Term
What does this describe?
develop when a tunnel or cleft of tall columnar endocervical epithelium becomes covered by squamous metaplasia. They appear grossly as translucent or yellow and may vary in diameter from a few millimeters to 3 cm.
Is this something to be concerned about? |
|
Definition
nabothian cyst
NOT pathologic! they are a normal consequence of the dynamic histology fo the cervix |
|
|
Term
| When would you treat a pt for having a nabothian cyst? And what exactly is that? |
|
Definition
The only indication for treatment is relief from pain or a bothersome feeling of fullness in the vagina
Nabothian cysts (also called mucinous retention cysts, epithelial inclusion cysts) are discrete cystic structures that form when a cleft of columnar epithelium becomes covered with squamous cells and the columnar cells continue to secrete mucoid material. The cysts vary from microscopic to several centimeters in size; the larger ones project above the surface of the portio. They may appear translucent or opaque. Nabothian cysts may occur following minor trauma or childbirth. |
|
|
Term
|
Definition
|
|
Term
soft, fleshy growth that may arise from the vulva, vagina, cervix, urethral meatus, perineum and anus.
May be single or multiple and generally cause few sxs.
What is it? |
|
Definition
|
|
Term
| skin-colored or pink, range from smooth flattened papules to a verrucous, papilliform appearance |
|
Definition
|
|
Term
| What's the difference in how condyloma acuminata and condyloma lata appear? |
|
Definition
| condyloma lata are flat and velvety. Caused by secondary syphillis infection |
|
|
Term
What are the three major forms of tx for condyloma acuminata?
What is discouraging about tx? |
|
Definition
chemical or physical destruction, immunologic therapy, or surgical excision
discouraging: recurrence rates of 30 to 70 percent within six months of treatment |
|
|
Term
What are chemical agents used for genital warts? How do they work aka-- MOA? (3)
what's teratogenic? what can be used internally? |
|
Definition
Podophyllin: arrests the cell cycle in metaphase and leads to cell death; teratogenic; not to be used for internal warts
Tricholacetic acid: physically destroys the wart tissue by protein coagulation; can be used during pregnancy and can be used internally
5-fluorouracil epinephrine gel: pyrimidine antimetabolite that interferes with DNA synthesis by blocking the methylation of deoxyuridylic acid, leading to cell death |
|
|
Term
| What are two immune modulating agents for condyloma acuminata? |
|
Definition
Imiquimod: positive immune response modifier, which acts by local cytokine induction: not for internal use
Interferon alfa: Primary systemic therapy with interferon can achieve complete resolution of the anal condyloma in 25 to 80 percent of patients |
|
|
Term
What type of HPV is associated with cervical cancer?
What type of HPV is associated with warts? |
|
Definition
| HPV types 6 and 11 are a major cause of warts, and types 16 and 18 are the major causes of cervical cancer. |
|
|
Term
|
Definition
| HPV is spread by direct skin-to-skin contact, including sexual intercourse, oral sex, anal sex, or any other contact involving the genital area (eg, hand to genital contact). It is not possible to become infected with HPV by touching a toilet seat. |
|
|
Term
| If warts come back, they usually do so within ___to ____ of treatment. |
|
Definition
| If warts come back, they usually do so within three to six months of treatment. |
|
|
Term
| gardasil protects against what types of HPV? |
|
Definition
| (types 6, 11, 16, and 18) |
|
|
Term
| What are the most common causes of cervicitis? |
|
Definition
|
|
Term
Pt presents with:
- Purulent or mucopurulent discharge from the endocervix
- Intermenstrual or postcoital bleeding
- Dysuria, urinary frequency
- Dyspareunia
- Vulvovaginal irritation
What could it be?
|
|
Definition
|
|
Term
| What are two cardinal signs of cervicitis? |
|
Definition
1) Purulent or mucopurulent discharge on the surface and/or exuding from the canal
2) Minor trauma from insertion of a cotton or Dacron swab frequently precipitates bleeding (friability), |
|
|
Term
| what's the tx for chlamydia? |
|
Definition
| Azithromycin 1 g orally once or doxycycline 100 mg orally twice daily for seven days |
|
|
Term
| What's the tx for gonorrhea? |
|
Definition
| Cefixime 400 mg orally once or ceftriaxone 125 mg intramuscularly once are the primary treatments recommended; cefpodoxime, 400 mg orally once, is an alternative that is likely as effective, although fewer data to support its use are available. When intramuscular administration of ceftriaxone is given, lidocaine hydrochloride can be used as a diluent to decrease the discomfort associated with the injection. |
|
|
Term
| If a pt treated for cervicitis does not respond to first round of abx...what do you do/suspect? |
|
Definition
we repeat the diagnostic workup and ensure (1) that NAAT were the tests used for detection of C. trachomatis and N. gonorrhoeae, and (2) that sex partners have been appropriately treated and that the patient has not been re-exposed to potential pathogens. A sensitive diagnostic test should also be performed for trichomoniasis.
Vaginal fluid should be reexamined for the presence of bacterial vaginosis, and exposure to potential intravaginal irritants (lubricants, spermicides, douching) should be reassessed. Importantly, if possible, sex partners should also be examined and tested for these common sexually transmitted infections, particularly if they were not treated presumptively at the time of the woman's initial treatment for cervicitis. |
|
|
Term
| What is the name of the bacterium causing syphilis? |
|
Definition
|
|
Term
| How do you get syphillis? ie transmission |
|
Definition
| Treponema pallidum usually occurs via direct contact with an infectious lesion during sex |
|
|
Term
| What is the median incubation period for syphillis? |
|
Definition
| 21 days (range 3 to 90 days |
|
|
Term
How does syphilis typically clinically manifest in a patient?
|
|
Definition
| Briefly, after an average incubation period of two to three weeks, a papule, which is typically painless, appears at the site of inoculation. This soon ulcerates to produce the classic chancre of primary syphilis, a one to two centimeter ulcer with a raised, indurated margin. The ulcer generally has a non-exudative base and is associated with mild to moderate regional lymphadenopathy that is often bilateral. |
|
|
Term
Pt presents after having sex with high risk partner about 3 weeks ago. A few days ago they noticed a painless papule on their genitals.Now they're concerned because this papule ulcerated and now has a raised, indurated margin. What could it be?
|
|
Definition
|
|
Term
| After the first presence of painless ulcer in syphillis, how son will it go away? |
|
Definition
| Chancres heal spontaneously within three to six weeks even in the absence of treatment |
|
|
Term
What is a classic finding of secondary syphilis?
What is a big clue? |
|
Definition
The rash is classically a diffuse, symmetric macular or papular eruption involving the entire trunk and extremities, including the palms and soles
The involvement of the palms and soles is an important clue to the diagnosis of secondary syphilis. |
|
|
Term
These could be signs of what?
fever, headache, malaise, anorexia, sore throat, myalgias, and weight loss.
lymphadenopathy
alopecia
hepatitis
renal, ocular, nephrologic abnormalities |
|
Definition
|
|
Term
| How do you diagnose primary syphillis vs secondary? |
|
Definition
Primary: darkfield microscopy
Secondary: Serologic testing |
|
|
Term
What is tx of choice for syphillis?
what if pcn allergy? |
|
Definition
A single dose of benzathine penicillin G (2.4 million units IM) provides low but persistent serum levels of penicillin and is standard therapy for primary, secondary, or early latent syphilis
if allergy: tetracyclines, macrolides, or ceftriaxone |
|
|
Term
| What is the Jarisch-Herxheimer reaction? |
|
Definition
| reaction to penicillin when treating primary syphillis. it's an acute febrile reaction. just take tylenol |
|
|
Term
| What's the difference in how primary vs secondary syphillis manifests clinically? |
|
Definition
Primary syphilis, the classic lesion is a painless ulcer associated with mild to moderate regional lymphadenopathy.
Patients with secondary syphilis have marked systemic-malaise, fever, rash |
|
|
Term
| When should pt with syphillis follow up after tx? |
|
Definition
| All patients should be reexamined clinically and serologically at six and 12 months after treatment. |
|
|
Term
Pt presents with vaginal pruritis and/or a mucopurulent discharge. On examination, the cervix may appear normal or show signs of frank discharge. The cervical mucosa is often friable, and evidence of concurrent upper genital tract disease (abdominal pain, dyspareunia) may be present.
What could it be? |
|
Definition
|
|
Term
| What is the most specific and sensitive test for gonorrohea? |
|
Definition
| The most sensitive and specific test for N. gonorrhoeae infection in women is nucleic acid amplification |
|
|
Term
| What is the recommended drug of choice for treating gonorrhea? |
|
Definition
| Ceftriaxone 125 mg IM once OR Cefixime 400 mg orally once |
|
|
Term
| What age group is most commonly affected by fibroadenomas? |
|
Definition
|
|
Term
| Pt (who is btw 15 and 35) presents with well-defined, mobile mass on physical examination or a well-defined solid mass on ultrasound. They notice their seems to be some relationship to its growth and their menstrual cycle. WHat are you thinking? |
|
Definition
|
|
Term
| How do you manage a fibroadenoma? |
|
Definition
| managed with core needle biopsy or short-term (three to six months) follow-up with a repeat ultrasound and breast examination |
|
|
Term
| When should you start having paps? |
|
Definition
|
|
Term
| Women > 30 years of age..how often should they have a pap? |
|
Definition
Women aged 30 years and older should have a Pap test every 2 years. After three normal Pap test results in a row, a woman in this age group may have Pap tests every 3 years if
she does not have a history of moderate or severe dysplasia
she is not infected with human immunodeficiency virus (HIV)
her immune system is not weakened (for example, if she has had an organ transplant)
she was not exposed to diethylstilbestrol (DES) before birth |
|
|
Term
| If a women is <30..how often should she have a pap done? |
|
Definition
| Women younger than 30 years should have a Pap test every 2 years |
|
|
Term
| What is the most potent and plentiful of the three types of estrogen? |
|
Definition
|
|
Term
| Name three names of estrogen. |
|
Definition
estradiol: MOST POTENT!!! produced by ovaries
ESTRONE
ESTRIOL |
|
|
Term
| Androgens are converted to what kind of estrogen? |
|
Definition
|
|
Term
What's the name of the causative agent in syphillis?
What type of organism? |
|
Definition
Treponema pallidum
spirochete |
|
|
Term
| firm, punched out appearance and has rolled edged. It is small and painless. Can often be missed on routine exam. What is it? |
|
Definition
| primary syphillis: CHANCRE |
|
|
Term
How long does it take for a chancre to heal?
What would serology show if you get tested? |
|
Definition
3-6 weeks
serology is generally negative at this point |
|
|
Term
| What characterizes secondary syphillis? |
|
Definition
Charactertized by a skin rash that often appears as rough, red or brown lesions on the palsm of the hands and soles of feet.
Other sxs: lymphadenopathy, fever, headache, weight loss, fatigue, muscle aches, and patchy hair loss |
|
|
Term
| What is the name for the highly infective secondary eruptions? |
|
Definition
| mucocutaneous mucous patches |
|
|
Term
What is condyloma lata?
Where does it typically occur? |
|
Definition
part of secondary syphillis
found in most areas of the body
they are flat-topped papules which coalesce |
|
|
Term
When are serologic tests positive in syphillis?
|
|
Definition
|
|
Term
| During the tertiary stage of syphillis, how can the infection be transmitted? |
|
Definition
| via placenta or blood transfusion |
|
|
Term
| What are adverse effects of syphillis seen in the tertiary or late stages? |
|
Definition
CNS
Cardiovascular
Opthalmic
auditory abnormalities |
|
|
Term
What's the name of the lesion that can develop 1 to 10 years after syphilis infection?
what are they? |
|
Definition
gummas
destructive, necrotic, granulomatous lesions |
|
|
Term
| How do you diagnose syphillis? |
|
Definition
determined by identifying motole spirochetes on dark-field microscopic examination and direct fluorescent antibody tests from primary or secondary lesions or lymph node aspirates.
Presumptive diagnosis: Venereal Disease Research Laboratory and Rapid Plasma Reagin and treponemal tests (FTA-ABS or TP-PA) You can't use just one test because false positive are sometimes assoic with medical conditions unrelated to syphillis |
|
|
Term
| What are three non tremponemal and 3 treponemal tests for syphillis? |
|
Definition
nontrep:
VDRL
RPR card test
Automated reagin test
Treponemal:
FTA=ABS
TP=PA
MHA-TP |
|
|
Term
| What is tx for syphillis? |
|
Definition
Benzathine pen G
pt should be followed by quantitative VDRL titers and examinations at 3,6, and 12 months and should abstain from sexual intercourse until lesions are completely healed. |
|
|
Term
What is this?
frequently begins within 3 months after delivery and may start with a sore or fissured nipple. There is obvious cellulitis in an area of breast tissue, with redness, tenderness, local warmth, and fever
How do you treat? |
|
Definition
dicloxacillin or a cephalosporin, 500 mg orally every 6 hours for 5–7 days
and regular emptying of the breast by nursing followed by expression of any remaining milk by hand or with a mechanical suction device. |
|
|
Term
What is fibrocystic changes of the breast?
What influences the changes? |
|
Definition
| The primary tissue components of the breast are fat, fibrous stroma, and epithelial structures. The hormonally responsive component is the epithelium, but considerable paracrine communication exists between the epithelium and stroma. Hormonal stimulation may result in dilated fluid-filled lobular acini interpreted as microcysts on histologic sections and is usually accompanied by relative stromal abundance. This is commonly referred to as fibrocystic change. Depending on the particular pattern of epithelial structures and associated stroma, a breast may appear mammographically dense, feel nodular to palpation, or both. Fibrocystic change is generally classified as proliferative or nonproliferative according to the epithelial features of the process. |
|
|
Term
| What's the best study in a pt who is young women with dense breasts and you're trying to differentiate between a solid and cystic mass? |
|
Definition
|
|
Term
| What is the recommended initial modality to evaluate a breast mass in a patient < 40 years of age? |
|
Definition
|
|
Term
| True or False. Nipple discharge is usually benign. |
|
Definition
|
|
Term
| Someone presents with nipple discharge. What do you want to know? |
|
Definition
spontaenous or non spontaneous
non bloody?
bilateral? |
|
|
Term
| A nonspontaneous, nonbloody, bilateral nipple discharge is usually attributed to what? |
|
Definition
| fibrocystic changes or the breast or ductal ectasia |
|
|
Term
What happens to breast during fibrocystic changes/ductal ectasia?
what populations are most affected (ie. age group) |
|
Definition
dilation of the mammary ducts, periductal fibrosis and inflammation
adolescent women as well as perimenopasual women |
|
|
Term
| milky breast discharge. What do you think? (3) |
|
Definition
common during childbearing
also think hyperprolactinemia or hypothyroidism
Meds: oral contraceptives and tricylci antidepressants |
|
|
Term
| Purulent discharge from the breast, indicates what? |
|
Definition
| infectious etiology and may be due to mastitis or a breast mass |
|
|
Term
| Green, yellow or brown sticky nipple discharge can be due to |
|
Definition
| ductal ectasia or fibrocystic changes of the breast |
|
|
Term
| Bloody, unilateral nipple discharge...what are top three things you're thinking? |
|
Definition
invasive ductal carcinoma
intraductal papilloma
intraductal carcinoma |
|
|
Term
| What are signs of breast masses that suggest malignancy? |
|
Definition
greater than 2 cm
immobility
poorly defined changes
retraction or change in nipple
bloody nipple discharge
ipsilateral lymphadenopathy |
|
|
Term
| How many years does it take for a breast tumor to reach palpable size? |
|
Definition
|
|
Term
| What defines breast carcinoma in situ? |
|
Definition
| when malignant cells replce the normal epithelium lining the ducts or lobules. The basement membrane remains intact and therefore, the cells cannot metastacize. |
|
|
Term
| What are the two main types of carcinoma in situ (breast)? |
|
Definition
lobular carinoma in situ
Ductal carcinoma in situ |
|
|
Term
| How do you evaluate a patient with DCIS? |
|
Definition
core needly biopsy
women at increased risk of developing invasive cancer or a recurrence of the DCIS lesion |
|
|
Term
| How do you manage patient with LCIS? |
|
Definition
|
|
Term
- What are risk factors for breast cancer?
|
|
Definition
age
personal hx of breast cancer
hx of atypical hyperplasia (ducta or lobular) on past biopsies
inherited genetic mutations
first degree relative with breast or ovarian cancer diagnosed at early age
early menarche
late cessation of menses age >55
no term pregnancies
late age at first live birth
never breast fed
alcohol consumption
recent oral contraceptive use
use of hormone therapy
personal hx of endometrial, ovarian or colon ca
jewish heritage |
|
|
Term
| What are intraductal papillomas? What age is most affected? Other than location, any other imp features? |
|
Definition
intraductal growths composed of abundant stroma and lined by both luminal and myoepithelial cells.
Solitary intraductal papillomas are found int he major lactiferouos ducts of women, typically between the ages of 30 and 50.
Cause a serous or serosanguinous drainage |
|
|
Term
| how do you manage intraductal papillomas? |
|
Definition
standard recommendation for management of papillomas is that they be excised whenever they are diagnosed by core needle biopsy
Once the diagnosis of solitary papilloma is confirmed by excisional biopsy, no additional treatment is needed. Unless there is associated atypia, there is no increased risk of subsequent breast cancer. |
|
|
Term
molloscum contagiosum
how do you treat?
What's virus that causes? |
|
Definition
caused by pox virus
The infection is usually self-limited and spontaneously resolves after a few months in immunocompetent patients. Treatment of lesions appearing outside of the genital region would be for cosmetic reasons only. Genital lesions should be definitively treated to prevent spread by sexual contact. Curettage, cryotherapy, or laser therapies are modalities that may be used to remove individual lesions |
|
|
Term
| firm, dome shaped papules with an umbilicated center |
|
Definition
|
|
Term
| Molluscum contagiosum is a common disease of childhood. In adults, molluscum contagiosum infection is most closely associated with what? |
|
Definition
| associated with underlying cellular immunodeficiency, such as occurs during HIV infection. It can also occur in the setting of chemotherapy or corticosteroid administration. |
|
|
Term
| How is molloscum contagiosum spread? |
|
Definition
The virus can be transmitted via autoinoculation by scratching or touching a lesion. For example, if the lesions develop on the face, shaving may spread the virus. Molluscum can also be transmitted during contact sports [8]. When it occurs in the genital region, molluscum contagiosum is classified as a sexually transmitted disease. Infection can also be spread via fomites on bath sponges or towels [8]. Like smallpox, the only known host for molluscum contagiosum is humans.
Estimates for the incubation period of the virus vary from one week to six months, but it is typically estimated to be between two and six weeks [12]. |
|
|
Term
| Pt presents after weekend in the mountains where they spent lots of time in a hot tub. They now present with vulvar itching/burning, copious discharge with randcid color, dysuria and dyspareunia. What could it be? |
|
Definition
| Trichomaniasis caused by T. vaginalis--flagellate protozoan |
|
|
Term
| "frothy," thin and yellow green to gray in color..what do you think? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What do you warn pts about when taking metronidazole? |
|
Definition
| don't drink because of disfulfiram like reaction |
|
|
Term
| the pH of the vagina in someone with trich will be what? |
|
Definition
|
|
Term
| What's the normal pH of the vagina? |
|
Definition
|
|
Term
| how does an ovarian cyst develop? |
|
Definition
| when an ovarian follicle fails to rupture during follicular maturation, ovulation does not occur |
|
|
Term
| Pt presents with mild to moderate unilateral lower abdominal pain and states they noticed a change in their menstrual cycle (ie. amenorrhea). Pelvic exam shows unilateral tenderness with a palpable mobile, cystic adnexal mass. What could it be? |
|
Definition
|
|
Term
If you suspect functional ovarian cyst, what imaging do you get? is this always true?
what might reading state? |
|
Definition
pelvic US
reading may state: unilocular simple cyst without evidence of thicke septations, soft tissue elemts or evidence of interanl or external excresences.
Most causes: you need to rule out pregnancy and follow up with a repeat pelvic examin in about 6 weeks. Most follicular cysts spontaenously resolve |
|
|
Term
| What type of medication can you give to pt with functional ovarian cyst? |
|
Definition
| estrogen an dprogesterone containing oral contraceptives to suppress gonadotropin stimulation of the cyst. It may not shrink the current cyst but can prevent another cyst from growing |
|
|
Term
| What is the most common tumor found in women of all ages? |
|
Definition
| benign cystic teratoma aka dermoid cyst |
|
|
Term
| Dermoid cells are unique because they contain what? |
|
Definition
| differentiated tissue from all three embryonic germ layers: ectoderm, mesoderm and endoderm |
|
|
Term
Do patients have symptoms with dermoid cysts?
What other features? What is tx? |
|
Definition
typically asymptomatic; unilateral cystic adnexal mass that is mobile and nontender
tumor usually has a high fat content that makes it more readily identified by CT as well as giving it more buoyancy tendancy in the pelvis--also causing more ovarian torsion (15%)
tx: SURGICAL removal bc of possibility of ovarian torsion and rupture. |
|
|
Term
| Ovarian cancer is the ___ most common of all cancers in women in US and most common cause of gynecologic cancer. |
|
Definition
|
|
Term
Ovarian Cancer:
what age group affected most?
What ethnic background? |
|
Definition
fifth and sixth decades of life
white 50% more affected than blacks |
|
|
Term
| What are risk factors for ovarian ancer? |
|
Definition
nulliparity
parimary infertility
endometriosis
BRCA 1 or 2
Hereditary nonpolyposis colorectal cancer |
|
|
Term
| What can decrease risk of ovarian cancer? |
|
Definition
| five year cumulative use of oral contraceptives decreases the lifetime risk of ovarian cancer by one half |
|
|
Term
| What are some early warning signs for ovarian cancer? |
|
Definition
increase in abdominal size
abdominal bloating
fatigue
abdominal pain
indigestion
inability to eat normally
urinary frequency
constipation
back pain
urinary incontinence of recent onset
unexplained weight loss |
|
|
Term
| What defines dysmennorhea? |
|
Definition
painful menstruation that prevents a woman from performing normal activities
may be accompanied by : diarrhea, nausea, vomiting, headache and dizziness |
|
|
Term
Primary dysmennorhea:
what ages are most affected vs secondary dysmenorrhea? |
|
Definition
primary: greatest in women in their late teens to early 20's and declines with age
Secondary dysmenorrhea more prominent as woman ages bc risking prevalence of causal factors. |
|
|
Term
| What causes the pain in primary dysmenorrhea? |
|
Definition
pain due to excess prostaglandings produced in endometrium
they also work on smooth muscle causing nausea, vomiting and diarrhea
Prostaglandin F2alpha is a potent vasodilator and inhibitor of platelet aggregation |
|
|
Term
| What are common causes of secondary dysmenorrhea? |
|
Definition
endometriosis
adenomyosis
adhesions
PID
leiomyomata |
|
|
Term
|
Definition
| presence of ectopic endometrial tissue within the myometrium |
|
|
Term
| What is secondary dysmenorrhea? |
|
Definition
| caused by structural abnormalities or disease processes that occur outside the uterus |
|
|
Term
| If patient states they have pain during periods AND during sex (aka dyspareunia)...is it primary or secondary dysmenorrhea? |
|
Definition
| more likely a secondary cause |
|
|
Term
| Pt presents with recurrent, month after month, spaskmodic lower abdominal pain that occurs in the first to 3 days of menstruation. What type of dysmenorrhea most likely? |
|
Definition
|
|
Term
| Pt presnts stating they have pain that often lasts longer than menstrual period. It may start before menstruation begins and become worse during menstruation then lasts after mensturation. what could it be? |
|
Definition
|
|
Term
| "boggy" uterus..what are you thinking? |
|
Definition
|
|
Term
| What's tx for primary dysmenorrhea? |
|
Definition
NSAIDS: such as iburpofen, naproxen and mefenamic acid
other: heating pad, exercise, oral contraceptives to induce anovulation, psychotherapy |
|
|
Term
|
Definition
| reduction of the frequency of menses with cyclic lengths of greater than 35 days but less than 6 months |
|
|
Term
|
Definition
| reduction in number of days or amt of menstrual flow |
|
|
Term
| How do you define abnormal uterine bleeding? |
|
Definition
| difference in frequency, duration and amt of menstrual bleeding |
|
|
Term
Pt with amenorrhea...what type of pathology could be involved?
(4) |
|
Definition
1. pregnancy
2. hypothalmic pituitary dysfunction
3. ovarian dysfunction
4. genital outflow abnormality |
|
|
Term
| What symptoms suggest pregnancy? |
|
Definition
| breast fullness, weight gain, and nausea |
|
|
Term
| Most common cause of amenorrhea? |
|
Definition
|
|
Term
| How is hypothlamic gonadotropin releaseing hormone regulated? |
|
Definition
| modulated by catecholmine secretion from the CNS and by feedback from sex steroids of the ovaries |
|
|
Term
| What is the definitive method to identify hypothalamic pituitary dysfunction? |
|
Definition
measure FSH and LH and prolactin levesl in the blood
usually FSH and LH are in low range
prolactin is normal in most conditions and elevated in prolactin secreting tumor |
|
|
Term
| if you suspect ovarian dysfunction as cause for amenorrhea...what do you expect tests to show? (ie. FSH and LH) |
|
Definition
| FSH and LH concentratiosn should rise |
|
|
Term
| What is the most common anatomic cause of secondary amenorrhea in women? |
|
Definition
Asherman syndrome which is scarring of uterine cavity
this can happen after D&C |
|
|
Term
| How do you determine cause of amenorrhea? ie .name of test |
|
Definition
| Progesterone challenge test |
|
|
Term
| What does the progesterone challenge test determine? How much do you give? |
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Definition
Determines whether or not the patient has adequate estrogen, a competent endometrium and a patent outflow.
100 mg injection of progesterone in oil or a 5 to 14 course of oral medroxyprogesterone acetate or micronized progesterone is expected to induce progesterone withdrawal bleeding within a few days of completing oral course |
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