Adolescent/Gynecology

Question 1

Inability to maintain healthy body weight

Answer 1

Anorexia nervosa

Question 2

Diagnostic criteria for anorexia nervosa

Answer 2

1) distorted body perception
2) restriction of energy intake
3) intense fear of gaining weigh

Question 3

Highest fatality rate of any mental health disorder

Answer 3

Anorexia nervosa

Question 4

Binge eating with Compensatory mechanism

Answer 4

Bulimia nervosa

Question 5

Binge eating without compensatory mechanism

Answer 5

Binge eating disorder

Question 6

When parental consent is not required

Answer 6

Life threatening emergencies
Medical care during pregnancy
Treatment for STI
Treatment for substance abuse
Emancipated minor

Question 7

Onset of menses

Answer 7

2 years after thelarche
After peak height velocity
SMR stage 3 or 4

Question 8

White odorless mucous discharge that precedes menarche by 3-6 mo

Treatment

Answer 8

Physiologic leukorrhea

No intervention

Question 9

First Pap smear

Answer 9

21 yo

Question 10

Lack of menses by age 15
Or 3 years following breast development

Answer 10

Primary amenorrhea

Question 11

3 mo amenorrhea after onset of menses

Answer 11

Secondary amenorrhea

Question 12

Amenorrhea
DUB
obesity
Hirsutism
Acne
Elevated testosterone levels

Management

Answer 12

Polycystic ovary disease (PCOS)

Diet/exercise
Low androgen OCP
Spironolactone
Metformin for obese

Question 13

Female athletic triad

Answer 13

Amenorrhea
Osteoporosis
Disordered breathing

Question 14

Management for female athletic triad

Answer 14

Increase caloric intake
Reduction in training intensity
Calcium supplements
Smoking cessation

NOT OCPs

Question 15

Etiology of primary dysmenorrhea

Management

Answer 15

Prostaglandins produced during ovulation cycle

NSAIDs

Question 16

Management for labial adhesions with Dysuria or secondary bacterial infection

Answer 16

Estrogen cream

Question 17

Full sexual maturity
No menarche
Cyclical abdominal pain
Abdominal mass
Bluish bulging hymen

Answer 17

Imperforate hymen

Question 18

Abdominal pain
No palpable midline mass

Answer 18

Turbo-ovarian abscess

Question 19

Vaginal irritation
Pain
Pruritus
Dysuria

Answer 19

Vulvovaginitis

Question 20

Non sexually transmitted causes of vulvovaginitis

Answer 20

Enterobius vermiculariS
GAS
Staph
Candida

Question 21

sexually transmitted causes of vulvovaginitis

Answer 21

Gonorrhea
Chlamydia
Trichomonas
HSV

Question 22

Milk curd discharge
Itchy

Management

Answer 22

Candida vaginitis

Topical clotrimazole

Question 23

Malodorous
Fishy
Amine odor
“Whiff test”
Clue cells

Management

Answer 23

Bacterial vaginosis

(Gardenella vaginalis, ureaplasma, mycoplasma hominis)

Metronidazole

Question 24

Diagnostic criteria for bacterial vaginosis

Answer 24

Copious grey-white vaginal discharge
Vaginal pH > 4.5
Clue cells
Fish odor on KOH

Question 25

Flat papular warts Pedunculated Sexual contact Management

Answer 25

Condyloma acuminata (HPV) Chemical cauterization (Podophyllin or podofilox)

Question 26

Diagnostic evaluation for HSV

Answer 26

Viral culture

Question 27

Red crusted suprapubic macules Blue-gray dots (maculae cerulae) Slow/sluggish Management

Answer 27

Pediculosis pubis (pubic lice) Permethrin

Question 28

Most prevalent no viral STD in US teens

Answer 28

Trichomonas vaginalis

Question 29

Burning. Itching Abnormal vaginal odor Dyspareunia Flagellated organisms Frothy yellow discharge Strawberry cervix Management

Answer 29

Trichomonas vaginalis Flagyl Abstinence until both partners are treated Repeat test 3mo later

Question 30

Most common reportable STD

Answer 30

Chlamydia trachomatis

Question 31

Treatment for chlamydia

Answer 31

Doxycycline x 7 days Or Azithromycin 1g x 1

Question 32

Lower abdominal pain Shuffling gait Cervical motion tenderness

Answer 32

Pelvic inflammatory disease

Question 33

Most appropriate STI screening for asymptomatic sexually active person

Answer 33

Urine PCR Chlamydia and gonorrhea Serum HIV and syphilis

Question 34

Treatment for gonorrhea STI

Answer 34

ceftriaxone IM x 1 <150 kg: 500mg >150 kg: 1g

Question 35

RUQ pain Sexually active

Answer 35

Fitz-high Curtis syndrome (Perihepatitis)

Question 36

Unilateral abdominal discomfort Fluid filled ovarian cyst Management

Answer 36

Ovarian cyst <6cm: f/u US >6cm or Sx: laparoscopic cyst aspiration

Question 37

Sudden lower abdominal pain Radiates to back, side, groin/leg N/V

Answer 37

Ovarian torsion

Question 38

Definition of abnormal uterine bleeding

Answer 38

Occurs in cycles < 20 days or > 45 days apart Lasts > 7 days Large amount of blood loss per episode (>80mL or > 10 saturated pads/tampons per day)

Question 39

Disulfiram-like reaction

Answer 39

Alcohol + metronidazole

Question 40

Large LAD in groin “Groove” sign Management

Answer 40

Lymphogranuloma venereum (Chlamydia trachomatis) Doxycycline 100mg PO BID x 3 wks

Question 41

Pituitary infarction (necrosis) Postpartum hemorrhage/shock Hypopituitarism

Answer 41

Sheehan Syndrome (Postpartum hypopituitarism)