GYN MISC

Question 1

Metabolic syndrome criteria

Answer 1

at least 3 of the following
1) HDL <50 or drug therapy for low HDL
2) waist circumference >88 cm (35 inch)
3) SBP >130, DBP >85, or drug therapy for HTN
4) Fasting glucose >100 or drug therapy for hyperglycemia
5) TG level >150 or drug therapy for elevated levels

Question 2

how long do you have to have female sexual dysfunction for diagnosis and what is most common diagnosis

Answer 2

6 months, cause sig distress in individual
hypoactive sexual disorder (sexual interest/arousal disorder)

Question 3

what is ospemifene and how does it work

Answer 3

selective estrogen receptor modulator with agonist (genital tract) and antagonist (breast tissue)
effective tx for dyspareunia due to postmenopausal genitourinary syndrome
agonist in endometrium, but not associated with endometrial CA

Question 4

what is flibanserin

Answer 4

aka addyi
used for hypoactive sexual disorder in premenopausal women without depression
serotonin receptor agonist/antagonist
doesnt work that well and has many side effects like syncope, fatigue, nausea

Question 5

what is the only FDA approved non hormonal treatment for vasomotor sx of menopause and dose and side effects

Answer 5

paroxetine 7.5 mg qd
Weight changes, decreased libido, nausea, vomiting, headaches

Question 6

TB
when should you test for it?
diagnosis
treatment

Answer 6

-Test for it when you have clinical suspicion (cough >2-3 weeks, fever, night sweats, weight loss). If suspicious get CXR and 3 sputum samples for culture, AFB stain or NAATs for TB
-diagnosis: PPD, blood test, CRX, endometrial bx
-treatment:
STAGE 1: 4 drugs, lasts 2 months
-RISE (rifampin, isoniazid, ethambutol, supplement of B6)
STAGE 2: 2-7 months, 2-3 drugs
total treatment for 6-9 months

Question 7

Gonorrhea treatment and FU
In pregnancy?

Answer 7

Ceftriaxone 500 mg IM x1
If greater than 150kg, give 1 gram
TOC not needed, even in preg
Repeat testing in 3 months

Question 8

Chlamydia treatment and follow up?
In pregnancy?

Answer 8

Non pregnant- doxy 100 mg BId x7d. No TOC, repeat testing in 3 months
Pregnant- azithro 1g PO x1. TOC in 4 weeks, repeat testing in 3 months