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Oral Boards > Office > Flashcards

Office Flashcards

1
Q

What are the most common causes of chronic pelvic pain?

A

Endometriosis
Adhesions
Interstitial Cystitis
Irritable Bowel Syndrome

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2
Q

What triad of symptoms are commonly associated with interstitial cystitis?

A

Urinary frequency, urgency, pain

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3
Q

How is interstitial cystitis diagnosed?

A

History, PE, rule out other etiologies

Can do cystoscopy with hydrodistention: may see petechiae/glomerulations or Hunner ulcers (not required for dx)

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4
Q

What is the definition of vulvodynia?

A

Vulvar pain not attributed to an identifiable cause or due to specific lesions (such as infections dystrophies ulcers, VIN, masses, varicosities, and bx negative)

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5
Q

What are some treatments for vulvodynia?

A
  1. Vulvar care (local anesthetics, estrogen cream, topical TCA, trigger point injections, botox)
  2. Oral TCAs or anticonvulsants
  3. Biofeedback and pelvic PT
  4. Transcutaneous nerve stim
  5. Vestibulectomy
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6
Q

What are some theories behind the pathophysiology of endometriosis?

A
  1. Retrograde menstruation
  2. Hematologic spread
  3. Lymphatic spread
  4. Coelomic metaplasia
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7
Q

Frequency of testing for:
GC/CT

A

13-24 if sexually active > 25 if high risk

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8
Q

Frequency of testing for:
glucose and FBS

A

Annually if high risk
Every 3 yrs beginning at age 45

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9
Q

Frequency of testing for:
Lipid profile

A

5 yearly beginning at age 21

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10
Q

Frequency of testing for:
DEXA

A

Age 65 or sooner with risk factors, repeat every 2 yrs as needed

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11
Q

Frequency of testing for:
HIV

A

At least once in lifetime, consider annual if high risk

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12
Q

Describe the TACE questionnaire

A

Tolerance
Annoyed
Cut down
Eye opener

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13
Q

What are the 5 As for (smoking cessation) counseling?

A

Ask
Advise
Assess
Assist
Arrange

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14
Q

What are the effects of smoking in pregnancy?

A

FGR, LBW, PPROM, previa, abruption, ectopic, recurrent SAB

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15
Q

What is the recommended amount of Ca intake/supplementation per day?

A

18yo and under 1300mg
19-49yo 1000mg
50yo and over 1200mg

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16
Q

What is the recommended amount of Vit D intake/supplementation per day?

A

600-800iu

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17
Q

How long do you continue cervical ca screening in women with hx of CIN2/3 or AIS?

A

25 years of post treatment surveillance (even if that goes past age 65)

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18
Q

What are the cervical ca screening recommendations for immunosuppressed or HIV positive patients?

A

Screen annually for life, beginning within 1 yr of initiation of sexual activity

19
Q

What is the post-hyst screening after treatment of CIN2/3 or AIS?

A

Annually x 3 yrs
After 3 neg screens, screen every 3 yrs for 25 yrs

20
Q

What are some reasons to consider CKC instead of LEEP?

A

Positive ECC
Positive margins on LEEP
Carcinoma or adenocarcinoma in situ
Discrepancy btwn Pap and less severe Colpo
Inadequate colpo
Completion of childbearing

21
Q

At what age do you start colon cancer screening?

A

Age 45, or 10 yrs prior to colon ca dx in family member
- Continue to age 85, but with R/B/A assessment in 76-85yo

22
Q

What are some options for colon cancer screening?

A

Colonoscopy
Sigmoidoscopy
CT colonography
Fecal occult blood testing (guiac FOBT)
Fecal immunochemical testing (FIT)
Sigmoidoscopy + FIT

23
Q

How often to repeat colonoscopy?

A

Baseline: q 10 yrs
One 1st deg relative: 5 yrs
> One 1st deg relative: 3 yrs
Benign colonic polyp 3-5 yrs
Polyp with atypia 3 yrs

24
Q

When to screen for lung cancer?

A

Low dose CT annually in adults 50-80yo with smoking hx
20 py hx and current smoker, or, quit < 15 yrs ago

25
Q

What breast ca screening is done for BRCA 1/2?

A

Breast exam 2x per year
25-30yo annual MRI
30+ annual mammo + MRI

26
Q

Risk of breast and ovarian cancer with BRCA 1

A

Breast - 70%
Ovarian - 30-45%

27
Q

Risk of breast and ovarian cancer with BRCA 2

A

Breast - 45-70%
Ovarian - 15%

28
Q

What is the risk of male breast ca with BRCA?

A

6%

29
Q

What other cancers are associated with BRCA?

A

Gastric
Pancreatic
Prostate
Melanoma

30
Q

What risk reducing surgeries are recommended with BRCA?

A

RRSO by age 40 or when childbearing complete
Ppx mastectomy

31
Q

What factors do you consider in starting statins?

A

Clinical cardiovascular disease
LDL > 190
DM 45-70yo and LDL 70-189
LDL 70-189 and CVD risk > 7.5%

32
Q

How do you calculate cardiovascular risk?

A

ACC/AHA Pooled Cohort Equations CV Risk calculator

33
Q

What are risk factors for cardiovascular disease?

A

Age
Family hx CHD
HTN
DM
Current cigarette smoking
Obesity
Sedentary lifestyle
Low HDL

34
Q

Define bone mass that is:
- Normal
- Low Bone Mass
- Osteoporosis

A

Normal: <-1 SD T score
Low: -1 to -2.5 T score
Osteoporosis: <= 2.5 T score

35
Q

What is the T score vs the Z score?

A

T score:
- SD from mean peak bone density in young adult

Z score:
- SD from age/sex/race matched cohort

36
Q

What are some risks factors for osteoporosis?

A

Personal hx fracture
First degree relative with fracture
Frailty
Caucasian race
Low calcium intake
Inadequate physical activity
Estrogen deficiency
Current cigarette smoker
Alcoholism
Drug/medication exposures
Prone to falls (poor eyesight, etc)
Some chronic illnesses: RA HIV, COPD, DM, hemophilia, celiac

37
Q

What is the normal percentage of bone loss?

A

Pre-menopause: 0.5% yr
Post-menopause: 5% yr

38
Q

What labs are included in the work up of osteoporosis?

A

CBC
Chem profile (Ca, Phos)
Vit D level
24h urine calcium
PTH
TSH

39
Q

When do you treat osteoporosis?

A

T score < 2.5 OR
T score of -1.0 or less and FRAX score > 3% hip, or 20% any

40
Q

What are some treatments of osteoporosis?

A

Bisphosphonates (reduce osteoclasts)
HRT
SERMs
Calcitonin

41
Q

What are the criteria for inpatient therapy for PID?

A

Cannot exclude surgery (appy)
Pregnant
Severe illness (N/V, high fever)
TOA
No response to oral therapy
Unable to follow or tolerate outpatient oral therapy

42
Q

What is the ddx of a vulvar ulcer?

A

HSV, syphilis, chancroid, granuloma iguinale, lymphogranuloma venereum, HPV condyloma, Bechet’s, vulvar carcinoma

43
Q

What is a general treatment for an ulcer?

A

Erythromycin will cover syphilis, chancroid, granuloma inguinale, and LGV

44
Q

What are some contraindications to HRT?

A

Breast cancer, endometrial cancer, DVT, significant heart dz, liver disease, undiagnosed VB

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