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Reproductive JB Flashcards

(54 cards)

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1
Q

MCC vaginitis

A

Bacterial vaginosis

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2
Q

bacterial vaginosis etiology

A

gardnerella vaginalis

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3
Q

Bacterial vaginosis dx

A 
Amsels criteria: 
Clue cells 
pH>4.5
thin, homogenous watery grey white discharge
\+ whiff test
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4
Q

Bacterial vaginosis tx

A

metronidazole
safe in pregnancy, may use gel or PO
clindamycin

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5
Q

Bacterial vaginosis need to tx partner?

A

no

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6
Q

Breast cancer dx

A

mammogram
US - initially for <40yo
FNA w/ bx

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7
Q

Breast cancer preventative measures

A

Mammogram annually >40yo or 10yrs prior to 1st degree relative diagnosis
Breast exam (clinical) 20-39yo q 3yrs. >40yo annually
Self exam: monthly >20yo, after menstruation or day 5-7

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8
Q

Breast cancer tx

A 
Anti estrogen (tamoxifen) for ER positive tumors 
aromatase inhibitors (letrozole, anastrozole) for postmenopausal with ER + breast cancer
monoclonal ab (trastuzamab or Herceptin) for HER2 positivity
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9
Q

Breast cancer preventative medication

A

SERM (tamoxifen or raloxifene) for postmenopausal or >35yo w/ high risk of breast cancer.
use for 5y

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10
Q

Vulvular cancer sx

A

DES exposure

pruritic (MC)

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11
Q

MC type vulvular cancer

A

BCC

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12
Q

Vulvular cancer dx

A

Pap w/ cytology

colposcopy w/ bx

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13
Q

Cervical cancer associated with:

A

HPV 16, 18

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14
Q

MC type cervical cancer

A

SCC

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15
Q

Cervical cancer w/ DES exposure

A

clear cell carcinoma

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16
Q

MC sx of cervical cancer

A

post coital bleeding

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17
Q

Cervical cancer prevention

A

HPV vaccine (Gardasil 9)

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18
Q

Contraception safe during lactation

A

Progestin only OCPs

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19
Q

Most effective form of contraception besides abstinence

A

IUD

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20
Q

IUD risk

A

increased risk of PID

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21
Q

dysfunctional uterine bleeding tx

A

hormone tx
IUD
tx underlying

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22
Q

eclampsia dx

Study These Flashcards
A

preeclampsia + seizures or coma
abrupt tonic clonic seizures 1-2m
post ictal hyperreflexia

23
Q

eclampsia tx

Study These Flashcards
A 
ABCDs
magnesium sulfate for seizures 
lorazepam 2nd line if refractory
Deliver fetus once pt stabilized 
hydralazine
24
Q

endometrial cancer PE

Study These Flashcards
A

postmenopausal bleeding

endometrial stripe >4mm on transvaginal US

25
endometrial cancer dx
``` bx pelvic exam D&C transvaginal US CT/MRI Labs: CA-125 (both endometrial and ovarian cancer) ```
26
combo OCPs are protective against
ovarian and endometrial cancer
27
endometrial cancer MC sx
postmenopausal bleeding
28
Endometriosis sx
Triad: cyclic premenstrual pelvic pain +/- low back pain, dysmenorrhea, dysparenuria infertility
29
endometriosis dx
laparoscopy w/ bx definitive
30
endometriosis tx
combined OCP + NSAID progesterone, leuprolide, danazol surgery: laparoscopy w/ ablation if fertility desired. TAH-BSO if no desire for conception
31
endometritis risk factor
C-section PROM >24h vaginal delivery D&C
32
Endometritis tx
infection post c section: clindamycin + gentamicin. May add ampicillin for group B strep coverage. Zosyn is alternative infection after vaginal delivery or chorioamnionitis: ampicillin + gentamicin
33
What herniates in enterocele
pouch of Douglass herniates into upper vagina
34
Fibrocystic breast disorder dx
US | FNA: straw colored fluid
35
Gestational diabetes dx
Screening: 24-48 wks gestation w/ 50g oral glucose challenge (non fasting) Confirmatory: 3h 100g OGTT gold standard. done in the morning after overnight fast
36
Gestational diabetes tx
Labor induction at 38wks if uncontrolled delivered at 40wks if controlled/no macrosomnia insulin TOC glyburide safe in pregnancy and metformin
37
gestational HTN tx
methyldops 1st line chronic/preexisting HTN | labetalol, hydralazine, nifedipine
38
Molar pregnancy (gestational trophoblastic dz) sx
Painless vaginal bleeding uterine size/date discrepancies preeclampsia before 20wks hyperemesis gravidarum
39
Molar pregnancy tests
bHcG >100,000 low AFP US: snowstorm/cluster of grapes. no fetal heart sounds or feta lparts
40
gynecomastia tx
clomiphene tamixifen danazol
41
hyperemesis gravidarum tx
``` doxylhamine + pyridoxine FDA approved metaclopramide diphenhydramine zofran (cleft palate risk) promethazine ```
42
Hypothalamic amenorrhea labs
normal/decreased FSH and LH decreased estradiol normal prolactin
43
hypothalamic amenorrhea tx
clomiphene
44
menopause dx
``` FSH assay most sensitive initial test (increased FSH) increased LH decreased estrogen same androstenedione levels estrone predominant ```
45
menorrhagia tx
OCP Progesterone GnRH agonist: leuprolide w/ add back progesterone
46
Molar pregnancy tx
``` surgery. suction curettage mainstay asap, weekly bHcG levels hysterectomy rhogam avoid pregnancy for 1y high risk of choriocarcinoma ```
47
Mucopurulent cervicitis tx
STD Obtain culture Tx w/ ceftriaxone + azithromycin + metronidazole +/- doxycycline pending result
48
Ovarian cancer tx
Early: TAH-BSO + selective lymphadenectomy Surgery: monitor w/ CA-125 chemo: taclitaxel + cisplatin or carboplatin
49
placenta previa dx
pelvic US, do not do pelvic exam
50
PCOS sx
triad: amenorrhea, obesity, hirsutism
51
PCOS labs
decreased FSH, increased LH, increase testosterone, increased estrogen, low SHBG, high androstenedione
52
PCOS tx
combo OCP mainstay. avoid norgestrel and levonorgestrel hirsutism: spironolactone, leurprolide, finasteride infertility: clomiphene wedge resection
53
preeclampsia sx
HTN + proteinuria +/- edema after 20wks, up to 6wks postpartum hyperreflexia
54
Rectocele tx
prophylactic: kegal, weight control Nonsurgical: pessary (sx relief), estrogen tx (for atrophy) Surgical: hysterectomy, ligament fixation

PNCE (33 decks)

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