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USMLE2 OBGyn 2
Gyn
| Question | Answer |
|---|---|
| definition of primary amenorrhea | no menses by age 16 or no menses 4 years after thelarche |
| thelarche | breast development |
| secondary amenorrhea | no menses for 3 mo after it started |
| isolated premature thelarche | breast development without pubic/axillary hair development |
| delayed thelarche | no breast development by age 13 |
| laser or cold-knife conization of the cervix are at a more significant risk of | late bleeding usually occurs 7 to 14 days after the procedure |
| cervix is derived from | fusion of paramesonephric ducts |
| clitoris is derived from | genital tubercle |
| what differentiates the paramesonephric ducts from the mesonephric ducts? | MIF (mullerian inhibiting factor) |
| what structure forms the male sexual organs? | mesonephric ducts |
| Grade I stress incontinence | only present with severe stress, including laughing, coughing, or sneezing |
| Grade II stress incontinence | present with moderate stress, including walking up and down stairs or rapid changes in position |
| Grade III stress incontinence | present with mild stress, including rising from a seated to a standing position. The patient is continent when supine. |
| Urge incontinence | detrusor muscle instability, and leakage occurs secondary to involuntary and/or uninhibited bladder contractions |
| Tx for pts presenting with recurrent infection of the Bartholin gland should have | marsupialization. The entire abscess and cyst is removed with the space sutured open to allow epithelialization to occur, eliminating the space for recurrent infections to form. |
| What is the most common cause of malignant transformation in Vulvar intraepithelial neoplasia (VIN) | human papillomavirus (HPV) |
| What accounts for about 85 to 90% of vulvar cancers? | Squamous cell carcinoma |
| clear cell adenocarcinoma of the vagina is highly associated with what? | exposure to diethylstilbestrol (DES) exposure in utero |
| Lichen sclerosis occurs in whom? How to tx? | postmenopausal women who no longer produce estrogen --> atrophic changes in epith. TOC is a topical corticosteroid cream once daily plus a topical 2% testosterone cream once daily, which helps to build up the atrophic epithelium, for at least 6 weeks |
| What is hidradenitis suppurativa and how to tx? | abscess formation and superinfection of apocrine sweat glands and cysts; occurs in axillary & genital regions; chronic, progressive disease. I&D for abscesses and abx for cellulitis. |
| Fox-Fordyce disease | collection of pruritic, multiple microcysts also caused by occlusion of the apocrine glands |
| 2-cm mass at the 4 o'clock position on the labia majora, mass is nontender and no erythema or drainage is noted. How to tx? | Bartholin cyst. For cysts that are less than 2 cm and asymptomatic, the best action is to do nothing and advise the patient to take warm sitz baths; the cysts usually resolve on their own. |
| Looks like a mass at the 8 o'clock position on the labia majora with pain tenderness and erythema, with area of fluctuance | Bartholin gland abscess is usually with incision and drainage with insertion of a Word catheter. |
| How to tx recurrent Bartholin cysts? | marsupialization - excision of the entire cyst and abscess with suturing open of the empty space and allowing re-epithelialization to occur. |
| When to tx Bartholin cysts with abx? | only if cellulitis or gonorrhea infection, not with just abscess |
| Most common organism causing Bacterial Vaginosis | Gardnerella vaginalis |
| most important factor in the prognosis of endometrial cancer | histologic grade of endometrial cancer is the most important prognostic factor for endometrial carcinoma |
| How to tx endometrial Complex hyperplasia | progesterone (oral Provera or IM Depo-Provera) in doses high enough to inhibit and eventually reverse the process of hyperplasia due to unopposed estrogenic stimulation. |
| How to tx endometrial atypical hyperplasia | Hysterectomy is the treatment of choice because of the high likelihood of progression to malignancy. |
| What is the tx of choice for endometrial CA? | Total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) and lymph node dissection |
| What is the most common indication for hysterectomy? | Uterine leiomyomas are the most common indication for hysterectomy, responsible for approximately of 30% of procedures performed |
| T-shaped uterine cavity with or without dilated horns | diethylstilbestrol exposure in utero |
| small septate indentation present at the uterine fundus | arcuate uterus |
| uterine septum which is located at the fundus | Partial bicornuate uterus |
| midline fusion of the Müllerian ducts is arrested, either completely or incompletely | Didelphys uterus |
| uterine septum that extends from the fundus to the cervical os is present | bicornuate uterus |
Created by:
christinapham
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