Lectures 2 Flashcards Preview

OB/GYN > Lectures 2 > Flashcards

Flashcards in Lectures 2 Deck (81)
Loading flashcards...

Define spontaneous abortion

Loss of fetus in less than 20 weeks


Most common organisms responsible for PID

Gonorrhea, chlamydia

Then think of ascending infxns: so anerobes, GN/GB, GBS




Danazol = synthetic steroid/androgen previously used in the tx of endometriosis

-largely replaced by GnRH agonists b/c of their masculinizing/virulizing effects


What time of the month are pts most likely to present w/ PID

Beginning of the cycle (like day 1 aka on first day of menstrual period)
-for some reason when the pain is the worst


How does obesity increase risk of endometrial hyperplasia

-obesity: adipose tissue contains aromatase => increased peripheral conversion of androgens to estrogens


Differentiate appearance of pt w/ PID 2/2 gonorrhea vs. chlamydia

Gonorrhea- more ill appearing, usually more tender, higher fever, thicker discharge

Chlamydia- less severe, discharge thinner/more watery


Prevalence of ectopic pregnancy

(a) How does it change if have previous ectopics?

1% overall

(a) 10% if had one previously
25% if had 2+


Differentiate which part of puberty estrogen and testosterone are responsible for in females

Estrogen = thelarche (breast development)
Progesterone = pubarche (pubic hair)


Top 2 things on Ddx for postmenopausal bleeding

60-80% endometrial atrophy
10-15% endometrial cancer => hence all F over 45 w/ AUB get endometrial biopsy


Risk factors for vulvar neoplasms

-HPV, h/o abnormal pap
-lichen sclerosis** (thin white patches of skin)
-immunocompromised or immunsuppressed
-Paget's disease (adenocarcinoma)


Gold standard tx for endometriosis

OCPs, specifically continual OCPs (no progesterone withdrawal bleed part)


Gold standard diagnostic test for endometriosis

Technically gold standard diagnostic tool is laparoscopic exploration w/ tissue biopsy
-but that's pretty invasive so really just diagnosed clinically


Differentiate the two classifications of delayed puberty

1. Hypergonadotropic hypogonadism = elevated FSH
ex: Turners, Mullerian agenesis, imperforate hyman

2. Hypogonadotropic hypogonadism = arcute nucleus not producing GnRH
-constitutional delay


Location of cervical cancer

Squamocolumnar junction- squamous outside and columnar inside
-squamocolumnar junction receds up the endocervical canal w/ age, as it recedes that's where you get the transitional zone where metaplasia occurs


Difference in UA interpretation in pregnant women

Pregnant women can have + leukestrase w/o UTI, but nitrates is ALWAYS abnormal
-ketonuria in pregnancy can be 2/2 dehydration

Low threshold for treating UTI in pregnancy b/c pregnant women have higher incidence of asymptomatic UTI


32 yo F1 p/w positive urine pregnancy test at 9 4/7 and painless vaginal bleeding w/ chills
-T 101.5, HR 95, BP 95/60
-cervix closed on exam
-beta-hCG of 6500
-no fetus in gestation sac on US


Septic abortion
= infectioned POCs

Tx- surgery, need to evacuate the uterus


Most common sit of endometriosis

Bilateral Ovaries
-ovarian endometrioma = chocolate cyst

2nd most common = posterior col de sac


Teen w/ ovarian mass

Buzzword for germ cell tumor


List in order the normal process of puberty in girls

Breast development (thelarche) --> Adrenarche --> Growth spurt --> Menarche

-20% of the time adrenarche comes before thelarche


Difference in risk profile from estrogen/progesterone therapy from only estrogen therapy

E/P has increased risk of 4: VTE, stroke, coronary heart disease, breast cancer

While just estrogen: increased risk of VTE and stroke (not of coronary heart disease or breast cancer)


Tx for gonorrohea

Ceftriaxone IM x1
+ Azithromycin to tx common chlamydia coinfection

-also tx partners


Describe the process of a D&C for termination of pregnancy

Paracervical block w/ or w/o mild IV sedation
-serial dilation of cervix
-then curretage out intrauterine material


Lupron- what is it?

Lupron = GnRH agonist

For hormone-responsive cancers and estrogen-dependent conditions (ex: endometriosis or uterine fibroids)

-can be given pre-op before myomectomy to decrease burden


Inpatient tx for PID

Cefotetan (cephamycin = type of cephalosporin) IV q12
+ Doxy IV q12

Treat until afebrile or clinically improved for 24 hrs, then switch to PO and monitor


Ddx of first trimester vaginal bleeding

spontaneous abortion
ectopic pregnancy
vaginal/cervical lesions or lacerations
extrusion of molar pregnancy


Risk factors for ectopic pregnancy

Fallopian tube scarring/damage
-h/o ectopic
-chlamydial infection

ART (assistive reproductive therapy): IVF


Most common subtype of vulvar neoplasm

90% of vulvar neoplasms are squamous cell carcinomas (can be progression from VIN)

-5% melanoma
-5% other: Bartholin's, Pagets (red and scaly)


Explain the mechanism of hypogonadotropic hypogonadism

Delayed puberty b/c arcuate nucleus doesn't produce GnRH


Describe what it means for a pap smear to show a high-grade squamous intraepithelial lesions

cells on the pap smear suggest an abnormality that will be present from 2/3 to full thickness of the transitional zone


Ddx for acute abdominal pain in 25 yo sexually active female

1. 1. 1. R/o ectopic pregnancy
-Ovarian Cyst
-Kidney stone