Kobgyn 700-750

Front 1

Q700. what is the initial Tx for all types of endometrial hyperplasia in child-bearing patient?; Non-child bearing patient?

Back 1

A700. Child bearing:; Progestin therapy for 3 months; (followed by resampling of Endometrium); Non-child bearing:; Hysterectomy

Front 2

Q701. MC functional Ovarian cyst; usu unilateral; what can they lead to?; Tx?

Back 2

A701. Follicular cyst; leads to: Ovarian torsion; Tx: resolve spontaneously

Front 3

Q702. MCC of infertility in USA

Back 3

A702. PID

Front 4

Q703. Dx:; patient with abdominal pain, adnexal tenderness and cervical motion tenderness, possible ESR, Inc WBC, fever, or purulent cervical discharge

Back 4

A703. PID

Front 5

Q704. how is the tuboovarian abscess rupture treated in PID?

Back 5

A704. Removal of infected tube

Front 6

Q705. Antibiotic Tx for outpatient versus inpatient with PID

Back 6

A705. Outpatient: Ceftriaxone + Doxycycline; Inpatient: Clindamycin + Gentamycin

Front 7

Q706. Bug that causes PID in pt with intrauterine device

Back 7

A706. Actinomyces Israelii

Front 8

Q707. Dx:; nodularities on Broad ligament and a retroverted uterus with abdominal pain; Tx?

Back 8

A707. Endometriosis; Tx: birth control pills

Front 9

Q708. MCC of infertility in menstruating woman over age of 30 without PID?

Back 9

A708. Endometriosis

Front 10

Q709. How is chlamydia Tx in pregnant patient?

Back 10

A709. Erythromycin

Front 11

Q710. Dx:; ovarian cyst that can cause a missed period or dull lower; Quadrant pain; can rupture to cause acute abdominal pain and intraabdominal hemorrhage; Tx?

Back 11

A710. Corpus Luteum cyst; Tx: resolve spontaneously (or oral contraceptives if recurrent)

Front 12

Q711. Dx:; large, bilateral ovarian cysts filled with clear, straw-colored fluid;; high b-hCG

Back 12

A711. Theca-Lutein cyst

Front 13

Q712. First step in management for a cystic adnexal mass in premenarchal and postmenopausal patients

Back 13

A712. Exploratory Lap (due to high risk on cancer in those age groups)

Front 14

Q713. what percent of ovarian masses in women of reproductive age are functional cysts?; non-functional neoplasms?

Back 14

A713. functional cysts = 75%; non-functional neoplasms = 25%

Front 15

Q714. First Dx evaluation for Ovarian cysts

Back 15

A714. Pelvic Ultrasound...wait 6 - 8 weeks then repeat

Front 16

Q715. in reproductive-aged woman who has an ovarian cyst seen on ultrasound, what management steps are taken if the cyst size is:; 1. < 6 cm; 2. 6 - 8 cm; 3. > 8 cm

Back 16

A715. 1. observe for 6 - 8 weeks -> start on oral contraceptives -> repeat US; 2. if Unilocular = repeat steps above; if multilocular or solid on US = Exploratory Laparoscopy; 3. Exploratory Laparoscopy for cystectomy

Front 17

Q716. if ovarian cysts do not resolve with oral contraceptives in 60; 90 days, what is next step?

Back 17

A716. Cystectomy via Laparoscopy

Front 18

Q717. Definition:; Endometriosis in the ovary

Back 18

A717. Endometrioma

Front 19

Q718. Risk factors for endometriosis; (2)

Back 19

A718. First-degree relatives (mothers AND Sisters); autoimmune disorders

Front 20

Q719. how is endometriosis detected on rectovaginal exam?

Back 20

A719. Uterosacral nodularity

Front 21

Q720. Instead of using oral contraceptives for endometriosis, what else can be used?; (2); what do they do?

Back 21

A720. GnRH agonists in steady state (Leuprolide); or Danazol (inhibits gonadal steroid synthesis); they supress FSH and LH

Front 22

Q721. what are the drawbacks to Danazol therapy for Endometriosis?

Back 22

A721. Androgen-related anabolic side effects:; Acne, Oily skin, weight gain, deep voice, Hirsutism

Front 23

Q722. AE of GnRH agonists

Back 23

A722. Estrogen deficiency; Menopausal symptoms: hot flashes, loss of bone density, HA, vaginal atrophy and dryness

Front 24

Q723. what intraabdominal problem can endometriosis lead to?

Back 24

A723. Adhesion formation -> bowel obstructions

Front 25

Q724. what is the drug management of Endometriosis in the woman wanting to conceive?

Back 25

A724. None; Only Tx in these patients is Conservative surgical therapy by removal of lesions laparoscopically

Front 26

Q725. what percent of women with Adenomyosis also have Endometriosis?; Fibroids?

Back 26

A725. Endometriosis - 15%; Fibroids - 50%

Front 27

Q726. Incidence of Adenomyosis?

Back 27

A726. 15% of women in late 30s - early 40s

Front 28

Q727. Dx:; pelvic exam reveals a diffusely enlarged globular uterus and secondary dysmenorrhea

Back 28

A727. Adenomyosis

Front 29

Q728. What is the first Dx test for Adenomyosis?; What is the only definitive Dx test?; What is the Tx?

Back 29

A728. Ultrasound (if suggestive, then MRI to distingiush b/t it and Fibroids); Definitive means of Dx and Tx: Hysterectomy

Front 30

Q729. Tx for Adenomyosis; (3 meds or one procedure)

Back 30

A729. NSAIDs and analgesics,; Oral Contraceptives,; Progestins; Definitive Tx: Hysterectomy

Front 31

Q730. Dx:; fever, rash and desquamataion of palms and soles of feet, hypotension

Back 31

A730. Toxic Shock Syndrome (s.aureus)

Front 32

Q731. how is HIV screened and confirmed?

Back 32

A731. screened with ELISA; confirmed with Western blot

Front 33

Q732. Dx:; Cottage cheese-like discharge, pruritis, burning, dysuria, vulvar edema; what is Dx test and result?; Tx?

Back 33

A732. Candida Albicans; Test: branching hyphae and spores on KOH prep; Tx: Topical OTC Azole cream

Front 34

Q733. Dx:; diffuse, malodorous, gray-green, frothy discharge from vagina; what is Dx test and result?; Tx?

Back 34

A733. Trichomonas Vaginalis; Test: Bugs swimming under microscope; Wet prep; Tx: Metronidazole (Flagyl) 2g orally in single dose

Front 35

Q734. Dx:; vaginal discharge that is thin, yellow and has a "fishy" amine odor; what is Dx test and results?; Tx?

Back 35

A734. Bacterial Vaginosis (Gardnerella); Test: Clue cells on Wet prep, Whiff test exaggerates the odor with KOH; Tx: Metronidazole (Flagl) 500mg orally BID for 7 days

Front 36

Q735. Dx:; Painless cancre; what is the Hystological Dx test and results?; Tx?

Back 36

A735. Syphilis (stage 1); Test: Spirochetes on Dark-field Microscopy; Tx: Penicillin

Front 37

Q736. Dx:; maculopapular rash extending to the palms and soles and/or moist papules on the skin or mucous membranes

Back 37

A736. Syphilis (stage 2)

Front 38

Q737. Dx test for HSV; Tx?

Back 38

A737. Tzanck smear; Tx: Acyclovir

Front 39

Q738. Dx:; painful, demarcated, non-indurated ulcer located anywhere in the anogenital region; painful inguinal lymphadenopathy

Back 39

A738. Chancroid (Haemophilus Ducreyi)

Front 40

Q739. Dx:; STD that causes LGV; (2) possible Tx?

Back 40

A739. Chlamydia (MC STD); Tx: Doxycycline 100mg orally BID for 7 days, 1-time dose of Azithromycin

Front 41

Q740. Dx:; mucopurulent cervicitis; gram-negative bug; Tx?

Back 41

A740. N. Gonorrhea; Tx: Ceftriaxone 250mg IM

Front 42

Q741. Dx:; small, 1 - 5mm domed papule with umbilicated center, can occur all over body; what is Dx test and results?; Tx?

Back 42

A741. Molluscum contaginosum; Tests: waxy material and intracytoplasmic inclusions on Wright stain or Giemsa stain; Tx: Cryotherapy

Front 43

Q742. Dx:; Pruritis, iritated skin, vesicles and burrows confined to pubic area; Tx?

Back 43

A742. P. Pubis (Pediculosis) ["Crabs"]; Tx: Lindane (Kwell) shampoo to pubic hair

Front 44

Q743. what is the protrusion of the vaginal vault secondary to the loss of support structures post hysterectomy?

Back 44

A743. Vaginal Vault Prolapse

Front 45

Q744. Initial Tx for pelvic relaxation or Stress Incontinence?; If that doesn't work, what is the Tx?

Back 45

A744. Kegel exercises; if not: Vaginal Pessaries (and/or Estrogen replacement)

Front 46

Q745. Dx:; Urine loss with exertion or straining (coughing, exercise, etc); cause?

Back 46

A745. Stress incontinence; cause: Pelvic relaxation and displacement of the Urethrovesical junction

Front 47

Q746. Dx:; urine leakage due to involuntary and uninhibited bladder contractions; cause?

Back 47

A746. Urge Incontinence; cause: Detrusor instability

Front 48

Q747. Dx:; continuous urine leakage; cause?

Back 48

A747. Total Incontinence; cause: Urinary fistulas from birth trauma or pelvic surgery / radiation

Front 49

Q748. Dx:; incomplete voiding, urinary retention and overdistention of the bladder; cause?

Back 49

A748. Overflow Incontinence; cause: poor or absent Bladder Contractions due to meds or neurological dysfunction

Front 50

Q749. what are (2) easy office Dx evaluations for incontinence?

Back 50

A749. Standing stress test; Cotton swab test

Front 51

Q750. what class of meds are used to help Tx Stress Incontinence?

Back 51

A750. Alpha Adrenergic agents