Repro Dx Flashcards
(118 cards)
1
Q
abdominal cramping, vaginal bleeding
Cervical os closed, no visible POC, uterus normal size
A
complete spontaneous abortion
2
Q
Abdominal cramping, vaginal bleeding ± tissue
Cervical os open, POC visible in cervical canal (may also see in vagina)
A
incomplete spontaneous abortion
3
Q
Non-viable preg not yet expelled
Cervical os closed
No sx
A
missed abortion
4
Q
Vaginal bleeding w/o cervical Δ
Spotting
A
threatened abortion
5
Q
Vag bleeding w/ cervical Δ
Abd cramping, mod-heavy bleeding, cervical os open
A
inevitable abortion
6
Q
Fever, chills, vag discharge, uterine and abd tenderness following abortion
A
septic abortion
7
Q
Chocolate cyst ovary
A
endometriosis
8
Q
Uterus larger than expected for date of gestation
Absent fetal heart sounds
A
molar pregnancy
9
Q
What causes +Breasts and no uterus?
A
Mullerian Agenesis
10
Q
primary amenorrhea
A
Absence of menarche by age 16 w/ nrml pubertal devel or by 14 w/o pubertal devel or 2 yrs after completion of sexual maturation
11
Q
secondary amenorrhea
A
Absence of menstruation for at least 3 cycles in females who previously had regular menstrual cycles
or
6 months in females with irregular cycles
12
Q
primary amenorrhea w/ ↓GnRH: ↓ FSH ↓ LH ↓ Estradiol
A
Hypothal d/o
13
Q
Poor breast development, 1° amenorrhea, short stature, webbed neck
A
Turner’s Syndrome
14
Q
No uterus, shortened vagina, hormone levels nrml
A
Mullerian Agenesis
15
Q
Cyclic pain due to retention of blood, nrml hormone levels
A
Imperforate Hymen
16
Q
Horizontal “wall” of tissue formed that creates blockage of vagina, nrml hormones
A
Transverse Vaginal Septum
17
Q
secondary amenorrhea w/ Weight loss, excessive exercise, anorexia nervosa, stress
A
Functional Hypothalamic Amenorrhea
18
Q
Post-partum pituitary necrosis
Pituitary cell destruction
Severe hypotension 2° to massive hemorrhage
A
Sheehan Syndrome
19
Q
secondary amenorrhea w/ hot flashes, vaginal dryness
A
Premature Ovarian Failure
20
Q
secondary amenorrhea w/ presence of Intrauterine adhesions or fibrosis
A
Asherman Syndrome
21
Q
dx of endometriosis
A
Laparoscopy is gold standard
22
Q
Dysmenorrhea, dyspareunia (painful sex), dyschezia
Infertility
Urinary sx
Tender nodularity of cul-de-sac & uterine
ligaments, “fixed” uterus
10/10 pain curled over, worst pain they’ve ever had
A
Endometriosis
23
Q
3rd spacing: Bloating, abdominal fullness, n/v/d, weight gain, decreased urine output, excessive thirst, SOB, pleural effusion, calf/chest pain (DVT/PE), electrolyte imbalance
A
Ovarian Hyperstimulation Syndrome (OHSS)
24
Q
Estrogen ↑
FSH ↑
Anti-mullerian hormone (AMH) ↓ levels
Indicates:
A
↓ ovarian reserve
25
Intermenstrual bleeding, post-coidal or post-menopausal bleeding, may prolapse through cervix
Usually <1 cm
Endometrial Polyps
26
Heavy menstrual bleeding
Pelvic pain (non-cyclical)
Progressive dysmenorrhea
Asymptomatic
Diffusely enlarged globular “boggy” uterus (soft)
Symmetrical uterine enlargement
Adenomyosis
27
HMB is MC presenting sx
Dysmenorrhea, pelvic pain/pressure, infertility
Compressive sx: urinary freq, difficulty w/ bowel mvts
Enlarged, firm, irregular NT uterus,
Leiomyoma
| "fibroids"
28
Post-meno bleeding
Meno/metrorrhagia in pre-meno
Nrml uterus size no PE findings
Endometrial Cancer
29
Presents as rapidly growing mass with vaginal bleeding ± pain
Leiomyosarcoma
30
Dull/sharp, constant/intermittent, pelvic pain, pressure or fullness
Painful intercourse, bloating, torsion
Admexal fullness, admexal/cervical motion tenderness
Ovarian Cysts
31
Filled with serous/watery fluid
Thin walled
Can reach 5-7cm, typically not much larger
Simple Cyst
32
```
May be fluid filled: blood, mucous, etc.
Solid component
Internal debris
Thick walled
Septations
Papilla
```
>5cm
“ground glass” appearance with internal echos
Complex Cyst
| corpus luteal
33
Simple Cyst composition
granulosa cells (SAME cells as follicles)
34
Occurs as a result of bleeding into a follicle or corpus luteal cyst
Hemorrhagic Cyst
35
“chocolate cysts”
Endometrioma
36
What tumor marker will likely be elevated with Endometrioma
CA-125
37
cyst that occur from hyperstimulation from HCG & resolve after source of HCG is removed
Theca Lutein Cysts
38
Cystadenoma
serous and mucinous
39
Abdominal fullness, back pain, constipation, diarrhea, early satiety, fatigue, nausea
Pelvic pain, pelvic mass, inguinal lymphadenopathy
Weight loss
Ovarian Cancer
40
2nd mc gyn malig and mc cause of gyn rel death
Ovarian Cancer
41
mc type of Ovarian Cancer
Epithelial Cell
42
mc type of Ovarian Cancer in pediatric pop
Germ Cell
43
SEVERE pain (sharp/stabbing/colicky, radiation), nausea/vomiting, low grade fever
Ovarian Torsion
44
Oligomenorrhea (<9 periods/year)
Amenorrhea (no period >3 months)
Obesity
Infertility
Hyperandrogenism: acne, hirsuitism, male-pattern hair loss, ↑ testosterone
Insulin resistance: acanthosis nigricans
Ovarian cysts are rare because they don't ovulate
Preg complications: early preg loss, gestaional diabetes, pre-eclampsia, preterm birth
Polycystic Ovarian Syndrome (PCOS)
AKA Stein-Leventhal Syndrome
45
acute onset fever, pain, problems voiding
very tender prostate
+leukocytes, (+culture)
Prostatitis: Type I - Acute Bacterial Prostatitis
46
Recurrent UTIs that respond to abx
Pain- lower and, perineal, testicular, scrotal, rectal, back (no fever)
LUTS
painful ejaculation, change in semen color, retarded ejaculation, erectile dysfn
Prostate may be normal, somewhat enlarged, body and somewhat tender
Urine cx usually nrml
Prostatitis: Type II - Chronic Bacterial Prostatitis
47
Pelvic pain, urinary sx, ejaculatory dysfn
No identifiable infectious etiology
Prostatitis: Type III - Chronic Abacterial Prostatitis / Chronic Pelvic Pain Syndrome
48
Asymptomatic but WBC in prostatic secretions or prostate tissue found incidentally during prostate eval
Prostatitis: Type IV - Asymptomatic Inflammatory Prostatitis
49
LUTS
Hesitancy, weak stream, interrupted stream, incomplete voiding, straining to void, dribbling, nocturia, incontinence
Recurrent UTIs, enlarged prostate on DRE (normally is 2 fingerbreadths or less)
BPH
50
LUTS and nodules palpated on DRE
| elevated PSA
Prostate Cancer
51
Absent cremasteric reflex
Elevated scrotum on affected side
Enlarged painful testis
Abnormal testicular lie
Testicular Torsion
52
Gradual onset of unilateral scrotal pain
Frequently accompanied by urinary sx (e.g.,
dysuria)
Epididymal and/or testicular swelling
Epididymitis
53
Unilateral testicular swelling and scrotal
edema 4 to 5 days after parotitis secondary to
mumps
Orchitis
54
“Bag of worms”
↑ in size w/ standing or valsalva maneucer
Varicocele
55
Tense, smooth scrotal mass that easily transilluminates
Hydrocele
56
Smooth painless mass that transilluminates
Spermatocele
57
Discrete painless mass on the testicle, testicular swelling, testicular pain, scrotal "heaviness" or "firmness"
If tz for epididymitis fails may be cancer
Back pain if metastatic
Testicular Cancer
58
Inability to retract the foreskin over the glans penis
Painful erections
Hygiene issues may ensue due to difficulty cleansing area
Phimosis
59
Retracted foreskin of uncircumcised penis can not be returned to normal anatomic position →
venous occlusion, edema, arterial insufficiency of the distal penis
Paraphimosis
60
Superficial squamous epithelium entrapts nests of glandular columnar cells → mucus trapping → bleb formation
Nabothian Cyst
61
Seen in periods of high estrogen- menarche, OCP, pregnancy
Very friable so vulnerable to infection, trauma and bleeding
Ectropian
62
Pts complain of postcoital bleeding
Cervical Polyps
63
Painless, premature dilation
Can lead to pregnancy loss or preterm delivery
Cervical Insufficiency
64
When HPV infection occurs usually latent and cleared but can stick around long enough to cause change in cells
Cervical Dysplasia
| Cervical Intraepithelial Neoplasia
65
Abnormal bleeding, watery
discharge, postcoital bleeding,
venous/lymphatic/ureteral
compression
Cervical Cancer
66
Primary amenorrhea with high FSH
ovarian failure
67
Primary amenorrhea with low or normal FSH
hypothalamus/pituitary disorder
68
XXX
superfemale (no obvious phenotype)
69
Small testes, reduced fertility, Gynecomastia, male gender identity
XXY Klinefelters syndrome
70
painless solid testicular enlargement
testicular tumor
71
testicular tumor rule of ninties
90% 24-45 yo
90% of germ cell origin
90% of tumors malignant
90% curable with modern therapeutic modalities
72
MC type of testicular tumor
germ cell (aggressive)
mc type of germ cell tumor is classic seminoma
73
testicular tumor in infants and < 3 yo
yolk sac tumor
74
Pelivc pain, missed LMP, vaginal bleeding
If 3 wk and no sac→ suspicious
Adnexal mass, free fluid in pelvis, hemodynamically unstable, inappropriately rising βhCG with no intrauterine sac
Ectopic Pregnancy
75
Abnormal vaginal bleeding
Uterine size > dates
Hyperemesis gravidarum
Bhcg > 100,000 mIU/mL
Hyperthyroidism
PreEclampsia < 20 weeks
Gestational Trophoblastic Disease (GTD)
76
T sign on US for multi gestation
Monochorionic
77
Lambda (λ) sign for multi gestation
Dichorionic
78
Softening and effacement of the cervix prior to onset of contractions
Cervical Ripening
79
Stimulation of contraction before onset of labor
induction
80
MC cause of mastitis
s aureus from infants pharynx
81
placenta covering opening of cervix
placenta previa
82
Defective decidual formation causing abnormla placenta attachment to myometrium
placenta accreta
83
premature separation of placenta
Abruptio Placentae
84
most common cause of vaginal discharge and odor
Bacterial vaginosis (BV)
85
Mc Vulvovaginal tumor
Batrholin Gland Cyst/Abscess
86
↑ discharge, white or grey, fishy odor, odor may be worse after sex, no pain with sex (dyspareunia)
Copious thin, white vaginal discharge
+ whiff
Bacterial Vaginosis (BV)
87
Very itchy, externally, internally or both
Thick cottage cheese like discharge adherent to vag walls, burning with urination (because urine hits external genitalia)
Discomfort with sex (due to inflammatory response)
Erythema, edema
Vulvovaginal Candidiasis
| Yeast infection
88
Female comes in with sx- yellow to greenish discharge, irritation, dyspareunia, dysuria, copious frothy (bubbly) discharge
Trichomoniasis
89
painless valvular mass, detected on pelvic exam, very large can cause discomfort with walking, sitting or sex, clear, white fluid
Bartholin Gland Cyst
90
Tender, warm, painful, mucopurulent vulvovag drainage, likely will show up in ER
Batrholin Gland abscess
91
Vaginal lesions + itching
may have bleeding or pain
May have already been tx for something else with no relief
Vulvar Cancer
92
Painless vagina and/or postcoital bleeding
Vaginal Cancer
93
Breast pain
Cyclic - related to menstural cycle
Non-cyclic
Extramammary
Mastalgia (mc is cyclic)
94
Breast pain, swelling, warmth, redness
Mastitis
95
MC cause of Mastitis
s. aureus
96
Dimpling of the breast, nipple retractions
breast tumors
97
biggest RF of breast tumors
age
98
Bilateral cyclic pain, breast swelling, palpable mass ad heaviness, lumpy breasts
Fibrocystic Breast Disease
99
MC benign breast cont
Fibrocystic Breast Disease
100
Well defined, mobile mass
Can be multiple in same breast or bilaterally
Changes w/ menstrual cycle, ↑ in size w/ preg and extrogen therapy, shinks during menopause
Fibroadenoma
101
Single, non-tender, firm, immobile mass
MC in upper outer quadrant
Nipple discharge (unilateral), dimpling, skin thickening, breast pain, skin thickening, breast pain, and eczematous changes
breast ca
102
mc type of breast ca
Ductal carcinoma in situation (DCIS)
103
Acute onset (sx < 6 months) of erythema, edema, and peau d’orange appearance of breast ±palpable lump
Fast progression
Inflammatory Breast Cancer (poor prognosis)
104
Men: urethritis ‐ dysuria, mild urethral discharge
Women: cervicitis ‐ mild discharge, urethritis ‐ dysuria, mild urethral discharge
Chlamydia
105
Men- dysuria, urethritis and purulent discharge
Women- asymptomatic or vagina discharge, dysuria, cervicitis
Gonorrhea
106
Fever > 101 °F, pelvic pain, cervical motion tenderness (chandelier sign), annexation tenderness, cervical discharge
PID
107
Gold standard to dx PID
PCR
108
Women- likely to be asymptomatic
Confined to genitalia, tender papule with surrounding erythema, becomes pustular and forms painful, undermined ulcer
Tender regional adenopathy
Chancroid
109
Painless ulcerative genital lesions without reginal lymphadenopathy
Granuloma Inguinale (Donovanosis)
110
Chancre forms at site of inoculation, initially painless papule, erodes with raised borders and heals within 3-6 wks
maculopapular rash can involve any surface of the body, commonly presents on palms and soles
Syphilis
111
Often asymptomatic
Flesh gray color, papule either sessile or pedunculated
HPV
112
Pruritus: pubic, axilla, chest, eyelashes
Visible lice/eggs
maculae ceruleae (taches bleues), bluish‐gray irregularly shaped macules, lower abdominal wall, buttocks, and upper thighs
Pubic Lice
113
Lesions and burrows
Pruritus
Grey or skin colored ridges, linear or surpiginous, vessicle/papule at end
Scabies
114
MC presenting sx of menopause
vasomotor instability
115
irritation, burning, itching, vag discharge (yellow-brown), postcoital bleeding, dyspareunia, vaf epithelium red then becomes pale, dec rugation and vag wall beomces smooth
vulvovaginal atrophy
116
pelvic pressure, ball coming out of vag has to push it back in to walk and stand
uterine prolapse
117
pelvic pressure during bowel mvts, constipation, bulging post wall
rectocele
118
pressure in pelvis and vag, inc discomfort w/ straining, coughin, bearing down or lifting, incomplete bladder emptying
cystocele
