Gynecology: Infections and Contraception for USMLE
This module focuses on key concepts in gynecological infections and contraception, crucial for success on the USMLE. We will cover common infections, their diagnosis and management, and various contraceptive methods, including their mechanisms, efficacy, and counseling points.
Gynecological Infections
Understanding common gynecological infections is vital. This includes bacterial vaginosis, vulvovaginal candidiasis, and sexually transmitted infections (STIs) like chlamydia, gonorrhea, and trichomoniasis. Accurate diagnosis and appropriate treatment are paramount.
Bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis.
Bacterial Vaginosis (BV)
Vulvovaginal Candidiasis (Yeast Infection)
Sexually Transmitted Infections (STIs)
STIs require prompt diagnosis and treatment to prevent complications and further transmission. Key STIs to master include Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis.
| STI | Common Symptoms | Diagnostic Method | Treatment |
|---|---|---|---|
| Chlamydia | Often asymptomatic; mucopurulent cervicitis, dysuria, intermenstrual bleeding | Nucleic acid amplification test (NAAT) | Azithromycin or Doxycycline |
| Gonorrhea | Often asymptomatic; purulent discharge, dysuria, pelvic inflammatory disease (PID) | NAAT or culture | Ceftriaxone (often with azithromycin) |
| Trichomoniasis | Frothy, yellow-green discharge; pruritus; dyspareunia; strawberry cervix | Microscopy, NAAT, or culture | Metronidazole or Tinidazole |
Contraception
Contraception involves a wide array of methods, each with distinct mechanisms, efficacy rates, and patient considerations. A thorough understanding is crucial for patient counseling and management.
Hormonal Contraceptives
Intrauterine Devices (IUDs)
Barrier Methods and Emergency Contraception
Barrier methods, such as condoms, offer protection against both pregnancy and STIs. Emergency contraception (EC) is a crucial option for preventing pregnancy after unprotected intercourse.
Remember to counsel patients on the dual protection offered by condoms against both pregnancy and STIs. This is especially important for individuals at risk of STIs.
Ulipristal acetate (Ella) or copper IUD.
Integrating Knowledge for USMLE
For the USMLE, focus on the clinical presentation, diagnostic criteria, management pathways, and key counseling points for each condition and contraceptive method. Practice integrating this knowledge by working through clinical vignettes.
Visualizing the menstrual cycle and hormonal feedback loops is essential for understanding how hormonal contraceptives work. The interplay between GnRH, FSH, LH, estrogen, and progesterone dictates ovulation. Hormonal contraceptives disrupt this delicate balance by providing exogenous hormones, leading to negative feedback on the hypothalamus and pituitary, thus preventing the LH surge required for ovulation. Additionally, they alter cervical mucus and the uterine lining.
Text-based content
Library pages focus on text content
Learning Resources
Comprehensive guidelines from the CDC for the diagnosis and treatment of STIs, essential for clinical decision-making.
An authoritative, in-depth review of all contraceptive methods, including efficacy, side effects, and contraindications.
The American College of Obstetricians and Gynecologists provides patient-friendly infographics and resources on various contraceptive methods.
A review article from the New England Journal of Medicine discussing the pathogenesis, diagnosis, and management of bacterial vaginosis.
World Health Organization fact sheets provide global statistics and key information on major STIs.
A clear and concise video explaining different types of contraceptive methods and how they work.
A comprehensive overview of vulvovaginal candidiasis, including epidemiology, clinical presentation, diagnosis, and treatment.
A platform specifically designed for USMLE preparation, offering detailed explanations and practice questions on gynecology topics.
A detailed overview of intrauterine devices, including their history, types, mechanisms of action, and effectiveness.
The CDC's official resource on contraception, covering various methods, effectiveness, and safety information.