Kobgyn 650-700

Front 1

Q650. when do diaphragms and cervical caps need to be refitted postpartum?

Back 1

A650. 6 weeks

Front 2

Q651. what are the (3) hormonal contraceptives of choice postaprtum?; Why?

Back 2

A651. Depo-provera,; Norplant,; Progesterone-only minipill b/c they are less likely to decrease milk production in breast-feeding patients

Front 3

Q652. What are the causes of postpartum hemorrhage?; (6)*

Back 3

A652. Coagulation Defect;; Atony;; Rupture;; Placenta (POC) retained;; Implantation site bleed;; Trauma

Front 4

Q653. what are the steps in managing a postpartum hemorrhage?; (4 steps)

Back 4

A653. 1. RULE OUT cervical/vaginal lacerations; 2. if still bleeding: give Uterotonic agents (Oxytocin); 3. if still bleeding: D&C; 4. if still bleeding: Laparotomy with bilateral O'Leary sutures to tie off uterine arteries

Front 5

Q654. Dx:; fever, high WBC, uterine tenderness 5 - 10 days post C- section; Tx?; (2)

Back 5

A654. Endomyometritis; Tx: D&C, broad-spectrum Antibiotics until afibrile for 48 hrs

Front 6

Q655. what is the underlying cause of labial fusion?

Back 6

A655. excess Androgens

Front 7

Q656. MC form of enzymatic deficiency assoc with ambiguous genitalia; what is deficient?

Back 7

A656. Congenital Adrenal hyperplasia; (21-hydroxylase deficiency)

Front 8

Q657. Dx:; hyperandrogenism, salt wasting, hypotension, hyperkalemia, hypoglycemia, ambiguous genitalia

Back 8

A657. Congenital Adrenal Hyperplasia; (21-hydroxylase deficiency)

Front 9

Q658. what main lab is elevated in Congenital Adrenal Hyperplasia?; what is Tx?

Back 9

A658. 17-alpha-hydroxyprogesterone; Tx: Cortisol (and a mineralcorticoid if pt is salt-wasting)

Front 10

Q659. what is the name of the fertilized oocyte 2 - 4 days after fertilization?; what is it called in the next stage?

Back 10

A659. Blastomere / Morula; next: Blastocyst

Front 11

Q660. Dx:; patient at puberty with primary amenorrhea and cyclic pelvic pain, lower abdominal girth

Back 11

A660. Imperforate hymen

Front 12

Q661. Definition:; build-up of blood behind the hymen in person with imperforate hymen; Tx?

Back 12

A661. Hematocolpos; Tx: surgery

Front 13

Q662. (2) causes of Vaginal Agenesis

Back 13

A662. Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH); Androgen Insensitivity

Front 14

Q663. Dx:; normal female karyotype with ovaries and secondary sexual characteristics, but congenital absence or hypoplasia of vagina, cervix, uterus and fallopian tubes

Back 14

A663. Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH)

Front 15

Q664. what is the Tx for Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH)?

Back 15

A664. Create vagina: with dilators; or McIndoe procedure (surgically creating vagina with skin grafts)

Front 16

Q665. Dx:; woman with scant pubic hair and small breasts with vaginal agenesis or absence and absence of uterus; cause?

Back 16

A665. Androgen Insensitivity; cause: nonfunctioning androgen receptors (normal levels of Testosterone)

Front 17

Q666. Dx:; symmetric white, thinned skin on labia, perineum and perianal region. Shrinkage and agglutination of labia with occasional pruritis or dysparunia; Tx?

Back 17

A666. Lichen Sclerosis; Tx: Topical steroids (Clobetasol)

Front 18

Q667. Dx:; localized thickening of the vuvlar skin from edema with chronic pruritis, possible raised white lesion on labia majora or clitoris

Back 18

A667. Squamous cell hyperplasia

Front 19

Q668. Dx:; multiple shiny, flat, purple papules usu on the inner aspects of the labia minora, vagina and vestibule. Often erosive and causing pruritis and mild inflammation

Back 19

A668. Lichen Planus

Front 20

Q669. Dx:; Thickened white epithelium, slight scaling, usually unilateral and circumscribed on vulva, with pruritis; (2) Tx?

Back 20

A669. Lichen Simplex Chronicus; Tx: Ultraviolet light, Topical steroids

Front 21

Q670. Dx:; Red, moist and sometimes scaly lesions on vulva, which may also be found on scalp, axilla, groin and trunk

Back 21

A670. Vulvar Psoriasis

Front 22

Q671. Dx:; palpable red granular spots and patches in the upper third of the vagina on the anterior wall

Back 22

A671. Vaginal Adenosis

Front 23

Q672. how are vulvar lesions Dx?

Back 23

A672. Biopsied

Front 24

Q673. MC benign tumor on the vulva

Back 24

A673. Epidermal Inclusion cysts

Front 25

Q674. Definition:; Disease that causes occlusion of the sweat glands on mons pubis and labia majora, causing cyst formations; Tx?

Back 25

A674. Fox-Fordyce Disease; Tx: I&D

Front 26

Q675. how do you differentiate an epidermal cyst from a sebaceous cyst?

Back 26

A675. Epidermal - solitary cyst; Sebaceous - collection of cysts

Front 27

Q676. where are the Skene glands located?

Back 27

A676. Paraurethral

Front 28

Q677. where are the Bartholian glands located?

Back 28

A677. Bilaterally at 4 and 8 o'clock on labia majora

Front 29

Q678. what is first step in Tx if a Bartholian cyst first appears in woman over 40yo?

Back 29

A678. Biopsy to RULE OUT Bartholian gland carcinoma

Front 30

Q679. Tx of a Bartholian Abscess; what is Tx for recurrent Bartholian Abscesses?

Back 30

A679. Tx: I&D with placement of Word catheter; Recurrent: Marsupialization

Front 31

Q680. Definition:; Cervical dilated retention cysts

Back 31

A680. Nabothian cysts

Front 32

Q681. Definition:; Cervical cysts that lie deep in the stroma and are from remnants of Wolffian ducts

Back 32

A681. Mesonephric cysts

Front 33

Q682. even though cervical polyps are not premalignant, why are they removed?

Back 33

A682. to avoid masking bleeding from other sources and to avoid misidentification for an endometrial polyp

Front 34

Q683. MC Uterine formation anomaly; cause?

Back 34

A683. Septate uterus; cause: Problems with fusion of Paramesonepheric ducts

Front 35

Q684. what are anomalies of the uterus assoc with (non-gyn medical)?; (2)

Back 35

A684. Urinary tract anomalies; Inguinal hernias

Front 36

Q685. Dx:; amenorrhea or dysmenorrhea, dyspareunia, cyclic pelvic pain, infertility or recurrent pregnancy loss or premature labor

Back 36

A685. Uterine anatomic anomalies; (Septate uterus)

Front 37

Q686. Dx:; small uterine cavity, second-trimester pregnancy loss, malpresentation and possible premature labor

Back 37

A686. Bicornuate uterus

Front 38

Q687. Tx of Septate and Bicornuate uteri

Back 38

A687. Surgical removal of septum

Front 39

Q688. Definition:; Benign, estrogen-sensitive smooth muscle tumors of the uterus; found in what percentage of reproductive-age women?

Back 39

A688. Fibroids (Uterine Leiomyomas); in 20 - 30% of reproductive-age women

Front 40

Q689. Incidence of Fibroids in Black women; (3) causes to increase risk of developing fibroids

Back 40

A689. 3 - 9 x higher in Black Risks:; Non-smoking,; Obese,; PeriMenopausal

Front 41

Q690. what distinguishes a Fibroid from adenomyosis?

Back 41

A690. Fibroid has a Pseudocapsule

Front 42

Q691. Top (2) MC Sx in patient with Fibroids

Back 42

A691. Asymptomatic (50 - 65%) (MC otherwise is Prolonged bleeding)

Front 43

Q692. Drug Tx for Fibroids; (3); MOA of these drugs collectively

Back 43

A692. Provera,; Danzol,; GnRH agonists (Lupron) MOA - shrink fibroids by reducing circulating Estrogen

Front 44

Q693. If drugs dont work, what is the name of the surgical Tx for Fibroids?; Only Difinitive Tx?

Back 44

A693. Myomectomy (removal of one or more Fibroid surgically); Only Difinitive Tx: Hysterectomy

Front 45

Q694. what causes Endometrial Hyperplasia?

Back 45

A694. continuous endogenous or exogenous Estrogen in absence of Progesterone

Front 46

Q695. In endometrial hyperplasia, what proliferates in endometrium?; (2)

Back 46

A695. Glandular and Stromal elements of endometrium

Front 47

Q696. Risk factors for getting Endometrial Hyperplasia; (9)

Back 47

A696. CLONED PHD:; Chronic Anovulation,; Late Menopause (> age 55),; Obesity,; Nulliparity,; Estrogen-producing tumors (granulosa-theca cell tumor),; Diabetes,; PCOS,; Hypertension,; Drugs - Tamoxifen

Front 48

Q697. Dx:; long periods of Oligomenorrhea or amenorrhea followed by irregular or excessive uterine bleeding

Back 48

A697. Endometrial Hyperplasia

Front 49

Q698. main Dx evaluation used to Dx Endometrial Hyperplasia; what is second choice?

Back 49

A698. Endometrial biopsy (or D&C...second choice)

Front 50

Q699. Risk of malignant transformation from Endometrial Hyperplasia in:; 1. Simple Hyperplasia; 2. Complex Hyperplasia; 3. Atypical Simple Hyperplasia; 4. Atypical Complex Hyperplasia

Back 50

A699. Simple = 1%; Complex = 3%; Atypical Simple = 8%; Atypical Complex = 29%

Front 51

Q700. what is the initial Tx for all types of endometrial hyperplasia in child-bearing patient?; Non-child bearing patient?

Back 51

A700. Child bearing:; Progestin therapy for 3 months; (followed by resampling of Endometrium); Non-child bearing:; Hysterectomy