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Medicine (MD/DO)
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USMLE Step 2
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Obstetrics & Gynecology
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Uterine, Cervical & Vaginal Disorders

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Obstetrics & Gynecology | Medicine (MD/DO) School Study Aid

Uterine, Cervical & Vaginal Disorders
15 Picmonics to Learn | 30 mins
Dysfunctional Uterine Bleeding
Assessment
Bimodal Age Distribution
Painless Vaginal Bleeding
Amenorrhea
Menorrhagia (Heavy Menstrual Bleeding)
Metrorrhagia (Bleeding Between Menses)
Interventions
Balloon Thermotherapy
Hormone Medications
Dilation and Curettage (DandC)
Considerations
Monitor for Anemia
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3 mins
Pelvic Inflammatory Disease (PID)
Mechanism
Neisseria gonorrhoeae
Chlamydia Trachomatis
Symptoms
Cervical Motion Tenderness
Chandelier Sign
Salpingitis
Tubo-ovarian abscess
Hydrosalpinx
Complications
Ectopic Pregnancy
Infertility
Adhesions
Fitz-Hugh-Curtis Syndrome
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2 mins
Pelvic Inflammatory Disease (PID) Interventions
Antibiotics
No Intercourse for 3 Weeks
Semi-Fowler's Position
Analgesics
Monitor Temperature
Treat Partners
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2 mins
Endometriosis Characteristics
Endometrial Tissue Outside of Uterus
Glands and Stroma
Most Common in Ovary, Pelvis, Peritoneum and Bowels
"Chocolate Cyst" in Ovary
Adenomyosis
Theories
Retrograde Flow
Metaplastic Transformation
Mullerianosis
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2 mins
Endometriosis Symptoms and Treatment
Symptoms
Dysmenorrhea
Cyclic Pelvic Pain
Dyschezia
Dysuria
Dyspareunia
30-40% are Infertile
Treatment
Surgery
NSAIDs
OCPs
Progesterone (Progestins)
GnRH Agonists
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1 min
Choriocarcinoma
Germ-cell tumor
Trophoblastic tissue
Hematogenous spread to lungs
Malignant
Theca-lutein cysts
Hydatidiform Mole
hCG
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59 secs
Cervical Cancer Screening
Women Aged 21-65 Years
Pap Smear Every 3 Years
Women Aged 30-65 Years
Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
Identify Lesions
High grade lesions
Cryotherapy
Loop Excision
Cold Knife Conization
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2 mins
Cervical Cancer Assessment
Cause/Mechanism
Human Papillomavirus (HPV)
Assessment
Metrorrhagia
Leukorrhea
Pain
Abnormal Pap Test
May Be Asymptomatic
Considerations
HPV Vaccine
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2 mins
Vaginitis
Cause/Mechanism
Infection
Postmenopausal Atrophy
Assessment
Vaginal Discharge
Pruritus
Interventions
Antifungals (Miconazole, Clotrimazole)
Antibiotics
Estrogen Hormones
Abstinence
Considerations
Good Hygiene
Recurrent Vaginitis
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2 mins
Uterine Leiomyoma (Fibroids) Characteristics and Presentation
Most Common Gynecologic Tumor
Benign Smooth Muscle Tumor
Risk Factors
Early Menarche
Hormone Sensitive
African Americans
Presentation
Abnormal Menses
Infertility
Urinary Symptoms
Irregularly Enlarged Uterus
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3 mins
Endometrial Hyperplasia
Characteristics
Unopposed Estrogen
With or Without Atypia
Signs and Symptoms
Postmenopausal Vaginal Bleeding
Amenorrhea
Menorrhagia
Metrorrhagia
Short Menstrual Cycles
Diagnosis
Transvaginal Ultrasound
Treatment
Progesterone
Complications
Endometrial Carcinoma
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2 mins
Endometritis
Postpartum
Postpartum Endometritis
Cesarean Birth
Fever
Uterine Tenderness
Acute
Acute Endometritis
Neutrophils
Pelvic Inflammatory Disease (PID)
Chronic
Chronic Endometritis
Plasma Cells
Idiopathic
Treatment
Gentamicin + Clindamycin
Ampicillin-Sulbactam
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3 mins
Vaginal Cancer
Characteristics
HPV 16, 18
Squamous Cell Carcinoma is Most Common Subtype
Clinical Features
Vaginal Bleeding
Leukoplakia
Diagnosis
Colposcopy with Biopsy
Management
Radiation Therapy
Surgery
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2 mins
Asherman Syndrome
Characteristics
Endometrial Adhesions or Fibrosis
Etiology
Pelvic Inflammatory Disease
Dilation and Curettage (D&C)
Clinical Features
Infertility
Recurrent Miscarriages
Abnormal Uterine Bleeding
Diagnosis
No Bleeding after Progesterone Withdrawal
Honeycomb Uterus
Management
Surgical Resection
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3 mins
Vaginal Cancer Subtypes
Squamous Cell Carcinoma
Squamous Cell Carcinoma
Most Common Subtype
Associated with Cervical Squamous Cell Carcinoma
Clear Cell Adenocarcinoma
Clear Cell Adenocarcinoma
Diethylstilbestrol (DES) Exposure
Sarcoma Botryoides
Sarcoma Botryoides
Malignant Rhabdomyosarcoma
"Bunch of Grapes" in Vagina
Spindle-Shaped Cells
Desmin Positive
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3 mins

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