Female Health

Question 1

Name this condition. red scaly rash that starts on nipple and spreads to areola on one breast.
Is this diagnosis concerning?

Answer 1

Pagets disease of the breast
Requires biopsy. High incidence of breast cancer

Question 2

Acute red, swollen and warm area to breast of younger woman with no distinct lump palpable. Symptoms developed quickly and skin has peau d’orange appearance.

Answer 2

Inflammatory breast cancer - highly agressive

Question 3

If + family hx of BRCA or breast cancer, screening in individual occurs ___ years prior to when family member diagnosed

Answer 3

10 years prior ie. family diagnosed at 45, screening starts at 35 in patient

Question 4

PID and tubal ligation are risk factors for what medical emergency?

Answer 4

Ectopic pregnancy

Question 5

T/F. most breast cancer is located in the tail of spence?

Answer 5

True

Question 6

Heavy menstrual bleeding, pelvic pain or cramping and urinary urgency

Answer 6

Uterine lyeomas or fibroids

Question 7

T/F. papable ovaries in postmenopausal women is NOT always concerning.

Answer 7

False - rule out ovarian cancer

Question 8

T/F you can perform a PAP test during menses.

Answer 8

False

Question 9

Cervical cancer screening starts at what age and ends at what age in US?

Answer 9

21-65

Question 10

HPV vaccine is given at what age? what is the age range for this vaccine?

Answer 10

11-12 years
9-26 years

Question 11

KOH slide is used for what condition

Answer 11

Candida

Question 12

Whiff test is used for

Answer 12

BV

Question 13

Tzanck smear is used for

Answer 13

HSV

Question 14

For pts age 21-24 years with LSIL PAP results, repeat PAP test in ____ months

Answer 14

12

Question 15

If LSIL at age 25-29 years, then what diagnostics to order?

Answer 15

colposcopy w/ cervical biopsy

Question 16

What is next steps if endometrial cells are observed on PAP?

Answer 16

Endometrial biopsy (NOTE - different from colposcopy)`

Question 17

Ethyl estradiol and drosperenone COC - give trade name and what it is used for

Answer 17

Yaz
PMDD, PCOS, acne, hirutism

Question 18

In progestin only COC, if dose is late > 3 hours or a day is missed, backup contraception should be used for ___ days

Answer 18

2 days

Question 19

Contraindications for COC

Answer 19

Smoker > 35 w/ 15 cigarettes or more per day
History of VTE/DVT
Liver disease
Breast cancer
Unexplained PV bleeding
CAD/CVD
Migraines w/ aura

Question 20

Follow up in ___ months following COC to check ____

Answer 20

2-3 months, BP

Question 21

all of the following are:
active PID, pregnancy, hx ectopic, undiagnosed pv bleeding, uterine or cervical abnormality

Answer 21

CI to IUD

Question 22

Start depo w/ in first ___ days of menstrual cycle

Answer 22

5 days

Question 23

Ovulation may not occur for weeks or months following removal of what 2 cokntraceptives

Answer 23

Implant and depo provera

Question 24

If 2 contraceptive pills are missed

Answer 24

take 2 pills for 2 days then use backup till next pack`

Question 25

Breast lumps that feel tender and rubbery and mobile 2 weeks before menses

Answer 25

fibrocystic breasts

Question 26

T/F metformin is used to induce ovulation in females w/ PCOS

Answer 26

True

Question 27

All of the following are at high risk for what condition: eating disorder long term use of PPIs gastric bypass chronic steroid use

Answer 27

OP

Question 28

When to repeat DXA after starting biphosphonates

Answer 28

Q 2 years

Question 29

All of the following are CI to what medication: Inability to sit upright Esophageal motility dx hx of PUD or hx of GI bleeding

Answer 29

Biphosphonates

Question 30

Tamoxifen or SERM has increased risk for DVT and PE and is used for osteoporosis. true /false?

Answer 30

True

Question 31

Abnormal vaginal discharge w/ pH > 4.5 (alkaline)

Answer 31

BV

Question 32

Petechial or pustular skin lesions of hands and soles; swollen red and tender joints +/- signs of urethritis

Answer 32

Disseminated gonnococcal disease

Question 33

T/F. MSM there is recommended annual screening of gonorrhoea throat swab in addition to HIV, syphillis and Hep B surface antigen

Answer 33

True

Question 34

Test of cure for STI in pregnant women occur __ weeks following treatment

Answer 34

3 weeks

Question 35

Maculopapular rash on hands/ feet or may be generalized. Non-pruritic

Answer 35

Syphillis

Question 36

True/false. Confirmatory test for syphillis is VDRL or RPR?

Answer 36

False, confirmatory tests are treponemal tests FTA-ABS or TPPA

Question 37

condylomata lata

Answer 37

secondary syphillis

Question 38

condylomata accuminata

Answer 38

genital warts HPV

Question 39

T/F. False + RPR can be caused by pregnancy, lyme disease, autoimmune dx and acute or chronic disease

Answer 39

true

Question 40

Fitz-Hugh Curtis syndrome

Answer 40

Chlamydial or gonococcal infection of liver capsule. Scars look like violin strings --> complication of PID

Question 41

Acute febrile reaction occuring w/ in first 24 hours after treatment of syphillis and/or lyme disease. Ususally spontaneously resolves in 12-24 hours

Answer 41

Jarish-Herxheimer reaction

Question 42

Reiters syndrome S&S

Answer 42

More common in males. Immune mediated reaction secondary. to chlamydial infection that spontaneously resolves. Treatment is supportive I can't see (conjunctivitis), pee (urethritis) or climb up a tree (migratory arthritis - ie. knee)

Question 43

T/F PID is a clinical diagnosis

Answer 43

TRUE. TREAT!!!!!

Question 44

All of the following are risk factors for what? Born between 1975 and 1985 History of mutliple sexual partners

Answer 44

HIV

Question 45

Tenofovir and zidovudine are treatments for what condition? What two diagnostics should be monitored for these meds?

Answer 45

U/A - nephrotoxic CBC - bone marrow suppression

Question 46

What is the test to order for HIV suspected?

Answer 46

HIV-1, 2 antibody w/ p24 antigen with reflexes

Question 47

PCP (pneumocystis carinii pneumonia) prophylaxis starts when CD4 counts are < _____

Answer 47

200