MTB 2 CK - Gynecology Flashcards Preview

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Flashcards in MTB 2 CK - Gynecology Deck (67):
1

Diagnostic criteria for PMDD

Symptoms present for 2 cycles
Symptom-free 1 wk period in first part of cycle
Symptoms present in second half of cycle
Dysfx in life

2

How to tx PMS, PMDD

Less caffeine
Less alcohol
Less cigs
Less choc
More exercise
SSRIs if severe

3

PE findings for menopause

Atrophic vaginitis
Decreased breast size
Vaginal and cervical atrophy

4

How to dx menopause

Increased FSH

5

Contraindications to HRT

Breast or endometrial carcinoma
Hx of PE or DVT

6

Postcoital bleeding indicates

Cervical cancer
Cervical polyps
Atrophic vaginitis

7

Oligomenorrhea indicates

Pregnancy
Menopause
Anorexia
Tumor secreting estrogen

8

Menometrorhagia is

Irregular bleeding

9

Menometrorhagia indicates

Endometrial polyps
Endometrial cancer
Exog estrogen
Malignant tumors

10

Metrorrhagia is

Intermenstrual bldg

11

Metrorrhagia indicates

Endometrial polyps
Endometrial/cervical cancer
Exog estrogen

12

Hypomenorrhea indicates

Obstruction
OCPs

13

Menorrhagia indicates

Endometrial hyperplasia
Fibroids
Dysfx uterine bldg
IUD

14

How to eval AUB

CBC
Pt/PTT
Pelvic US

15

What is dysfx uterine bldg

Unexplained abnl bldg usually due to anovulation

16

Workup in dysfx uterine bldg

Hypothyroid
HyperPRL
Endometrial bx

17

Tx AUB

OCPs
D&C if hemorrhaging
Ablation or hysteretomy

18

How does vaginal diaphragm work

Contraceptive jelly on it

19

How to use vaginal diaphragm

Put it in 6 hours before sex, leave in for 6 hours afterward

20

Benefits of OCPs

Reduce risk of ovarian carcinoma, endometrial carcinoma, and ectopic pregnancy

21

How does vaginal ring work

Est and prog constantly released while it's left in for 3 weeks

22

How does transdermal patch work

Est and prog patch placed on skin for 7 d

23

How often do you have to get depo

q3mo

24

What is the mechanism of labial fusion

Excess androgens (exogenous or endogenous)

25

Most common cause of labial fusion

21 B hydroxylase deficiency

26

What does lichen sclerosis look like

Thin white skin

27

How to tx lichen sclerosis

Topical steroids

28

What does squamous cell hyperplasia look like

Raised white lesion from itching

29

How to tx squamous cell hyperplasia

Sitz baths or lubricants

30

S/sx of Bartholin cysts

Pain
Tenderness
Dyspareunia

31

Tx Bartholin cysts

I&D with culture
Marsupialization

32

Pres Trich

Profuse frothy green DX
Itching
Abnl odor
Pain

33

How to dx Trich

Wet mount for motile flagellates

34

Risk factors for Trich

Anything that raises pH
ABx use
DM
Overgrowth of nl flora

35

Tx Trich

Flagyl for both partners

36

BV bug

Gardnerella

37

Symps BV

Gray white vaginal DC with fishy odor

38

Dx BV

Wet mount with clue cells

39

Tx BV

Flagyl or clinda

40

Pres candidiasis

White cheesy vaginal DC

41

Dx candidiasis

KOH with pseudohyphae

42

Tx candidiasis

Miconazole
Clotrimazole
Econazole
Nystatin

43

What is Paget disease

Intrathelial neoplasia in postmenopausal white women

44

Pres of Paget disease

Vulvar soreness and pruritis with red lesions with superficial white coating

45

How to dx Paget

Bx

46

Tx Paget

Radical vulvectomy

47

Most common type of vulvar cancer

SqCC

48

Pres of SqCC

Pruritis
Bloody vaginal DC
Lesion (small ulcerated to large cauliflower)

49

How to dx SqCC

Bx

50

Staging SqCC

While pt is in surgery
0 = in situ
I = 2 cm in vulva/perineum
III = lower urethra or anus, u/l LAN
IV = invasion to bladder, rectum, b/l LAN
IVa = distant mets

51

Tx SqCC

Radical vulvectomy
LANectomy

52

What is adenomyosis

Invasion of endometrial glands into myometrium

53

When does adenomyosis occur

35-50

54

Risk factors for adenomyosis

Endometriosis
Uterine fibroids

55

Pres of adenomyosis

Dysmenorrhea
Menorrhagia

56

How to dx adenomyosis

Clinical!
Large globular boggy uterus

57

Most accurate test for adenomyosis

MRI

58

How to tx adenomyosis

Hyst

59

Most common sites for endometriosis

Ovary
Pelvic peritoneum

60

Pres endo

Cyclic pelvic pain that starts 1-2 weeks before menses and peaks 1-2 days before
Abnl bldg
Nodular uterus
Adnexal mass
Dysmenorrhea
Dyspareunia

61

How to dx endo

Laparoscopy for rusty or dark brown lesions

62

Tx endo

NSAIDs
OCPs
Danazole, leupron (decrease FSH, LH)

63

Danazol sfx

Acne
Oily skin
Wt gain
Hirsuitism

64

Leupron sfx

Hot flashes
Decreased bone density

65

Pres PCOS

Amenorrhea
Irregular menses
Hirsuitism
Obesity
Acne
DM2

66

Dx PCOS

Pelvic US for b/l enlarged ovaries with cysts
High free T
LH:FSH > 3:1

67

Tx PCOS

Wt loss
OCPs
Clomiphene and metformin if desire conception