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24 Cards in this Set
- Front
- Back
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WHich woman does not need a pap smear
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Pap smear screening is not indicated in patients who have had a total hysterectomy with removal of the cervix, unless it was done for cervical cancer or a high-grade cervical cancer precursor.
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How long should women get pap smears
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Patients with a uterus can discontinue cervical cancer screening between the ages of 65 – 70 if they have had three consecutive negative smears and no history of high-grade cervical intraepithelial neoplasia or cancer.
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When she woman begin getting colonoscopy
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Colon cancer screening is recommended at age fifty.
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Signs of gonorrhea
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Mucopurulent cervicitis with peak in the symptoms during and after menstruation is classically gonorrhea.
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Dx of syphilis
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The classic coiled spirochete is easily seen with dark-field microscopy
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trichomonas
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This patient most likely has trichomoniasis. The erythematous patches on the cervix are characteristic of “strawberry cervicitis.” Trichomonads are unicellular protozoans, which are easily seen moving across the slide with beating flagella
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bacteria vaginoisis
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A drop of KOH releases amines from the cells and a fishy or putrid odor is noted if bacterial vaginosis is present
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When should the first pap smear be given
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recommendation is for patients to have an annual Pap smear starting at 21 years of age regardless of history of sexual activity.The recommendation to start screening at age 21 years regardless of the age of onset of sexual intercourse is based in part on the very low incidence of cancer in younger women. It is also based on the potential for adverse effects associated with follow-up of young women with abnormal cytology screening results.
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Contraceptive method with lowest pregnancy rates
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Contraceptive methods with <1% pregnancy rates (typical use) are Depo-Provera, IUD, sterilization (male or female), and Implanon.
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risk factors for osteoporosis
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Risk factors for osteoporosis are early menopause, glucocorticoid therapy, sedentary lifestyle, alcohol consumption, hyperthyroidism, hyperparathyroidism, anticonvulsant therapy, vitamin D deficiency, family history of early or severe osteoporosis, or chronic liver or renal disease.
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Vaccines not given during pregnancy
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Pregnancy or the possibility of pregnancy within 4 weeks is a contraindication to the MMR and varicella vaccinations. Tetanus, Hepatitis B, Polio and Pneumococcal vaccinations would not be contraindicated.
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#1 killer of women
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Heart disease is the number one killer of women
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WHy folate with pregnancy and how much
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Folate can also help prevent neural tube defects. Studies have shown that diet alone is not effective in achieving adequate levels and routine folate supplementation is therefore recommended. Women of reproductive age should take a daily 400-microgram supplement. Adequate levels are especially important prior to pregnancy and during the first 4 weeks of fetal development.
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Risk factors for molar pregnancies? Why?
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There is a much higher incidence among Asian women in the United States (1/800.) Molar pregnancy occurs more frequently in women less than 20 or older than 40 years old. The incidence is higher in areas where people consume less beta-carotene and folic acid.
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Complete and partial molar pregnancy
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A complete mole has a characteristic “snowstorm” appearance on ultrasound. This is due to the presence of multiple hydropic villi. This patient has a classic presentation for a molar pregnancy. Vaginal bleeding is universal in molar pregnancies. Uterine size greater than dates (weeks from LMP) can be seen in 25-50% of moles, although size less than dates can be seen in 14-33% of moles. There is no fetus seen in cases of a complete mole. There can be a fetus, which is usually grossly abnormal, in cases of a partial mole. There is detectable beta-hCG in molar pregnancies. The beta-hCG values are generally higher than the values observed in normal pregnancy.
Molar pregnancies are classified as either complete or partial, depending on several histologic, pathologic and genetic characteristics. Partial moles may contain fetus/fetal parts, placenta/cord; complete moles do not. Partial moles are triploid karyotype (usually 69XXY, 69XXX, or 69XYY) resulting from fertilization of egg by dispermy; complete moles are diploid resulting from fertilization of “empty egg” by single sperm (46XX, 90%) or by 2 sperm (X & Y = 46XY 6-10%.) Partial moles show marked villi swelling; complete moles show trophoblastic proliferation with hydropic degeneration. Clinically, partial moles present with lower beta-HCG levels, affect older patients, have longer gestations, and are often diagnosed as missed or incomplete abortions. Complete moles usually present with larger uteri, preeclampsia and higher likelihood of developing into post-molar GTD. |
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Which of the following is most appropriate to rule out a molar pregnancy in this patient?
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pelvic ultrasound
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Management of molar pregnancy
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Suction curettage (D&C) is the standard management for molar pregnancies
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How soon can a couple resume trying to have a baby after D&C due to partial molar pregnancy
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Contraception until 6 months after negative beta-HCG levels.
Once evacuation has been accomplished, patients must be followed regularly with serial beta-HCG levels to insure spontaneous regression. Pregnancy should be avoided during this follow-up period, and for the following 6 months. |
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patient’s chances of successfully conceiving and delivering a viable infant after having a complete or partial molar pregnancy
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Excellent, because of the low risk of developing another mole
The risk of developing another molar pregnancy is approximately 1-2% (higher than compared to women who have never had a molar pregnancy). Therefore, full-term pregnancy is considered very plausible, even in women with repeated molar pregnancies. |
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Types of Gestational trophoblastic disease (GTD)
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1. molar pregnancies
2. persistent/invasive moles 3. choriocarcinoma |
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Most common vulvar cancer
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Squamous cell carcinoma accounts for approximately 90% of vulvar cancers.
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greatest risk factor for developingvulvar intraepithelial neoplasia grade 3
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HPV
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What does cryotherapy treat
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Cryotherapy is primarily used to treat cervical dysplasia.
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Dx:
vulva is fiery red background mottled with whitish hyperkeratotic areas without a distinct lesion. No nodularity or tenderness is noted. |
Paget’s disease of the vulva
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