Vaginal Bleed Flashcards

1
Q

A 30 year old woman with newly diagnosed vulvar dermatosis also has the oral lesions, as shown here known as Wickham striae. What is her diagnosis most likely to be?

Lichen planus 
Lichen sclerosus
Pemphigus vulgaris
Fox-Fordyce disease
Bullous pemphigoid
A

Lichen planus

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2
Q

A 26 year old woman presents with recurrent vulvar skin lesions that are painful and drain purulent material occasionally (shown in picture). Antibiotics give partial, temporary relief. She has two brothers with similar skin lesions in their axillae. What is the likely diagnosis of her condition?

Vitiligo
Lichen planus
Lichen sclerosus
Hidradenitis suppurativa
Atrophic vaginitis
A

D-Hidradenitis suppurativa

Blocked apocrine glands in axilla and groin area

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3
Q

This condition is commonly associated with which of the following?

Anorexia
Hypertension
Hyperlipidemia
Polycystic ovarian syndrome
eczema
A

PCOS (DM, cancer)

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4
Q

A 36 year old patient has undergone two incision and drainage procedures for a Batholin
Gland duct abscess. Which of the following would be provide the most definitive treatment for her recurrent Bartholin gland duct abscess?

Marsupialization
Long-term antibiotics
Five percent lidocaine ointment
Warm compresses and frequent sitz baths
Short term antibiotics
A

Marsupialization

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5
Q

Which human papillomavirus (HPV) subtype is most strongly associated with adenocarcinoma of the cervix?

HPV 6
HPV 16
HPV 18
HPV 31
HPV 41
A

18

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6
Q

Which of the following does NOT increase a women’s risk of developing endometrial cancer?

Obesity
Tamoxifen
Smoking
Unopposed estrogen
E-    Family history
A

Smoking

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7
Q

A 38 yo G7P7 woman, comes to the ER c/o increased vaginal bleeding over the past 5 hrs. Abdominal examination shows no abnormalities. However, bimanual and rectal exams show an 8-cm mass in the upper cervix and right parametrium. The ovaries are not palpable. CT scan shows a right hydroureter above the level of the mass. Which of the following is the most likely diagnosis?

a) Ovarian epithelial carcinoma
b) Transitional cell carcinoma of the bladder
c) Adenocarcinoma of the endometrium
d) Peritoneal mesothelioma
e) Squamous cell carcinoma of the cervix

A

e)Squamous cell carcinoma of the cervix

Cervical ca loves the ureters (hydro ureter and nephrosis)

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8
Q

Dysfunctional uterine bleeding is most common in:

a) Women with endometriosis
b) Women at the extremes of their reproductive years
c) Multigravidas
d) Women with uterine myomas
e) None of the above

A

b)Women at the extremes of their reproductive years

(<20 >40)

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9
Q

A 40 year old woman comes to you with menstrual problems. She c/o her periods coming more frequently, and she is unable to predict when it will start. Her menses have become very heavy at times to the point of leaking through her clothes despite wearing pads. Hb is 118 g/L. Which of the following blood tests is most useful in deciding on treatment?

a) Serum progesterone
b) Ferritin
c) Thyroid-stimulating hormone (TSH)
d) Follicle-stimulating hormone (FSH)
e) Serum iron

A

Ferritin

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10
Q

The most common cause of post menopausal bleeding is?

a) Endometrial carcinoma
b) Ovarian carcinoma
c) Foreign body
d) Atrophic vaginitis
e) Cervical cancer

A

Atrophic Vag

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11
Q

Cases

42 year old , 2 years of irregular bleeding

DdX- 1)————————————-

     2) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
       3) ------------------------------------

Work up to rule out DDx——————-
——————–
——————–
All work up normal. Likely DDx

A

Ddx; DUB, Endometrial Ca, hypothyroidism

Work up; Endometrial Bx
Pelvic US

DUB most likely if N

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12
Q

59 year old with bleeding , 2 years after menopause. Ddx

1) —————————-
2) —————————
3) ————————–

Work up

A

1) Atrophic Vaginitis
2) Endometrial Ca
3) Coag Issues
4) Cervical Ca

Workup; Coags, Endometrial Bx

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