Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
51 Cards in this Set
- Front
- Back
|
Q1200. Contraception - Levonorgestrel (Norplant) - What is it
|
A1200. Taken off market 2002; progestin subdermal implant; suppresses ovulation; thickens cervical mucus; makes endometrium unsuitable for implantation; effect lasts 5 yrs.
|
|
|
Q1201. Contraception - Levonorgestrel (Norplant) - Side Effects
|
A1201. Irreg vag bleeding; weight gain; galactorrhea; acne; breast tenderness; headache; hard to remove
|
|
|
Q1202. Contraception - Postcoital morning-after pill; What is it
|
A1202. Progesterone +/- estrogen; take within 72 hrs of unprotected sex; suppresses ovulation; discourages implantation
|
|
|
Q1203. Contraception - Postcoital morning-after pill; Side Effects
|
A1203. N/V; fatigue; breast tenderness; headache; dizziness
|
|
|
Q1204. Contraception - Medroxyprogesterone; (Depo-Provera); What is it
|
A1204. IM injection given every 3 mos; suppresses ovulation; thickens cervical mucus; makes endometrium unsuitable for implantation
|
|
|
Q1205. Contraception - Medroxyprogesterone; (Depo-Provera); Side Effects
|
A1205. Irreg vag bleeding; depression; weight gain; breast tenderness; delayed restoration of ovulation after discontinue
|
|
|
Q1206. Contraception - Surgical Sterilization; (Tubal Ligation, Vasectomy); What is it
|
A1206. Tubes ligated, cauterized or mechanically occluded
|
|
|
Q1207. Contraception - Surgical Sterilization; (Tubal Ligation, Vasectomy); Side Effects
|
A1207. Essentially irreversible; bleeding; infection; failure; ectopic pregnancy
|
|
|
Q1208. Intraductal Papilloma - What is it
|
A1208. Common cause of bloody nipple discharge
|
|
|
Q1209. Fibrocystic Change - What is it
|
A1209. Catchall term; spectrum of clinical findings; mastalgia; breast cysts; fibroadenoma; mastitis; hyperplasia; nodularity; commonly seen in premenopause; from exaggerated response of stroma to hormones & growth factors; increased cancer risk only if cellular atypia
|
|
|
Q1210. Fibrocystic Change - History/PE
|
A1210. Cyclic,; premenstrual,; b/l breast pain,; tenderness, swelling; excessive tissue nodularity
|
|
|
Q1211. Fibrocystic Change - Dx
|
A1211. Fine-needle aspiration; cytologic exam
|
|
|
Q1212. Fibrocystic Change - Tx
|
A1212. Decreased caffeine and nicotine; vit E; progestins; danazol; tamoxifen; diuretics
|
|
|
Q1213. Fibroadenoma - What is it
|
A1213. MC breast lesion < 30; benign, slow-growing tumor; epithelial & stroma components; recurrence common; phyllodes tumor - (cystosarcoma phylloides); grows fast; large type of fibroadenoma; rarely malignant
|
|
|
Q1214. Fibroadenoma - History/PE
|
A1214. Round; firm, NT; mobile; solitary mass, discrete
|
|
|
Q1215. Fibroadenoma - Dx
|
A1215. Surgical excision - tissue for Dx
|
|
|
Q1216. Fibroadenoma - Tx
|
A1216. Surgical excision
|
|
|
Q1217. Breast Cancer - What is it
|
A1217. MC cancer (incidence); no. 2 in cancer death; risk factors – gender, age, breast Ca 1st degree relatives, history of breast cancer, 1st fullterm preg after 35 y/o, history of fibrocystic change with cellular atypia, increased exposure to estrogen – nullparity, early menarche, late menopause, late menarche - decreased risk, BRCA-1 & BRCA-2 mutations - early-onset familial breast, and ovarian cancers
|
|
|
Q1218. Breast Cancer - History/PE
|
A1218. Lump – hard, irreg, not mobile, painless; possible nipple discharge; can be asymp and nonpalpable; MC location - upper outer quad; mets to - lymph nodes, bones, brain, lung, liver; advanced disease - skin changes: dimpling, redness, ulceration, edema, axillary adenopathy
|
|
|
Q1219. Breast Cancer - Dx
|
A1219. Mammography - ↑ density, microcalcifications, irregular borders; US - solid mass vs. benign cyst; tumor markers for recurrent- CEA, CA 15-3, CA 27-29, estrogen receptor (ER), progesterone receptor (PR), HER2/neu status; metastatic disease - ↑ ESR, ↑ alk phos, ↑ calcium; CXR - pulmonary metas; CT - chest, abdomen, pelvis, brain; bone scan
|
|
|
Q1220. Breast Cancer - Tx
|
A1220. All hormone receptor pos. - tamoxifen; estrogen rec. neg - chemo; trastuzumab - HER2/neu-expressive cancers; partial mastectomy and axillary dissection followed by radiation; modified radical mastectomy (total mastectomy plus axillary dissection); contraindications to breast-conserving therapy - large tumor, multifocal tumors, subareolar location, fixation to chest wall, nipple involved, overlying skin involved; Invasive cancer requires axillary dissection; stage IV - radiation and hormones, mastectomy may required; ER- and PR+ - favorable
|
|
|
Q1221. Ectopic Pregnancy - What is it
|
A1221. Implants outside uterus cavity; MC site - ampulla; risk - history of PID (most common), prior ectopic pregnancy, tubal/pelvic surgery, DES exposure in utero, IUD
|
|
|
Q1222. Ectopic Pregnancy - History/PE
|
A1222. Classic triad – amenorrhea, light vag bleeding, lower abdom or pelvic pain/tender pelvic or adnexal mass; ruptured ectopic - surgical emergency; sudden, sharp abdom pain, shock, orthostatic hypotension, tachycardia; shoulder pain; generalized abdominal and adnexal tenderness with rebound tenderness
|
|
|
Q1223. Ectopic Pregnancy - Dx
|
A1223. B-hCG - levels lower than normal preg, level takes > 2D to double; serum progesterone < normal; transabdom or transvag US; Dx - empty uterine cavity and B-hCG of 6,500; culdocentesis - > 5cc of nonclotting blood, identifies hemoperitoneum, not sensitive nor specific
|
|
|
Q1224. Ectopic Pregnancy - Tx
|
A1224. Serial B-hCG and US; expectant management if - asymp; decreased B-hCG; small mass; no US evidence of bleeding; methotrexate - stable, unruptured; all others, surgery – salpingostomy, salpingectomy, salpingo-oophorectomy; RhoGAM if appropriate
|
|
|
Q1225. Ectopic Pregnancy - Complications
|
A1225. Inevitable loss of fetus; hemorrhagic shock; future ectopic pregnancy; infertility; maternal death; Rh sensitization
|
|
|
Q1226. Vaginitis - What Causes it
|
A1226. Vagina normally - mixed bacterial flora; acidic envi (pH 3.5-4.5); maintained by lactic acid- producing lactobacilli; change in environment => overgrowth of other bacteria, can be bact., fungi, protozoa
|
|
|
Q1227. Bacterial Vaginosis - History/PE
|
A1227. Gray, fishy-smelling discharge; often pruritus and irritation
|
|
|
Q1228. Bacterial Vaginosis - Dx
|
A1228. pH > 4.5; saline smear - clue cells; KOH prep - positive whiff test
|
|
|
Q1229. Bacterial Vaginosis - Tx
|
A1229. PO metronidazole
|
|
|
Q1230. Trichomonas - History/PE
|
A1230. Profuse, malodorous, yellow-green discharge; dysuria; dyspareunia; erythema; strawberry petechiae in upper vagina/cervix
|
|
|
Q1231. Trichomonas - Dx
|
A1231. pH > 4.5; saline smear - motile trichomonads; KOH prep - nothing
|
|
|
Q1232. Trichomonas - Tx
|
A1232. PO metronidazole; Tx partner; test for other STDs
|
|
|
Q1233. Candidal Vaginitis - History/PE
|
A1233. Thick, white discharge - cottage-cheese texture; pruritus with or without burning; erythematous, excoriated vulva/vagina
|
|
|
Q1234. Candidal Vaginitis - Dx
|
A1234. pH - normal; saline smear - nothing; KOH prep - pseudohyphae
|
|
|
Q1235. Candidal Vaginitis - Tx
|
A1235. Topical antifungals (miconazole); po fluconazole
|
|
|
Q1236. Vaginitis - Dx
|
A1236. Detect vag pH with nitrazine paper; micro exam of discharge - saline (wet prep), KOH; rule out STDs - gram stain of discharge; Chlamydia Ag test; rule out UTI - clean-catch UC and UA
|
|
|
Q1237. Vaginitis - Complications
|
A1237. Increased risk of PID - with bacterial vaginosis; preterm labor; ROM
|
|
|
Q1238. Cervicitis - What is it
|
A1238. N. gonorrhea; Chlamydia; co-infection common; infect cervical glandular epithelium; cervix - red & bleeds easily; yellowish-green mucopurulent discharge; discharge can be seen exuding from endocervical canal
|
|
|
Q1239. Cervicitis - Dx
|
A1239. Cervical motion tenderness (CMT); no other signs of PID
|
|
|
Q1240. Pelvic Inflammatory Disease - What is it; Risk Factors
|
A1240. Microorg. ascend into:; endometrium - endometritis; uterine wall - myometritis; fallopian tubes - salpingitis; ovaries - oophoritis; parietal perit. - peritonitis; most causes - gonorrhea & chlamydia; risk factors - multiple sexual partners, unprotected or freq. sex, young age at 1st intercourse, mucopurulent cervicitis, prior PID, IUD; incidence decreases with – OCPs, barrier contraception
|
|
|
Q1241. Pelvic Inflammatory Disease - History/PE
|
A1241. Lower abdominal pain; fever, chills; menstrual disturbances; purulent cervical discharge; cervical motion tenderness; adnexal tenderness; RUQ pain may indicate perihepatitis (Fitz-Hugh–Curtis syndrome)
|
|
|
Q1242. Pelvic Inflammatory Disease - Dx
|
A1242. Lower abdom, adnexal and cervical motion tenderness; fever; increased ESR; increased CRP; WBC > 10,000; cervical swab pos. for chlamydia or gonorrhea; US - pelvic abscess; Def. Dx - laparoscopy; consider - B-hCG, RPR/VDRL, HIV, LFTs
|
|
|
Q1243. Pelvic Inflammatory Disease - Tx
|
A1243. Don't wait on culture results; treat partner; outpatient (3 options) - cefoxitin + probenecid × 1dose; ceftriaxone IM × 1 dose and doxycycline × 14 days; ofloxacin × 14 days and metronidazole × 14 days; admit - if surgical emergency can't be ruled out, tubo- ovarian abscess - admit for at least 24 hours, pregnant, don't improve after 48-72 hrs. of outpatient Tx, severe illness, n/v, high fever, immunodeficient, noncompliant; cefoxitin or cefotetan and doxycycline × 14 days.
|
|
|
Q1244. Pelvic Inflammatory Disease - Complications
|
A1244. Ectopic pregnancy; chronic pelvic pain; infertility; repeated infections; Fitz-Hugh-Curtis syndrome; pelvic/tubo-ovarian abscess - severe pain, high fever, n/v, signs of sepsis, peritoneal signs, adnexal mass; admit - IV Antibiotics, hydration, drainage or TAHBSO
|
|
|
Q1245. Toxic Shock Syndrome - What is it
|
A1245. Acute illness; caused by preformed S. aureus toxin (TSST-1); 90% women of childbearing age in 5 days of onset of menses, tampon use; nonmenstrual almost as common- organisms from: nasopharynx, bones, vagina, rectum, wounds
|
|
|
Q1246. Toxic Shock Syndrome - History/PE
|
A1246. Abrupt onset - fever, vomiting, diarrhea; can => hypotensive shock, diffuse macular erythematous rash (sunburn-like); nonpurulent conjunctivitis; desquamation of palms and soles within 1–2 weeks
|
|
|
Q1247. Toxic Shock Syndrome - Dx
|
A1247. BC - neg
|
|
|
Q1248. Toxic Shock Syndrome - Tx
|
A1248. Admit; rehydration; remove source of toxin; antistaph Antibiotics - nafcillin, oxacillin; manage renal or cardiac failure
|
|
|
Q1249. Menorrhagia - What is it; Cause
|
A1249. ↑ amount of flow > 80 mL per cycle or prolonged bleeding, flow lasts > 8 days causes; leiomyoma; endometrial hyperplasia; endometrial polyps; endometrial cancer; cervical cancer; pregnancy complications
|
|
|
Q1250. Oligomenorrhea - What is it; MCC
|
A1250. ↑ length of time between menses; 35–90 days between cycles; MCC - pregnancy
|
