GYN

Question 1

MC organism in BV

Answer 1

Gardnerella vaginalis

Question 2

discharge is watery gray filmy with fishy/musty odor

Answer 2

BV

Question 3

(+) whiff test and presence of clue cells

Answer 3

BV

Question 4

Treatment for bacterial vaginosis

Answer 4

Metronidazole (Flagyl) 500mg BID x7

Question 5

flagellated protozoan T. vaginalis causes

Answer 5

Trichomonas

Question 6

discharge is copious frothy green with a fishy odor and pruritus

Answer 6

Trich

Question 7

PE finding indicative of Trichomonas

Answer 7

strawberry cervix

Question 8

Wet mount showing a motile organism

Answer 8

Trichomonas

Question 9

discharge is like “cottage cheese” white and clumpy with pruritus

Answer 9

Candidiasis

MCC Candida albicans

Question 10

wet prep demonstrates pseydohyphae

Answer 10

Candidiasis

Question 11

Hx of small painless genital ulcer that healed
Now Inguinal LAN with abscess formation
+/- proctitis

Answer 11

Lymphogranuloma Venereum (LGV)

Question 12

rectal discharge, bleeding, and painful inflammation in MSM recent travel to South America

Answer 12

LGV

Question 13

Treatment of LGV

Answer 13

Doxycycline 100mg BID x3weeks

Question 14

Cause of syphilis

Answer 14

Treponema pallidum

corkscrew spaed spirochete

Question 15

Primary stage of syphilis

Answer 15

painless ulcer at site of exposure

Question 16

diffuse maculopapular rash with lesions involving palms and soles

Answer 16

secondary syphilis

Question 17

condylomata lata

Answer 17

moist heads up lesions in intertriginous regions

Question 18

Different classifications of tertiary syphilis

Answer 18

Neurosyphilis
Cardiovascular (now rare)
Gummatous/Late benign syphilis

Question 19

Sxs of neurosyphilis-

Answer 19

P: personality- emotional lability
A: affect- flat
R: reflexes- hyperreflexia
E: eye- Argyll-Robertson pupil
S: sensorium- illusions, delusions, hallucinations
I: intellect- memory & judgement impairment
S: speech- slurring
 \+ tabes dorsalis
\+ CN abnl, ocular, & otic manifestations

Question 20

w/o for syphilis

Answer 20

VDRL or RPR for screening

FTA-ABS is confirmatory

Question 21

Tx for primary, secondary, and early latent syphilis

Answer 21

Benxathine Penicillin G (Bicillin) 2.4mill units IM x1

Question 22

Tx late latent syphilis

Answer 22

Bicillin weekly x3

Question 23

Neurosyphilis tx options

Answer 23

Aqueous PCN G IV daily x2weeks
Procaine PCN IM daily + Probenecid QID x2wk
Ceftriaxone 2g IV daily x2wk

Question 24

dysmenorrhea

Answer 24

painful menses

Question 25

menorrhagia

Answer 25

prolonged menstrual bleed >7d

Question 26

metorrhagia

Answer 26

bleeding between menstrual periods

Question 27

menmetorrhagia

Answer 27

prolonged, excessive, irregular

Question 28

MCC PID

Answer 28

Chlamydia & Gonorrhea

Question 29

abd pain and cervical motion tenderness

Answer 29

PID

Question 30

Outpt tx for PID

Answer 30

Ceftriaxone IM + Doxy BID 14d

Question 31

MCC mastitis | if bilat suspect

Answer 31

Staph aureus | bilat- neonatal streptococcal infection

Question 32

breast abscess tx

Answer 32

I&D | abx TOC- Cephalosporin or Methicillin Sodium

Question 33

lumpy breast tissue that is transient

Answer 33

fibrocystic breast "disease"/changes

Question 34

Fibrocystic breast changes d/t what hormone

Answer 34

estrogen

Question 35

Tx for severe fibrocystic breast disease that have failed conservative tx and OCPs

Answer 35

Danazol

Question 36

Breast mass that is round, firm, discrete, relatively moveable and NONtender "rubbery"

Answer 36

Breast Fibroadenoma

Question 37

RF for breast CA

Answer 37

``` BRCA endometrial CA prolif form of fibrocystic breast dis menses <12 nulliparous/late White more likely to get (AA higher mortality) ```

Question 38

mammography screening should DEF start

Answer 38

50-65 q1 yr

Question 39

estrogen receptor positive breast CA tx

Answer 39

Tamoxifen | Anastrozole (not in premenopausal)

Question 40

Dx PCOS

Answer 40

Need 2/3: 1) oligomenorrhea/anovulation 2) hyperandrogenism- via PE or labs 3) US demonstrates ( "string of pearls")

Question 41

LH:FSH >3

Answer 41

PCOS

Question 42

PMS is associated with which phase of cycle

Answer 42

luteal

Question 43

PMDD core sxs

Answer 43

Depressed, Anxiety, Sad, Irritable/Anger dx must have atleast 1 core sx, 5 sxs all together

Question 44

best pharmacotherapy for PMS or PMDD

Answer 44

SSRI Fluoxetine

Question 45

premenstrual pelvic pain | dysmenorrhea

Answer 45

w/o endometriosis | laparoscopy

Question 46

ovarian CA MC what type

Answer 46

90% epithelial

Question 47

adnexal mass | next step

Answer 47

US (pref transvag)

Question 48

endometrial CA MC what type

Answer 48

adenocarcinoma | MC type 1 estrogen receptive

Question 49

what lab value is indicative of menopause

Answer 49

FSH >30

Question 50

dominant estrogen once a woman is in menopause

Answer 50

estrone

Question 51

in a women with a uterus, what kind of HRT should be used

Answer 51

combined estrogen & progesterone