Archer USMLE step 3 Gynecology lecture notes. These lecture notes are samples and are intended for use with Archer video lectures. For video lectures, please log in at http://www.ccsworkshop.com/Pay_Per_View.html

2. Menopause Amenorrhea for at least 1 year associated with elevated FSH level

5. Differential Diagnosis of Menopause Disease Characteristics Notes Premature ovarian failure Age <40 years Thyroid disorders Weight gain or loss, heat or cold intolerance, fatigue, anxiety, change in bowel habits More frequently hypothyroidism, but also hyperthyroidism may cause amenorrhea Autoimmune disorders Other systemic symptoms, such as joint pain May cause premature ovarian failure Hyperprolactinemia Galactorrhea, drug use, headache, visual disturbance Pregnancy Weight gain, nausea, breast tenderness Late-onset congenital adrenal hyperplasia Elevated 17 OH progesterone May be associated with virilization

6. Lab Studies - Menopause

7. Test Notes Follicle stimulatig hormone (FSH) An elevated follicle stimulating hormone level (>30 mIU/mL) is consistent with the diagnosis of menopause . In women under 40, two to three levels may be needed to make the diagnosis; best done around day 3 of the cycle if it can be timed Thyroid stimulating hormone Screen for hypothyroidism or hyperthyroidism Prolactin Hyperprolactinemia may be accompanied by galactorrhea Pregnany test (BhCG) Although unlikely in this age group, pregnancy can occur Estradiol May be useful in women using hormonal contraception; 7 days after discontinuation of oral contraceptives, a result of <20 pg/mL is consistent with menopause

22. Post Menopausal Bleeding

24. Contraception

55. OCPs and Interactions

75. Vaginitis / Vaginal Disharge Step3 Topics  Diagnosis, Antibiotic choices in pregnancy, Treat sexual partner or not, counseling

104. Dysmenorrhea

113. Infertility Inability to conceive after 12 months of unprotected intercourse.

117. Hypertension in pregnancy Essential hypertension Pre-Ecclampsia Ecclampsia

118. First Trimester Bleeding

119. Third Trimester Bleeding

120. Post partum hemorrhage

121. Post partum blues Post partum depression Psychosis

122. PELVIC PAIN

124. Pelvic Inflammatory Disease

132. Cervical Cancer Pap Smear – ASCUS etc and management LEEP etc – Rx choices CIN I, II and III Cervical Cancer

133. Normal Pregnancy