🩺 Gynecology: 50 Keyword Anchor Cues
Grouped by Menstrual Disorders, Infections, Neoplasia, Uterine Pathology, and Procedures
🩸 I. Menstrual & Hormonal Disorders (1–12)
| Topic | Anchor Trigger |
|---|---|
| Primary Amenorrhea | No menses by 15y + normal 2° sex = Mullerian agenesis |
| Secondary Amenorrhea | Absent menses >6m + check β-hCG + TSH + Prolactin |
| PCOS | Oligo-ovulation + hyperandrogenism + polycystic ovaries (2/3) |
| Hypothalamic Amenorrhea | Athlete + stress + ↓GnRH = Functional Hypothalamic |
| Sheehan Syndrome | PPH + lactation failure + amenorrhea = Pituitary infarct |
| Asherman's Syndrome | Curettage hx + amenorrhea + normal hormones = Intrauterine adhesions |
| Menorrhagia | Heavy menses + normal cycle + anemia = Rule out fibroids, adenomyosis |
| Dysmenorrhea (Primary) | Painful menses + young + no pathology = Prostaglandins → NSAIDs |
| Secondary Dysmenorrhea | Pain + older + pathology (endo/adeno/IUD) = Investigate cause |
| Premenstrual Syndrome | Mood + breast tenderness + bloating → luteal phase = PMS |
| Menopause | ≥12m no menses + ↑FSH + ↓E2 = Menopause |
| Premature Ovarian Failure | <40y + Amenorrhea + ↑FSH + infertility = POF |
🦠II. Infections & STDs (13–23)
| Topic | Anchor Trigger |
|---|---|
| BV (Bacterial Vaginosis) | Fishy odor + clue cells + pH >4.5 = BV |
| Candidiasis | Cottage cheese discharge + itchy + pH <4.5 = Candida |
| Trichomoniasis | Frothy green discharge + strawberry cervix + mobile protozoa |
| Chlamydia | Silent PID + mucopurulent cx + NAAT test = Azithromycin |
| Gonorrhea | Gram– diplococci + cervicitis + Rx: Ceftriaxone |
| PID | Pelvic pain + cervical motion tenderness + discharge = PID |
| Genital Herpes | Painful grouped vesicles + recurrence = HSV-2 |
| Syphilis | Painless chancre → condyloma lata → neuro signs = VDRL/RPR/FTA |
| HPV Genital Warts | Painless cauliflower lesions + types 6/11 = Rx cryotherapy / imiquimod |
| Chancroid | Painful ulcer + soft chancre + H. ducreyi = "school of fish" on gram stain |
| Lymphogranuloma Venereum | Painless ulcer → painful lymphadenopathy (buboes) + Chlamydia L1–3 |
🫀 III. Fibroids, Endometriosis, & Adenomyosis (24–33)
| Topic | Anchor Trigger |
|---|---|
| Fibroid (Leiomyoma) | Menorrhagia + firm irregular uterus + submucosal = Hysteroscopy / Myomectomy |
| Adenomyosis | Boggy tender uterus + dysmenorrhea + menorrhagia = MRI |
| Endometriosis | Pelvic pain + dyspareunia + chocolate cyst = Endometrioma |
| Endometrial Hyperplasia | Postmenopausal bleed + thickened endometrium = Biopsy |
| Endometrial Cancer | Postmenopausal bleeding + ↑E2 exposure + endo stripe >4mm = TVS → biopsy |
| Cervical Polyp | Intermenstrual bleeding + red mass from os = Polypectomy |
| Endometrial Polyp | Abnormal bleed + local growth + seen on SIS = Polypectomy |
| Asymptomatic Fibroid | No symptoms + incidental USG finding = Observe |
| Submucosal Fibroid | Heavy bleeding + cavity distortion = Hysteroscopic resection |
| Infertility + Fibroid | Submucosal location = most likely to cause infertility |
🥚 IV. Ovarian Pathology & Tumors (34–43)
| Topic | Anchor Trigger |
|---|---|
| Functional Cyst | <5 cm + luteal/follicular + spontaneous resolution = Watchful wait |
| Dermoid Cyst (Mature Teratoma) | Young + calcification + hair + Rokitansky nodule = Remove if large |
| Serous Cystadenoma | Unilocular + benign + serous fluid = Common epithelial tumor |
| Mucinous Cystadenoma | Multiloculated + large + mucinous = Risk of rupture/Pseudomyxoma |
| Ovarian Torsion | Sudden pain + adnexal mass + Doppler ↓ flow = Surgical emergency |
| PCOS Cyst | "String of pearls" on USG + oligo/anovulation = Treat insulin resistance |
| Theca Lutein Cyst | Bilateral + high β-hCG (molar/twins) = Regress post-delivery or evacuation |
| Granulosa Cell Tumor | Precocious puberty / AUB + Call-Exner bodies = Estrogen-producing |
| CA-125 Tumor Marker | ↑CA-125 = Postmenopausal? Rule out Ovarian Ca (esp. epithelial) |
| Meigs Syndrome | Benign ovarian tumor + ascites + pleural effusion = Fibroma |
💊 V. Contraception, Infertility, Procedures (44–50)
| Topic | Anchor Trigger |
|---|---|
| OCP Pills | Estrogen + Progesterone combo + inhibits ovulation = Use daily same time |
| Depot Medroxyprogesterone | IM every 3 months + amenorrhea + ↓BMD = Prog-only |
| Copper-T (IUCD) | Long-acting + may ↑bleeding + safe postpartum = Check strings |
| LNG-IUS (Mirena) | Hormonal IUD + ↓bleeding + lasts 5y = Good for HMB/Endo |
| Emergency Contraception | Levonorgestrel 72h OR Ulipristal 120h = ASAP after unprotected sex |
| Tubal Ligation | Permanent + best done post-delivery + risk of ectopic if failure |
| IVF | Multiple failed IUI + blocked tubes + ↑FSH = IVF indication |
| IUI | Mild male factor + unexplained infertility = First-line ART |
| HSG | Tubal patency test + day 7–10 of cycle + watch for PID hx |
| D&C | Abnormal bleed + miscarriage evac + diagnostic = Use with caution in nullips |
🎯 High-Yield Clinical Pearls
Vaginal Discharge Differentials
- BV: Fishy odor, clue cells, pH >4.5
- Candida: Cottage cheese, itchy, pH <4.5
- Trichomoniasis: Frothy green, strawberry cervix
Amenorrhea Workup
- Primary: No menses by 15y with normal 2° sex characteristics
- Secondary: Always check β-hCG, TSH, Prolactin first
- Hypothalamic: Athlete triad (eating disorder, amenorrhea, osteoporosis)
Ovarian Cyst Management
- Functional: <5cm, watch and wait
- Dermoid: Young patient, calcification, hair
- Torsion: Sudden pain + decreased Doppler flow = Emergency!
Contraception Timing
- Levonorgestrel: Within 72 hours
- Ulipristal: Within 120 hours (5 days)
- Copper IUD: Within 5 days (most effective EC)
Red Flag Symptoms
- Postmenopausal bleeding: Always
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