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89 Cards in this Set
- Front
- Back
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Rx for precocious puberty
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GnRH analogues
cortisol |
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why must precocious puberty be treated
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to prevent premature closure of the epiphyseal plates
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what is central precocious puberty
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caused by an increased GnRH
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what study should be done with a px suspected of having central precocious puberty
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brain imaging
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what causes central precocious puberty
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early activation of the HPO axis caused by an increased GnRH
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what is the difference between PMDD and PMS
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PMDD is more severe
-disrupts daily activities -depression -anheidonia |
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what should be done if PMS or PMDD symptoms are present through cycle
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psychiatric work up for mood disorder
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Rx for PMS or PMDD
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SSRI
if this doesnt work give alprazolam |
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how is PMS or PMDD diagnosed
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2 consecutive cycles with
-symptom free follicular phase -symptomatic luteal phase |
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what can help in the diagnosis of PMS or PMDD
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menstrual diary for 3 weeks
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MCC of male pseudohermaphrodite
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androgen insensitivity
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what are px with androgen insensitivity at increased risk for and what should be done
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testicular carcinoma by 3 or 4 decade
gonadectomy after puberty |
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what should be done in a px who cannot get pregnant and has been ovulating
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hysterosalpingogram
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what must be ruled out from menopause or premature ovarian failure
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hyperthyroidism
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how can oocyte aging be assessed
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early follicular phase FSH level
clomiphene challenge inhibin B level |
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how can anovulatory cycle be Dx
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mid luteal serum progesterone level test for ovulation
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how can ovulatory reserves be tested
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serum inhibin B
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what causes amenorrhea in athletes
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decreased LH and GnRH
results in decerased estrogen |
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what causes the symptoms in dysmenorhea
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prostaglandin released from endometrial breakage
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what is amenorrhea
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absence menses for 6 months
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when should an endometrial biopsy be done in px with dysfunctional uterine bleeding
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those over 35 yo to exclude endometrial hyperplasia and carcinoma
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Rx for dysmenorrhea
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NSAIDS
OCP |
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Rx for minor DUB
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iron supplements
progestin |
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Rx for severe DUB
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iron supplements
estrogen endometrial ablation or hysterectomy |
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emergency contraceptive that can be used within 120 hours after sex
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levonorgestrel
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emergency contraceptive used as 2nd trimester abortifacient
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prostaglandin E2
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Next step in a px with amenorrhea on OCP after pregnancy has been ruled out
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increase estrogen
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what does a diaphragm require to be effective
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contraceptive gel
should be placed 6 hours before intercourse and left 6 hours after |
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how do OCP work
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estrogen supresses FSH = no maturation of follicle
progesterone inhibits LH surge = no ovulation |
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OCP are protective against
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ovarian cancer
endometrial cancer benign breast disease dysmenorrhea |
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what contraceptive decreases its effects with overweight women
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transdermal patch
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what contraceptive is a/w weight gain
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DMPA
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what is the MCC of labial fusion
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21 B hydroxylase def
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Rx for labial fusion
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reconstructive surgery
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what causes fibroids to change in size
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estrogen dependent
increased with OCP or pregnancy decrease with menopause |
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a/w porcelein white polygonal macules
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lichen sclerosis
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a.w cigarette paper appearance
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lichen sclerosis
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a.w parchment paper appearance
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lichen sclerosis
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what is the next step in suspicion of lichen sclerosis
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vulvar punch biopsy to rule out cancer
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what is a complication of lichen sclerosis
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obliteration of labia minora and clitorus
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what are wickhams striae and what is it a/w
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fine white streaks
a/w lichen planus |
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pruritic, polygonal, purple, papules
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lichen planus
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what is lichen planus a/w
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hep c
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what is the Rx for bartholin Gland cyst
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I/D
if recur perform marsupialization if continue to recur excision should be done |
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Dx
px with white yellow vaginal discharge that is nonmalodorous and no other symptoms |
physiological leukorrhea
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what is the normal vaginal pH and why
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<4.5
lactobacillus keep it that way |
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how is bacterial vaginosis Dx
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3/4
-grey discharge -positive whiff test -clue cells -pH >4.5 |
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what normally supresses gardnerella vaginosis
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lactobacilli
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Rx for candida vaginosis
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clotrimazole
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pH in candida vaginosis
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3.5-4.5
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cheesy vaginal discharge
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candida vaginossi
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smelly green frothy discharge
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trichomonas vaginosis
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smelly gray discharge
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gardnerella vaginosis
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Rx for paget disease
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vulvectomy
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Dx
vaginal biopsy shows large cells with clear cytoplasm in epidermis |
paget disease
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cells seen in paget disease originate from what
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aprocrine glands
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Dx
vulvular soreness and pruritis appearing as a red lesion with superficial white coat |
paget disease
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when can CA 125 be used useful to indicate ovarian cancer
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post menopausal women
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next step in management for complex hyperplasia without atypia
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cyclic progestins
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next step in management for complex hyperplasia with atypia
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hysterectomy
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Rx for squamous cell carcinoma < 2 cm
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remove surgically
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Rx for squamous cell carcinoma >2 cm
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radiation
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Rx for squamous cell carcinoma that involves lymph nodes
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combination chemo
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what is adenomyosis
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endometrial glands in the myometrium
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most accurate test for adenomyosis
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MRI
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how is adenomyosis Rx and diagnosed definitely
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hysterectomy
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what are risk factors for adenomyosis
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endometriosis
fibroids |
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MCC of female infertility
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endometriosis
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what is endometriosis
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endometrial tissue found outside the endometrium
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presentation of endometriosis
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cyclic pelvic pain that starts 1-2 weeks before menstruation
dysmenorrhea dyschezia dyspareunia nodular uterus adnexal mass |
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how is endometriosis diagnosed
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laparoscopy
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what is seen on laparoscopy in a px with endometriosis
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chocolate cysts
powder burn lesions rusty or dark brown lesions |
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what correlates with the severity of endometriosis
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CA 125
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Rx for mild symptoms of endometriosis
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NSAIDS and OCP
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Rx for severe symptoms of endometriosis
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danazol
leuprolide surgery for those who are infertile |
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Dx
female with sudden onset of lower abdominal pain that radiates to the back and groin, adnexal mass is felt |
ovarian torsion
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MCC of androgen excess in females
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PCOS
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MCC of amenorrhea
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PCOS
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MCC of hirsutism
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PCOS
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Dx
females presenst 48 hours after delivery with pain in the breast and no fever |
breast engorgement
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Rx for breast engorgement
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acetomenophen
cool compress NSAIDS |
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what causes galactocele
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plugges ducts
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Rx for galactocele
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aspiration
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what is a complication of ovulation inducing drugs
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ovarian hyperstimulation syndorme
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what are the symptoms ovarian hyperstimulation syndrome
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abdominal pain
ovarian enlargement ascites respiratory symptoms |
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how can PCOS be diagnosed
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LH FSH ration greater than 3:1
increased DHEA |
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how can menopause be diagnosed
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increased FSH
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US shows a string of pearls appearance
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PCOS
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what will PCOS show on progesterone challenge
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no ovulation
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