Meds- office

Question 1

POPs
Indication
Dose
MOA
Side effects/CI

Answer 1

contraception
0.35 mg norethindrone
suppresses ovulation (block FSH and LH)
AUB, mood changes, acne

Question 2

Nuvaring

Answer 2

contraception
0.12 mg etonorgestrel/15 mcg ee/day
suppresses ovulation (blocks FSH and LH surge)
AUB, headache, vaginitis

Question 3

nicotine replacement
Indication
Dose
MOA
Side effects/CI

Answer 3

smoking cessation
14 mg/day patch (if <10 cig or 45 kig)
Nicotine
skin irritation, insomnia

Question 4

varencicycline
Indication
Dose
MOA
Side effects/CI

Answer 4

smoking cessation
0.5 mg daily x 3d to BID to 1 mg BID
Binds to nicotine receptor to reduce positive feedback
HA insomnia, irritability

Question 5

Buproprion
Indication
Dose
MOA
Side effects/CI

Answer 5

smoking cessation
150 mg x3d to BID
enhances dopamine release
Seizures

Question 6

Flibanseran
Indication
Dose
MOA
Side effects/CI

Answer 6

Decreased sexual interest
100 mg PO daily
5HT agonist and antagonist
Dizziness

Question 7

Alendronate
Indication
Dose
MOA
Side effects/CI

Answer 7

osteoporosis
10 mg PO daily or 70 mg weekly
inhibits osteoclasts
GI upset, MSK pain,

Question 8

Acetic acid for colposcopy

Answer 8

3-5% application
dehydrates cells; large/dense nucleated cells appear white

Question 9

HRT (Menopause)

Answer 9

Estradiol/micronized progesterone
0.025-0.05 mg patch/200mg x 12-14d
VTE, stroke

Question 10

HRT (POI)

Answer 10

Estradiol/norethindrone
0.1mg patch/5mg x 12-14d

VTE stroke

Question 11

vaginal estrogen

Answer 11

Estradiol
0.05 mg qd x2w, then 2x/week

Question 12

spironolactone

Answer 12

hirsutism
50-100 mg BID
Competes with aldosterone for receptor sites
also binds and inhibits 5 alpha reductase, inhibits conversion of T to DHT
hyperkalemia, amenorrhea

Question 13

Trichomonas tx

Answer 13

flagyl 500 mg PO BID x7 days, OR 2g PO x1
inhibits protein synthesis
n/v, metallic taste

Question 14

candida tx

Answer 14

diflucan
150 mg po x1 dose
Antifungal (blocks fungal CYP450 and membrane synthesis)
HA dizziness

Question 15

granulation tissue

Answer 15

silver nitrate
75% silver nitrate, 25% potassium
coagulates cellular protein to form eschar
pain

Question 16

dicloxacillin

Answer 16

mastitis
500 mg QID x10-14d
inhibits cell wall synthesis

Question 17

UTI treatment

Answer 17

bactrim (TMP-SMX)
800mg/160mg BID x 3d
Gram neg; Inhibits bacterial folic acid synthesis/folate metabolism
allergy; SJS

Question 18

UTI ppx

Answer 18

macrobid
50-100 mg qd
gram neg, inhibits protein synthesis

Question 19

pyelo treatment

Answer 19

ceftriaxone
1g IV q24h
inhibits cell wall synthesis

Question 20

chlamydia tx

Answer 20

doxy 100 mg BID x7 or azithro 1g PO x1 for pregnant patients

Question 21

expedited partner treatment for gonorrhea

Answer 21

Cefixime 800 mg POx1

If chlamydia has not been ruled out, treat with doxy 100 mg BID x7d

Question 22

HSV treatment
Primary episode

Answer 22

valacyclovir 1g BID x7-10d
Acyclovir 400 mg TID for 7-10d
HSV; inhibits viral DNA synthesis
increased LFTs

Question 23

HSV recurrence treatment

Answer 23

valacyclovir 500 mg BID x3d
Or 1g qd for 5 days
Or acyclovir 400 TID for 4 days or 800 BID for 5 days
HSV; inhibits viral DNA synthesis
increased LFTs

Question 24

HSV ppx
Pregnancy PPx?

Answer 24

valacyclovir 1g qd
Valeted 500 BID or acyclovir 400 TID
HSV; inhibits viral DNA synthesis
increased LFTs

Question 25

MVA

Answer 25

lidocaine 20 mL of 1%
paracervical block
toxicity bleeding syncope

Question 26

antidepressant

Answer 26

sertraline, SSRI
50 mg qd
decreased libido, fatigue

Question 27

anxiolytic

Answer 27

clonazepam
0.25 mg PRN
enhances GABA activity
drowsiness, ataxia

Question 28

Severe herpes treatment

Answer 28

Valcyclovir 5-10 mg/kg IV every 8 hours for 2-7 days, then PO for 10 days

Question 29

What type of birth control do you commonly prescribe. 3 examples

Answer 29

1) lo Estrin- 1 mg norethindrone and 20 mcg estradiol
2) cryselle- 0.3 mg norgesterel and 30 mcg ethinyl estradiol
3) yaz- 3 mg drosperinone and 20 mcg ethinyl estradiol

Question 30

mastitis
-non severe no MRSA
-PCN allergic
-non severe with MRSA risk

Answer 30

-dicloxacillin 500 QID or keflex 500 QID
-PCN allergic: erythromycin 500 BID
-non severe with MRSA risk- bactrim BID (dont give if infant preterm or <1 mo old) or clindamycin 450 TID