EXAM 4 Gremminger

Question 1

• Woman age 21, never had PAP, has had 10 partners so far. What would you be concerned about?

Answer 1

HPV, Starting at a young age with 10 or more partners, very increased risk for HPV

Question 2

• 20-year-old woman comes in because her boyfriend has chlamydia. What do you treat her with?

Answer 2

Azithromycin 1gm PO

Question 3

• 20-year-old woman comes in because her boyfriend has chlamydia. What do you treat her with? She’s allergic to azithromycin

Answer 3

Allergy to azithromycin: 2nd choice would be: doxycycline 100mg BID x7 days

Question 4

• 43-year-old woman comes in with vaginal discharge during pelvic. See some hyphae on vaginal smear. What do you think is going on?

Answer 4

Yeast infection

Question 5

• 24-year-old woman coming in with irregular vaginal bleeding. She’s been having periods since age 16, but now she is having irregular bleeding. Most common cause:

Answer 5

pregnant – can have a little bit of bleeding early on in pregnancy

Question 6

• 40-year-old woman comes in, single, not in a relationship with anybody, she is sexually active, she is a smoker. Drinks 2-3 beers per day. BMI is 26. She’d like to get on birth control. Safest method:

Answer 6

IUD

Question 7

• Counseling about menstrual cycles, they are worried about not having a cycle. How long do they have to go to classify as secondary amenorrhea:

Answer 7

3 months

Question 8

• Risk factors for PMS symptoms:

Answer 8

Caffeine, alcohol, nutrition, stress, smoking, family history

Question 9

• 27-year-old female who comes in complaining of painful menstruation. What is most likely the cause:

Answer 9

endometriosis

Question 10

• 23-year-old male comes in and says he has painful sore on his penis. When you look at it, you see fluid filled vesicle that is painful to touch. Most likely:

Answer 10

Herpes

Question 11

• How is herpes normally treated?

Answer 11

Acyclovir

Question 12

• Most common serious complication of somebody with gonococcal infections:

Answer 12

PID

Question 13

• How long can a woman wait to take Plan B?

Answer 13

72 hours

Question 14

• Man in 30s comes in with a lesion on his penis with no pain. When you look at it, you see a flat lesion with indurated margins, not painful. What do you think he has?

Answer 14

Syphilis

Question 15

• What would you treat Syphilis with?

Answer 15

Penicillin, If allergic: Doxycycline

Question 16

• Latent syphilis: treat with

Answer 16

Penicillin G

Question 17

• What age should a woman start receiving pap smears?

Answer 17

21

Question 18

• **Know the cervical cancer screening guidelines and recommendations:

Answer 18

<21: no screening; 21-29: cytology alone, every 3 yrs; 30-65: anyone of the following, cytology alone, every 3 yrs, FDA approved primary hrHPV testing alone, every 5 yrs, cotesting (hrHPV testing and cytology) every 5 yrs; >65 no screening after adequate negative results; hysto with cervix removal: if no hx of high-grade precancerous cervical lesions, or cervical cancer

Question 19

• Woman coming in age 40 complaining of vaginal discharge. You see protozoa on the vaginal smear. What does she have?

Answer 19

Trichomonas

Question 20

• How do you treat Trichomonas?

Answer 20

Flagyl

Question 21

• 25-year-old who comes in and says she has irregular menstrual cycles spaced out over several months. She has some facial hair, she is overweight, fasting blood sugar is 130. What is most likely going on?

Answer 21

Polycystic Ovarian Syndrome

Question 22

• 27-year-old female who comes in and says she hasn’t had a menstrual cycle in 6 months. You want to order a lab test, which would you order? CBC or prolactin level?

Answer 22

Prolactin

Question 23

• Patient with factor V mutation. What contraception should you avoid?

Answer 23

Estrogen

Question 24

• Started a patient on oral contraceptives and they want to know what happens if you miss one pill?

Answer 24

Take it as soon as you remember or with the next dose

Question 25

• Started someone on depo shot, what might someone notice when starting this?

Answer 25

Weight gain

Question 26

• Menopausal woman coming to you with terrible hot flashes. She doesn’t want to take hormone replacement therapy due to family history of breast cancer. What alternative treatment option?

Answer 26

Antidepressants – Effexor (Venlafaxine)

Question 27

• Somebody has hormonal IUD, what is one of the common side effects?

Answer 27

Reduces menstrual flow

Question 28

• Young woman coming in who has been on oral contraceptives for six years, she has decided that she’d like to have a baby. She would like to know when it is safe to start trying to conceive?

Answer 28

She can start trying to conceive immediately after stopping contraceptive.

Question 29

• Average age for menopause in the United States?

Answer 29

51-52

Question 30

• Average age for perimenopause?

Answer 30

40-45

Question 31

• Woman with hot flashes hasn’t had menstrual cycle in 6 months. How long does she need to go before you can say she is in menopause?

Answer 31

One year

Question 32

• Which hormone level increases in woman who is perimenopausal?

Answer 32

FSH

Question 33

• Average age girls start menstrual cycle?

Answer 33

11-14

Question 34

• Primary amenorrhea is considered if they haven’t had a menstrual cycle by age:

Answer 34

15

Question 35

• Four most common STIs:

Answer 35

Chlamydia, gonorrhea, syphilis and trichomoniasis

Question 36

Urethritis in men most commonly caused by

Answer 36

Chlamydia