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99 Cards in this Set
- Front
- Back
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most common breast lesion in women <30
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fibroadenoma
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most common location for breast CA
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upper outer quadrant
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risk factors for breast CA
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high fat, low fiber diet; increased exposure to estrogen (nulliparity, early menarche, late menopause)
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common cause of bloody nipple discharge
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intraductal papilloma
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tumor markers for recurrent breast CA
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CEA, CA 15-3, CA 27-29
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abnormal labs in metastatic breast CA
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increased ESR, alk phos, calcium
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all hormone-receptor + patients with breast cancer should receive what?
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tamoxifen
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monoclonal antibody that binds to HER2/neu
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trastuzumab
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contraindications to breast-conserving therapy
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large size, subareolar, multifocal, fixed to chest wall, skin/nipple involvement
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OCPs that lactating women can use
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progestin-only minipill
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GnRH analogs
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nafarelin or leuprolie
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how does danazol work?
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suppresses mensturation by inhibiting midcycle FSH and LH surges
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definition of primary amenorrhea
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no menses by age 16; no sexual characteristics by age 14
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intrauterine adhesions
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asherman's syndrome
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most common cause of secondary amenorrhea
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asherman's
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primary amenorrhea with increased LH
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testicular feminization
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primary amenorrhea with increased FSH
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ovarian failure, gonadal dysgenesis (turner's)
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primary amenorrhea with decreased or normal FSH
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steroidogenic enzyme defects, constitutional developmental delay
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positive progestin challenge and hirsutism
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PCOS
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postive progestin challenge and not hirsute
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mild hypothalamic dysfunction
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negative progestin challenge and FSH over 40
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gonadal failure
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negative progestin challenge and FSH under 40
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severe hypothalamic dysfunction
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metrorrhagia
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bleeding between periods
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endometrial thickness less than what indicates low likelihood of hyperplasia or endometrial CA
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<4 mm
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treatment for endometrial hyperplasia with atypical cells or carcinoma
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hysterectomy
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hirsutism with increased androgens (testosterone >2, DHEAS >7)
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r/o ovarian or adrenal neoplasm
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hirsutism with increased serum testosterone
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suspect ovarian tumor
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hirsutism with increased DHEAS
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suspect adrenal source
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hyperandrogenism, insulin resistance, and acanthosis nigricans
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HAIR-AN syndrome
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labs in PCOS
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increased LH/FSH ratio (>2:1), increased testosterone, increased androstenedione, DHEAS, decreased glucose/insulin ratio
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treatment for infertility associated with PCOS
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clomiphene
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most common location for ectopic pregnancy
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ampulla of oviduct
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amenorrhea, light vaginal bleeding, and lower abdominal pain
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ectopic pregnancy
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empty uterine cavity on US with B-hCG of 6500
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ectopic
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MTX is effective for what ectopic pregnancies
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small (<3 cm), unruptured
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clue cells
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gardnerella
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grayish-white, fishy discharge
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gardnerella/bacterial vaginosis
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Rx for gardnerella
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metronidazole or clinda X 7 days
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profuse, malodorous, yellow-green frothy discharge
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trichomonas
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flagellated organisms on saline smear
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trichomonas
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rx for trichomonas
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po flagyl
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most common cause of death in end-stage cervical cancer
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uremia
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most common cause of death in ovarian cancer
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bowel obstruction
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increased CA-125 in premenopausal woman
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may point to benign disease such as endometriosis
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marker for epithelial cell ovarian CA
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CA-125
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marker for endodermal sinus ovarian CA
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AFP
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marker for embryonal carcinoma
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AFP, hCG
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marker for choriocarcinoma
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hCG
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marker for dysgerminoma
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LDH
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gene related to ovarian CA
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BRCA-1 (and 2, but less so)
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strawberry cervix
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trichomonas
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normal ejaculate volume
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>1 ml
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normal sperm concentration
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>20 million/ml
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normal initial forward motility of sperm
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>50%
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normal amount of sperm with normal morphology
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>60%
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what do patients with fat necrosis have a history of?
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trauma in area of mass
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classic cause of ambiguous genitalia
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congenital adrenal hyperplasia - most caused by 21-hydroxylase deficiency
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hyponatremia, hyperkalemia, hypotension, elevated 17-hydroxyprogesterone
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21-hydroxylase deficiency
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candidal infection in girl may be presentation of what?
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diabetes
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abnormal lab in chemo-induced ovarian failure?
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increased FSH
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what phase: profuse, clear, thin mucus
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ovulatory
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increased risk of what with PCOS
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endometrial hyperplasia
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DES exposure in vitro
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clear cell adenocarcinoma of vagina
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treatment for motor urge incontinence
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oxybutinin
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treatement for overflow incontinence
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bethanecol/alpha blockers
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friable cervix, yellow/green discharge
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chlamydia
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Rx for chlamydia
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one dose azithroycin
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if pt has chlamydia, do they need rx for gonorrhea?
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no
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if pt has gonorrhea, do they need rx for chlamydia?
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yes
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treatment for precocious puberty
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GnRH agonists
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rx for PCOS and impaired glucose tolerance
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metformin
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what does raloxifine increase the risk of?
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DVT
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next step for CIN I/LGSIL
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colposcopy
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rx for hypertrophic dystrophy of vulva
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corticosteroid cream
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lab to check in pt with amenorrhea/hyperprolactinemia
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TSH - want to r/o hypothyroidism as cause
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indications for endometrial biopsy in DUB
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>35, obese, diabetes, HTN
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how does estrogen replacement therapy affect requirement for l-thyroxine?
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increases it
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indications for inpatient treatment of PID
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t>39, N/V, ileus, adolescents, nulliparous, low SES,
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kallman's syndrome
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normal karyotype with hypogonadotropic hypogonadism, eunuchoid stature, anosmia
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tumor that causes precocious puberty
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granulosa cell
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what does mullerian inhibiting factor do?
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secreted by gonads - suppresses development of uterus, tubes, vagina
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treatment for superficial thrombophlebitis
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NSAIDs, heat, rest
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treatment for tubo-ovarian abscess
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gent/clinda/amp, if not shrinking in 24-48 hours, then drain surgically
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tests of ovulatory function
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basal body temp and midluteal progesterone
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what is pathognomonic for primary ovarian failure (e.g. in turner's)
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increased FSH
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risk factors for osteoporosis
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thin, smoking, EtOH, steroids, menopause, malnutrition, family hx, asian/white
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test in primary amenorrhea if no breast development
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FSH
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test in primary amenorrhea if breast development is decreased/increased
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GnRH stimulation/karyotypin
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suspected PMS, advise pt to do what
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keep menstrual diary
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rx for atrophic vaginitis
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estrogen (plus progesterone if pt still has uterus)
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46XX with normal secondary sex characteristics, amenorrhea, absent/rudimentary uterus
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mayer-rokitansky-kuster-hauser syndrome
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mullerian agenesis
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mrkh syndrome
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cause of amenorrhea in an athlete
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estrogen deficiency
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papule that turns into beefy red ulcer, inguinal lymphadenopathy
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granuloma inguinale
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rx for granuloma inguinale
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tetracycline
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donovan bodies on giemsa/wright's stain
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granuloma inguinale
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treatment for lichen sclerosis
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superpotent topical steroids, clobetasol/halobetasol
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malaise, HA, fever, papule that turns into painless ulcer
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lymphogranuloma venereum
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cause of lymphogranuloma venereum
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chlamydia L1-3
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