Office- Miscellaneous Flashcards
What is the most common genetic bleeding disorder in women?
Von willebrand disease
What is the inheritance of von willebrand disease?
Autosomal dominant type 1
Autosomal recessive type 2
What is the prevalence of von willebrand disease?
1%
What is the evaluation for von willebrand disease?
CBC
PT/PTT
Fibrinogen
Ristocetin cofactor activity level for vWF, vWF antigen, factor VIII
What are indications for screening for von willebrand disease?
- Adolescent with HMB prior to initiating OCP
- Adults with HMB
- Patients undergoing hysterectomy for HMB
- History of excessive bleeding
What is the treatment for von willebrand disease?
Desmopressin
OCP
IUD
Nexplanon
TXA
What medication should be avoided in patients with von willebrand disease?
NSAIDs
Aspirin
What OB considerations should be taken into account for patients with von willebrand disease?
Avoid vaccum delivery
Avoid scalp placement
Delay circumsion
Increase risk of PPH
Increase risk of epidural hematoma
What are malignant characteristics of melanoma?
Irregular borders
Non-uniform darkening
Ulceration
Bleeding
Increasing size
What are symptoms of migraine without aura?
Unilateral
Pulsatile
Aggravated by routine activity
Moderate to severe pain
Nausea
Photophobia
What are the criteria for irritable bowel syndrome?
Abdominal pain relieved by defecation
Abdominal pain associated with increase or decrease in stool frequency
Abdominal pain associated with harder or looser stools
Dyspepsia
What is the treatment for irritable bowel syndrome?
Antispasmodics and fiber modification
How long does it take to develop symptoms from food poisoning?
2-6 hours
What are the typical culprits for food poisoning?
Salmonella
Norovirus
Campylobacter
E. coli
Listeria
What are symptoms of food poisoning?
Diarrhea
Vomiting
What is the treatment for food poisoning?
Supportive treatment
How long does it take to develop symptoms from travelers diarrhea?
24-72hrs
What are the typical culprits for travelers diarrhea?
E.coli
What are the symptoms of travelers diarrhea?
Abdominal cramping
Watery diarrhea
Low grade fever
Vomiting
What is the treatment for travelers diarrhea?
Supportive treatment
pepto bismol
Cipro 500mg BID for 5 days
What symptoms does Giardiasis cause?
Watery diarrhea
abdominal bloating
Flatulence
Malabsorption
What is the incubation period for Giardiasis?
10-20 days
How do you diagnosis Giardiasis?
Fecal examination for trophozoites
What is the treatment for Giardiasis?
Flagyl 250mg TID for 7 days
What bacteria cause bloody diarrhea?
Campylobacter
E.coli
Shigella
C.diff
What medications are contraindicated in pregnancy?
Chloramphenicol- Grey baby syndrome
Tetracycline- Tooth discloration
Erythromycin- Hepatotoxic
Quinolone- Affects cartilage
Nitrofurantoin- neonatal hemolytic anemia
What medications are contraindicated with breastfeeding?
Bromocriptine
Cyclophosphamide
Ergotamine
Lithium
Methotrexate
Radioactive iodine
What is the recommendation for expedited partner therapy?
Should be given when patient is infected with gonorrhea, chlamydia or trichomonas.
Prescription given at the same time for patient and partner
Written instructions for partner for medication use, effects and contraindications, evaluation and STD testing
What is the treatment for gonorrhea?
Ceftriazone 500mg IM or weight based dosing
No need for azithromycin now
Retest in 3 months for reinfection
What is the management for IUD without visible strings?
- Attempt to retrieve strings (cytobrush)
- If not successful exclude pregnancy and counsel patient and give back up or emergency contraception
- Pelvic ultrasound
- If not visualized then do X-ray of abdomen and pelvis
- If still no visualized then assume expelled and counsel patient
IF seen in abdomen laparoscopic removal
What are the SERMs?
Tamoxifene
Raloxifene
Clomiphene
Ospemifene
Bazedoxifene
What is the indication for treatment with tamoxifene?
- Prevention of breast cancer in high risk group
- Adjuvant treatment of breast cancer
- Metastatic breast cancer
What is the indication for treatment with raloxifene?
- Chemoprevention for patients at risk for breast cancer
- Osteoporosis prevention and treatment
What are the side effects of tamoxifene?
Uterine polyps/hyperplasia
VTE
vasomotor symptoms
What are the side effects of raloxifene?
VTE
How does raloxifene work?
Bind to estrogen receptor
Stimulates estrogen effects on bone and lipids
No estrogen effect on uterus or breast
What is the indication for ospemifene?
Treatment of moderate to severe dyspaurenia due to vulvar/vaginal atrophy of menopause
How does ospemifene work?
Binds to estrogen receptor
Stimulates estrogen affects in vagina
No estrogen effect on breast
