OBGYN

Question 1

What are risk factors for breast cancer development in women

Answer 1

menarche before 12yo
old age of first full-term pregancy, no pregnancies
menopause after 52yo

Question 2

what is the most common type of breast cancer

Answer 2

infiltrating intraductal carcinoma (IIC)

Question 3

what are fibroadenomas

Answer 3

benign tumors of the breast - often present in woman in their 20s and 30s

Question 4

what is the presentation of fibroadenomas

Answer 4

painless
firm/rubbery
mobile
solitary, round, well-circumscribed with distinct smooth borders

Question 5

what is fibrocystic breast disease

Answer 5

benign condition in which the breast feels lumpy

Question 6

what is the treatment of breast abscess

Answer 6

I&D and anti-staph abx
- Nafcillin/oxacillin IV or cefazolin + metronidazole
- (Vanco in lactating woman)

Question 7

what are the cervical cancer screening guidelines

Answer 7

21-29 yo: every 3 years
30-65yo: every 5 years
do not screen woman < 21yo
do not screen woman with hysterectomy
do not screen woman > 65yo

Question 8

what is a cystocele

Answer 8

bladder prolapse - buldge of bladder into the vagina

Question 9

what is pelvic inflammatory disease

Answer 9

infection that ascends from the cervix or vagina to involve endometrium and/or fallopian tubes

Question 10

what are common causative agents for pelvic inflammatory disease

Answer 10

gonorrhea and chlamydia

Question 11

what are complications of pelvic inflammatory disease

Answer 11

infertility, ectopic pregnancy, tubo-ovarian abscess

Question 12

what is the treatment for pelvic inflammatory disease

Answer 12

out patient: Ceftriaxone IM 250 + PO Doxycycline +/- PO Flagyl
Inpt: doxy + IV cefotetan or cefoxitin then PO doxy

Question 13

what is rectocele

Answer 13

Herniation of rectum into the posterior wall of the vagina

Question 14

what are treatment options for rectocele

Answer 14

kegel exercises
pelvic floor retraining
behavioral changes
bowel regimen
pessary
surgical repair

Question 15

what is the most common cause of vaginitis

Answer 15

candida vaginitis

Question 16

how is candida vaginitis diagnosed

Answer 16

KOH - branching kyphae
pH < 4.5 (acidic)

Question 17

what is the treatment of candida vaginitis

Answer 17

oral fluconazole (Diflucan) 150mg PO x 1
- can use topical clotrimazole or tioconazole

Question 18

what is the common pathogen causing bacterial vaginosis

Answer 18

gardnerella

Question 19

what is the clinical presentation of bacterial vaginiosis

Answer 19

frothy, grayish-white, fishy-smelling vaginal discharge

Question 20

how is BV diagnosed

Answer 20

“Clue cells”
saline wet mount adding 10% KOH produces fishy odor (+ wiff test)
pH >4.5

Question 21

what is the first line treatment for BV

Answer 21

metronidazole (flagyl) orally or vaginally 500mg PO BID x 7 days

Question 22

what are second line options for tx of BV

Answer 22

Clindamycin 300mg BID x 7 days

Question 23

what should not be consumed while taking metronidazole

Answer 23

Alcohol

Question 24

what is the clinical presentation of trichomonas vaginitis

Answer 24

purulent, frothy, yellow-green, malodorous, thin vaginal discharge
associated with burning, pruritis, dysuria, frequency, lower abdominal pain and dyspareunia

Question 25

how is Trichomonas vaginitits diagnosed

Answer 25

strawberry cervix on pelvic exam (petechiae on cervix)
- mobile and pear-shaped protozoa with flagella on wet mount

Question 26

what is the treatment of trichomonas vaginitis

Answer 26

metronidazole 500mg BID for 7 days or e gram oral doze of tinidazole

Question 27

how is atrophic vaginitis diagnosed

Answer 27

presence of thin, clear or blood discharge, pH 5 to 7, loss of vaginal rugae

Question 28

what is the treatment of atrophic vaginitis

Answer 28

cojugated estrogens vaginal cream