gynecology

Question 1

Uncomplicated cystitis treatment

Answer 1

Bactrim 3 days

Question 2

Gonorrhea treatment

Answer 2

IM ceftriaxone + azithro for chlamydia coverage

Question 3

Medical management of fibroids

Answer 3

GnRH agonist(Lupron) or medroxyprogresterone (provera) to decrease bleeding prior to surgery or bridge to menopause.

Question 4

Signs of leomyomata –> leomyosarcoma

Answer 4

rapid growth within a year

Question 5

Effects of submucosal fibroids vs subserosal

Answer 5

infertility. vs. impingement on the ureters

Question 6

hCG threshold where US should reveal a pregnancy

Answer 6

1500-2000

Question 7

How to determine abnormal pregnancy

Answer 7

hCG above threshold 1500-2000+ no evidence of intrauterine pregnancy

Question 8

1. hCG>2000 + bleeding + Gestational sac =?

2. hCG>2000 + bleeding +no gestational sac =?

Answer 8

1. threatened abortion. close follow-up

2. likely ectopic. US + metho/surgical management

Question 9

mirena contraindications

Answer 9

Current STI/ PID, structural abnormality

Question 10

Contraception with risk of VTE

Answer 10

anything w/ estrogen/ progesterone combo. OCPs, patch, ring

Question 11

Etiologies of secondary amenorrhea

Answer 11

1. hypothalamic causes (weight loss, hypothyroid, hyperprolactin)
2. pituitary causes (Sheehan)
3. Ovarian causes (PCOS, premature ovarian failure)
4. outflow tract causes (asherman’s, stenosis)

Question 12

Precocious puberty ages

Answer 12

7 in caucasian

6 in african american

Question 13

FSH levels in delayed puberty from CNS defect vs. gonadal defect

Answer 13

Low in CNS defect (poor nutrition, anorexia, exercise, illness) vs. high in gonadal defect (turner)

Question 14

Precocious puberty causes

Answer 14

idiopathic
anatomical pathology centrally
peripheral causes (undetectable FSH and LH levels)

Question 15

five basic etiologies of infertility

Answer 15

1. ovulatory (ovulatory dysfunction)
2. uterine (fibroids)
3. tubal (PID)
4. male factor
5. peritoneal factor (endometriosis)

Question 16

Most common cause infertility

Answer 16

endometriosis

Question 17

Most common cause of postmenopausal bleeding

Answer 17

atrophic endometrium

Question 18

Risk factors of endometrial cancer

Answer 18

Estrogen exposure ( early menarche late menopause tamoxifen, obesity), HTN, DMII,

Question 19

Risk factors for cervical cancer

Answer 19

STDs, risky sexual behavior, cigarettes, HIV, HPV

Question 20

How is cervical cancer staged?

Answer 20

Clinical staging via

1. EUA
2. CXR
3. Barium enema, proctoscopy
4. Cystoscopy
5. Intravenous pyelogram

Question 21

What are the most common ovarian tumors in women younger than 30

Answer 21

cystic teratomas

Question 22

Most common ovarian malignancy

Answer 22

Epithelial ovarian tumors (especially older women)

1. serous
2. mucinous
3. borderline
4. endometrioid