gynecology

Question 1

Tx for gonococcal urethritis

Answer 1

Cefritaxone (250 mg IM) once (and also treat for Chlamydia)

Question 2

Tx for non-gonococcal urethritis (chlamydia)

Answer 2

Azithromycin once (OR) Doxycycline x 7 days

Question 3

what does PCOS do to LH and FSH

Answer 3

increases pituitary synthesis of LH (and decreases pit synthesis of FSH) (LH:FSH ratio > 2)

Question 4

PCOS effects of LH and FSH

Answer 4

• increased LH increases ovarian synthesis of androgens –> hirsuitism
• androgens aromatized to estrogen in adipose –> increases risk of endometrial Cancer
• increased estrogen has positive feedback on LH (and negative on FSH) –> suppressed FSH causes follicle degeneration (anovulation)
• fluid accumulation creates subcortical cysts that enlarge ovaries

Question 5

if premenopausal is still menstruating, what day of cycle to test FSH

Answer 5

day 3 (if FSH increased, best marker of menopause)

Question 6

in what stage of syphilis do widespread mucucutaneous lesions occur

Answer 6

secondary stage, 4-10 weeks after chancre appeared

Question 7

what are the stages of syphilis

Answer 7

primary, secondary, latent, and tertiary

Question 8

what forms in tertiary syphilis

Answer 8

gummas (necrotic nodules)

• also neurosyphilis affects CNS
• aortic syphilis affects CVS (aneurysm)
• 3-10 years after initial infection

Question 9

Tx for trichomoniasis

Answer 9

metronidazole

Question 10

trichomoniasis phys exam finding

Answer 10

red “strawberry” spots on vaginal walls and cervix