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49 Cards in this Set
- Front
- Back
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When is pap screen indicated post-hysterectomy?
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When hysterectomy performed for cervical cancer or HG-CIN
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Which syphilis tests are non-treponemal specific?
How do they differ in utility from treponemal-specific testing? |
RPR, VDR are non-treponemal; non-specific for syphilis
If highly suspect syphilis and need confirmatory, perform treponemal-specific test |
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When does HSV present with fever?
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During primary outbreak
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Postmenopausal post-coital bleeding
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Cervical Cancer
PERFORM CERVICAL BX NOT PAP |
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Fixation of cervix
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Cervical cancer
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What is the gold standard for diagnosis of HSV?
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Culture; best done early in lzn; culture has 10-20% FN rate
Note: Ab screening would only indicate lifetime exposure |
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Tachycardia
Irregular frequent menses Temperature instability Anxiety Sleep disturbance |
Hyperthyroidism!
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Clue Cells
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BV
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KOH fish whiff
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BV
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Thick, white clumpy discharge
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Yeast vaginitis
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Multinucleate giant cells on discharge
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HSV
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Recommended folate supplementation for women trying to get pregnant.
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40 mcg; diet alone not effective
Remember: folate decreases homocysteine levels |
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Breast cancer screening guidelines by age according to ACOG.
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Begin screening q1-2 years at 40-49
qyear at 50+ |
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28 year-old female on OCPs
Prior hx irregular menses BMI 33 Acanthosis nigricans Appropriate workup? |
DM screen
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Which contraceptives have a less than 1% fail rate?
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IUD, Depo, sterilization
OCP has 3% Condom has 12% |
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What are the risk factors for osteoporosis?
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Early menopause
Glucocorticoid tx Sedentary lifestyle EtOH Hyper thy Hyperparathy |
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What is the number 1 killer of women?
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Heart Dz
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What single factor determines the fail rate of the Ortho Evra patch?
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Patient weight: 198 lbs
Note: patch is E2 and PG |
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Tubal ligation decreases risk of _____ cancer.
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Ovarian
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OCPs decrease risk of _____ cancer.
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Endometrial and ovarian cancers
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Which OCP should be used with caution in patients with depression?
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Progestin only
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What test discerns stress urinary incontinence from urge urinary incontinence?
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Cystometric exam--investigation of pressure and volume changes in bladder with filling of known volumes
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Stress Urinary Incontinence:
Mechanism Diagnostic Test Treatment |
Bladder neck fallen out of normal intra-abdominal position
Dx: Loss of bladder angle, cystometric investigation Tx: Urethropexy or urethral sling |
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Urge Incontinence:
Mechanism Diagnostic Test Treatment |
Detrusor muscle overactive and contracts unpredictably
Cystometric exam shows uninhibited contractions Tx: Anticholinergic meds to relax detrusor (surgery may worsen) |
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Overflow Incontinence:
Mechanism Diagnostic Test Treatment |
Overdistended bladder due to hypotonic bladder
Postvoid residual (catherization) shows large amount of urine Tx: Intermittent self-catheterization |
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Fistula:
Mechanism Diagnostic Test Treatment |
Communication between bladder or ureter and vagina
\Dye into bladder shows vaginal discoloration Surgical repair of fistulous tract |
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Painless loss of urine concurrent with Valsalva.
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SUI
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I have to go to the bathroom and can't make it there in time.
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Urge Incontinence
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Loss of urine with Valsalva
Dribbling Diabetes or SC injury |
Overflow incontinence
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Constant leakage of urine after surgery or prolonged labor.
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Fistula
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At what age should adults receive varicella zoster vaccine?
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60
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At what age should cholesterol screening begin? How often?
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45 q5 years!
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At what age should fasting blood sugar be tested? How often?
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45 q3y
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At what age should TSH be tested? How often?
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50 q5y
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At what age should pneumococcal vaccine be administered?
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65
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Most common cause of mortality in women <20 years old.
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MVA
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Most common cause of death in women >39 years old.
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CVD
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What are the four signs of placental separation?
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Gush of blood
Lengthening of cord Globular, firm shape of uterus Uterus rises up to anterior abdominal wall |
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How does the texture of the endometrium differ from that of the cervix?
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Cervical/Vaginal tissue is smooth
Uterus is shaggy in appearance |
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What is the third stage of labor? Upper limit of normal?
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Delivery of infant-->delivery of placenta
Upper limit of normal is 30 minutes |
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What is an abnormally retained placenta?
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Third stage of labor that has exceeded 30 minutes
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What are the risk factors for uterine inversion?
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Grand-multiparous pt (5+ births)
Placenta implanted in fundus (top of uterus) Placenta accreta (abnormally adherent placenta) |
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Perimenopause AKA _____
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Climacteric
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What is premature ovarian failure?
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Cessation of ovarian function due to atresia of follicles prior to 40 years of age.
At ages younger than 30 years, autoimmune dz or karyotypic abnlts should be considered. |
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What hormonal changes immediately occur in perimenopause?
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Because ovarian inhibin levels decrease, FSH and LH levels rise before estradiol levels fall.
Decreased estradiol leads to vaginal atroph, bone loss, and vasomotor symptoms |
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Treatment for symptoms of climacteric.
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Continuous estrogen-progestin--small but sig inc'd risk BrCa, heart dz, pulm embolism, stroke; no e/o AEs if <6 mos E2 tx
OR Raloxifene (SERM)--helpful in preventing bone less, but doesn't alter hot flushes |
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Will FSH remain elevated in climacteric after estrogen replacement?
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Yes, bc FSH responds to inhibin, not estrogen.
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Where does the most common osteporosis-associated fracture occur?
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Thoracic spine as a compression fracture
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Why should progestin be added to estrogen replacement therapy in perimenopausal women?
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To prevent endometrial cancer
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