms, depression

21

What 2 other supplements can help with vasomotor symptoms of menopause?

Soy/isoflavones
Black cohosh

22

If an individual has a uterus, what do they need to be on for hormonal replacement?

Progesterone and estrogen

23

What are some contraindications for estrogen therapy?

CVA, thromboembolic disease, undiagnosed genital bleeding, biliary tract disorder, known estrogen dependent tumor

24

Where are the majority of breast cancers found?

In outer, upper quadrants

25

Higher risk of cancer with Menarche <___ years

12 years old

26

Menopause > ___ increases risk of breast cancer?

55 years old

27

No IUP or IUP > ____ year old increases risk of breast cancer.

30 y/o

28

Why do you preferable do the CBE during the follicular phase?

Estrogen dominant cycle, can then compare with mass in other phase

29

Which nodes do you check on a CBE?

axillary, epitrochlear, supraclavicular

30

What are the two types of mammography and what is the difference?

Screening vs. diagnostic
Screening if for an individual with no mass

31

How many views on done on screening mammogram?

4 views (2 on each)

32

What are 2 other things they can do with diagnostic mammography?

Compress more, and magnify

33

What are the three types of mastalgia?

Cyclic, non-cyclic & extra-mammary

34

What are some Rx for mastalgia?

Appropriate bra
weight loss, less caffeine
Vit E
Meds

35

What are some Meds for mastalgia?

OCPS
Depo-provera (progesterone only)
Bronmocriptine & lisuride
Danazol
SERMS (off-label tamoxifen, raloxifen)

36

What does nonspontaneous, nonbloody & B/L breast discharge indicate?

Ductal ectasia (fibrocystic changes)

37

What does purulent nipple discharge indicate?

Abscess

38

What meds can cause milky discharge?

Tricyclics, OCPs

39

What does bloody, unilateral nipple discharge indicate?

Intraductal CA, invasive ductal CA, papilloma (benign)

40

What are some symptoms of a prolactinoma?

HA, diplopia, vision change,

41

What are two causes of hyperprolactinemia?

Tumor in pituitary or tumor secreting prolactin.

42

If prolactin is elevated what do you do?

MRI sella turcica along with visual fields

43

What is dense epithelial & fibroblastic tissue: encapsulated, solid, round, mobile & rubbery often found in adolescents and young women?

Fibroadenoma

44

What is inc’d fibrosis w/in lobule along w/compression & distortion epithelium?

sclerosing adenosis

45

What is a benign disease that is proliferative w/out atypia. >2 2 cell ayers above basement membrane.

Epithelial hyperplasia

46

What is neoadjuvant chemo ?

Chemo used to shrink mass before it is removed

47

After initial treatment how often are women seen by gyn?

First 2 years- 3-6 months
3rd year and beyond see annually

48

What stage of breast cancer do you: mastectomy or BCT w/ or w/out irradiation

Stage 0

49

What stage of breast cancer do you: surgery local control, chemo +/or hormonal

Stage IV

50

What stage of breast cancer do you: modified radical or or BCT w/irradiation, axillary node, + chemo, + tamoxifen, + neoadjuvant chemo (try to shrink mass with chemo before you go to remove mass), radiation supraclavicular LN + chest wall & breast (inflammatory type)

Stage III

51

What stage of breast cancer do you: mastectomy or BCT w/or w/out irradiation, sentinel node/axillary node, + chemo.

Stage I

52

What stage of breast cancer do you: modified radical or or BCT w/irradiation, axillary node, + chemo, + tamoxifen, radiation supraclavicular LN (+ 4 LN) + chest wall?

Stage II

53

What is the only med approved by the FDA to treat mastalgia?

Damazol

54

What are the two types of carcinoma in situ?

Lobular carcinoma in situ (LCIS)
Ductal carinoma in situi (DCIS)

55

What is the single largest risk factor for development cancer?

Age- Over 50

56

If ER positive or negative breast cancer easier to treat?

ER positive- can attack estrogen receptors

57

Is Her2/neu positive good or bad?

Bad

58

What is normal cyclic symptoms associated with ovulation which do not interfere w/ the patient's daily routine?

Molimina

59

What are the most common somatic symptoms that occur with PMS?

Abdominal bloating and fatigue

60

What is the term for breast pain and swelling?

Mastodynia

61

What is the most common behavioral symptoms of PMS?

Emotional lability

62

What is the current theory for what causes of the basis of PMDD?

Serotoninergic dysregulation

63

What 2 supplements have shown to decrease symptoms of PMS and PMDD?

carbonate and magnesium

64

What are the 4 FDA approved drugs for PMDD?

Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and drospirenone/ ethinyl estradiol

65

What is the time period during which the changes of menopause occur

climacteric

66

The plasma concentration of _______ begin to increase several years in advance of actual menopause.

FSH

67

What is usually the first physical manifestation of decreased ovarian function

Hot flush

68

What is the only FDA approved med for treating mastalgia?

Danazol