Week 1 pt 1 Highlights

Question 1

Subspecialties recognized by the American Board of Obstetrics & Gynecology (ABOG) include what?

Answer 1

1) Maternal-fetal medicine
2) Gynecologic oncology
3) Reproductive endocrinology-infertility
4) Female reproductive medicine & reconstructive surgery (aka urogynecology)

Question 2

1) Obstetrician-gynecologist specialist referred to as _________
2) There’s a ________________ approach

Answer 2

1) OB/GYN
2) Multidisciplinary

Question 3

List 4 elements of the ethical practices of women’s health

Answer 3

Nonmaleficence, beneficence, autonomy, justice

Question 4

“Life-course” perspective of women’s health:
1) What does it start with?
2) What does it continue into?
3) What does it provide?

Answer 4

1) Starts with preconception health
2) Throughout pregnancy + during postpartum period
3) A perspective for healthy living

Question 5

What begins with preconception health?

Answer 5

“Life-course” perspective of women’s health

Question 6

Genetics likely only responsible for ~_________ of direct causes

Answer 6

~1/3

Question 7

Barker hypothesis
Adaptive developmental plasticity
Allostasis

These all describe what?

Answer 7

Origin of disease

Question 8

___________ or conditions during ___________ that account for epigenetic changes may lead to future CVD, obesity, DM, stroke

Answer 8

Perturbations; pregnancy

Question 9

True or false: A normal pregnancy will not be protective of disease later in life

Answer 9

False; a normal pregnancy may be protective of disease later in life

Question 10

What health should be a priority to promote a healthy first pregnancy?

Answer 10

Preconception

Question 11

1) What is the goal of primary prevention? Give an example of this type of prevention
2) Define secondary prevention

Answer 11

1) To eliminate or decrease risk factors for disease
-Immunizations
2) Screening tests for disease in asymptomatic patients

Question 12

Recommended vaccines for women include HPV vaccine (11-26yo) to prevent what?

Answer 12

Cervical neoplasia & cancer

Question 13

Who can’t get the HPV vaccine, MMR, or live vaccines in general?

Answer 13

Pregnant women

Question 14

1) What does secondary prevention involve? (3 things)
2) What are the only effective screening tests for gyn cancers?
3) Are there effective screening tests for ovarian, endometrial, vaginal, or vulvar cancers?

Answer 14

1) Screening, evaluation, & counseling
2) Pap (Papanicolaou) smear [for cervical CA] & mammography for breast CA
3) No

Question 15

The goal of screening for CA is to detect _____________ disease in healthy, asymptomatic patients to

Answer 15

preclinical

Question 16

American College of Obstetricians & Gynecologists (ACOG)*
American Cancer Society (ACS)
United States Preventive Services Task Force (USPSTF)

What do these 3 things have in common?

Answer 16

Breast cancer publishers of clinical screening guidelines

Question 17

What do we use ACOG for?

Answer 17

Breast cancer screening recommendations

Question 18

What are the 3 major screening exams for women at average risk for breast cancer?

Answer 18

Clinical breast exam, screening mammogram, & patient self-screening

Question 19

What are the ACOG recommendations for breast cancer screening?

Answer 19

1) Clinical breast exam (CBE):
25-39 years – every 1-3 years
40 years & older – annual
2) Screening mammogram:
40-75 years –screen annually or biennially
Older than 75 years – continue annually or biennially based on shared decision-making
3) Breast self-exam: not universally recommended (breast self-awareness encouraged)

Question 20

40-75 years: screen annually or biennially for what?

Answer 20

Breast cancer

Question 21

What is encouraged in lieu of breast self-exam?

Answer 21

Breast self-awareness

Question 22

HPV is a risk factor for what?

Answer 22

Cervical CA

Question 23

Pregnant women are screened for what 4 STIs?

“important to know”

Answer 23

HIV, chlamydia, gonorrhea, syphilis

Question 24

Metabolic disease screening for osteoporosis can be done via ______ testing for all women starting at 65 years (q>2yrs)

Answer 24

BMD

Question 25

DEXA 1) SD from the mean peak BMD of a normal, young adult population is called what? 2) SD from the mean BMD of a population of the same sex, race, age is what? 3) Normal BMD T-score is what?

Answer 25

1) T score 2) Z score 3) >/= -1

Question 26

______thyroidism may present in older women as dementia

Answer 26

Hypo

Question 27

Autonomy also includes the patient’s right to do what?

Answer 27

Refuse care

Question 28

Informed consent: 1) Derived from what? 2) What cannot be delegated? 3) What must it be?

Answer 28

1) Autonomy 2) Responsibility of performing physician (clinician) to gain informed consent 3) Voluntary

Question 29

What is the checklist to guide the informed consent process?

Answer 29

1) Plan 2) Reason 3) Expectation 4) Preferences 5) Alternatives 6) Risks 7) Expenses 8) Decision

Question 30

What 3 things are crucial to patient healthcare enrichment & decreasing potential for litigation?

Answer 30

1) Pt safety 2) Ethical practice 3) Value

Question 31

What is the goal of culturally competent care?

Answer 31

Everyone afforded the same quality of care no matter where you are from, socioeconomic status, etc.

Question 32

Care must be ____________ competent and _________- based on women from diverse backgrounds.

Answer 32

culturally; sensitive

Question 33

What are some limitations of the traditional model of the female sexual response?

Answer 33

1) Women are sexual for many reasons 2) Sexual stimuli are integral to response 3) Phases of desire and arousal overlap 4) Orgasm may not be necessary 5) Outcome may influence motivation 6) Dysfunctions may overlap

Question 34

__________________ Model includes positive and negative feedback loops of sexual function

Answer 34

Intimacy-based

Question 35

Physiological components of female sexual response include what? (3 things)

Answer 35

1) Autonomic nervous system (ANS) 2) Positive neurotransmitters 3) Negative neurotransmitters

Question 36

1) What does female sexual dysfunction include? 2) ~1/3 of women with sexual dysfunction have what?

Answer 36

1) Pain disorders 2) clinically depressed

Question 37

Medical conditions commonly affecting sexual response are associated with what 2 things?

Answer 37

Loss of adrenal androgen production and/or loss of estrogen production

Question 38

What are some medical risk factors for female sexual dysfunction? (6)

Answer 38

1) Depression (with or without antidepressants) 2) Breast CA that req. chemo 3) Radical hysterectomy for cervical CA 4) HTN 5) DM 6) Sexual abuse

Question 39

What are some biological and psychological risk factors for female sexual dysfunction?

Answer 39

1) Healthy pregnancy 2) Complicated pregnancy where intercourse and orgasm are precluded 3) Postpartum considerations 4) Recurrent miscarriage 5) Therapeutic abortion 6) Infertility 7) Perimenopause, natural menopause, and premature menopause 8) OCPs

Question 40

Screening for Sexual Dysfunction requires what?

Answer 40

Respectful & nonjudgmental approach

Question 41

1) What should you not do during HPI? 2) Use “_________ ” instead of “husband” 3) Use “______________ ” instead of “intercourse”

Answer 41

1) Don’t make assumptions about partner(s) 2) partner 3) sexual activity

Question 42

Most common cause of reduced libido is _____________ .

Answer 42

depression

Question 43

Antidepressants may ___________ libido (side effect).

Answer 43

decrease