Women's Health
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61 questions
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| PALM-COEIN Polyps, Adenomyosis, Leiomyomas, Malignancy, Coagulopathy, Ovulatory dysfunction, Endometrial, Infection/Iatrogenic | What are the causes of Abnormal Uterine Bleeding? |
| Ovulatory: Regular cycles Causes: Structural & coagulation defects Anovulatory Cause: hormonal or endocrine | Classification of AUB? |
| No periods for 3 mo ( if previous regular), or 6 mo if previously irregular W/U : HCG, TSH, FSH, Prolactin, PaP, STI check | Amenorrhea definition and cause |
| AUB > 35 y.o or < 35 with RF ( PCOS or obesity, DM, tamoxifen), postmenopausal bleeding. | Indication for endometrial Bx: |
| Bleeding > 7 days of 2-3 days longer than usual. Frequent bleeding < 21 d. | What is the definition of Menorrhagia? |
| 'Adolescent: Von Willebrand Dz Young adult: an ovulation, pregnancy , infection Adult: Fibroid, PCOS, thyroid Postmenapausal: anticoagulation, malignancy | What are the most common causes of menorrhagia/ age group? |
| Rotterdam criteria 2/3 Ovulatory dysfunction, Clinical androgen excess, Polycystic ovaries on US ( not required) | PCOS Definition |
| Wt loss and exercise OCP Metformin | How do you treat PCOS? |
| Obesity, hydadrenitis, keratosis pillars, skin tags, Acanthosis ingrains, hirsutism, alopecia, acne, broad shoulders | What are some of the findings associated with PCOS? |
| PCOS ( most common), 21 hydroxylase deficiency, Tumor ( adrenal or ovary, Ovarian hyperthecosis ( insulin resistance in postmenaupause) Drugs ( Danzol) | What are the causes of hirsutism? |
| Start at 21- 29 every 3 years with cytology alone. 30-65: HPV and cytology q 5 years or cytology alone Q 3 years or HR HPV Q 5 years. Type 16 & 18 go to colposcopy. | Who do you screen with Pap? |
| Repeat cotest in 12 mo or test for HPV 16&18 | How do you manage + HPV and - Pap |
| Colposcopy. | How to you manage + HPV and ASCUS |
| Women > 65, or total hysterectomy | When do you stop screening for cervical cancer? |
| If pt > 40 need endometrial Bx. | How do you manage endometrial cells on Pap? |
| Screen for 20 years post treatment Initially every year with contest x 2, If neg in 3 years, if neg in 5 years. | How often do you screen woman with hx of CIN 2 or greater? |
| Repeat in 3 years. Low risk of progression 0.28% | How do you manage ASCUS with -HPV |
| Girls: 9- 26 Men 11-26 Three doses: 0, 2, 6 Protects against HPV 6,11,16, 18, | HPV vaccine indication |
| CIN1 = HPV infection CIN 2= High grade lesions : 40% regress CIN 3 = Progress to cervical cancer. | Pap Classifications |
| Ovaria cyst or ectopic pregnancy | What are the causes of adenexal mass in premenopausal women? |
| Azithromycin 1 mg single dose or Doxy 100 mg bid x 7 days. | What is the treatment of chlamydia? |
| Sexually active women < 25 | Who do you screen for STI? |
| New sex partner, douche, Abx use, IUD, pregnancy. | Risk factors for BV |
| Metronidazole 2 mg single dose or 500 bid x 7 days Treat sex partner | How do you treat Trich? |
| Fluconazole ( Diflucan ) 150 mg single dose Miconazole cream 2% itravaginally x 7 days Clotrimazole cream 2 % for 14 days. | How do you treat vaginal yeast infection |
| > 4 infection in a year Fluconazole 150 mg Q 3 d for 2 wks, followed by one a week for 6 mo. RF: Hyperglycemia, Pregnancy, OCP, Immunosuppresion, diaphragm and IUD. | How do y ou treta chronic yeast infections? |
| Ceftriaxone 250 mg IM and Doxy 100 mg bid x 14 days + Metronidazole 500 mg bid x 14 days | PID treatment |
| Pregnant, severely ill, N/V high fever, suspect turbo-ovarian abscess, | When do you hospitalize for PID? |
| Receptive anal: .5-3% Vaginal: .1-.2% Oral < .1% | What is HIV risk for sexual assault? |
| Tenofovir-emtricitabine (Truvada) daily for 7-10 days Must be started within 72 hours of assault. Check GFR > 60 OK, Bep b and HCG. | What is PEP for sexual assault? |
| IUD > 99 % Implants ( Implanon and Nexpalnon) Surgical sterilization Abstinence | What are the most effective methods of contraception? |
| OCP, Injectables Depo Provera), Vaginal ring ( Nuvaring), Patch ( Ortho Evra) | What are the other effective methods of contraception (1-99%)? |
| Implanon or Nexplanon ( Etonogestrel) Duration 3 years, bu effective up to 4. SE: Change in bleeding pattern. Decrease dysmenorrhea and pelvic pain. | Implantable contraception |
| Smokers > 35, Hx of DVT, Hx of Stroke, PVD, migraine with aura, HTN, SLE with antiphospholipid Ab, DM with complication, Breast cancer | When do you avoid estrogens for contraception? |
| < 35 mcg Estradiol | OCP estrogen: what is the highest dose can use ? |
| Praroxetine ( FDA approved) Also, ecitalopram, petaline fluoxetine and gabapentin. | Post menapausal hot flash treatment? |
| DEXA: Hip T score ( standard dev. from mean in young healthy women) T score: < -2.5 Osteopenia : T -1--2.5 | Osteoporosis Definition |
| All women > 65, or younger with RF, evidence of osteopenia | Who do you screen for osteoporosis? |
| T score < 2.0 T score < 1.5 with RF All with osteoporotic fx | Who do you treat for osteoporosis? |
| Renal insufficiency, Vit D deficiency, Hyperparathyroid, Hyperthyroid, Hypogonadism, Chronic liver disease, MM, Inflammatory bowel disease, Celiac | What are the secondary causes of osteoporosis? |