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Gyn Labs 1
Gynecology
| Question | Answer |
|---|---|
| If find mass on CBE: | Order a diagnostic mammogram (not screening), unless age <30, then order U/S |
| fibroadenoma Dx | FNA; Cyto study of bloody fluid or solid tumor aspirate; U/S to differentiate solid from cystic mass; excisional bx |
| Age <30 yo, palpable lump, still there after menses, order: | unilateral breast U/S |
| Age > 30yo, palpable lump, order: | unilateral dx mammogram & U/S; |
| Palpable lump, age >40 yo & due for screening mammo: | get mammogram on unaffected side at same time |
| BI-RADS category 0-4: | Needs additional imaging evaluation |
| BI-RADS category 4: | Suspicious abnormality |
| BI-RADS category 6: | biopsy-proven malignancy |
| Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is: | less than 15% |
| Primary diagnosis of syphilis | Darkfield microscopy of chancre |
| Diagnosis of neurosyphilis | CSF examination recommended in symptomatic, late-latent, HIV co-infection (lumbar puncture) |
| VDRL becomes positive __ after inoculation with syphilis | About 2 weeks |
| Gram stain with a “school of fish” appearance is probably what | Chancroid (Haemophilus ducreyi) |
| Best source of HSV for testing | Unroofing the vesicle |
| Gold standard for HSV testing | Culture |
| __% of US have positive herpes Abs on serological testing | 50 |
| Most appropriate way to test for herpes | Culture (not serological) |
| Primary test of menopause: | FSH |
| GnRH Low: | hypothalamic hypogonadism, dopamine, opiates |
| GnRH high: | primary hypopituitary hypogonadism, epinephrine |
| GnRH testing: avoid: | steroids, ACTH, gonadotropin or estrogen medications for ≥48hrs |
| FSH low: | secondary gonadal failure, stress, malnutrition/anorexia, severe illness, hyperprolactinemia, PG |
| FSH high: | primary gonadal failure, castration, alcoholism |
| LH low = | pit or hypothalamic failure, severe stress, anorexia, malnutrition, severe illness, PG, hemochromatosis, sickle cell anemia, hyperprolactinemia |
| LH high = | gonadal failure, precocious puberty, pituitary adenoma, menopause, PCOS |
| LH: Best time to obtain single specimen | between 11am and 3pm |
| Progesterone low = | preeclampsia, threatened abortion, placental failure, fetal demise, ovarian neoplasm, amenorrhea, ovarian hypofunction, PCOS |
| Progesterone High = | ovulation, PG, hyperadrenocorticalism, adrenocortical hyperplasia, luteal cysts, molar pregnancy, choriocarcinoma |
| FSH assays done to dx: | menopause, menstrual irregularities, gonadal failure, predicting ovulation, evaluating infertility, pituitary disorders |
| Estrogen: high = | precocious puberty, ovarian tumor, adrenal tumor, gonadal tumor, normal pregnancy, cirrhosis, liver necrosis, hyperthyroidism |
| Estrogen: Low = | failing PG, Turner syndrome, hypopituitarism, hypogonadism, Stein-Leventhal syndrome, menopause, anorexia, PCOS |
| Max testosterone values when: | around 7am and 8pm |
| testosterone high = | ovarian tumors, adrenal tumor, congenital adrenocortical hyperplasia, trophoblastic tumor, PCOS, idiopathic hirsutism, drugs |
| testosterone low = | primary/ secondary ovarian failure, drugs |
| Progesterone w/drawal test evaluates: | H-P-gonadal axis |
| Progesterone withdrawal test: in normal cycle, progesterone surge: | inhibits FSH/LH and leads to withdrawal bleeding |
| Progesterone withdrawal test: probs causing failure of bleeding: | Estrogen production inadequate; Hypothalamic dysfunction; Uterus abnormal |
| Prolactin high = | pit adenoma, 2d amenorrhea, galactorrhea, hypothyroid, hypoglycemia, PCOS, anorexia, paraneoplastic syndromes, dz of hypothalamus /pituitary stalk, renal fail, drugs lowering dopamine, high estrogen |
| Prolactin low = | Sheehan syndrome, pituitary destruction by tumor |
| Prolactin levels should be collected: | 3-4hrs after waking |
| Ovarian cancer workup | US (if pos: CXR for mets). CA-125. HCG. Ex-lap. CT or MRI prn. Colonoscopy. Mammogram if breast mass. |
| Ovarian failure / amenorrhea: associated hormones | elevated FSH / LH |
Created by:
Abarnard
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