Flashcards in OB/GYN Deck (102)
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1
3 indications for getting a QUANTitative BhCG
dx and follow ectopic pregnancy
monitor trophoblastic disease
screen for fetal aneuploidy
2
Avg age of thelarche, adrenarche/pubarche and menarche
thelarche = 8-9
adrenarche/pubarche = 9-10
menarche = 12-13
3
Ages for primary amenorrhea
14 w/o secondary sex characteristics
16 if secondary sex characteristics
4
2 Cell hypothesis
LH -> Thecal cells -> androgen precursors
FSH -> Granulosa cells -> convert androgens into estradiol (therefore requires BOTH fxnal cells)
5
Trigger for ovulation
E2 rises --> LH surge mid-cycle --> ovulation
6
Corpus luteum prodoces...
progesterone
7
role of progesterone
endometrial proliferation
8
3 clinical signs of heavy periods
changes tampon q1hr, mutliple nighttime changes, anemia
9
6 predisposing factors for vaginal candidiasis
Abx, steroids, immunodef, DM, OCPs, pregnancy
10
vaginal pH in candidiasis
normal (3.8-4.2)
11
Tx vaginal candidiasis? Recurrent?
Tx = topical antifungals (monistat) or oral (fluconazole)
recurrent Tx = antifungal monthly after menses OR oral med daily/weekly
12
highly infectious vaginal infxn
trichomoniasis
13
the pt c/o genial pruritus, frequency, dysuria, and dyspareunia. On PE you note erythema, yellow-green frothy discharge, and punctate cervical hemorrhages ("strawberry cervix"). What is the dx?
trichomoniasis
14
4 Dx test trichomonas
vaginal pH >4.5, pap, saline prep (motile flagellated organisms), cx
15
Tx trichomonas
DOC = metronidazole, 1x 2g dose, also tx partner
16
Positive amine test
bacterial vaginosis
17
Clue cells
bacterial vaginosis
18
6 complications of bacterial vaginosis
PID, endometritis, post-op infxn, PPROM, chorioamnionitis, preterm delivery
19
Tx bacterial vaginosis
oral metronidazole
20
palpable mass on labia majora, painful and swollen but not fever, no drainage. Dx? Tx?
bartholin's gland cyst
Tx = drain and catheter, sitz bath and marsupialization (definitive)
21
palpable, fluctuant mass on labia majora. painful, swollen, erythematous with drainage. Dx, Tx?
bartholin's gland abscess
Tx drainage, abx, catheter, sitz bath and marsupialization (definitive)
22
4 causes of bartholin's gland abscess
gonorrhea, chlamydia >>coliforms, anaerobes
23
palpable, firm, indurated mass on labia majora. No pain but is swollen. Dx, Tx?
bartholin's gland tumor, dx = bx
Tx = excision
24
Abx for bartholin's gland abscess (4)
doxy + metro
augmentin
azithromycin (chlamydia)
ceftriaxone (gonorrhea)
25
MC type of cervical cancer
SCCA
26
5 RF for cervical cancer
early 1st intercourse, multiple partners, High-risk HPV infxn, recurrent STDs, smoking
27
when can you switch from q2yr to q3yr pap smears?
30yo+ and 3 consecutive negative paps
28
2 indications for d/c pap smears
hysterectomy for a benign condition and no h/o high-grade cytologic abnormalities
OR
>65yo + 3 consec. neg. paps and normal for the past 10 yrs
29
management of ASC-US: low risk HPV
rescreen at 1yr
30