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premenstrual dysphoric disorder criteria?
- last at least 2 cycles
- no pain during first week of the 1st half
- pain during the second half of the period
rx for premenstrual dysphoric disorder?
decrease caffeine, alcohol, cigarettes, chocolate
- if symptoms persist
- give SSRI
blood levels of what are diagnostic for menapuase?
what is the rx for menapuse?
Hormone replacement therapy for symptoms and to prevent osteoporosis
when is hrt contraindicated for menopause?
- history of hypercoagubility (PE or DVT)
- endometrial or breast ca responsive to estrogen
1st line rx for ovulatory bleeding?
nsaids to decrease blood loss
post menopausal bleeding is assumed to be what?
post coital bleeding is presumed to be what?
- endometrial cancer
- cervical cancer
abnormal uterine bleeding causes?
- post coital bleeding
work up for abnormal uterine bleeding?
- cbc --anemia/TFT/prolactin?betaHCG
- pap smear
- pelvic ultrasound
dysfunctional uterine bleeding is due to what?
high estrogen and no progesterone from the corpus luteum..endometrium outgrows blood supply and sloughs off
pt over 35 with dysfunctional uterine bleeding?
next step in management
endometrial biopsy to rule out carcinoma
pts over what age with abnormal uterine bleeding should undergo endometrial biopsy to rule out endometrial carcinoma?
rx for dysfunctional uterine bleeding?
When is Dysfunctional Uterine Bleeding considered severe?
- if the patient is anemic
- symptoms are not controlled by OCP
- lifestyle is compromised
endometrial ablation or hysterectomy
what contraception devices lead to pelvic inflammatory diseases?
most common congenital adrenal hyperplasia?
21 hydroxylase deficiency
most common cause of labial fusion is?
21 hydroxylase deficiency
rx for lichen sclerosus and lichen planus of the vulva?
rx for squamous cell hyperplasia?
- topical steroids
- baths and lubricants
rx for Bartholin gland cyst?
3 causes of vaginitis?
diagnostic tests for each one?
- gardnerella--koh clue cells
- candidiasis--koh pseudohyphae
- trichomonas--koh flagellates
what is adenomysosis?
most accurate test?
- endometrial gland within the myometrium
- MRI then
- Biopsy of the myometrium
most accurate test for endometriosis?
rx for adenomyosis?
rx for endometriosis?
analgesia with nsaid and OCP for mild symptoms
- leuprolide and danazol for severe
- Surgery for refractory
side effect of leuprolide?
leuprolide--GnRH--decreases estrogen--hot flashes, osteoporosis
Danazol--progesterone antagonist--prevents release of fsh--masculanizing side effects
rx for pCOS?
rx if pts wants to conceive?
- weight loss
- ocp to prevent the hirsutism
clomiphene and metformin
what two std's present with bubo swelling or inguinal lymph nodes swelling?
- LGV--C. trachomatic L1,L2,L3 painless ulcer
- Chancroid-- h. ducrey--painfull ulcer
feels like im sitting on an egg, pelvic heaviness is characteristic of ?
- bladder into vagina
- rectum into vagina
- small bowel into vagina
most accurate test for pid?
Best initial test for PID?
- dna probe
a woman presenting with abdominal pain, tenderness, cervical motion tenderness, fever, leukocytosis, next step in management?
rule out pregnancy
pid for outpatient?
- metro + doxycycline
- cefoxatime + doxy
- clinda and genta
rx of genital warts?
- alpha interferon
what std looks like IBD?
rx for pcos?
mcc of female infertiliyt?
rx for alopecia aerata?
newborn with assymmetric inguinal and gluteal folds?
Congenital hip dysplasia
rx for fibroids?
- us on asymptomatic
- gnrh agonist
rx if woman doesnt want to remove endometrial cancer?
management of ascus with no hpv?
- repeat pap in 6 months
most importatnt diangost sign for endometrial cancer?
rx for squamous cell carcinoma of the vagina?
what cervical tumor causes precocious?
what ages get lichen sclerosus?
rx for inflammatory carcinoma of breats?
- hormone therapy
what breast cancer is hormone responsive?
bloody discharge of nipple?
most common breast cancer?
invasive ductal carcinoma
risk for breast cancer?
- long ovulation--early menarche and late menarche
3 diseases that cause dislocation of the lens of eye/?
woman presenting with pelvic pain worse before she menstruates?
rx for pagets disease of the vulva and squamous cell carcinoma of the vulva?
scc of vagina?
- unilateral vulval involvement--modified vulvectomy
- bilateral--radical vulvectomy
- <2 cm--surgery
- otherwise radiation