GYN

Question 1

primary amenorrhea

Answer 1

no menses by age 16

Question 2

secondary amenorrhea

Answer 2

menses cease after establishment

Question 3

PAP results - Bethesda classification of dysplasia

CIN 1

Answer 3

HPV or mild dysplasia

Question 4

PAP results - Bethesda classification of dysplasia

CIN 2

Answer 4

moderate dysplasia

Question 5

PAP results - Bethesda classification of dysplasia

CIN 3

Answer 5

severe dysplasia

Question 6

PAP results - Bethesda classification of dysplasia

CIS

Answer 6

carcinoma in situ

Question 7

Refer for cervical dysplasia when?

Answer 7

no later than CIN 2

Question 8

When to start PAP testing?

Answer 8

age 21

Question 9

Woman age 21 - 29

frequency and type of PAP testing

Answer 9

every 3 years

cytology only

Question 10

Woman 30 - 65

frequency and type of PAP testing

Answer 10

every 3 years if cytology

OR

every 5 years if cytology and HPV testing

Question 11

When to stop PAP screening?

Answer 11

age 65 - 70 depending on overall health and risk factors

Question 12

What are the 3 major causes of vaginitis?

Answer 12

trich
BV
cadidiasis

Question 13

What are the signs and symptoms of trich?

Answer 13

malodorous, frothy yellowish-green discharge
pruritis / itching
vag erythema
“strawberry patches” on cervix and vagina
dysparunia
dysuria

Question 14

What is the microscopic test for trich?

Answer 14

SALINE prep

see motile trichomonads

Question 15

What is the treatment for trich?

Answer 15

metronidazole (Flagyl) – an antibiotic despite -azole suffix

Question 16

What are the signs and symptoms of BV?

Answer 16

watery, gray, “fishy” discharge

vaginal spotting

Question 17

What is the microscopic test for BV?

Answer 17

SALINE prep
see clue cells

what are clue cells -
epithelial cells with poorly defined borders

Question 18

What is the treatment for BV?

Answer 18

metronidazole (Flagyl) – an antibiotic despite -azole suffix

OR
clindamycin (Cleocin)

Question 19

What are the signs and symptoms of vaginal candidiasis?

Answer 19

thick, white, curd like discharge
vulvovaginal erythema
pruritis

Question 20

What are the microscopic findings of vaginal candidiasis?

Answer 20

KOH prep
shows psuedohyphae

looks like “spaghetti and meatballs”

Question 21

What is the treatment for vaginal candidiasis?

Answer 21

miconazole (Mono-stat)

terconazole
butaconazole

–> these ARE antifungals with -azole suffix

Question 22

Metronidazole vs miconazole – which is the ABT?

Answer 22

metronidazole

Question 23

What does PID look like?

Answer 23

flu symptoms
+
GYN

Question 24

What are the signs and symptoms of PID?

Answer 24

fever 
chills 
nausea / vomiting
vaginal discharge
dysuria
dysparunia

Question 25

Physical exam findings in PID?

Answer 25

adnexal tenderness
abdominal tenderness
fever > 38 C

Question 26

Treatment of PID for most

Answer 26

class: fluoroquinalone

ofloxacin
OR
levofloxicin +/- metronidazole (Flagyl)

Question 27

Treatment of PID for more refractory disease

Answer 27

class: cephalosporin + tetracycline + other stuff

cefoxitin + probenecid + doxy +/- metronidazole (Flagyl)
OR
ceftriaxone + doxy +/- metronidazole (Flagyl)

Question 28

What is the effect of probenecid?

Answer 28

slows renal excretion rate of ABT making regimen more effective

Question 29

What is the usual cause of abnormal uterine bleeding?

Answer 29

endocrine dysfunction

Question 30

Somatic symptoms of PMS/PDD have to do with what?

Answer 30

physical symptoms

Question 31

Management of PMS/PDD most supported in the literature?

Answer 31

caffeine restriction