Women's Health EOR Review
What are the two phases of the menstru- Follicular (proliferative) and luteal (secre-
al cycle? tory) phases
What hormones are secreted during the GnRH from the hypothalamus ’ FSH and
follicular phase of menstruation? LH release from anterior pituitary
What hormones are secreted during the
Progesterone from corpus luteum
luteal phase of menstruation?
Failure of menses to occur by age 15 in
the presence of normal growth and sec-
ondary sexual characteristics (breasts,
axillary/pubic hair)
How is primary amenorrhea defined?
At age 13 if no menses has occurred
and there is a complete absence of sec-
ondary sexual characteristics ’ evaluate
for primary amenorrhea
Karyotype, serum FSH, LH, prolactin,
What diagnostics should you consider in
total/free testosterone, TSH, T4, urine
working up amenorrhea?
pregnancy test
Pregnancy MCC
What is the most common cause of
secondary amenorrhea? What are some
Hypothyroid, weight changes, prolactino-
other causes?
ma
>80 mL estimated blood loss OR men-
How is menorrhagia defined?
struation >7 days
How is metrorrhagia defined? Bleeding between periods
How is oligomenorrhea defined? Bleeding >35 days apart
How is polymenorrhea defined? Bleeding <21 days apart
What is the etiology of primary dysmen-
Excess of prostaglandins
orrhea?
Primary: days 1-3
When is the pain for primary vs. sec-
ondary dysmenorrhea? Secondary: mid-cycle and increases in
severity until end of cycle
How is menopause defined? 12 months of amenorrhea
, Women's Health EOR Review
How does menopause hormone replace-
Uterus: estrogen + progesterone
ment therapy differ when a patient has a
No uterus: estrogen only
uterus vs. does not?
One year of amenorrhea at what age
40
defines premature ovarian failure?
SSRIs: fluoxetine, sertraline
What are some treatment options for SNRIs: venlaxafine
PMDD? Birth control, low-dose estrogen, GnRH
last line
What is the difference between PMS and PMDD has a marked disruption in func-
PMDD? tioning
Ceftriaxone 500 mg IM + azithromycin 1
What is the treatment for gonorrhea?
g x 1 for chlamydia coinfection
Azithromycin 1 g x 1, retest 3-4 weeks
after treatment
What is the treatment for chlamydia?
Or doxycycline 100 mg BID x 1 week
What types of HPV are the most onco-
16 and 18
logic?
What is the causative agent in chan-
Haemophilus ducreyi
croid?
Painful genital ulcers
Foul smelling genital discharge
Inguinal lymphadenopathy
What is the presentation of chancroid?
Ceftriaxone 250 mg IM x 1 dose or
azithromycin 1 g PO x 1 dose
What is the treatment for chancroid?
Fluctuant lymphadenopathy ’ needle as-
piration
, Women's Health EOR Review
What is the causative agent of lym- Unique strain of chlamydia trachomatis
phogranuloma venereum? (L1, 2, 3)
Ulcer at site of inoculation followed by
tender lymphadenopathy
What is the presentation of lymphogran-
uloma venereum?
What is the treatment for lymphogranulo-
Doxycycline 100 mg BID x 21 days
ma venereum?
Ceftriaxone 500 mg IM x 1, doxycycline
How do you treat mild to moderate PID? 100 mg BID x 14 days +/- metronidazole
500 mg BID x 14 days
ADMIT
How do you treat severe PID?
Cefotetan + doxycycline
Or clindamycin + gentamicin
What are some indications to admit a Pregnant, treatment failure, severe
patient with PID? symptoms, TOA, ? surgical emergencies
Ultrasound
What is the imaging method of choice for
TOA?
Abdominal tenderness + cervical motion
tenderness + adnexal tenderness should PID
make you consider what?
Primary: painless chancre lesion, ~1-2
What is the presentation of primary vs. cm on vulva or penis
secondary vs. tertiary syphilis?
Secondary: diffuse maculopapular rash
What are the two phases of the menstru- Follicular (proliferative) and luteal (secre-
al cycle? tory) phases
What hormones are secreted during the GnRH from the hypothalamus ’ FSH and
follicular phase of menstruation? LH release from anterior pituitary
What hormones are secreted during the
Progesterone from corpus luteum
luteal phase of menstruation?
Failure of menses to occur by age 15 in
the presence of normal growth and sec-
ondary sexual characteristics (breasts,
axillary/pubic hair)
How is primary amenorrhea defined?
At age 13 if no menses has occurred
and there is a complete absence of sec-
ondary sexual characteristics ’ evaluate
for primary amenorrhea
Karyotype, serum FSH, LH, prolactin,
What diagnostics should you consider in
total/free testosterone, TSH, T4, urine
working up amenorrhea?
pregnancy test
Pregnancy MCC
What is the most common cause of
secondary amenorrhea? What are some
Hypothyroid, weight changes, prolactino-
other causes?
ma
>80 mL estimated blood loss OR men-
How is menorrhagia defined?
struation >7 days
How is metrorrhagia defined? Bleeding between periods
How is oligomenorrhea defined? Bleeding >35 days apart
How is polymenorrhea defined? Bleeding <21 days apart
What is the etiology of primary dysmen-
Excess of prostaglandins
orrhea?
Primary: days 1-3
When is the pain for primary vs. sec-
ondary dysmenorrhea? Secondary: mid-cycle and increases in
severity until end of cycle
How is menopause defined? 12 months of amenorrhea
, Women's Health EOR Review
How does menopause hormone replace-
Uterus: estrogen + progesterone
ment therapy differ when a patient has a
No uterus: estrogen only
uterus vs. does not?
One year of amenorrhea at what age
40
defines premature ovarian failure?
SSRIs: fluoxetine, sertraline
What are some treatment options for SNRIs: venlaxafine
PMDD? Birth control, low-dose estrogen, GnRH
last line
What is the difference between PMS and PMDD has a marked disruption in func-
PMDD? tioning
Ceftriaxone 500 mg IM + azithromycin 1
What is the treatment for gonorrhea?
g x 1 for chlamydia coinfection
Azithromycin 1 g x 1, retest 3-4 weeks
after treatment
What is the treatment for chlamydia?
Or doxycycline 100 mg BID x 1 week
What types of HPV are the most onco-
16 and 18
logic?
What is the causative agent in chan-
Haemophilus ducreyi
croid?
Painful genital ulcers
Foul smelling genital discharge
Inguinal lymphadenopathy
What is the presentation of chancroid?
Ceftriaxone 250 mg IM x 1 dose or
azithromycin 1 g PO x 1 dose
What is the treatment for chancroid?
Fluctuant lymphadenopathy ’ needle as-
piration
, Women's Health EOR Review
What is the causative agent of lym- Unique strain of chlamydia trachomatis
phogranuloma venereum? (L1, 2, 3)
Ulcer at site of inoculation followed by
tender lymphadenopathy
What is the presentation of lymphogran-
uloma venereum?
What is the treatment for lymphogranulo-
Doxycycline 100 mg BID x 21 days
ma venereum?
Ceftriaxone 500 mg IM x 1, doxycycline
How do you treat mild to moderate PID? 100 mg BID x 14 days +/- metronidazole
500 mg BID x 14 days
ADMIT
How do you treat severe PID?
Cefotetan + doxycycline
Or clindamycin + gentamicin
What are some indications to admit a Pregnant, treatment failure, severe
patient with PID? symptoms, TOA, ? surgical emergencies
Ultrasound
What is the imaging method of choice for
TOA?
Abdominal tenderness + cervical motion
tenderness + adnexal tenderness should PID
make you consider what?
Primary: painless chancre lesion, ~1-2
What is the presentation of primary vs. cm on vulva or penis
secondary vs. tertiary syphilis?
Secondary: diffuse maculopapular rash
