Pedia Gynecology, Precocious Puberty Flashcards Preview

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Flashcards in Pedia Gynecology, Precocious Puberty Deck (36):
1

Most common position for gynecologic exam

Frog leg

2

Position for gynecologic exam of older children

Also used for children with foreign body or discharge

Knee chest

3

Most common shape of hymen

Crescent

4

Most common gynecologic problem in prepubertal females

Vulvovaginitis

5

Most common cause of vulvovaginitis

Poor perineal hygiene

6

Pathognomonic sign of labial adhesion

Midline vertical line

7

Treatment for labial adhesion

Topical estrogen cream

8

Most common symptom of urethral prolapse

Prepubertal bleeding

9

Treatment for urethral prolapse

Topical estrogen cream

10

Thinning of vulvar epithelium with loss of rete pegs common in prepubertal and postmenopausal women

Lichen sclerosus

11

Treatment for lichen sclerosus

Avoid trauma or irritants
Topical steroids
Sitz bath

12

Majority of foreign body cases are within the ages of

3 and 9 years old

13

Classic symptom of foreign body in the vagina

Foul smelling bloody discharge

14

Treatment for vulvar lacerations

Bed rest for 24 hours
Ice pack
Analgesics

15

Treatment for vulvar hematoma if less than 4cm non expanding

Bed rest
Compress
Analgesic

16

Treatment for vulvar hematoma if more than 4cm and expanding

Evacuate clot

17

High index of suspicion for sexual abuse if the child presents with

Posterior fourchette injury
Hymenal laceration
Transections from 3 and 9 o clock position

18

Most common type of ovarian cysts

Functional cysts

19

Surgical intervention done if the patient has torsion of the ovarian cyst to preserve fertility

Cystectomy

20

Most common benign ovarian tumor

Teratoma

21

Most common malignant germ cell tumor of the ovary

Dysgerminoma

22

Goal of treatment in precocious puberty

Induce pseudomenopause

23

LH levels of ____ is diagnostic of precocious puberty

LH >5 mIU/ml

24

Most common cause of precocious puberty

Idiopathic

25

Most common ovarian tumor that can cause precocious puberty

Granulosa cell tumor

26

This syndrome causes precocious puberty due to mutation in G3 protein activating adenylate cyclase that leads to constant secretion of FSH, LH, TSH and GH

McCune Albright syndrome

27

First symptom of McCune Albright syndrome

Vaginal bleeding

28

Triad of McCune Albright

3 Ps- pigment, polyostotic, pockets

Cafe au lait spots
Polyostotic fibrous dysplasia
Cysts of skull and long bones

29

This test differentiates incomplete from true precocious puberty

GnRH agonist stimulation test

30

Indications for medical treatment of precocious puberty is when menarche happens before _____ or bone age is more than _____ of chronological age

Menarche <8 years old
Bone age >2 years of chronological age

31

GnRH dependent drug of choice in precocious puberty

Leuprolide

32

Excessive terminal hair growth is dependent on what hormones

Androgens

33

In females, testosterone is secreted by what organ?

Ovaries

34

In females, adrenal gland secretes this hormone

DHEAS

35

This disease occurs when you have bilaterally enlarged ovaries (5-7cm) with gradual onset

Theca cells produce testosterone and virilization happens around 4th decade of life

Stromal hyperthecosis

36

Drug of choice for hirsutism

Spironolactone