Just Might Be On This Damn Exam Flashcards
Based on Review Session and Pat's Own Mouth
Diagnostic test for identifying reasons for infertility, galactorrhea, and amenorrhea. Good at identifying possible hormone secreting tumor as well.
Serum Prolactin Level
You think she might have something going on “down there”…you think it might be trichamonas or BV. How you gonna find out? What might you see?
Wet mount. Flagellated and motile trichomonads for trich. May see Clue cells for BV
Oh crap…she’s positive for a qualitative Hcg test…but she is definitely NOT pregnant. What might this be?
Ovarian cancer!!!
She’s trying to get pregnant, Hcg is present in qualitative Hcg test. What do you tell her?
Congrats!
A woman has severe one sided abdominal pain, and has been suddenly spotting. A quantitative Hcg test is performed and Hcg is present but it is there in very low amounts. What might be happening?
Ectopic pregnancy or miscarriage
She thinks she might be pregnant, a quantitative Hcg test is performed and she has HUGE levels…what might be happening?
Molar pregnancy or even twins. Better find out…cuz one might be awesome and one might suck!
There is a thick, white, curdy discharge coming from her vagina. She’s in a bit of pain and is uncomfortable. What test might you perform? What might you find?
KOH smear. Hyphae and mycelia if candidiasis is the culprit.
According to the amsel criteria…how you gonna know if someone has BV?
3 of 4 of the following: Graying/white vaginal discharge, pH>4.5, fishy WHIFF after KOH, presence of CLUE cells - it was the BV…in the vagina…with the lead pipe.
How do you test gestational diabetes in the 3rd trimester?
GTT (glucose tolerance test)
This test is commonly used to monitor infertility.
FSH.
This might be elevated in women who have adrenal tumors, congenital adrenal hyperplasia, ovarian tumors, PCOS.
Testosterone
Serum testosterone may be helpful in identifying what?
Ovarian tumors, virilizing conditions in women.
This is the best test to determine if ovulation has occurred.
Serum progesterone level (on day 21 of the cycle)
Low levels of progesterone indicate (decreased/increased) risk of spontaneous abortion and/or onset of menopause.
Increased
Serum estrogen levels are checked to assess what?
Menstrual and fertility problems
This test can the presence of absence of ovulation or the time of ovulation. If there is a non “frond-like” pattern on the slide, it means what?
Fern test. It would mean ovulation HAS occurred
Wanna know if it’s chlamydia, gonorrhea, or E. Coli? What do you want to do?
Culture that vagina for bacteria
Testing some Rh crap that I don’t understand
Coombs test
Let’s talk about PAP’s. Not Blue Ribbon…but the other kind. Who gets screened for cytology and how often?
Women age 21-65, every 3 years.
Who gets screened via co-testing on pap smear? Who often?
Women age 30-65, every 5 years if they want to cut down on visits.
T/F You should screen women younger than 21
FALSE
T/F You should screen a 28 year old for HPV
FALSE. Not til she’s 30 will you do co-test screenings
T/F A woman who has had a hysterectomy with the removal of her cervix who has no history of cancer or pre cancer DOES NOT HAVE TO BE SCREENED AT ALL.
TRUE
T/F Grandma has been screened every year and she’s been clear. Now she’s turning 65, to celebrate…you take her for a screening.
FALSE
T/F You find ASC-US or LGSIL but HPV is negative. You must do a colposcopy to find out wtf is going on!
FALSE
You’ve got a kid who lost her IUD…not at home…I mean inside. How you gonna take a look?
Pelvic US
How are you going to dx retroperitoneal lymphadenopathy associated with malignancies or identify the depth of myometrial invasion in endometrial carcinoma and extrauterine?
Pelvic/Abdomina CT
This procedure best EVALUATES ENDOCERVICAL CANAL, ENDOMETRIAL CAVITY and FALLOPIAN TUBE LUMINA. It’s good at finding uterine abnormalities as well as tubal abnormalities when assessing fertility issues
Hysterosalpingogram (HSG)
I’m gonna take a look at the cervix proper…
Colposcopy
I’m gonna stick a needle in the pouch of douglas to figure out what type of inwraperitoneal lesion we’re dealing with here folks…
Cultocentesis
Gonna take a “LEEP” of faith and remove some vulvar and cervical lesions. While I’m at it, I’ll remove some vulvar condylomata and cervical dysplasias.
Loop electrocautery excision procedure
FDA says the fetus will be jacked up if I give this drug…regardless of benefit.
Category X
FDA says that nothing should come between me and this drug…it seems to be safe
Category A
FDA says it doesn’t look good, doesn’t look bad…but no animal fetuses have been hurt and no women have even been tested
Category B
FDA says animal fetuses have suffered a little, but no human tests have been performed. However, benefits might outweigh the risks.
Category C
FDA says tests have been done on humans and the results weren’t very good for the fetuses, but still…in extreme cases…benefits may outwit the risks.
Category D
Best medication for osteoporosis, Paget’s disease, and bone metastases
Bisphosphonates.
T/F Bisphosphonates should be taken with food
FALSE. Need to have an empty stomach
T/F Calcitonin is good at reducing bone resorption as a second line drug for osteoporosis but it does not reduce pain associated with osteoporotic fractures and vertebral fractures
FALSE. It’s good at reducing that pain
Most common side effects of bisphosphonates
Esophogitis, abdominal pain, diarrhea
Weight bearing exercise, smoking cessation, vitamin D and calcium supplementation, and glucocorticoid avoidance will help reduce…
Osteoporosis
Women over 50 should take 1000, 1100, 1200, 1300, or 1400mg/day of calcium. Young women age 9-18 should take how much?
>50 = 1200mg/day 9-18 = 1300mg/day 19-50=1000mg/day
How do you stimulate withdrawal bleeding in a woman who is not pregnant but who has no menses?
Progesterone challenge. If you do it and there is withdrawal bleeding then an ovulation is the problem causing her lack of menses. If it doesn’t stimulate bleeding, then something else is wrong.
Who do you give clomephine citrate to?
Women who respond to progestin challenge with bleeding who want to get pregnant
T/F HRT is indicated for use to prevent osteoporosis
FALSE
T/F It is safe to use HRT’s for longer than 5 years in most cases.
FALSE
T/F Breast cancer is an absolute contraindication for estrogen use
FALSE (according to Pat)
You’ve got hot flashes, I’ve got some natural, alternative stuff for ya…here…try some ____
Black cohosh, flaxseed, vitamin E
This natural stuff is an important modulator of hormone metabolism
Flaxseed
____ has been touted as an alternative therapy to HRT
Soy…yeah…soy
Put this natural stuff on your dry vagina…
Vitamin E oil
Who do you treat most often with conjugated estrogens, estradiol, and estrone sulfate (Premarin, Estring)?
Menopausal women
The most potent estrogen therapy
Estradiol
For a women with an intact uterus, _____ is always included with the estrogen therapy because the combination reduces the risk of endometrial carcinoma associated with unopposed estrogen
Progestin
For women who have undergone hysterectomy, unopposed ____ therapy is recommended
Estrogen
Plan be treatment med is ____. Treatment is should be administered within ____hrs after intercourse.
Levonorgestrel, 72 hours.
Preven medication is ____ and should be administered within ____hrs after intercourse.
Estradiol and Levonorgestrel. 72 hours.
Nausea is worse with (Plan B, Preven).
Preven
IUD’s should be inserted within ____ after intercourse to be effective for emergency contraception
7 days
Ortho Evra is a ____
Birth control patch