Term
| What are the acute and chronic causes fo endomtritis? |
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Definition
| Acute - strep pyo, staph, childbirth or abortion; chronic - post abortion, post partum, IUD, or PID. |
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Term
| What is the diff btw endmetriosis and adenomyosis? |
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Definition
| Endo is tissue in place other uterine, adeno is endo glans and stroma in myometrium |
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Term
| Whicih of the following theories explains endometriosis - lymph dissemination, regurgi, metaplastic theory? |
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Definition
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Term
| Pain, menstrual irreg, infertility, rare maligs are result of endometriosis but what is treat? |
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Definition
| OCP of progesterone, pain relivever, ablation or hysterectomy |
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Term
| Dysmenorrheal, pain, abnorm bleeding seen in adenomyosis but what type of patient is it seen and what treat? |
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Definition
| Perimenopausal women, treat with hormones and hysterectomy |
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Term
| Name this pathology, - most common invasive cancer in women, presents with bleeding, due to estrogen excess, post-menopause, obesity, diabetes, HTN, infertility, has worse prognose as up in invasion. |
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Definition
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Term
| T or f, Papillary serous and clear cell type endometrial carcinoma have a good prognosis. |
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Definition
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Term
| What is diff btw leiomyoma and leimyosarcoma? |
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Definition
| Leio is most common benign smooth muscle proliferation presents with bleeding, sarcoma is malign with high metases |
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Term
| What are the risk factors for cervical dysplasia? |
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Definition
| Early sex age, multplie partners, high parity, HPV, immune status |
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Term
| Cervical Intraepithelial Neoplasia is more dysplastic the higher the grade, risks are from HPV 16,18, cervical transformation zone, and intraepithelial lesions. Which risk causes invasive squamous cell and which causes invasive adenocarcinoma? |
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Definition
| HPV 16,18 causes aquamous cell; HPV and intraepi lesion causes adeno (also DES exposure) |
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Term
| What is the screening requirement for uterus cancer, cervix, ovary? |
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Definition
| None because early present with bleeding and good cure, new screening, no effective screening |
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Term
| What er the indications for endmertial biopsy? |
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Definition
| Any postmeno bleeding, perimeno intermenstrual bleeding, abnormal bleed with history of anovulation |
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Term
| Endometrial carcinoma has two pathways, ID type 1 and 2: A - from estrogen excess, PTEN and KRAS mutations with diploid cells, majority early stage and curable. B - unknown cause, HER2-Neu and P53 mutations with aneuploidy, most advanced stage with poor survival. |
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Definition
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Term
| What endometrial thickness increases risk of cancner? |
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Definition
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Term
| Which of the following are risk factors for endometrial cancer - hyperplasia, obesity, estrogen, HNPCC Lynch 2 syndrome, postmeno bleeding, tamoifen, diabetes, nullipariuty, HTN? |
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Definition
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Term
| Histology predicts lymph node metastasis in endometrial cancer surgical stagining, why is this beneficial? |
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Definition
| Crictical to prognosis, therapeutic lymphectomy, and radiation therapy choice (controversial). |
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Term
| How is surgical staging I-IV determined? |
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Definition
| Distance from uterus; 2-cervix, 3-adnexa or vagina or lymph nodes, 4 - bladder, rectum, distant lymph meta |
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Term
| Most gyn cancer deaths are from which type? |
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Definition
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Term
| Risks for ovarian cancer include, jews, early menarche, late menopause, nulliparity, infertility, personal history of breast or colon cancer (BRCA1/2), and family history of ovarian, breast, or colon cancer. But what things are protective? |
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Definition
| OCP, tubal iagtion, hystorect |
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Term
| Why are epithelial ovrian tumors derived from surface epithelium? |
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Definition
| Because ovulation occurs, and multiple ovulation induce proliferatin and helaing over time and allow for potential DNA probs; that |
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Term
| Most ovarian cancer patients aret aught to recognize abdominal symptoms, ascites, and pelvic masses as method of screening, why isn |
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Definition
| Most is caught in late stage of disease, low prevalence, There isn |
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Term
| What is the best ovarian tumor marker? |
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Definition
| CA 125 is the best available tumor marker for epithelial ovarian cancer and it is elevated in 80% of women with serous epithelial ovarian cancer (the most common histology of epithelial ovarian carcinoma. But it is elevated in many other conditions |
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Term
| T or f, In ovarian cancer, germ cell tumors affect younger women and present with early stage while stormal tumors secrete hormones. |
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Definition
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Term
| Optimal surgical for ovarian cancer is cytoreduction. Chemo Combo platinum/taxane is best regimen for ovarian cancer but how effective is ti? |
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Definition
| Cancer very responsive especially when chemo given intraperitonel, but most cancers recur |
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Term
| Name two cancer targets for new ovarian cancer drugs. |
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Definition
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Term
| What are 3 obstacles to cervical cancer screening? |
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Definition
| Variable screening, asymptomatic nature, high flase neg Pap, origin tumor within endocervical canal difficult to find |
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Term
| HPV vaccine is approved for girls in what age group? |
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Definition
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Term
| There is increasing incidence of ENDOcervical adenocarinoma, but what are the possible routes of spread for cervical cancer? |
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Definition
| Vagina, parametria, PA and pelvic nodes |
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Term
| Stage 1 A1 requires simple hysterectomy and Stage 1 A2 cervical cancer requires radical hysterectomy for completely respectable cancer, what is diff? |
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Definition
| simple is remove uterus, cervix, vag just below cervix; radical is uterus, upper 3rd vagina, pelvic wall all the way to ureter |
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Term
| What is the new standard treatment for locally advanced 2B-4A cervical cancer? |
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Definition
| Cisplatin based chemo radiation, with the biggest complications of ovaian ablation and vaginal fibrosis |
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Term
| Name this hereditary illness - increased risk of colon/endometrial cancers (small amount of ovarian), due to defective DNA repair at MSH2, MSH6, MLH1 causing microsatellite instability, requires increased screenings for early age. |
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Definition
| Lynch II syndrome aka HNPCC, hereditary non-polyposis colon cancer |
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Term
| Mutations in BCRA1/2 increase breast cancer and ovarian risk, what do they normally do? |
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Definition
| BCRA1 gets phosphrd ann BCRA 2 complexes with rad 51 and 1 regulate transcription and 2 does DNA repair |
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Term
| There is increased risk of breast cancer in patients who are jew, old, and fmily history, but what are limitation of gentetic testing? |
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Definition
| A neg test is only neg if fmail history pos, genetics syndromes, unknown genetic variants, some mutations cannot be detected. Screening has no impact on survival or staging for ovarian cancer |
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Term
| Ovarian and tubal cancers can br prevented in BCRA1,2 patietns with what surgical techniques? |
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Definition
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Term
| What is the mechanism of copper IUD? |
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Definition
| Inhib sperm motility, acrosome enzymes, causes inflammatory reaction causing phago of sperm, can also be used as emergency contraception |
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Term
| Why does nursing delay ovulation? |
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Definition
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Term
| T or F, Most abortions are less than 8 weeks in preggers. |
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Definition
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Term
| What is the mechanism of mifepristone and misoprostol? |
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Definition
| Mifepristone blocks the action of progesterone by binding to progesterone receptors without activating them. Withdrawal of progesterone during early pregnancy leads to expulsion of the embryo via a prostaglandin-mediated mechanism. Following administration of mifepristone during early pregnancy, the trophoblast separates from the decidua. Levels of hCG in the maternal circulation decline and prostaglandins are released locally. Uterine bleeding results. Mifepristone induces cervical ripening and rhythmic uterine contractions. Misoprostol also induces uterine contractions. |
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Term
| What are the med and surg option in second trimester? |
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Definition
| Med - induce labor, surg - dilation and evacuation; abortions are safer than live births |
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Term
| What are the major causes of abortion related death? |
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Definition
| Infection and hemorrhage; abortion less risky than caryying child to term |
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Term
| Why does estrogen production fall as a woman ages and what is average age of menopause? |
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Definition
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Term
| Describe the common features of early, middle, and late perimenpause. |
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Definition
| Longer or irregular menses cycles, increased FSH, hot flashes, menorrhagia; late is 1 year after last period, post is 1 year after until death |
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Term
| What are the symptoms of menopause as age increases? |
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Definition
| Hot flashes, irreg mense, mood, sleep probs, GU incontinence, dysuria, dyspareunia, osteopro |
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Term
| What is the mechanism for vasomotor symptoms and vaginal atrophy in menopause and what are hormonal and non-hormanl treat? |
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Definition
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Term
| Which drugs are beneficial for women in sexual dysfunction? |
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Definition
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Term
| The most commonly reported sexual dysfunction in men is premature ejac, what is treatment? |
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Definition
| SSRI, anathestic, condom; peyronie is bent penis |
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Term
| On biopsy, The two major components _______ and ________. Hemosiderin-laden macrophages are common, and _______ cysts. |
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Definition
| Glands, stroma, chocolate |
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Term
| T or F, The most common sites of endometriosis are Ovaries, Anterior and posterior cul-de-sac, Posterior broad ligaments, Uterosacral ligaments. Classic pelvic finding is a fixed uterus, with scarring and tenderness posterior to the uterus. |
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Definition
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Term
| Endometriosis has been attributed to the production of cytokines, and growth factors by cells associated with endometriotic implants, and irritation of pelvic nerves by endometriosis. The stage of endometriosis is correlated with the presence or severity of symptoms. |
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Definition
| False, not correlated with symptoms |
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Term
| What are some gynecologic causes of endometriosis? |
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Definition
| Adenomyosis, PID, Leiomyomata, Adnexal cysts |
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Term
| What are some non-gyn cuases of endometrio? |
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Definition
| Urological: interstitial cystitis, urinary tract infections. Musculoskeletal Issues: fibromyalgia, neuralgia, chronic back pain. Gastrointestinal issues: irritable bowel syndrome, diverticulitis |
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Term
| What is the difference between minimal, mild, moderate, ans severe endometrio? |
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Definition
| Minimal disease is characterized by isolated implants and no significant adhesions. Mild endometriosis consists of superficial implants less than 5 cm in aggregate, scattered on the peritoneum and ovaries. No significant adhesions are present. Moderate disease exhibits multiple implants, both superficial and invasive. Peritubal and periovarian adhesion may be evident. Severe disease is characterized by multiple superficial and deep implants, including large ovarian endometriomas. Filmy and dense adhesions are usually present. |
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Term
| Epidemiological evidence from large cohort studies suggests that endometriosis is an independent risk factor for epithelial ovarian cancer, but how is risk reduced? |
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Definition
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Term
| Although endometriosis can reduce the probability of conceiving during a monthly cycle, it does not usually completely prevent conception. What are some mechanisms? |
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Definition
| Distorted Pelvic Anatomy: pelvic adhesions and endometriomas. Altered Peritoneal Functions due to prostanoids, cytokines, growth factors. Altered Immune Functions |
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Term
| What is the dosing frequency of injectrable, implant, IUD, ring, and pathc contraceptives? |
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Definition
| Monthly, 3-5 yrs, 5 yrs, 4 weeks, weekly |
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Term
| What is the most common contraceptive used by women? |
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Definition
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Term
| What are the effects of progestin and estrogen used in hormonal contraception? |
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Definition
| Progestin blocks LH/FSH, thins endometrium, thickens cervical mucus; estrogen inihbis FHSLH, has cycle control.; benfits of both include cycle control, helps control ovarian cysts, cancer reduction, PID, bone loss, hirsuitism, and dysmenorrheal |
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Term
| What are two types of drugs the decrease the effectiveness of OCPs? |
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Definition
| Anticonvulsants and anti-infectives (not antibitiotics) |
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Term
| List some side effects of OCPs. |
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Definition
| Ups breast cancer diagnosis, cervical cancer link, venous thromboembolism, MI, stroke, breast tenderness, nausea, bloating, mood |
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Term
| What effect does OCP have on SHBG and Test? |
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Definition
| Ups SHBG, downs Total and free test |
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