Office- Miscellaneous

Question 1

What is the most common genetic bleeding disorder in women?

Answer 1

Von willebrand disease

Question 2

What is the inheritance of von willebrand disease?

Answer 2

Autosomal dominant type 1
Autosomal recessive type 2

Question 3

What is the prevalence of von willebrand disease?

Answer 3

1%

Question 4

What is the evaluation for von willebrand disease?

Answer 4

CBC
PT/PTT
Fibrinogen
Ristocetin cofactor activity level for vWF, vWF antigen, factor VIII

Question 5

What are indications for screening for von willebrand disease?

Answer 5

1. Adolescent with HMB prior to initiating OCP
2. Adults with HMB
3. Patients undergoing hysterectomy for HMB
4. History of excessive bleeding

Question 6

What is the treatment for von willebrand disease?

Answer 6

Desmopressin
OCP
IUD
Nexplanon
TXA

Question 7

What medication should be avoided in patients with von willebrand disease?

Answer 7

NSAIDs
Aspirin

Question 8

What OB considerations should be taken into account for patients with von willebrand disease?

Answer 8

Avoid vaccum delivery
Avoid scalp placement
Delay circumsion
Increase risk of PPH
Increase risk of epidural hematoma

Question 9

What are malignant characteristics of melanoma?

Answer 9

Irregular borders
Non-uniform darkening
Ulceration
Bleeding
Increasing size

Question 10

What are symptoms of migraine without aura?

Answer 10

Unilateral
Pulsatile
Aggravated by routine activity
Moderate to severe pain
Nausea
Photophobia

Question 11

What are the criteria for irritable bowel syndrome?

Answer 11

Abdominal pain relieved by defecation
Abdominal pain associated with increase or decrease in stool frequency
Abdominal pain associated with harder or looser stools
Dyspepsia

Question 12

What is the treatment for irritable bowel syndrome?

Answer 12

Antispasmodics and fiber modification

Question 13

How long does it take to develop symptoms from food poisoning?

Answer 13

2-6 hours

Question 14

What are the typical culprits for food poisoning?

Answer 14

Salmonella
Norovirus
Campylobacter
E. coli
Listeria

Question 15

What are symptoms of food poisoning?

Answer 15

Diarrhea
Vomiting

Question 16

What is the treatment for food poisoning?

Answer 16

Supportive treatment

Question 17

How long does it take to develop symptoms from travelers diarrhea?

Answer 17

24-72hrs

Question 18

What are the typical culprits for travelers diarrhea?

Answer 18

E.coli

Question 19

What are the symptoms of travelers diarrhea?

Answer 19

Abdominal cramping
Watery diarrhea
Low grade fever
Vomiting

Question 20

What is the treatment for travelers diarrhea?

Answer 20

Supportive treatment
pepto bismol
Cipro 500mg BID for 5 days

Question 21

What symptoms does Giardiasis cause?

Answer 21

Watery diarrhea
abdominal bloating
Flatulence
Malabsorption

Question 22

What is the incubation period for Giardiasis?

Answer 22

10-20 days

Question 23

How do you diagnosis Giardiasis?

Answer 23

Fecal examination for trophozoites

Question 24

What is the treatment for Giardiasis?

Answer 24

Flagyl 250mg TID for 7 days

Question 25

What bacteria cause bloody diarrhea?

Answer 25

Campylobacter E.coli Shigella C.diff

Question 26

What medications are contraindicated in pregnancy?

Answer 26

Chloramphenicol- Grey baby syndrome Tetracycline- Tooth discloration Erythromycin- Hepatotoxic Quinolone- Affects cartilage Nitrofurantoin- neonatal hemolytic anemia

Question 27

What medications are contraindicated with breastfeeding?

Answer 27

Bromocriptine Cyclophosphamide Ergotamine Lithium Methotrexate Radioactive iodine

Question 28

What is the recommendation for expedited partner therapy?

Answer 28

Should be given when patient is infected with gonorrhea, chlamydia or trichomonas. Prescription given at the same time for patient and partner Written instructions for partner for medication use, effects and contraindications, evaluation and STD testing

Question 29

What is the treatment for gonorrhea?

Answer 29

Ceftriazone 500mg IM or weight based dosing No need for azithromycin now Retest in 3 months for reinfection

Question 30

What is the management for IUD without visible strings?

Answer 30

1. Attempt to retrieve strings (cytobrush) 2. If not successful exclude pregnancy and counsel patient and give back up or emergency contraception 3. Pelvic ultrasound 4. If not visualized then do X-ray of abdomen and pelvis 5. If still no visualized then assume expelled and counsel patient IF seen in abdomen laparoscopic removal

Question 31

What are the SERMs?

Answer 31

Tamoxifene Raloxifene Clomiphene Ospemifene Bazedoxifene

Question 32

What is the indication for treatment with tamoxifene?

Answer 32

1. Prevention of breast cancer in high risk group 2. Adjuvant treatment of breast cancer 3. Metastatic breast cancer

Question 33

What is the indication for treatment with raloxifene?

Answer 33

1. Chemoprevention for patients at risk for breast cancer 2. Osteoporosis prevention and treatment

Question 34

What are the side effects of tamoxifene?

Answer 34

Uterine polyps/hyperplasia VTE vasomotor symptoms

Question 35

What are the side effects of raloxifene?

Answer 35

VTE

Question 36

How does raloxifene work?

Answer 36

Bind to estrogen receptor Stimulates estrogen effects on bone and lipids No estrogen effect on uterus or breast

Question 37

What is the indication for ospemifene?

Answer 37

Treatment of moderate to severe dyspaurenia due to vulvar/vaginal atrophy of menopause

Question 38

How does ospemifene work?

Answer 38

Binds to estrogen receptor Stimulates estrogen affects in vagina No estrogen effect on breast