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116 Cards in this Set
- Front
- Back
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first step in a patient with primary amenorrhea and FSH is high
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karyotype for turners
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first step in a patient with primary amenorrhea and FSH is low
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MRI for hypothalamic or pituitary disease
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first step in a patient with primary amenorrhea and FSH is normal
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serum prolactin and thyrotropin
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Dx px with primary amenorrheaPE shows bluish bulge where vaginal orifice should be
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imperforate hymen
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Dxpx with primary amenorrhea, absent sexual characteristics and anosmia
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kallman
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definition of premature ovarian failure
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menopause < 40 yo(absent menses for 6 months)
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MCC of secondary amenorrhea
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pregnancy
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initial step in a woman presenting with secondary amenorrhea and new galactorrhea when the BhCG is negative |
check TSH and prolactin levels
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Dxchild presents with thigh muscle weakness, waddling gait, and pronounced calf muscle
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duchenne muscular dystrophy
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Dx and Rxfemale neonate born in breech position is found to have asymmetric inguinal and gluteal skin fold
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developmental dysplasia of the hippaclik harness to maintain hips abducted
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how is benign paroxysmal positional vertigo Dx
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history (worse with movement)Dix hallpike maneuver
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how is benign paroxysmal positional vertigo Rx
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eplem meneuver
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Rx options for endometriosis
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NSAIDsOCPGnRH agonist-nafarelin-leuprolide-goserelinprogestindanazolaromatase inhibitors-anastrozole
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what must be given with aromataze inhibitors to avoid follicular cysts
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GnRH agonistOCP
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first line Rx in infertile woman with signs of endometriosis
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laparoscopy
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abnormal uterine bleeding:MCC
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anovulatory bleeding
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abnormal uterine bleeding:+ BhCG, intrauterine pregnancy, closed os
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threatened abortion
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abnormal uterine bleeding:enlarged uterus, menometrorrhagia for months
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fibroidsadenomyosismolar pregnancy
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abnormal uterine bleeding:a/w menstrual pelvic pain
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endometriosisadenomyosis
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abnormal uterine bleeding:menorrhagia, perimenopausal
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endometrial hyperplasia
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abnormal uterine bleeding:started with menarche
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bleeding diathesis-vWD
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abnormal uterine bleeding:+BhCG, severe pain, no fetus in uterus on US
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ectopic pregnancy
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abnormal uterine bleeding:metrorrhagia especially after intercourse, no pain, normal sized uterus
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polyp
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abnormal uterine bleeding:depression, constipation
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hypothyroidism
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controlling severe menorrhagia in a stable px
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estrogenOCP (monophasic)-ethinyl estradiolhigh dose progestin-medroxyprogsteronenorethindrone
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controlling severe menorrhagia in a unstable px
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IVtamponadepremarinphenergan
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MCC of irregular heavy uterine bleeding
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anovulation
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when is endometrial biopsy a necessary part of work up for abnormal uterine bleeding
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bleeding in a woman >35 yo
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Rx of choice for primary dysmenorrhea
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NSAIDsOCP
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Rx for PMS and PMDD
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B6NSAIDsOCPSSRI / alprazolamprogestins
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first line treatment for endometriosis
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combined OCP (monophasic)laparoscopy
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MCC of female infertility
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endometriosis
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MCC of hirsutism
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PCOS
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lab findings a/w PCOS
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increased LH (LH:FSH > 3:1)increased testosterone / DHEA / androstenedione
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what cancer are woman with PCOS at increased risk for and why
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endometrial and breastb/c of increased estrogen
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Rx for PCOS
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exercise and weight lossspironolactoneOCPclomiphenemetforminstatinsprogesterone
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MC clotting disorder that can cause menorrhagia
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vWD
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lab values a/w vWD
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increased BT and PTT
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what are the 3 Ds of endometriosis
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dysmenorrheadyspareuniadyschezia
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when can lactational amenorrhea be relied upon as an effective method of contraception
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exclusively breast feeding every 3-4 hours for 6 months
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Rx for acute angle closure glaucoma
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B-a+cholinergicsdiureticsPG
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a/w "dew drops on rose petals
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varicella
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features of bacterial vaginosis
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clue cellsincreased pH
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features of trichomonas infection
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motileincreased pHstrawberry cervic
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features of candida vaginitis
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cottage cheesepseudohyphaenormal pH
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Rx for gonorrhea
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ceftriaxone
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Rx for chlamydia
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docycycline(azithromycin)
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complications of PID
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infertilityectopic pregnancychronic pelvic paintubo-ovarian abscessadhesions
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a/w "feels like sitting on an egg"
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pelvic prolapse
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what is a cystocele
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prolapse of bladder into the vagina
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what is a rectocele
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prolapse of rectum into vagina
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what is a enterocele
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prolapse of small bowel into vagina(usually follows a hysterectomy)
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what is a uterine prolapse
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prolapse of uterus into vagina
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which STD is mistaken for IBD because of its a/w fistula
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lymphogranuloma venereum
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a woman presents with symptoms of cystitis but gram stain shows no organisms. what is the likely cause
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chlamydia
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what are the stages of syphilis
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Stage 1-chancreStage 2-rash on palms and sols-lymphadenopathyStage 3-gumma-tabes dorsalis
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Rx for syphilis
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penicillin(doxycycline)
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how is PID diagnosed
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abd, pelvic, or adnexal painvaginal discharge with WBCleukocytosis, fever, increased ESR and CRP
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what drug is no longer used to Rx gonorrhea due to resistance
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fluoroquinilones
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antidote for:organophosphates
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atropinepralidoxine
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antidote for:mercury
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dimercaprolsuccimer
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antidote for:carbon monoxide
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100% O2(hyperbaric)
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antidote for:heparin
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protamine
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antidote for:isoniazid
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B6
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Dxpainless pruritic papule with regional lymphadenopathy that evolves into a necrotic ulcer with a black eschar
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anthrxax
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Rx for anthrax
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penicillinampicillindoxycycline
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what is the most important prognostic factor in endometrial cancer
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grade
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when are pap smears started
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21 years old
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general treatment for squamous cell cancer of the vagina
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radiation
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indications for an endometrial biopsy
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menometrorrhagiapost menopausal bleeding
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next step in management in a woman who has CIN2 who has completed fertility
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Excision with-LEEP-conization-laser ablation
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next step in the management of ASCUS pap smear with a negative HPV
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repeat pap
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next step in the management of ASCUS pap smear with a positive HPV
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colposcopy
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next step in the management of AGUS pap smear
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colposcopy with endocervical curettageEMB if high risk
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Rx for a lesion found to be HSIL on biopsy
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repeat colposcopyexcision with LEEP, conization and laser ablation
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Dxivory or porcelain white macules and plaques with pruritis in the anogenital region
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lichen sclerosis
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Rx for lichen sclerosis
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steroids-clobetasol-pimecrolimus
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symptoms of ovarian cancer
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adnexal massascitesabdominal pain fatigueweight loss
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risk factors for endometrial cancer
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unopposed estrogen-PCOS-tumor
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risk factors for ovarian cancer
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family historyBRCA 1+2
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what marker is elevated in endometrial and ovarian cancer
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CA-125
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US findings indicative of a benign mass
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cystic masssmooth lesionfew septa
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US findings indicative of a malignant mass
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irregularitiesnodularitymany septa
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ovarian tumor a/wpsammoma bodies
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serous cystadenocarcinoma
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ovarian tumor a/westrogen excess
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granulosa theca
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ovarian tumor a/wandrogen secretion
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sertoli leydig
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complication of gonorrhea or chlamydia that infects the capsule of the liver
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fitz hugh cutis
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heart murmur a/w:diastolic, lower left boarder, increases with inspiration
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TS
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heart murmur a/w:diastolic, openning snap
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MS
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heart murmur a/w:systolic, second right interspace
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AS
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heart murmur a/w:systolic, second left interspace
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PS
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heart murmur a/w:late systolic, apex
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MP
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heart murmur a/w:diastolic, wide pulse pressure
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AR
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heart murmur a/w:systolic, left lower sternum
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TR
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heart murmur a/w:systolic, apex
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MR
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Rx for pediculosis capitis and pubis
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permethrin
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other than medications, what can cause gynechomastia
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tea tree oilcirrhosistestocular germ cell tumorhyperthyroidismhemodialysis patients
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next step in a fibroadenoma appearing breast mass
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FNA
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next step in a fibroadenoma appearing breast mass that FNA shows solid and benign
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repeat
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next step in a fibroadenoma appearing breast mass that FNA shows solid and malignant
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treat
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next step in a fibroadenoma appearing breast mass that FNA shows cystic, clear fluid and mass that disappears
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reassurance
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next step in a fibroadenoma appearing breast mass that FNA shows cystic bloody fluid
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cytology
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Dxwoman appears with smooth mobile mass, FNA shows clear non bloody fluid
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fibrocystic change
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MCC of bloody nipple discharge
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intraductal papilloma
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MCC of breast mass in a 25 yo
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fibrocystic change
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possible treatments for fibrocystic change
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eliminate caffeine and OCP
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MCC site of breast cancer
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upper outer quadrant
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what findings are suspicious on a mammogram
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calcificationshyperdense regions
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Rx for ductal carcinoma in situ of the breast
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lumpectomy with or without radiation
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what is the management of LCIS once invasion has been eliminated
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observationtamoxifene
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why does tamoxifene work so well with LCIS
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they are always ER and PR positive
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breast disease:MC
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invasive ductal
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breast disease:serous or bloody nipple discharge
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intraductal papilloma
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breast disease:MC mass in 35-50 yo
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fibrocystic change
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breast disease:MC tumor in teen and young women
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fibroadenoma
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breast disease:mass accompanied by redness, pain and warmth
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inflammatory carcinoma
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