gyn path

Question 1

which type of abortion has an open os

Answer 1

Incomplete (passage of contents) and Inevitable

Question 2

salpingectomy vs ostomy

Answer 2

ectomy– remove fallopian tube in presence of ruptured ectopic

ostomy- open up tube, suck out ectopic, and preserve tube in the case of no rupture

Question 3

methotrexate use parameters

Answer 3

bhcg <5000
preg < 3.5cm
no heartbeat
no folate

Question 4

at what beta quant should you see an intrauterine pregnancy

Answer 4

> 1500 –> if you have that and no IUP on US, its ectopic

Question 5

medical therapy for fibroids, 1st line

Answer 5

OCP=IUD

Question 6

mechanism of nsaids in uterus

Answer 6

impact prostoglandins and prevent bleeding, rather than inhibiting platelets which would lead to more bleeding

Question 7

vulvovaginitis bugs

Answer 7

trich
BV
candida

Question 8

cervicitis bugs

Answer 8

GC/CT

Question 9

candida

Answer 9

risk factors: DM, steriods, recent abx
wet prep: KOH shows hyphae
tx with fluconozole oral

Question 10

BV tests

Answer 10

saline –> clue cells
KOH –> + whiff

tx with metro, topical than oral

Question 11

trich

Answer 11

flagellated orgs
strawberry cervis –> cervical erythma

tx: metro, treat the partner too

Question 12

tx of GC/CT

Answer 12

CT= ceftriaxone IM
GC= doxy/azithro

Question 13

PID path

Answer 13

1/3- vaginal flora, 1/3 GC/CT, 1/3 ascending infection

Question 14

inpatient vs outpatient tx of PID

Answer 14

inpatient: cefoxitin + doxy, clinda + gent
outpt: ceftriaxone IM + doxy + metro

goal is to get atypicals and anaerobes

Question 15

sx treatment for menopause

Answer 15

hot flashes= SSRI (venlafaxine)

vaginal atrphy = topical estrogen

Question 16

what to consider with menopause?

Answer 16

heart disease and osteoporosis

check LDL and dexa –> if osteoporotic, give bisphosphonates

at menopause, prophylax with Vit D and Ca supplements (since first dexa won’t be until 65)

Question 17

endometrioma

Answer 17

chocolate cyst on an ovary

Question 18

tx of endometriosis

Answer 18

pelvic pain –> NSAIDS
axis –> OCP/IUD, GnRH analogue like leuprolide, danozole
chocolate cyst: dx diagnostic lap with laser ablation