OBGYN Flashcards by Kaylie Sniff

Theca cells

chol-> androstenedione

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FSH

Granulosa cells

aromatase
testosterone-> estrogen

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Tanner staging: buds, course/curly hair, areola mound

stage 2: buds
stage 3: curly hair
stage 4: areola mound

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estrogens: reproductive, preg, menopause

reproductive yrs: estradiol

preg: estriol
menopause: estrone

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DUB: Tx

bleeding: estrogens, OCP

OCP, Medroxyprogesterone, Lupron

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Dysmenorrhea: causes, Tx

primary: incr prostaglandins
secondary: pelvic pathology

Tx: NSAIDs

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PMDD Tx

gold std: SSRI

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amenorrhea: definitions

primary: no menarche by 13y/o NO secondary sex characteristics, 15y/o with characteristics

secondary: no menses for 3mo- previously normal, 9mo- oligo
- hyp: abnorm GnRH (anorexia, stress), N FSH/LH
- pit: decr FSH/LH, incr prolactin (pituitary adenoma)
- ovary: incr FSH/LH, decr E

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progesterone challenge test

withdrawal bleed: ovary (PCOS)

- no bleed: uterus (Asherman’s), hyp

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adenomyosis

endometrial tissue in myometrium

TENDER, symmetric, enlarged BOGGY uterus

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leiomyoma: population, presentation

uterine fibroids, fibromyoma

Population: AA, >35y/o

Sx: irregular, asymmetric, NONTENDER
BLEEDING

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Tx leiomyoma

observe

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endometritis MCC

infxn endometrium during preg

MCC: GABHS, S. aureus
C-section, post-abortion

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Dx endometritis

fever, abdom pain, uterine tenderness

**C-section, post-abortion

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endometriosis: MC location, Tx

location: ovaries

Tx: Progesterone

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MCC infertility

endometriosis

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endometrial hyperplasia: screening test, definitive test

screening: TVUS
definitive: Bx

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MC GYN CA

endometrial CA

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RF endometrial CA

Tamoxifen, E, nulliparity, anovulation

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when to do endometrial Bx

TVUS: stripe >4mm —- Bx

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most sensitive test for menopause

FSH

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prevention of osteoporosis in menopause

bisphosphonates, SERM (tamoxifen, raloxifene)

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stress incontinence: Tx

sneeze, cough, laugh

Tx surg

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urge incontinence: Tx

overactive detrusor, elderly

Tx meds
1st line: anticholinergics
nonselective: oxybutynin, Detrol (NOT elderly)
selective: Vesicare

bladder training

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overflow incontinence: PVR, Tx

post void residual >200mL if bladder atony: catheter 1st line

MC GYN CA mortality

ovarian CA

RF ovarian CA

FH, infertility, nulliparity, >50y/o, BRCA OCP protective

CA125

ovarian CA - monitor Tx

Sister Mary Joseph's node

ovarian CA | mets to umbilical LN

MC benign ovarian neoplasm

dermoid cyst teratomas

incr LH:FSH ratio 3:1

PCOS

PCOS Tx, complication

combo OCP spironolactone metformin complications: endometrial CA

Pap screening

Q2yrs, age 21 or 3yrs of sex Q3yrs, >=30y/o (if 3neg) DC 65-70y/o yearly if incr RF (HIV, DES)

ASC-US

HPV test neg (repeat Pap/HPV in 6-12mo) pos (colposcopy)

ASC-H

colposcopy

LSIL

30y/o HPV test

HSIL

colposcopy

RF cervical CA

smoking**, HPV**, DES, early sex

Clear Cell carcinoma

DES

cervical CA, vulvar CA: MC type

squamous

HPV vaccine

6, 11, 16, 18

vulvar CA Dx

pruritis, red/white ulcerative crusted lesions

Tx BV, Trich

metronidazole BV x 7days Trich x 1dose

strawberry cervix

trich

Tx Chlamydia, GC

Chlamydia: Azithro OR Doxy GC: Ceftriaxone

Haemophilus ducreyi

chancroid

painful genital ulcer, painful inguinal LAD

Chancroid

Tx chancroid

Azithro OR Ceftriaxone

whitening with 4% acetic acid application

HPV

cauliflower lesions, flesh colored

HPV

genital warts HPV

6, 11

CA HPV

16, 18, 31, 33

complication of PID

Fitz-Hugh Curtis

bartholin cyst- nontender Tx

none

UC >100,000 CFU

definitive Dx cystitis/pyelonephritis

UTI organism in sexually active

Staph saprophyticus

Tx UTI in preg

amoxicillin, macrobid NOT cipro

OCP for acne

combo

absolute CI to OCP

smoker >35y/o, biliary/liver dz, HLD, thromboemb, unDx vag bleed, preg, breast CA, hepatic CA

OCP in lactating

progestin only

Lupron

GnRH pulsatile: agonist cont: antagonist

Tamoxifen ADR

risk endometrial CA

ectopic Dx

TVUS: no gest sac, HCG >2000

McRoberts maneuver

shoulder dystocia Tx

US: cluster of grapes

molar pregnancy

gestational trophoblastic dz

molar preg

molar preg: sx

painless vaginal bleeding HCG markedly incr >100,000 hyperemesis gravidarum

Tx hyperemesis gravidum

doxylamine/pyridoxine (B6)

fetus normal in: non stress test, contraction stress test

non stress test: >=2 accelerations in 20min stress test: no late decelerations

gestational DM screening

24-28wks gestation | 3hr oral GTT (gold std)

Tx gest DM

insulin | early delivery 38wks

RhoGAM given at

28wks

PROM test

nitrazine pH test...

L:S fetal lung immaturity

premature labor

=3cm, >=80% effacement

Tx premature labor

tocolytics: Mg sulfate, terbutaline, ritodrine antenatal corticosteroids (fetal lungs)

threatened, spontaneous abortion

threatened: possible fetal viability (only one) spont: before 20wks

MCC 1st trimester bleeding

threatened abortion

threatened, inevitable, incomplete, complete, missed, septic abortion (POC, cervix)

threatened: NO, closed- bloody DC; Tx rest, serial HCG inevitable: NO, dilating incomplete: some, dilated complete: all, closed missed: NO, closed- NO preg sx septic: some, closed- foul brown DC, F/C

3rd trimester bleeding, rigid uterus, fetal bradycardia

abruptio placenta

Tx placenta previa

tocolytics (Mg sulfate) | delivery when fetus stable (L:S>2, >36wks)

Tx abruptio placenta

immediate delivery

painless vaginal bleeding, fetal bradycardia

vasa previa vessels crossing os (pelvic US) Tx immediate C-section

severe pre-eclapmpsia Dx, Tx

BP>160/110 proteinuria >5g/24hrs HELLP Tx: delivery, BP>180/110: hydralazine

Tx eclampsia

Mg sulfate

triple screen

15-20wks | AFP, HCG, estradiol

GTT in preg

24-28wks

low AFP, high hCG, low estradiol

trisomy 21

high AFP

open neural tube defects

low AFP, hCG, estradiol

trisomy 18

GBS screen

32-37wks

Tx post partum hemorrhage

oxytocin IV, misoprostol

Tx mastitis

warm compress, breastfeed | abx (Keflex, Augmentin- Amox/clav, dicloxacillin)

breast cyst, incr/decr with menses, tender

fibrocystic breast d/o | 30-50y/o

breast cyst, NO change with menses

fibroadenoma | teens-20s

BRCA

breast, ovarian CA

MC breast CA

infiltrative ductal carcinoma | in men too

scaling, itchy nipples- assoc with what and what?

Paget's assoc with: DCIS, infiltrative ductal CA

suspicious mammogram findings

microcalcifications, spiculated mass

peau d'orange

inflammatory breast CA

ER pos meds

SERM: tamoxifen, raloxifene | aromatase inhib: letrozole

HER2 pos meds

herceptin, tykerb, perjeta

CBE screening

Q3yrs 20-39y/o | Q1yr >40y/o

OBGYN Flashcards

(103 cards)