Gynecology

Question 0

Painful genital ulcers

DDx? (Name the microbes)

Answer 0

H. decruyi

HSV-2

Question 1

Genital papule➡️pustule➡️painful ulcer with gray base, yellow exudate and foul odor

• Dx?
• Tx?

Answer 1

Chancroid (haemophilus DUCREYI)
IM ceftriaxone or IM azithromycin
(One dose of either)

Question 2

Painless ulcer that heals…one month later patient develops painFUL buboes in the inguinal region

• Dx?
• Tx?

Answer 2

Lymphogranuloma venereum
(Chlamydia trachomatis L1, 2, 3 serotypes)

Tetracycline or doxycycline or erythromycin

• can develop into elephantiasis or bubo ulceration

Question 3

Initial treatment for periodic pain associated with menses (dysmenorrhea)

Answer 3

NSAIDs

then

OCPs

Question 4

Ages and criteria for diagnosing primary amenorrhea

Answer 4

16 yo: no menses + developed secondary sexual characteristics

14 yo: no menses + no secondary sexual characteristics

Question 5

First step after diagnosing primary amenorrhea

Answer 5

Pelvic exam/US

If +uterus: order FSH to differentiate b/t central (⬇️FSH, would get pituitary MRI next) and peripheral (⬆️FSH, would get karyotyping next)

NO uterus: karyotyping