Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Women's Health EOR
| Question | Answer |
|---|---|
| hCG comes from | trophoblastic tissue |
| Serum hCG detection | 5-7 days after conception, or 20-22d after LMP |
| hCG peak | 10-12w after conception |
| Urine hCG detection | 14d after conception |
| Ladin Sign | uterus softening after 6w |
| Heager sign | uterus isthmus widening and softening after 6-8w gestation |
| Piskacek sign | palpable lateral bulge or softening of uterine cornus at 7-8w gestation |
| Leukorrhea | vaginal discharge containing epithelial cells and cervical mucus |
| Goodell's sign | cervical softening due to increased vascularization ~4-5w gestation |
| Chadwick's sign | bluish coloration of the cervix ad vulva ~8-12w |
| When fetal heart tones become detectable w doppler | 10-12w gestation |
| Normal fetal HR | 110-160 |
| When cardiac activity becomes detectable w TVUS | 6w |
| Limb bud development | 7-8w |
| Finger and limb movement | 9-10w |
| Gravida | Number of times pregnant |
| Para | Number of births |
| Abortions | Number of pregnancies lost |
| How far along when the height of the fundus is at the umbilicus | 20-22w |
| How far along when the height of the fundus is at the xiphoid process | 36w |
| Normal things that increase during pregnancy | blood volume, cardiac output, stroke volume, tidal volume, HR |
| Normal things that decrease during pregnancy | Residual capacity, systemic vascular resistance, BP second trimester |
| EDD | crown to rump, Naegele's rule, Calander |
| Neagle's rule | minus 3m from month of LMP and add 7d to start of LMP |
| Multiple gestation signs | rapid weight gain and increasing size of the uterus, rapidly rising b-hCG and a-FP |
| Dizygotic twins | fraternal |
| Maternal twins | identical |
| Identical twin risk to fetus | fetal transfusion syndrome and discordant fetal growth |
| Maternal risk with twins | Preterm labor, spontaneous abortions, pre-e, anemia |
| Fetal risk as twins | IGR, placental abnormalities, breech, umbilical cord prolapse, pre-e |
| Variable deceleration | Sharp drop on fetal monitor w quick recovery |
| Variable deceleration likely cause | Cord compression |
| Patho of Variables on FHRM | occur due to fetal baroreceptors response to umbilical cord compression |
| 1st management of variables FHRM | trade to left lateral decubitus then right lateral decubitus |
| 2nd management of variables on FHRM | amnioinfusion to take pressure off the cord |
| 3rd management of variables on FHRM | C-section |
| Earlies likely cause | Head compression |
| Early decelerations | dips in fetal HR that occur with contractions |
| Patho of Earlies on FHRM | Vagal response from fetal head compression |
| Early decel management | Likely benign labor progress |
| Acceleration on FHRM | >15s but <2m |
| Patho of acceleration on FHRM | movement by baby |
| Late decel likely cause | Poor fetal oxygen during uterine contractions associated with uteroplacental insufficiency |
| Late decel management | interventions- mom move, IV fluids, O2, stop pit, possible C |
| Infective lactational mastitis | Infection of the breast in women who lactate secondary to nipple trauma |
| Most common bacteria causing breast infections | Staphylococcus |
| Bugs causing breast infections | Staph, MRSA, Strep, Candida |
| Signs and symptoms infectious mastitis | pain, tender, warmth, swelling, erythema, flu-like symptoms |
| Infective mastitis signs and symptoms | one side, red, hot, tender, flu like symptoms |
| Mastitis diagnostic studies | Clinical diagnosis |
| Mastitis rx | Continue breastfeeding, complete emptying of ducts, pain control with heat and NSAIDS, abx if systemic symptoms |
| Antibiotics for mastitis | Dicloxacillin, flucloxacillin, or cephalexin |
| Most common bugs of mastitis | Staph, MRSA, Strep, Candida |
| Number 1 causing bug of mastitis | Staph |
| Post menopausal breast inflammation | Cancer until proven otherwise |
| Breast abscess signs and symptoms | Unilateral, hot, tender, erythematous, may have nipple discharge, induration and fluctuance from pus |
| Breast abscess diagnostic studies | Clinical diagnosis, but could do ultrasound |
| Complication of acute mastitis | Breast abscess |
| Breast abscess rx | Continue breast feeding, I and D or aspirate, antibiotics |
| Antibiotics for breast abscess | Dicloxacillin or cephalexin, if MRSA or penicillin allergy clindamycin or Bactrim |
| Most common bugs of breast abscesses | Staph, MRSA, Strep, Candida |
| Congestive mastitis signs and symptoms | Bilateral breast enlargement and pain |
| Congestive mastitis diagnostic studies | Clinical diagnosis |
| Congestive mastitis comes from | Milk supply coming in |
| Fibrocystic breast changes signs and symptoms | Noncancerous fluid filled cysts, change in size with hormones, bilateral, mobile, ill-defined |
| Fibrocystic breast studies | US, Mamogram, Aspirate |
| Number one diagnostic studies of fibrocystic breasts | US |
| fibrocystic breast changes rx | Observation, reassurance, OCPs, caffeine reduction, fine needle aspiration |
| Most common breast mass in reproduction | Fibrocystic breast changes |
| Causes of fibrocystic breast changes | exaggerated changes from hormones |
| Fibrocystic breast changes may look like | breast carcinoma or fibroadenoma |
| Intraductal papilloma signs and symptoms | Typically bloody nipple discharge |
| Intraductal papilloma diagnostic studies | Mammogram, US, MRI, or core biopsy |
| Intraductal papilloma rx | May need excision based on size, symptoms, and cancer risk |
| Intraductal papilloma | Tumors involving the lining of the breast duct |
| Fibroadenoma signs and symptoms | Benign solid tumor, round, mobile, nontender, does not change size w cycle |
| Fibroadenoma diagnostic studies | Clinical diagnosis, US, aspirate |
| Definitive diagnostic for fibroadenoma | Aspiration |
| Fibroadenoma rx | Observe, reassurance, and follow up, could do excision if large, cryo if <4cm |
| Second most common benign breast mass | Fibroadenoma |
| Gynecomastia signs and symptoms | Palpable rubbery mass of tissue, bilateral, and tender |
| Gynecomastia diagnostic studies | Clinical diagnosis, but can test testosterone and mammogram if concern for cancer |
| Risk factors for gynecomastia | Hormones and idiopathic |
| Periods of life where men may have gynecomastia | Infants, adolescent, older |
| Gynecomastia rx | Supportive- stop offending agents, tamoxifen, testosterone replacement, surgical |
| Tamoxifen | estrogen antagonist of breast |
| Gynecomastia | Enlargement of glandular breast tissue and adipose tissue in males from increased estrogen or decreased androgens |
| Infiltrative ductal carcinoma | Cords and nests of cells w differing amounts of glands |
| Most common type of breast cancer | Infiltrative ductal carcinoma |
| Common mets with infiltrative ductal carcinoma | lymph |
| Infiltrative lobular carcinoma | Small cells infiltrate the mammary stroma and adipose tissue |
| Ductal carcinoma in-situ | Confined to breast ducts and lobes |
| Inflammatory carcinoma | Rapidly progressing, tender, firm, enlarged, skin findings |
| Skin findings of inflammatory carcinoma | erythema, itching, warm, peau d'orange |
| Types of inflammatory carcinoma | Medullary, mucinoid, tubular, papillary, metastatic |
| Paget disease of the breast | Ductal carcinoma, eczematous nipple, may have a lump, may have discharge |
| Paget disease spreads through | lymph |
| Lobular carcinoma | Premalignant, increased risk of invasive breast cancer |
| Cervical insufficiency signs and symptoms | asymptomatic, painless cervical dilation and effacement in the second trimester, may have contractions, may have bleeding or discharge |
| Clinical insufficiency diagnostic studies | Clinical diagnosis, wide internal os, possible budging membranes, TVUS |
| Risk factors for cervical insufficiency | Previous cervical trauma- LEEP, D+C, DES exposure |
| Cervical insufficiency rx | Cervical cerclage and bed rest, may add weekly Alpha-hydroxyprogesterone |
| Cervical insufficiency | inability to maintain pregnancy secondary to premature cervical dilation |
| Cervical cancer signs and symptoms | AUB, post coital bleeding, pelvic and back pain |
| Most common symptom of cervical cancer | Post coital bleeding |
| Cervical cancer diagnostic studies | PAP, Colpo w biopsy |
| Cervical cancer RF | HPV- 16 or 18, early sexual exposure, multiple partners, smoking, immunosuppress |
| Stage 0 cervical cancer rx | excision |
| Stage 1A, 1B, and 2A cervical cancer rx | excision and radiation |
| Locally advanced cervical cancer rx | Radiation and chemo |
| Advanced/metastatic cervical cancer rx | Systemic chemo |
| 3rd most common gynecologic cancer | Cervical cancer |
| Most common age of diagnosis of cervical cancer | 40-50s |
| Cervicitis signs and symptoms | Vaginal discharge and friable cervix |
| Cervicitis is typically caused by | STD- Gonorrhea and Chlamydia |
| Cervicitis may progress to | PID |
| Vaginitis is typically caused by | pH imbalance- BV, candidia, trich |
| Gonorrhea and Chlamydia signs and symptoms | Mucopurulent discharge and friable cervix |
| Gonorrhea and Chlamydia testing | NAAT |
| Gonorrhea rx | Ceftriaxone 500mg IM |
| Chlamydia rx | Doxycycline 100mg bid 7d |
| BV signs and symptoms | gray fishy smelling discharge, from a pH disturbance |
| BV test via | wet mount or MVP |
| BV rx | Fluconazole |
| Trich signs and symptoms | Yellow/green, malodors discharge, strawberry cervix (petecia) |
| How to test for Trich | NAAT |
| Trich rx | Metronidazole |
| HSV | Ulceration/sloughing of cervix |
| Primary amenorrhea | Without a period at age 13 without secondary characteristics or without period at 16 |
| Secondary amenorrhea | Loss of period when previously had, 3+ months if regular or 6+ if irregular |
| Menorrhagia | Prolonged/heavy bleeding at regular intervals |
| Metrorrhagia | Variable amounts of bleeding at irregular, frequent intervals (breakthrough) |
| Polymenorrhea | Short cycles (<21d) |
| Oligiomenorrhea | Long cycles (>35d) |
| Menometrorrhagia | Prolonged/heavy bleeding at irregular/between intervals |
| Cause of primary dysmenorrhea | increased prostaglandins |
| What causes uterine cramps | Prostaglandins |
| Cause of secondary dysmenorrhea | Uterine or pelvis pathology |
| Most common symptom of menopause | Hot flashes |
| MC malignancy in women | Breast cancer |
| CIN1 | Mild cervical dysplasia (lower 1/3) |
| CIN2 | Moderate cervical dysplasia (lower 2/3) |
| CIN3 | Severe cervical dysplasia (entire cervix) |
| NILM | Negative intraepithelial lesions or malignancy |
| ASC-US/H | Atypical squamous cells of undetermined significance or high grade |
| LSIL | Low grade squamous intraepithelial lesion, typically CIN1 |
| HSIL | High grade squamous intraepithelial lesion, CIN 2 or 3 |
| Primary infertility | Infertility in absence of previous pregnancy |
| Secondary infertility | Infertility after previous pregnancy |
| LH and FSH come from | Anterior piuitary gland |
| Estrogen job | Build up the endometrium |
| FSH job | Follicle and egg maturation |
| LH job | Causes follicle to produce estrogen |
| What triggers ovulation | LH surge |
| Predominant hormone in follicular phase | Estrogen |
| Predominant hormone in luteal phase | Progesterone |
| Progesterone job | Builds up endometrium |
| MOA oxybutin | acts on bladder to inhibit involuntary detrusor muscle contractions |
| What class of drug is oxybutin | Antimuscarinic |
| AE of oxybutin | dry mouth/eyes, constipation, retention, GERD, blurry vision |
| MOA imipramine | Bladder muscle relaxation and increase sphincter tone |
| What class of drug is imipramine | TCA |
| What class of drug is micrabegron | B-agonist |
| MOA mirabegron | Acts on B receptor in detrusor to relax it and increase capacity |
| AE of mircabegron | HTN |
| MOA bethanecol | Increase bladder contractions |
| What class of drug is Bethaechol | Cholinergic |
| What class of drug is Terazosin | A-blocker |
| MOA Terazosin | Decrease sphincter resistance |
| MOA methotrexate | Folic acid antagonist that inhibits DNA replication |
| When to use methotrexate in ectopic pregnancy | HD stable, hCG below 5,000, Mass <3.5cm, no fetal HR, Ability to comply with follow up |
| When not to use methotrexate in ectopic pregnancy | Ruptured ectopic, breastfeeding, immunodeficient, active pulm disease, HD unstable |
| Partial molar pregnancy | 69XXY or 69XXX, fetus is present, edema, missed abortion, small for gestational age |
| Complete molar pregnancy | 46XX or 46XY, no fetus or sac, diffuse edema, large for gestational age, theca lutein cysts, may have complications after |
| McRoberts maneuver | Hyperflexion and abduction of maternal hips |
| Wood's corkscrew maneuver | Rotation of fetal shoulders 180 degrees |
| Zavenelli maneuver | fetal head flexed and pushed back into vaginal canal immediate C |
| Job of tocolytics | stop uterine contractions/halts cervical change |
| Job of betamethasone | Induce fetal lung maturity |
| Job of mag sulf | Fetal neuro protection |
| Complication of PROM | Chorioamnionitis, endometritis, cord prolapse |
| Painless, hard, immobile lump in breast | Breast cancer |
| MC location of breast cancer | Tail of spence, upper outter location |
| MC non skin malignancy in women | Breast cancer |
| Number one diagnostic for breast cancer | Mammogram |
| If FHx breast cancer start MRI at | 25 |
| Breast screening <40 | US |
| Breast screening >40 | Mammo |
| Fine needle breast biopsy | Limited tissue cannot test for susceptibility |
| Core needle breast biopsy | Receptor susceptibility testing and reduces risk of inadequate sample |
| Open breast biopsy | Most accurate biopsy but takes the most biopsy |
| Genetics for breast cancer | BRACA 1 and 2 |
| Risk factors for breast cancer | genetics, older age, obesity, EtOH, radiation exposure, increased estrogen exposure, HRT/OCPs, endometrial cancer, fibrocystic breast |
| Breast cancer mets to | Liver, lungs, bones, and brain |
| Early breast cancer rx | Lumpectomy, sentinel biopsy, and adjunct radiation |
| Local spread of breast cancer | Nonadjunct chemo and radiation then surgery |
| Treatment for stage 1 or 2 breast cancer | Mastectomy/lumpectomy |
| Treatment for stage 3 breast cancer | chemo, surgery, radiation, endocrine susceptibility |
| Treatment for stage 4 breast cancer | chemo/systemic treatment |
| SERM treatments for breast cancer | Tamoxifen or raloxifene |
| Tamoxifen | preferred estrogen treatment for breast cancer, but linked to endometrial cancer and risk for thrombosis |
| Raloxifene | treatment for estrogen susceptible breast cancer when concern for uterine cancer or thrombosis |
| Aromatase inhibitors for breast cancer | Anastrozole or exemestane |
| Preferred estrogen susceptible treatment premenopausal | SERM |
| Preferred estrogen susceptible treatment postmenopausal | Aromatase inhibitors |
| HER 2 susceptible breast cancer rx | trastuzamab |
| AE for aromatase inhibitors | hot flashes, fatigue, arthritis, insomnia |
| AE for trastusamab | cardiotoxcity |
| Adjunctive chemo for breast cancer | doxorubicin or epirubicin |
| Worst prognosis of breast cancer | triple negatives |
| PAP smear guideline start | 21yr |
| How often to do PAP | every 3rd |
| When to start HPV testing with PAP | 30yr |
| If PAP cytology abnormal next step | reflex HPV |
| HPV variants we worry about with cervical cancer | 16 + 18 |
| What to do if you get ASC-US on PAP | repeat PAP in 1yr |
| What to do if you get LSIL on PAP | <25 repeat PAP in 1yr, >25 colposcopy |
| What to do if you get ASC-H on PAP | Colposcopy |
| What to do if you get HSIL on PAP | <25 colposcopy, >25 colpo or LEEP |
| If HPV+ for 16/18 repeat PAP when | 1yr |
| If HPV+ not high risk repeat PAP when | 3yr |
| Stage 0 cervical cancer | CIN 3- cancer in situ |
| Stage 1 cervical cancer | Radical hysterectomy |
| Stage 2 cervical cancer | Radical hysterectomy and chemo, possible radiation |
| HPV 6 + 11 cause | genital warts |
| Vaccine name for HPV | Gardasil 9 |
| When to give HPV vaccine | 9-26 |
| HPV vaccine 9-15y | Two doses 6-12m apart |
| HPV vaccine 16-26y | Three doses 0, 1-2m, and 6m apart |
| Gardasil 9 - contraindicated when | pregnancy or lactating |
| 3rd most common gyn cancer | Cervical cancer |
| Most common symptom of cervical cancer | Post-coital bleeding |
| Cervical cancer most commonly mets to | Paracervical LN |
| Cervical cancer mets to | Vagina, parametrium, pelvic LN |
| Types of cervical cancers | Squamous, adenocarcinoma, adenosquamous carcinoma, clear cell |
| Number one type of cervical cancer | Squamous cell |
| Management of Stage 0 cervical cancer | Excision or hysterectomy w saplingo-oophrectomy |
| Hysterectomy w saplingo-oophrectomy is definitive rx for | Cervical cancer stage 0 |
| Cervical cancer stage 1 a or b, or 2a rx | Excision w radiation |
| Cervical cancer locally advanced rx | Primary radiation and chemo |
| Advanced/met cervical cancer rx | Systemic chemo and radiation |
| Vulvovaginal cancer is typically a met from | Cervical cancer |
| Most common cells in vulvovaginal cancer | squamous cell carcinoma |
| Most common age group for vulvovaginal cancer | Post-menopausal |
| Red, white, pruritic plaque on vulva, AUB describes | Vulvovaginal cancer |
| Stage 1 vulvovaginal cancer | in vagina |
| Stage 2 vulvovaginal cancer | spread through vaginal wall |
| Stage 3 vulvovaginal cancer | Spread to ovaries |
| Stage 4 vulvovaginal cancer | Mets |
| Lichen sclerosis is a RF for what type of cancer | Vulvovaginal cancer |
| Stage 1 vulvovaginal cancer rx | Resection and radiation |
| Stage 2-4 vulvovaginal cancer rx | Chemo/radiation |
| Infertility | Trying >1yr for a baby and failure to conceive |
| #1 infertility rx | Aromatase inhibitors |
| Aromatase inhibitors for infertility | Letrozole |
| Letrozole MOA | Produce fewer follicles, lower estradiol, shorter 1/2 life |
| #2 infertility rx | SERM |
| SERM for infertility | Clomiphene citrate |
| Clomiphene citrate MOA | Increase gonadotropin, estrogen antagonist and agonist, ovulation induction |
| Sexual assault | Any involuntary sexual act in which a person is coerced or physically forced to engage in sexual activities |
| Rape trauma syndrome | Inability to think clearly or remember things |
| Domestic violence | Violence or neglect perpetrated within the context of family or intimate relationships |
| Neglect | Depriving dependent of basic needs |
| Domestic violence affects | all SES and all ethnicities |
| Risk for domestic violence does what when someone is pregnant | doubles |
| TVUS confirming pregnancy | Need to see yolk and fetal pole |
| Hagar sign | Softening between fundus and cervix |
| Chadwicks sign | Bluish discoloration of cervix and vagina |
| Normal weight gain during pregnancy | 25-35lbs |
| Frequencies of visit during pregnancies | 8-28 every 4w, 29-36 every 2w, 37-40 every week |
| Glucola fails 1hr test if | >140 |
| Glucola fails 3r test if two or more | fasting >95, 1hr >180, 2hr >155, 3hr >140 |
| First trimester | 0-12 |
| Second trimester | 13-28 |
| Third trimester | 29-40 |
| Circulatory system changes in pregnancy | Increased blood flow to placenta, increase cardiac output, increase respiratory rate, |
| When does milk production begin | 5w |
| MC obstetrics injury | Episiotomy or laceration |
| Grade 1 laceration tears | superficial vaginal mucosa |
| Grade 2 laceration tears | Perineal body and muscles |
| Grade 3 laceration tears | Through external anal sphincter |
| Grade 4 laceration tears | Rectum and vagina are one |
| MC gynecologic malignancy in US | Endometrial cancer |
| Endometrial cancer common cause | Unopposed estrogen |
| MC type of endometrial cancer | adenocarcinoma |
| Most common symptom of endometrial cancer | Postmenopausal bleeding |
| Hyperplasia without atypical cells rx | Progestin rx and repeat biopsy in 3m |
| Stage 1 endometrial cancer rx | Total hysterectomy +/- salpingo |
| Stage 2+3 endometrial cancer rx | Total hyst +/- salpingo, and LN excision |
| Stage 4 endometrial cancer rx | Total hyst, +/- salpingo, LN exision, and chemo/radiation |
| What indicative of a endometrial biopsy on TVUS | 4mm endometrium |
| 2nd most common gyn cancer | ovarian cancer |
| Highest mortality gyn cancer | Ovarian cancer |
| Symptom of ovarian cancer | Abdominal fullness and ascites |
| RF for ovarian cancer | BRCA 1+2, Lynch syndrome, and turner syndrome |
| Stage 1 ovarian cancer | ovaries only |
| Stage 2 ovarian cancer | pelvic extension only |
| Stage 3 ovarian cancer | Extra pelvic extension |
| Stage 4 ovarian cancer | Liver mets or pleural effusion |
| MC ovarian cancer cells | Epithelial |
| Germ cell ovarian cancer | younger women hCG+ and alpha-fetoprotein |
| Stroma ovarian cancer | secrete estrogen and androgens |
| Stage 1 ovarian cancer rx | Total hyst and bilateral oophrectomy |
| Stage 2-4 ovarian cancer rx | Total hyst, oophrectomy, and chemo and raditaion |
| Monitor ovarian cancer via | CA-125 |
Created by:
kendallmk