women's health review 1

Pt comes in almost in menopause almost no period 1 yr. what’s the lab finding

FSH elevated

You are working in peds and a mom comes in w teenage daughter. she doesn’t know why she should get Gardasil vax. why and what strain does it cover

strain 16 to protect cervical cancer

Women has severe abdominal pain, US shows twisting of vascular pedicle. How do deal with someone with torsion

laparoscopic surgical detorsion

<30 yrs old has low grade on pap w no HPV. when do you follow up pap

repeat pap in 1 yr

Pt has torsion. What US findings confirms that they have it

whirlpool sign

m/c physical features of a young pt suspected to have PCOS

hirsutism

Pt complains of foul yellow green frothy discharge with itching. KOH shows multiple flagellated protozoan. What will you see on the cervix

strawberry cervix, or petechiae

a young healthy women that’s 24 yrs old needs a pap how often

every 3 years

at what age do you start getting paps

beginning at 21

how to ppx a women exposed to chlamydia and gonorrhea

Doxy 100 BID for a week and ceftriaxone 500mg 1 IM shot

abx of choice for chlamydia in a pregnant pt

azithromycin

what does a yeast infxn look like on microscopy

pseudohyphae

Pt with PCOS what is complication of this dz in the future

difficulty conceiving

what sx are classic in PCOS

truncal obesity

Pt is not preg but late on period. pregnancy test is negative. on US shows 3x3 cyst. what cyst is suspected

corpus luteum cyst

Pt is not preg but late on period. pregnancy test is positive. on US shows 3x3 cyst. what cyst is suspected

theca luteum cyst

pt with suspected PCOS came back with their blood results.

LH inc in LH:FSH ratio, hi free testosterone

pt has a lump on their vagina that doesn’t hurt but has suddenly become painful. what is the next step

do an I&D

pt <30 yrs old has ASCUS on pap but negative for HPV. when do you return for a pap

in 1 yr and co test for HPV again

how to counsel a young pt that discovered that they have the BRCA1 mutation

ovary removal by 40

Pt hx of ovarian cyst. Adnexal fullness on pelvic exam what is the imaging modality

pelvic US

Germ cell tumor hx, pt comes in and on US shows the germ cell tumor again. What is next step

surgery, specifically laparoscopy

pt gets a pap done and it shows ASCUS and + HPV. what is indicated for the pt next

colposcopy

you do a colposcopy on a pt and it shows CIN1 on cervix. what do you do next.

observe

how to tx a Nabothian cysts

reassurance and observation

pt suspected to have BV, how do you tx them

metronidazole

woman in her 30s is trying to conceive for a while. after 9 months of trying what do you recommend

give metformin

what are risk factors for recurrent yeast infxn

abx use, diabetes

a pt is in the ER with a pmhx of painful pelvic pain. she also has fever and adnexal tenderness, as well as RUQ pain. what is the next step for this pt?

admission to hospital

a pt with cervical cancer has no interest in conceiving. what is the definitive tx

hysterectomy with lymph node dissection

does this pt with cervical cancer getting a hysterectomy w lymph node dissection also need radiation?

NO

a pt on sonogram has multiple cysts on their ovary. what type of cyst is it

follicular cysts (called a string of pearls)

what are the microscopy findings of a pt with gonorrhea

gram negative diplococci

how to tx a pt with gonorrhea

ceftriaxone 1 dose

are theca luteum cysts hemorrhagic, cancerous, or bilateral

b/l

a pt comes in complaining of abnl bleeding. if you are suspecting endometrial cancer, what is the next diagnostic test

biopsy

what are some risks of having an endometrium sampling, like in a hysteroscopy

perforation

a pt feels like something is falling out of their vagina. what would you tell them to do to reproduce the sx?

cough

a pt says that something is falling out of their vagina. you tell them to cough and the cervix is coming out of their vagina. what type of prolapse is this

uterine prolapse

how would you manage a uterine prolapse

pessary

a pt in perimenopause is 49 yrs old. she has vaginal dryness and dyspareunia. how would you relieve their sx

give them vaginal estrogen cream

a pt has a suspected prolapse. on exam you see a bulge in the posterior vagina. what is this prolapse

rectocele

how to define menopause

no period for 1 yr

what is the most common complication of a pt being tx for vulvovaginal cancer

wound breakdown

how would you describe extramammary paget’s disease

scaly patches, red dry ulcerative lesions with a well demarcated border

a pt with no surgical hx has hot flashes and menopause. what would you offer her

combo hormone replacement with estrogen and progesterone PO

elderly pt post menopausal has pelvic pain for a bit so she came to the ER. on sono the pt has a torsion. what is the best management for this

salpingectomy and oophorectomy

the most prognostic factor for vaginal cancer is

if it’s found in the lymph nodes it has a worse prognosis

what does the skin look like in a pt with lichen sclerosis

vulvar skin is thin, wrinkled, and white, with lichenification and hyperkeratosis. anterior parts of labia minora agglutinate. erosions, fissures, subepithelial hemorrhages, and ulcerations come from the scratching

pt has urinary leaking where she can’t make it to the bathroom on time, esp after trying to unlock her door.

urge urinary incontinence

if a postmenopausal pt has vaginal bleeding what do you do next

do a biopsy bc there is suspected endometrial cancer

an older woman is being tx for preinvasive dz of the vulva. what sx would she report having

pruritis

is being overweight/obese a dx for PCOS

no

what is a major risk factor for endometrial cancer

nulliparity