AAFP OB/GYN

Question 0

Most common pharmacologic cause of galactorrhea?

Other causes

Answer 0

Oral contraceptive

Metoclopramide, methyldopa, coding/morphine, SSRIs/tricyclics/dopamine receptor blockers

Question 1

Adolescent complaining of dysmenorrhea consisting of heavy periods for seven days with no spotting in between. Appropriate next step?

Answer 1

Naproxen during periods

Question 2

Most accurate estimate of gestational age in first trimester? Second trimester? Third trimester?

Answer 2

#Crown rump length
#Biparietal diameter and femur length
#Biparietal diameter, femur length, abdominal circumference

Question 3

Position to allow for visualization of child’s vagina and cervix without instrumentation?

Answer 3

Knee-chest position

Question 4

Drug to decrease size of ovarian cysts?

Answer 4

OCP

Question 5

Patient should remove contraceptive diaphragm within? Why?

Answer 5

24 hours; associated with toxic shock syndrome

Question 6

Atypical cervical squamous cells divided into what categories?

Answer 6

#Atypical squamous cells of unknown significance
#Atypical squamous cells – cannot exclude HSIL

Question 7

Most reliable clinical symptoms of uterine rupture?

Answer 7

Fetal distress

Question 8

Pt presents with ASCUS - management?

Answer 8

#Immediate colposcopy
#Reflex DNA testing for oncogenic HPV test
#Repeat cytology at 4-6 months (if two repeat psychologies are negative, return to routine screenings)

Question 9

Amsel criteria?

Answer 9

3/4 needed for BV

#pH over 4.5 (most sensitive)
#clue cells over 20% (most specific)
#Positive Whiff test
#Homogenous discharge

Question 10

Advice to give every patient on flagyl?

Answer 10

May cause disulfiram reaction with alcohol

Question 11

Recommended treatment for intravaginal genital warts in pregnant women?

Answer 11

Cryotherapy with liquid nitrogen or trichloroacetic acid

Question 12

Pt most likely to get pregnant if she has sex when?

Answer 12

One day prior to ovulation

Question 13

When to screen for GBS in pregnant patient?

Answer 13

35-37 weeks gestation

Question 14

Management for patient with PID and TOA?

Answer 14

#Hospitalization
#Cefoxitin IV + doxycycline

Question 15

Delayed puberty defined as?

Answer 15

# no secondary sexual characteristics by age 13
#No menarche by age 16
#No menarche five years after pubertal development

Question 16

Most common cause of atypical glandular cells of undetermined significance (AGUS)?

Answer 16

CIN

Question 17

Treatment for endometriosis?

Answer 17

Danazol

Question 18

Typical treatment for primary dysmenorrhea?

Answer 18

Naproxen

Question 19

Warts on vaginal mucosa itself – treatment?

Answer 19

#Trichloroacetic acid
#Interferons injection

(Podofilox and Podofilin not safe on mucosa)

Question 20

Painless bright red vaginal bleeding in pregnancy after 24 weeks?

Answer 20

Placenta previa

Question 21

Brisk vaginal bleeding and uterine tenderness in pregnant patient – likely diagnosis?

Answer 21

placenta abruption

Question 22

When does a diaphragm need to be refitted? How long should it remain in place after intercourse?

Answer 22

Weight gain over 15 pounds, pregnancy, pelvic surgery

6-24 hours

Question 23

Menstruating patient presents with thin-walled, simple cyst less than 8 cm – management?

Answer 23

Recheck in 2 to 3 months with ultrasound for resolution

Question 24

Effect of conjugated estrogen on breast cancer risk?

Answer 24

Increases

Question 25

Fetal macrosomia – indication for induction or cesarean section?

Answer 25

NO!

Question 26

Vulvar cancer under age 50 associated with? Over age 50?

Answer 26

HPV Lichen sclerosis

Question 27

Most accurate test (if positive) to determine whether patient will have preterm birth?

Answer 27

Vaginal Fetal fibronectin

Question 28

Plan B emergency contraception consists of?

Answer 28

Levonogestrel taken 12 hours apart

Question 29

Possible downside for epidural anesthesia during L&D?

Answer 29

``` #Longer labor; #more instrument assisted deliveries; #more fourth degree lacerations ```

Question 30

Differential for Metrorrhagia?

Answer 30

``` #Cervical disease #IUD problem #Endometritis #Polyps #Submucous myoma #Endometrial hyperplasia #Cancer ```