Women

Question 1

61 yo women with menopause - USPS recommendation on hormonal therapy for prevention of chronic dz?

Answer 1

USPSTF recommends against use of both unopposed estrogen and progestin for prevention of chronic dz. Research shows hormone therapy increase risk for a/e

Question 2

greyish vaginal discharge, dysuria, vaginal disorder, high pH >4.5, clue cells—– diagnosis?

Answer 2

bacterial vaginosis

Question 3

wells score used for?

Answer 3

prediction for DVT

Question 4

whiff test is?

Answer 4

amine test reveal fishy order

Question 5

thick, cruddy, white discharge, vaginal BURNING, and itching, LOW pH < 4.5, pseudohyphae — diagnosis?

Answer 5

Candidiasis

Question 6

green/yellow, motile/flagella on wet mount — diagnosis?

Answer 6

trichomoniasis

Question 7

abnormal vaginal discharge, cervicitis, abdominal pain, maybe asymptomatic — diagnosis?

Answer 7

chlamydia

Question 8

bacterial infection present with fever, abdominal pain if ascending, purulent discharge — diagnosis?

Answer 8

gonorrhea

Question 9

bacterial vaginosis treatment?

Answer 9

metronidazole 500mg PO BID for 7 days
or
clindamycin 100mg vaginal suppository nightly for 3 nights

Question 10

chancroid presentation and caused by which organism?

Answer 10

a gram negative coccobacillus.
sexually transmitted dz that cause pustule and progress to multiple, painful operations with sharply demarcated purulent bases. and assoc with painful inguinal lymphadenopathy (aka bubo)

Question 11

chancroid treatment

Answer 11

azithromycin 1 gm PO once
ceftriaxone 250mg IM once
ciprofloxacin 500mg PO BID for 3 days
or erythromycin 500mg PO four times a day for 7 days

Question 12

pregnant women should consume which vitamin?

Answer 12

folic acid 4mg PO QD.
consume diet of folate-rich foods and daily oral supplements of folic acid until 12 weeks of gestations. after a decrease to 0.4mg ad.

Question 13

folate is?

Answer 13

water-soluble vitamin B9

Question 14

folic acid is?

Answer 14

synthetic

Question 15

folic acid intake can mask?

Answer 15

b12 deficiency

Question 16

Gonorrhea treatment

Answer 16

ceftriaxone (Rocephin)

Question 17

Chlamydia treatment

Answer 17

with ceftriaxone PLUS azithromycin

Question 18

treatment for preeclampsia to reduce risk of seizures?

Answer 18

magnesium sulfate

Question 19

clomiphene citrate

Answer 19

given to women with infertility d/t anovulation (ovaries not releasing oocytes) with normal hormone levels.

Question 20

treatment for 10 week pregnant patient with HYPerthyroidism?

Answer 20

PRopylthiouracil (PTU)

Question 21

If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days?

Answer 21

Secretary luteal phase under the influence of estrogen and progesterone.

The endometrial changes seen in the latter half of the cycle are under the influence of both estrogen and progesterone from the corpus luteum. During this phase, the endometrium becomes more vascularized and slightly edematous.

Question 22

what test do you check at 24-28 weeks of gestation?

Answer 22

1 hr post Glucola blood glucose

Question 23

what is salpingitis?

Answer 23

inflammation of the fallopian tube

Question 24

dysuria, fever, malaise, myalgia, headache and lesions on genitalia, multiple clear vesicles, and erythematous ulcers with tender bilateral inguinal adenopathy – diagnosis?

Answer 24

herpes genitalis

treat with valacyclovir

Question 25

Rho gram is given to mother with what blood type and when to give?

Answer 25

AB negative mother, spontaneous abortion

give at 28 weeks gestation and within 72 hours of delivery with Rh-positive infant.

Question 26

what medication is given to enhance fetal lung maturity at 24-34 weeks gestation?

Answer 26

corticosteroids

Question 27

What should be the initial evaluation of the etiology of infertility in a 25 year-old female who has been trying to conceive for 1 year

Answer 27

Serum progesterone levels.
LH and mid luteal phase progesterone (to determine ovulatory function) and transvaginal ultrasound (to rule out the possibility of fibroids or polycystic ovaries), are first-line investigations.

Question 28

A 56 year-old female patient comes to the office for evaluation. She complains of dyspareunia and a thin vaginal discharge. On physical examination atrophic vulvar changes are noted associated with vaginal petechiae and a thin clear discharge. What medication is recommended to treat this patient’s symptoms?

Answer 28

This patient has atrophic vaginitis which is very common in postmenopausal patients. The vagina will appear atrophied, will look pale, and thin and dry in appearance. Best to treat with topical or oral estrogen preparations.

Question 29

progesterone peaks?

Answer 29

after ovulation

Question 30

luteinizing hormone peaks?

Answer 30

at the time of ovulation/ responsible for ovuation

Question 31

s/sx of pre-eclapmsia

Answer 31

high blood pressure, headache, blurred vision, right upper quadrant discomfort, brisk patellar reflexes, proteinuria, elevated fetal heart rate

Question 32

diagnostic test for hyperandrogenism?

Answer 32

free testosterone, show elevated free testosterone, and supports diagnosis of polycystic ovarian syndrome.

Question 33

What is is typically caused by reduced estrogen levels producing intense itching and thin vaginal mucosa with a resultant yellowish discharge that has a pH > 5.5.

Answer 33

Atrophic vaginitis

Question 34

A 25 year-old G2P2 married female presents to the clinic for birth control counseling. Her past history includes deep vein thrombosis with her last pregnancy. She does not want another pregnancy for at least 4 years. The birth control method that would be best for this patient is which of the following?

Answer 34

Levonorgestrel releasing IUD
IUD releases potent progestin only; is not a combination contraceptive. WHO rates progesterone only contraception as a “2”. A 2 means that progesterone only contraception can general be used after DVT but should be monitored and followed up with caution

Question 35

A 48 year-old G3P3003 female presents to the office complaining of severe secondary dysmenorrhea and menorrhagia over the last 6 months. On physical examination her uterus feels enlarged and irregular. Which of the following is the most likely diagnosis?

Answer 35

uterine leiomyomata

severe dysmenorrhea, menorrhagia, irregular uterus

Question 36

test performed at 10-13 weeks gestation?

Answer 36

Pregnancy-associated plasma protein A (PPA), beta-hCG, and ultrasound of nuchal transparency

Question 37

define menorrhagia

Answer 37

long and heavy flow menstrual flow

Question 38

define oligomenorrhea

Answer 38

menstrual periods that occur more than 35 days apart

Question 39

define metrorrhagia

Answer 39

is bleeding that occur at any time between menstrual periods

Question 40

define hypomenorrhea

Answer 40

light flow, sometimes only spotting

Question 41

A 45-year-old woman is noted to have four yeast infections in 1 year. Appropriate management of this patient should b

Answer 41

Recurrent vulvovaginal candidiasis is defined as four or more yeast infections in 1 year. The possibility of uncontrolled diabetes mellitus or immunodeficiency should be considered in women with recurrent vulvovaginal candidiasis. When it has been determined that no reversible causes are present (e.g., antibiotic therapy, uncontrolled diabetes, OCP use) and initial therapy has been completed, maintenance therapy may be appropriate. Selected long-term regimens include the use of clotrimazole and fluconazole. The role of boric acid and lactobacillus therapy remains in question