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Truelearn 3 Flashcards

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1
Q

Patients with provoked PE should be anticoagulated for how long generally

A

3 months

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2
Q

What is the most common cause of procedure related death in laparoscopic tubal sterilization?

A

Cardiopulmonary arrest

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3
Q

How do you repair an abdominal ureteral injury ?

A

Ureteroureterostomy

Transureteroureterostomy

Ureteral reimplantation

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4
Q

How do you repair pelvic ureteral injuries?

A

Ureteral reimplantation with/without psoas hitch and or Boari flap

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5
Q

What is the greatest risk factor for the development of epithelial ovarian cancer?

A

Family history of ovarian cancer

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6
Q

Patients with a history of cryptorchidism have fertility rates of ______ for unilateral and _____ for bilateral compared to fertile males

A

80% unilateral

50% bilateral

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7
Q

What’s the rate of expulsion of postpartum IUDs ?

A

10 - 27 %

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8
Q

The FDA banned transvaginal mesh for what purposes ?

A

Repair of cystocele ( anterior compartment)

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9
Q

On ultrasound, the corpus luteum is usually what size?

A

< 2.5 cm

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10
Q

Granulosa and theca cells surrounding a centra blood clot describes what structure responsible for making progesterone in a pregnancy before 10 weeks?

A

Corpus luteum

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11
Q

In a patient with BRCA1 what are the most common associated cancers ? (4)

A

Breast
Ovarian
Uterine serous papillary
Prostate

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12
Q

What’s the risk of Breast and Ovarian cancer in BRCA 1?

A

60 % Breast
40% Ovarian

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13
Q

What are the most commonly associated cancers for people with BRCA 2 mutation? (6)

A

Breast
Ovarian
Uterine
Prostate
Pancreas
Melanoma

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14
Q

What’s the lifetime risk of breast and ovarian cancer ( by age 70) in women with BRCA 2 mutation?

A

Breast 50%
Ovarian : 20%

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15
Q

How do you reduced ovarian cancer risk in patients with BRCA1? BRCA 2?

A

BRCA 1 - ppx BSO age 35 - 40

BRCA 2 - ppx BSO age 40 - 45

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16
Q

What kind of breast cancer is typically found in BRCA 1 carriers? BRCA 2 carriers?

A

BRCA1 - Most commonly triple negative

BRCA 2 - Most commonly ER/PR +

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17
Q

According to ADA diabetes screening should be performed in whom?

A

BMI >/= 25 with additional risk factors

Start at age 35 yrs and go every 3 years if results are normal

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18
Q

A fever within the first 3 days of surgery is most often related to _______ or ________

A

Atelectasis

Pneumonia

Remember, WIND!

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19
Q

What’s the mnemonic for remembering causes of postoperative fevers and associated time we can typically see these occurrences?

A

Wind (0 - 3 days)

Water (3 - 7 days)

Wound (5 - 7 days)

Walking (Anytime)

Wonder drugs ( Anytime)

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20
Q

What’s the typical size of pituitary macroadenoma?

A

> 10 mm

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21
Q

The CDC recommends empiric treatment for what three STDs in the setting of sexual assault?

A

Gonorrhea
Chlamydia
Trichomonas

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22
Q

Gonorrhea treatment dosing empirically for sexual assault

A

Ceftriaxone 500 mg IM x 1
Give 1g if ppt is > 150 kg

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23
Q

Chlamydia treatment consists of _____ or ______ ( and which one is preferred)

A

Doxycycline 100 mg BID x 7 days

Azithromycin 1g PO once can be given

Doxy is preferred over azithromycin because of microbial efficacy but azithromycin can be given for those who adherence is a concern or they are unlikely to complete the 7 day course

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24
Q

Treatment for trichomonas includes

A

Metronidazole 500 BID for 7 days
** be sure to tell patents to avoid alcohol **

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25
What is the way to proceed with HIV prophylaxis discussion in a patient with sexual assault?
Risk of transmission is pretty low but prophylaxis with antiretrovirals are usually offered to patients Meds best started within 4 hours and no later than 72 hours
26
What does the CDC recommend course for post exposure prophylaxis for HIV in Sexual assault victims
Initial supply for 3 - 7 days ( starter pack) OR the supply needed for an entire treatment course (28 days) Short term close follow up is recommended
27
Max dose of lido without epi? LIDO WITH epi?
4.5 mg/kg 7 mg/kg
28
How is 5 alpha reductase deficiency inherited and what is the Karyotype?
Autosomal recessive 46 XY
29
What is abnormal in a patient with 5 alpha reductase deficiency?
Defective conversion of testosterone to dihydrotestosterone
30
In 5 alpha reductase deficiency what anatomical structures are affected ?
External genitalia (penis, scrotum) Prostate Urethra * the external structures require the DHT in order to virilize normally, the internal structures are stimulated by testosterone and are able to develop normally*
31
What are contraindications for in office LEEP ? (4)
Significant anxiety Limited Pain tolerance Bleeding/coagulation disorders Current menses ( active bleeding obscures view of the cervix)
32
Per the guidelines CIN 2 or 3 should be treated with ______
LEEP or Cold knife cone biopsy
33
What is the treatment for cervical adenocarcinoma in situ
Hysterectomy if the patient has completed childbearing , but an excisional procedure should be done to rule out invasive cancer
34
Patients younger than 25 yrs with HSIL pap should have what done next ?
Colposcopy
35
Patient older than 25 years old, HSIL pap can be treated with ______ or _______
Colposcopy or excision ( LEEP or CKC)
36
Describe Factitious disorder ( also known as Munchausen Syndrome)
Women of reproductive age intentionally faking medical or psych symptoms to assume the sick role with no external rewards Usually will readily accept diagnostic and therapeutic procedures
37
How do you describe malingering ?
Faking illness in order to obtain obvious external rewards ( time off work, child custody etc ) Often times diagnostic and therapeutic procedures will be avoided in this individual
38
What does Munchausen by proxy refer to
Factitious disorder imposed on another person
39
What is the risk of CIN 3 progressing to cancer?
40%
40
What is the risk of CIN I and CIN 2 proceeding to cancer?
CIN 1 - 1% CIN 2 - 5%
41
What is the risk of leiomyoma containing an underlying leiomyosarcoma ?
1/2000 cases or 0.05%
42
Earliest age it consider herpes zoster vaccine in a patient?
50 years old
43
What can hep decrease ovarian cancer risk in women with BRCA 1 or BRCA2 who aren’t candidates or who don’t desire prophylactic BSO ?
Combine oral contraceptives - 50% decreased risk of ovarian cancer
44
What med is approved as add back therapy in patients taking Leupron ( Leuprorelin) for more than 6 months?
Norethindrone 5 mg daily
45
Clonidine can be used to treat both ______ and _______
Hypertension and Vado motor symptoms of menopause
46
Is clonidine FDA approved for hot flash use?
No but it is often used off label Meta analysis has shown that it is less effective than hormone replacement therapy (estradiol+/- progestin) but superior to placebo
47
What are some side effects of clonidine
Dry mouth Insomnia Drowsiness Rebound hypertension if abruptly stopped
48
First line treatment for lichen planus?
High potency topical steroids ( like clobetasol or halbetasol)
49
Physical exam highlights for lichen planus
5 Ps ( pruritic, purple, papular, polyhedral papules, plaques) It can also have white, lacy, reticulate striae
50
How do you manage cyclic mastalgia?
OCPs or supplemental progestins given during secretory phase of the cycle
51
How do you manage refractory mastalgia?
Danazol ** 90% of patients have relief but don’t use for more than 6 months because it van cause hirsutism** If Danazol fails, can do a course of bromocriptine or tamoxifen
52
Leuprolide acetate also known as Lupron is what category of drug ?
GnRH agonist
53
Orilissa also known as elagolix is in what drug family ?
GnRH antagonist It suppresses estrogen and inhibits endometriosis proliferation
54
When should test of cure be performed after chlamydia is diagnosed and treated in pregnancy?
4 weeks Then reset 3 months after treatment
55
Pregnant and postpartum people who experience IPV are how many times more likely to be victims of homicide compared to non pregnant/postpartum women?
2 times
56
What is the risk of renal anomaly in women with unicorn usage uterus?
40%
57
What is management for unicornuate uterus with pregnancy in rudimentary horn?
Termination recommended due to risk of uterine rupture
58
What percent of women with fibroids report mild pelvic pain ?
20%
59
What are the recommendations for Calcium and vitamin D supplementation in post menopausal women < 70 years ?
1200 mg calcium per day 600 IU Vitamin D
60
What are the recommendations for Calcium and vitamin D supplementation in post menopausal women OVER age 70?
1200 mg calcium 800 IU of vitamin D

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