Womens Reproductive Health Flashcards
(155 cards)
1
Q
After age 60 is hypertension more common in men or women
A
Women
2
Q
Is T2DM higher in men or women
A
Women
3
Q
PCOS involves a triad of:
A
Insulin resistance, anovulation, and increased androgens
4
Q
Autoimmune disorders are more common in
A
Women
5
Q
What percentage of pregnancies are planned
A
Less than half
6
Q
How often should the average women get a Pap test?
A
Every 3 years
7
Q
The most common gyne malignancy is
A
Uterine cancer
8
Q
Highest risk for uterine cancer is in
A
Obese, low parity women
9
Q
MB Breast Screening Program recommends mammograms starting at age
A
50
10
Q
50-69YO women should have a mammogram how often?
A
Every 2-3 years
11
Q
What age do paps start in MB?
A
21
12
Q
Cervical cancer is seen in women
A
20+
13
Q
Commonest causes of mortality for a 19YO woman
A
Accidents and complications from HIV, followed by suicide
14
Q
Which vaccination can reduce a woman’s risk of cervical cancer?
A
HPV vaccine
15
Q
Uterine cancer presents with
A
Abnormal bleeding
16
Q
Elevated risks in older mothers are
A
Genetic abnormalities, miscarriage, infertility, hypertension, gestational diabetes
17
Q
A 60 YO woman should get a mammogram every
A
2-3 years
18
Q
What nerve provides motor and sensory innervation to the perineal structures?
A
Pudendal nerve (S2-S4)
19
Q
Pessaries are
A
Prosthetic devices used to prop up the vagina by providing intravaginal support
20
Q
Large uterine fibroids may cause what sx
A
Pelvic pain, difficulties with micturition and defecation, backache and pain in the leg
21
Q
Where does the distal ureter course in relation to the uterine artery?
A
Ureter under the artery - water under the bridge
22
Q
Ovarian torsion presents as
A
Severe, constant, unilateral pelvic pain
23
Q
Diagnosing suspected ovarian torsion
A
Diagnostic laparoscopy
24
Q
Atypical endometrial hyperplasia can be a precursor to
A
Endometrial cancer
25
Most cases of endometrial cancers are due to
Prolonged unopposed estrogen exposure
26
Chronic HPV infection is a risk factor for
Cervical adenocarcinoma
27
Diethylstilbestrol exposure in utero increases risk of
Clear cell carcinoma of the cervix and vagina
28
Cervical Leiomyoma presents as
Protruding cervical mass with heavy bleeding
29
Uterine leiomyoma presents with
Bulk symptoms and heavy bleeding
30
Choriocarcinoma typically presents with
Vaginal bleeding, elevated B-hCG levels, enlarged uterus
31
Complete mullerian agenesis presents as
Amenorrhea and a blind vaginal pouch due to congenital absence of the uterus and cervix
32
Foreign body in the vagina can present as
Abdo pain, foul smell, discharge, bleeding
33
Sarcoma botryoides (a form of rhabdomyosarcoma) presents during infancy as
Polypoid of grapelike mass protruding from the vagina, associated with vaginal discharge and bleeding
34
Imperforate hymen usually presents as
Pubertal patients with cyclical abdo pain, amenorrhea, and hematocolpos
35
Treatment of a symptomatic bartholins duct cyst
Incision and drainage with possible word catheter placement
36
Which HPV strains cause condylomata accuminata
11 and 16
37
Cluster headache onset is often during
Sleep
38
Location of cluster headache
Behind one eye
39
Tension headache location
Bilateral band around the head
40
Duration of cluster headache
Less than 2 hrs, multiple times followed by remission
41
Corneal edema/cloudiness, fixed mid dilated pupil, conjunctival redness is a signs of
Acute angle closure glaucoma
42
Florescein staining of the eye is usually performed to detect
Corneal abrasions or herpetic keratitis
43
HPV vaccine indications
All female and male patients age 11-26
44
Signs of acute inhalant intoxication
Transient euphoria and loss of conciousness
45
Chronic abuse of nitrous oxide can result in
B12 deficiency and polyneuropathy
46
What acid base disturbance can result due to hypoventilation?
Respiratory acidosis
47
What type of contraception is preferred in postpartum breastfeeding mothers
Progestin only
48
Bilateral nipple discharge workup
Pregnancy test, galactorrhea evaluation
49
Unilateral nipple discharge workup
Ultrasound +/- mammogram
50
Workup for galactorrhea
Prolactin and TSH levels, pregnancy test
51
Thelarche is
The onset of breast development
52
The first sign of puberty in most girls is
Thelarche
53
Adrenarche is the onset of
Body odor, pubic hair, etc
54
Treatment for asymptomatic pelvic organ prolapse
Reassurance and observation
55
Obesity is a major risk factor for endometrial hyperplasia because
Adipose tissue increases peripheral conversation of androgens to estrone - increased estrogen levels and causing unopposed uterine exposure
56
Ideal contraception in hypertensive patient
Copper containing IUD
57
Chronically elevated estrone levels can have what effect on menstrual cycle
Anovulation and abnormal uterine bleeding
58
What effect do copper IUDs have on periods?
They usually get heavier and more painful
59
Primary dysmenorrhea is due to
Excessive prostaglandin production
60
First line treatment for primary dysmenorrhea is
NSAIDs
61
Leiomyomata uteri is also known as
Uterine fibroids
62
Uterine fibroids are located in
Uterine myometrium
63
Chlamydia treatment
Doxycycline
64
Gonorrhea treatment
Ceftriaxone
65
Screening for intimate partner violence should occur for who
All women of childbearing age
66
A female fetus gets masculinization by abnormal levels of testosterone in
Congenital adrenal hyperplasia
67
Effects of in utero estrogen exposure will wane by what age?
6 months
68
Protruding vaginal mass after delivery, with mother in shock but not overtly bleeding may indicate
Vaginal hematoma (uterine artery)
69
Follicular, lutein, and polycystic sclerotic ovaries are all what type of conditions?
Functional, benign
70
A cyst that produces estrogen
Follicular cyst
71
A cyst that produces progestin
Lutein cyst (can delay menses)
72
Theca lutein cysts are associated with high levels of
B HCG
73
Dysmenorrhea
Painful periods
74
Menstrual cycle normal length
24-38 days
75
Duration of menstrual flow normal
4.5-8 days
76
Normal volume of blood loss in menstruation
5-80mL
77
FSH high, estrogen low
Primary ovarian insufficiency
78
Significant hypotension from maternal blood loss lowering the BP and causing necrosis in the anterior pituitary gland
Sheehans syndrome
79
Low estrogen differential
POI, thyroid, prolactin, tumour
80
Medical management patient with fibroids
Progestin only (controls bleeding), combined HC, GnRH (instant menopause)
81
Tumour markers in gyne malignancies
CA125, CEA, LDH, AFP, BHCG
82
TAH BSO
Total hysterectomy and bilateral salpingoophorectomy
83
PALM and COIEN for abnormal bleeding
Polyp, adenomyosis, leiomyoma, malignancy
Coagulopathy, ovulatory issue, endometrial, iatrogenic, not yet classified
84
Endometrial tissue invading myometrium, bulky painful heavy uterus with heavy bleeding
Adenomyosis
85
Medical treatment of adenomyosis
Levonorgestrel containing IUD
86
Contraindications to OCPs
Stroke risk with pseudo tumour cerebri or migraines with aura
87
Treating lichen sclerosis
Steroid cream, maybe estrogen therapy
88
A tumour that has bone in it
Dermoid cyst
89
Total vs subtotal hysterectomy
Whether the patient keeps their cervix or not
90
Dermoid cysts arise from what type of cell
Primordial germ cell - all three germ layers
91
Treating condyloma accuminata
Laser, cryotherapy, podophyllin
92
How long after puberty does menarche occur
2 years after
93
Ca125 is a tumour marker for
Ovarian cancer
94
VIN in young women
Usual VIN, warty or basaloid
95
VIN in older women
Differentiated (d vin)
96
Vulvar cancer can spread via lymph to
Inguinal nodes
97
Vulvar cancer can spread via blood to
Lung, liver, bone
98
Cervical cancer types
1. Squamous cell carcinoma, 2. Adenocarcinoma
99
Mucopurulent cervicitis can be caused by
Gonorrhea, chlamydia
100
Profuse, frothy vaginal discharge
Trichomonas
101
Pruritic discharge, not STI
Candida
102
Foul and fishy discharge
BV
103
Treating for gonorrhea and chlamydia
Oral cefixime and azithromycin
104
Treating pelvic inflammatory disease
Ceftriaxone, doxycycline, metronidazole
105
Treating BV
Metranidazole
106
Treating syphilis
Benz G
107
Treating candidiasis
Topical azole, fluconazole PO
108
Treating lymphogranulonum venereum
Oral doxycycline
109
Bicillin (Benzathine penicillin G) treats
Syphilis
110
Most ectopic pregnancies are located in the
Ampulla
111
Rh negative women with pregnancy require
Rh immune globulin AKA WinRho, RhoGAM
112
Longer lifetime estrogen exposure increases risks of
Breast cancer
113
Mammography is recommended
Every 2-3 years for women 50-74
114
Signs of breast cancer
Mass, nodes in armpits, nipple changes
115
Estrogen ad progesterone receptor positive tumours in breast
Better prognosis (endocrine therapy)
116
HER2 status is associated with what prognosis
Poor prognosis
117
Treat HER2 cancers with
Trastuzumab
118
Treat ER PR positive breast cancers with
Aromatase inhibitors and CDK4/6 inhibitors
119
Treat triple negative breast cancers with
Chemotherapy
120
Cystocele
Bulging of bladder into the upper anterior vaginal wall
121
Rectocele
Weakness in the rectovaginal septum, bulging or descent toward posterior vaginal wall
122
Enterocele
Bulding of the rectum into the pouch of Douglas (usually with loops of bowel)
123
The baden walker system is used to grade
The clinical severity of pelvic prolapse in women
124
Stress incontinence
Occurs with increased intraabdominal pressure
125
Urgency incontinence
Urge with voiding, like you might not make it, caused by involuntary detrusor muscle over activity
126
Overflow incontinence defn
Continuous leakage with residual urine after emptying, due to detrusor under activity or bladder outlet obstruction
127
Treating mastalgia
NSAIDS - oral vs topical
128
Lactating vs non lactating mastitis treatment
Lactating - cloxacillin, non lactating - Amox clav
129
Post menopause, ovaries secrete mostly
Andosenedione and testosterone
130
Key feature of perimenopause
Menstrual irregularity
131
Contraindications for menopausal estrogen therapy
Unexplained vaginal bleeding, acute liver dysfunction, estrogen dependent cancer, coronary heart disease, previous stroke
132
Unilateral spontaneous bloody nipple discharge with mass workup for
Malignancy
133
What workup should a patient have prior to starting Trastuzumab
Echocardiogram to assess baseline function (to compare further reassessments to)
134
Common side effects of cisplatin and carboplatin
Ototoxicity
135
What workup should be obtained before using aromotase inhibitors (anastrozole, letrozole)
Baseline bone density scans
136
Tamoxifen increases the risk of
VTE
137
Bleomycin can cause
Pulmonary fibrosis
138
Trastuzumab risky side effect
Cardiotoxicity
139
No cervical change for more than 4 hrs with adequate contractions
C section
140
Adequate contractions are defined as more than
200mV units in ten minute interval
141
Vaginal delivery is contraindicated in patients with
Classical vertical cesarean delivery or abdominal myomectomy with uterine cavity entry
142
Intrauterine infusion to decreased cord compression and resolve variable decels
Amnioinfusion
143
Amnioinfusion is contraindicated in
Previous uterine surgery
144
Terbutaline is a
Tocolytic
145
Laboring patients at high risk of uterine rupture require
Laparotomy and cesarean delivery
146
What shot should all pregnant patients get
Flu shot
147
Normal internal genitalia, external virilization, undetectable serum estrogen in female is
Aromatase deficiency
148
Ambiguous external genitalia, normal internal female organs, electrolyte abnormalities
Congenital adrenal hyperplasia (21hydroxylase deficiency)
149
Hypogonadotropic hypogonadism with anosmia and low LH/FSH
Kallmans syndrome
150
Cafe au lair, polyostotic fibrous dysplasia, and autonomous endocrine hyper function (precocious puberty)
Mccune Albright syndrome
151
Cervical insufficiency clinical features
More than 2 prior painless second trimester losses, painless cervical dilation
152
Treatment for cervical insufficiency is
Cerclage placement
153
Thrombosis of the deep pelvic or ovarian veins, that becomes infected
Septic pelvic thrombophlebitis
154
Management of cervical intraepithelial neoplasia 3 in non pregnant women
LEEP, cold knife conization, cryoablation
155
Mechanism of hypertension caused by some OCPs
Increased angiotensinogen synthesis by estrogen during hepatic first pass metabolism
