Didactic Summative Random Review pt 1

corresponds with follicular phase

proliferative

corresponds with luteal phase

secretory

mullerian defects

most sensitive marker for menopause

FSH

can use in women WITHOUT a uterus

estrogen only → ↑ endometrial CA, no breast CA risk

used in women WITH a uterus

estrogen + progesterone → ↑ breast CA risk, protective against endometrial/ovarian CA

MC type of AUB

anovulatory → disruption of HPG axis; unopposed estrogen

heavy/prolonged bleeding

menorrhagia

bleeding inbtw periods

metrorrhagia

heavy intermenstrual bleeding

menometrorrhagia

light menstrual bleeding

hypomenorrhea

MCC postmenopausal bleeding

endometrial CA → until proven otherwise

failure of menarche onset by 13

primary amenorrhea

absence of menses > 3 months (if prev menstruated) or > 6 months (if irreg periods)

secondary amenorrhea → MCC is pregnancy

MCC infertility in US

PCOS

disproportionate LH > FSH

PCOS

grouped clear vesicles on erythematous base

HSV

MC bacterial STI

Chlamydia

climactic buboes

LGV

MCC urethritis in men

gram negative intracellular diplococci

gonorrhea

painLESS chancre

syphilis

extreme lower abdominal pain on ovulation

Mittelschmerz

painful menstruation that interferes with ADLs

dysmenorrhea

Venetian blind sign on US

adenomyosis → globally enlarged uterus

*TAH is dx and tx

postcoital/contact bleeding is ______ until proven otherwise

cervical CA

severe dysmenorrhea, chocolate cysts, laparoscopy w bx is definitive

endometriosis

U/L pelvic pain, irregular menses, dyspareunia

ovarian cyst

MC ovarian CA

epithelial (serous cystadenocarcinoma)

MC gynecological CA

endometrial

syndrome assoc w ↑ risk endometrial, ovarian, stomach, pancreatic and prostatic CA

Lynch syndrome

ovarian CA mets to umbilical lymph node

sister Mary Joseph nodule

MC type of endometrial CA

adenocarcinoma → endometrioid

RF: unopposed estrogen

MCC cervical CA

HPV

RF: early onset coitus

procidentia

Uterine prolapse a least 2 cm distal to hymen

replacement of rectum with finger pushing vaginal bulge back through introits to defecate (specific to rectocele)

splinting

ovarian CA tumor markers

CA-125

CA 19-9

clue cells

whiff test → fishy smell

thin milky discharge

↑ pH

BV → metro

white clumpy "cottage cheese" discharge

budding yeast & hyphae on wet prep

vaginal itchiness

RF: abx use, DM

candida vuvlovaginosis → -azoles

frothy pale green discharge → foul smelling

strawberry cervix

↑ pH; pear-shaped organism w tail

trich → metro

parabasal cells

↓ pubic hair

↑ pH

atrophic vaginitis → topical estrogen

purulent cervical discharge

chandeliers sign

PID → doxy + rocephin + metro

MC site of chlamydia in women

cervix → cervicitis

only ABX assoc w OCP failure

rifampin and griseofulvin

MC benign breast dx

fibrocystic breasts → menstrual fluctuation

eczematous, scaling rash on nipple

Paget's

MC type of breast CA

IDC → stellate (star like) on mammo

CI to BC patch

BMI > 30

BBW for significant bone mineral density loss

depo shot

IUD for parous women

mirena

IUD for nulliparous women

skyla

MCC of nipple discharge

intraductal pipilloma

start getting mammograms yearly

45-55 y/o

Nagele's rule

1st day of LMP - 3 months + 1 year & 7 days

GPA classification

G: # times pregnant

P: # births

- full term

- preterm (inc stillborn)

- abortions/miscarriages

- living

fundal height at umbilicus

20 wks

OGTT screening

24-28 wks

GBS screening

35-37 weeks

determines fetal position in 3rd trimester

Leopold's maneuver

blue discoloration of vulva, vagina or cervix

Chadwick's sign

softening of cervix

Goodell's sign

softening of lower uterine segment

Hegar's sign

shortening of cervix during labor (expressed as %)

effacement

distance in cm btw lowest bony portion of fetus & maternal ischial spines

station (0 = at level; + = going through canal)

ED FIRE ERE

engagement

descent

flexion

internal rotation

extension

external rotation

expulsion

tx for chronic HTN during pregnancy

methyldopa

HTN onset > 20 wks gestation & normotensive by 12 week PP

gestational HTN

MC presentation of fetal GBS

meningitis

sensorineural hearing loss

blueberry muffin rash

chorioretinitis

microcephaly

congenital CMV

when to give rhogam

28 wks & w/in 72 hrs delivery

layers that MUST be closed in C section

1st layer uterus, fascia, subQ, skin

leading cause of pregnancy related death in 1st trimester

ectopic pregnancy → MC ampulla; most dangerous is interstitial

cervial change (effacement or dilation) in the absence of uterine contractions

cervical incompétence

abortions

threatened: bleeding w/o dilation

inevitable: bleeding + dilation

incomplete

complete

missed: POC retained

septic: infx of uterus

blighted ovum: sac but no embryo

nitrazine test

ROM test

umbilical cord prolapse

occult = next to baby's head

overt = under baby's head (presenting first)

painLESS hemorrhage in 3rd trimester

placenta previa

unremitting abd/back/uterine PAIN

hypertonic uterus

hemorrhage

placenta abruption → concealed (blood stays in uterine cavity) & external (blood drains through cervix)

egg w no maternal DNA but 1 diploid or 2 haploid sperm

↑↑↑ hCG

cluster of grapes on US

trophoblastic molar pregnancy → hydatidiform

*risk for choriocarcinoma

turtle sign

shoulder dystocia → McRobert, Rubin or Woods maneuver

koplik spots on buccal mucosa

rash starts at hairline

prodrome: cough, coryza, conjunctivitis

comps: blindness

robeola → vit A

forscheimer spots on palate

rash starts on face & fades as it spreads

LAD

rubella

sudden high fever

rash STARTS ON TRUNK

roseola → HHV-6

parotitis

U/L epididymo-orchitis

mumps

U/L asymmetric flaccid paralysis (but MC asx)

transmitted via stool → do stool PCR/cx

destroys anterior grey horn (LMN)

acute polio

CHIKV vs DENV

DENV has hemorrhagic manifestations (bleeding gums)

sharply demarcated rash; butterfly pattern if on face

etiology → GABHS

erysipelas → amox or keflex

strawberry tongue

sandpaper rash sparing palms & soles

pasta lines

scarlet fever → PCV V

jones criteria (CCEPS)

rheumatic fever

poultry workers, pet stores

non-productive cough

chlamydia psittaci

erythema migrans, AV blocks, Bell's palsy, arthritis

Lyme disease

blanching red rash starting on wrists/ankles

RMSF

UTI tx for women

nitro, bactrim, or fosfomycin

asymptomatic bacteriuria tx

nitro, amox, augmentin, keflex

UTI in men tx

bactrim

rabies vax

day 0, 3, 7, 14

MCC of gastroenteritis in the US

seen in daycare & cruises

norovirus

pseudoappendicitis

high fever + rigors

watery → bloody diarrhea

comps: reactive arthritis, GBS

campylobacter → azithro

non-bloody diarrhea after eating eggs or poultry

salmonellosis

bloody diarrhea, lower abd tenderness

comps: toxic megacolon, HUS

shigellosis

faint salmon colored spots on trunk

stepwise fever

typhoid fever