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OME Flashcards

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1
Q

PRL excess can cause what?

Which leads to what?

A

GnRH deficiency

Amenorrhea post-partum

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2
Q

What drugs are the tx for Stage 4 endometrial cancer w/distant metastasis?

A

Paclitaxel
Doxorubicin
Cisplatin

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3
Q

Pt that is over 30 years old should get paps when? What else?

What age do you stop screening for cervical cancer? What other conditions must be met?

A

Pap and HPV q5 years ages 30-65

65, previous screens were (-), no HPV

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4
Q

What clinical signs would show a ruptured ectopic pregnancy?

Treatment?

A

ABD pain and free fluid in the peritoneum

EX-LAP w/Salpingectomy

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5
Q

What is a + Wrist X-ray?

A

Bone age is greater than 2 years of her chronological age

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6
Q

No passage of contents, closed cervical os, live baby, bleeding present is what?

A

Threatened abortion

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7
Q

A Simple cyst found on imaging measuring 3-10 cm, what is the management?

A

Reimage w/in 12 weeks

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8
Q

What are the sx of hyperemesis gravidarum?

Diagnose how?

A

Severe N/V and dehydration, electrolyte abnormalities

B-HCG levels > 100,000

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9
Q

What is the workup in evaluating precocious puberty?

A

Wrist X-ray
GnRH stim test
If LH elevated, do MRI brain
If not, US of ABD

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10
Q

What’s the 1st step in the workup of secondary amenorrhea? (Exclude UPT, TSH, PRL, Meds)

2nd?

3rd?

4th and 5th?

A

Progestin challenge

Give estrogen and progesterone

FSH and LH ratio

US and MRI

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11
Q

No passage of contents, open cervical os, dead baby is what?

A

Inevitable abortion

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12
Q

How do you diagnose a cystocele?

A

Cervical exam w/Q-tip sign

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13
Q

What is the path behind Kallman syndrome?

A

No hypothalamus so FSH and LH are low

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14
Q

Application of acetic acid on the vulva turns the area what when what is present?

Pathognomonic for what?

Tx?

A

Condylomata acuminatum

HPV

Imiquimod, podophyllin, trichloracetic acid or EXCISE if large

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15
Q

What is a marker of primordial follicles?

What will happen to it over a woman’s life?

A

AMH

Decrease

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16
Q

OAB is what?

What medication is used?

A

Motor urge (hypertonic)

Flomax

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17
Q

Complete mole is caused by what?

Fetal parts present?

A

Bad egg w/no nucleus
Dispermy (all dad’s chromosomes) 46XX

NO

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18
Q

LDH is a tumor marker for what?

A

Dysgerinoma

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19
Q

What diseases present w/NO breast development but there IS a present uterus?

A

Craniopharyngioma
Kallman’s
Turner’s

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20
Q

Passage of contents, closed OS, No baby is what?

A

Complete abortion

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21
Q

What is the treatment for endometrial cancer w/no distant metastasis?

Stage 2?

A

TAH + BSO

“ “ + radiation

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22
Q

What is the treatment for ectopic w/OUT rupture?

With?

A

Salpingostomy

Salpingectomy

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23
Q

What are the germ cell tumors?

A

Dysgerminoma
Endodermal sinus
Choriocarcinoma
Teratoma

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24
Q

PCOS is Dx w/2 of what 3 Rotterdam criteria?

A

Oligo and/or Anovulation
Inc DHEAS, Test or LH:FSH > 3:1
poly cystic ovaries via UA

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25
BRCA+ women have increased risk of what? When should they be screen? What is recommended?
Ovarian, breast, endometrial Q6 mo ovarian w/TV US and CA-125 Prophlyactic TAH+BSO age 35, b/l mastectomy at ANY age
26
PCOS pts are at increased risk of developing what?
Endometrial cancer due to anovulation (no progesterone)
27
What defines hostile mucus? Treatment?
Less than 6cm on smush test Estrogen
28
If a Pap smear shows ASCUS, what is the management?
Repeat pap q3mo OR HPV DNA
29
When should a girl have menarche by? Secondary sex characteristics?
15 13
30
When is MAC used in choriocarcinoma? What does it stand for?
Refractory disease, Brain metastasis (look for abnormal MRI) Methotrexate, Actinomycin D, Cyclophosphamide
31
What is the most basic form of advanced fertilization? Middle? Most?
IUI - hyper[ ] sperm inside mom IVF - make zygote w/natural coming together, then implant in mom ISCI - force the sperm into the egg after inducing ovulation, then put it back inside
32
What is the tx for candida infection?
TOPICAL fluconazole If it fails go oral
33
Endodermal sinus tumor has what tumor cell marker?
AFP Also called yolk sac tumor
34
Passage of contents, open OS, retained parts is what?
Incomplete abortion
35
What are the epithelial cell tumors?
Serous cystadenocarcinoma Mucinous Cystadenocarcinoma Endometroid Cystadenocarcinoma Brennan Tumor
36
What are the MC causes of fistulas? Dx how? Tx?
Crohn’s or radiation Tampon test Surgery - LIFT procedure (fistulotomy)
37
Which cancers have the highest mortality in women? Incidence?
Ovarian > Endometrial > Cervical Endometrial > Cervical > Ovarian
38
When should serum progesterone levels rise (daY)? What medicine can be used to stim ovulation?
Day 22 Clomiphene or pergonal
39
GnRH stimulation test that results in increased LH means what? If negative then do what?
Central lesion US of the ABD
40
What are steps in order to manage PPH?
``` Uterine massage Oxytocin, methergine Balloon tamponade Ligation of uterine, internal iliac a. TAH ```
41
Endometriosis treatment 1st step? Next? Then what?
NSAID OCPs Leuprolide
42
What is the Path behind Craniopharyngioma?
No ant. Pituitary so LH and FSH are very low
43
Treatment for mild CAH? Adrenal failure?
Prednisone (turns off ACTH) Prednisone AND Fludrocortisone
44
The suspensory ligament of the ovary contains what structures?
Ovarian vein and artery
45
What are the inpatient regimens to treat PID?
Cefoxitin + Doxy OR Clinda + Genta
46
How do you remove teratomas? What can they cause? How? also called what?
Ovarian cystectomy Ovarian torsion bc they big Rokitansky nodule
47
What causes Savage syndrome? What is the other name? Treat how?
Menopause caused by an FSH-R insensitivity (FSH and LH will be elevated) Resistant ovary syndrome HRT for pregnancy, but nothing really
48
AIS: is there: Breasts? Uterus? Diagnose how? Genotype?
Yes breast No uterus INC testosterone XY
49
What is the methergine? MOA? When is it contraindicated?
Smooth m. Constrictor that acts primarily on the uterus 5-HT2A receptors pt w/HTN and Pre-E
50
No passage of contents, closed OS, dead baby is what? What must be done?
Missed abortion Induce delivery
51
What is the MC type of fibroid?
Submucosal
52
what makes testosterone in a female? DHEA?
Ovaries Adrenals
53
Pt w/delayed puberty, + Bone age but normal FSH and LH ratio is what?
Hypogonadotropic hypogonadism
54
What are the stromal tumors?
Sertoli-Leydig | Granulosa-Theca
55
What is the progression of the endometrium to cancer?
Atypia —> Complex atypia —> Dysplasia —> adenocarcinoma
56
Cervical cancer that has spread to the sidewall is what stage? Lower 1/3 of the vagina?
IIIb IIIa
57
When can women receive the HPV vaccine?
9-26
58
In terms of hormones, what does anovulation mean?
There was no switch to progesterone at 14 days
59
Free fluid in the abdomen w/good blood flow indicates what?
Ovarian cyst rupture
60
What are the stages of puberty and their corresponding ages?
8 - breasts 9 - arm PIT hair 10 - growth spurt 11 - menarche
61
When do you perform colonoscopy? Pap smear?
Age 50 q10 yr Age 21 q3 yr
62
Delayed puberty w/+ bone age and INC FSH and LH is most likely what?
Hypergonadotropic hypogonadism Aka the ovaries do not listen
63
PID is diagnosed by what 3 clinical signs?
Cervical motion tenderness (chandelier sign) uterine tenderness Adnexal tenderness 1 of 3 required
64
Management if woman having life-threatening bleeding? How to turn off uterine bleeding?
2 large bore IVs IVF Type and cross Transfuse PRL IV Estrogen
65
Reproductive age woman with vaginal bleeding most likely due to what?
PAD Pregnancy Anovulation DUB
66
A woman that has secondary amenorrhea and has a PMHx of 5 elective abortions most likely has what?
Asherman syndrome
67
What is the Path behind overflow/hypotonic bladder? What does this mean? What happens to the bladder?
Lesions of spine or nerves (trauma, diabetic neuropathy, MS) Cannot sense urge to void Massively distended
68
What what volume in the bladder is there a sense to void? When does it hurt?
250 cc 500 cc
69
What are the output regimens to treat PID?
Centriaxone IM + Doxy + Metro OR Cefoxitin + Probenecid + Doxy + Metro
70
Abnormal cells on ectocervix indicates what? Endocervix?
LEEP or Cryo Cone biopsy
71
When diagnosing Lichen sclerosis what else must you r/o? Via what? Tx for lichen sclerosis?
SCC w/punch biopsy Topical corticosteroids
72
What is the Path behind motor urge (hypertonic) incontinence? Cystometry shows what? Tx?
Random detrusor contractions Contractions at ALL volumes Oxybutynin or propantheline (antispasmodics)
73
When does osteoporosis screening begin for women? W/what?
Age 65 w/DEXA
74
What must happen to be considered virilized?
Clitoral enlargement Deepen voice Amenorrhea
75
Pt w/neurogenic (hypotonic) bladder feels what? Cystometry shows what? Tx?
Involuntary loss of urine, bladder never empties ABSENT detrusor contractions, always full bladder Bethanechol, self-CATH
76
When do you screen w/mammograms?
Age 40 q1 year
77
Pt with irritative bladder w/hematuria that has a smoking history most likely indicates what? 1st step in workup?
Bladder cancer Cystoscopy
78
Woman that has amenorrhea w/irregular cycles but bleeds when given progestin most likely has what?
PCOS
79
What presents as a black, itchy lesion on the vulva? Treat how?
SCC or Melanoma Vulvectomy and LN dissection
80
What is the shock index? W/acute ABD what is the next step?
HR > Systolic BP Ex-Lap
81
Galactorrhea and amenorrhea is suspicious for what? Treat how?
Prolactin o a Pramixpaxole or Ropinerole

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