Reproductive Health

Question 1

when can you see gestational sac on US?

Answer 1

5-6 weeks

Question 2

Smoking during pregnancy is associated with…

Answer 2

low birth weight, increased risk of miscarriage, prematurity and VTE

Question 3

When can you give methotrexate for ectopic pregnancy?

Answer 3

small <3 cm, unruptured, w/o fetal cardiac activity.

Question 4

Normal fetal heart rate

Answer 4

120-160 bpm

Question 5

Quad screen is offered between weeks…

Answer 5

15-18 weeks

Question 6

When do you do a GTT?

Answer 6

24-28 weeks

Question 7

Prego women should avoid airline travel after…

Answer 7

35-36 weeks

Question 8

IUGR is defined as fetal growth below the —%.

Answer 8

<10%

Question 9

Late decels indicate…

Answer 9

uteroplacental insufficiency & fetal acidemia

Question 10

Variable decels indicate…

Answer 10

cord compression, no fetal distress

Question 11

Early decels indicate…

Answer 11

head compression

Question 12

Chorioamnionitis antibiotics?

Answer 12

Amp + gent

Question 13

True/false emergency contraceptive works after implantation

Answer 13

False emergency contraceptive only works before implantation

Question 14

Up to how many days after unprotected sex can you use emergency contraceptive?

Answer 14

Up to five days for progesterone only and combination emergency contraceptive and up to 5–8 days for copper IUD

Question 15

Combined hormonal contraceptives are contraindicated in…

Answer 15

DVT, pulmonary embolism, thrombophlebitis, uncontrolled hypertension, CAV, CAD, MI, heavy tobacco use, any estrogen dependent cancer including breast cancer, migraines with aura, hepatic adenoma, hepatic carcinoma, pregnancy

Question 16

True/false Combined hormonal contraceptives can only be started at the beginning of a menstrual cycle

Answer 16

False they can be started on any day of the menstrual cycle however if started on day one there’s no need for back up method. Starting any other day requires a barrier method or abstinence for 7 to 14 days

Question 17

What should you instruct the patient to do if she misses a single dose of her OCP

Answer 17

Take her missed doast immediately in the next dose at the usual time

Question 18

What should you instructed patient to do if she’s missed two doses of her OCP

Answer 18

Take two pills immediately and two pills the next day

Question 19

What should you instruct the patient whose missed three or more doses of her OCP

Answer 19

Discard the pack of pills, allow withdrawal bleeding and then start a new pack

Question 20

Is the Depo-Provera estrogen or progesterone or both?

Answer 20

Medroxyprogesterone only

Question 21

True/false progesterone only methods are safe for breast-feeding mothers and babies

Answer 21

True

Question 22

Once a patient stops Depo-Provera how long does it usually take for fertility to return

Answer 22

7 to 12 months

Question 23

What is the only absolute contraindication for progesterone only contraceptives

Answer 23

Breast cancer. Caution is recommended in those with: Respecters for cardiovascular disease, uncontrolled hypertension, current DVT or PE

Question 24

Long-term use of Depo-Provera can lead to…

Answer 24

Decreased bone mineral density however this appears to return to normal after Depo-Provera is stopped.

Question 25

What supplements should you recommend for a patient on the Depo-Provera to take

Answer 25

Calcium and vitamin D in addition to weight bearing exercise to prevent bone loss

Question 26

True/false high-risk sexual activity and young age are contraindication to intrauterine contraceptives

Answer 26

False

Question 27

IUCs are contraindicated with

Answer 27

Pregnancy, active infection, anatomic abnormalities or fibroids at the store at the uterine cavity enough to make insertion difficult, current gynecological cancer, unexplained vaginal bleeding, allergy or Wilson’s disease and current/history of breast cancer(Mirena only)

Question 28

Abortion with D&C during the first trimester can be performed up to —-weeks

Answer 28

12 weeks

Question 29

First trimester abortion with mifepristone and misoprostol can be used for up to —- weeks

Answer 29

FDA approved for up to seven weeks but commonly used up to nine weeks

Question 30

If cardiac activity is detected — Weeks after medical abortion it is considered a failure and surgical abortion is needed

Answer 30

Two weeks

Question 31

What lab should you order to further evaluate an ovarian mass

Answer 31

Ultrasound to determine size, beta hCG, alpha-fetoprotein, LDH, serum CA 125

Question 32

What should you do for further evaluation of a prepubertal patient with ovarian mass

Answer 32

Ultrasound in referral to GYN has these are most likely malignant

Question 33

What should you do for a pre-menopausal patient with ovarian mass

Answer 33

Ultrasound, basic labs and if less than 10 cm can be followed with ultrasound. If persistence for more than 12 weeks referral to GYN

Question 34

What should you do for the postmenopausal patient with ovarian mass

Answer 34

Ultrasound, basic labs for 5 to 10 cm with normal CA 125 can be followed with serial ultrasounds due to low risk of malignancy. Larger system should be laparoscopically excised

Question 35

Antibiotics of choice for epididymitis individuals 14 to 35 years old

Answer 35

Treat for gonorrhea and chlamydia with Rocephin and Doxy or azithromycin

Question 36

Antibiotics of choice for epidermidis an individuals greater than 35 years

Answer 36

Bactrim or FQ

Question 37

Drug of choice and treatment duration for prostatitis

Answer 37

Bactrim or FQ. Treat for 4 to 6 weeks

Question 38

Drug of choice for treatment of trichomonas? Duration in dosage?

Answer 38

One time dose of metronidazole 2g, treat partner. * is treatment fails go to Flagyl 500 BID times seven days

Question 39

After an RPR what test do you have to do to confirm diagnosis of syphilis?

Answer 39

FTA-ABS

Question 40

Irregular bleeding is coming after HRT and improves after…

Answer 40

6-12 months

Question 41

Nausea and vomiting in pregnancy starts around ——and usually resolves by——.

Answer 41

4 to 8 weeks in resolves by 13 to 14 weeks

Question 42

Monitoring of MTX for ectopic pregnancy

Answer 42

After diagnosis of ectopic give single dose of methotrexate. Recheck beta hCG on days four and seven if level continues to rise patient will need laparoscopy. If Betah H she do use down trending, turned it out to zero

Question 43

Preeclampsia during pregnancy raises your lifetime risk of

Answer 43

Ischemic heart disease

Question 44

Women with preeclampsia should plan to deliver at

Answer 44

37 weeks

Question 45

MC type of ovarian cancer

Answer 45

epithelial ovarian cancer

Question 46

whats ospemifene?

Answer 46

SERM that acts as an estrogen agonist in the vagina but has no effects on the endometrium or breast. Daily pill. Side effects include hot flashes and risk of VTE. Also reduces bone turnover =)