Other

Question 1

what is the recommended emergency contraceptive method

Answer 1

Plan B one-step within 3 days of unprotected sex
or
Ella (ulipristal) within 5 days
or
Copper IUD within 5 days

Question 2

what injection is the long-acting contraceptive injection

Answer 2

Depo-Provera

Question 3

a 24-year-old nulligravid woman presents to your office with an 18-month history of painful intercourse, difficulty defecating, and dysmenorrhea. These symptoms are cyclical and come and go with her menses. Her menses are regular and heavy, requiring 10 to 15 thick pads on the days of heaviest flow. She denies ever being diagnosed with a sexually transmitted infection (STI). She and her husband have been engaging in regular intercourse without contraception for 1 year in an attempt to conceive. On pelvic examination, you find a normal-sized, immobile, retroverted uterus with nodularity and tenderness on palpation of the uterosacral ligaments.
what is the diagnosis

Answer 3

endometriosis

Question 4

what are the three D’s of endometriosis

Answer 4

Dyspareunia, dyschezia and dysmenorrhea

Question 5

what is dyschezia

Answer 5

difficulty in defecating

Question 6

what is the definitive diagnosis for endometriosis

Answer 6

laparoscopy confirmed by biopsy

Question 7

what is found on physical examination with endometriosis

Answer 7

uterus is fixed and retroflexed on physical exam

Question 8

what are treatment options for endometriosis

Answer 8

NSAIDs
OCPs
Danazol
Depo Provera
GnRH agonist
surgery

Question 9

how is infertility characterized

Answer 9

inability to conceive within 12 months of unprotected intercourse

Question 10

what is the most common cause of infertility

Answer 10

anovulation

Question 11

how is infertility diagnosed

Answer 11

PAP
hormonal levels
US
hyperosalpingogram
semen analysis
ovulation check

Question 12

what is the treatment for infertility

Answer 12

based on the underlying cause
- may require. meds such as clomiphene citrate to hyperstimulate ovulation, surgery or IVF
- metformin increases ovulation and pregnancy rates when PCOS is the cause
- Bromocriptine to treat hyperprolactinemia

Question 13

What are Leiomyoma’s

Answer 13

uterine fibroids - benign smooth muscle cell tumors

Question 14

what are symptoms of leiomyomas

Answer 14

polymenorrhea
menorrhagia
intermenstrual bleeding and/or metorrhagia
pelvic pressure and increased abodminal girth

Question 15

what populations are most commonly affected by leiomyoma

Answer 15

black women with a family history

Question 16

how are leoimyomas diagnosed

Answer 16

Ultrasound and/or MRI - uterine mass present

Question 17

what is the symptomatic management of leoimyomas

Answer 17

NSAIDs
OCPs
Danazol
Leuprolide

Question 18

what are definitive management of leoimyomas

Answer 18

myomectomy
endometrial ablation
hysterectomy

Question 19

what is the most common type of ovarian cyst

Answer 19

follicular cyst

Question 20

what are examples of non-functional/neoplastic ovarian cysts

Answer 20

PCOS
endometriomas
dermoid cysts
ovarian serous and mucinous cystadenoma

Question 21

what are complications of ovarian cysts

Answer 21

1. hemorrhagic
2. rupture
3. torsion

Question 22

what is the first imaging study of choice for a suspected ovarian torsion

Answer 22

abdominal and pelvic ultrasound

Question 23

what is the prophylactic antibiotic therapy for sexual assault

Answer 23

Recephin 250mg followed by oral doxycyline BID for 7 days
Tetanus toxoid if indicated
option for emergency ccontraception

Question 24

what are the major types of urinary incontinence

Answer 24

1. urge incontinence (detrusor overactivity)
2. stress incontinence (weakness of pelvic floor)
3. overflow incontience (impaired detrusor contractility)
4. functional incontinence
5. mixed (combo of stress and urge

Question 25

what is urge incontinence

Answer 25

detrusor overactivity
frequent small amounts of urine

Question 26

what is the treatment of urge incontinence

Answer 26

bladder training exercises
if unsuccessful - anticholinergics (oxybutynin) and TCAs (impiramine)

Question 27

what is stress incontinence

Answer 27

weakness of the pelvic floor
urine leakage due to abrupt increase in intra-abdominal presure

Question 28

what is the treatment of stress incontinence

Answer 28

kegel exercises to strengthen pelvic floor musculature
vaginal estrogens
use of a pessary
surgery

Question 29

what is overflow incontinence

Answer 29

impaired detrusor contractility - occurs when urinary retention leads to bladder distention and overflow of urine through the urethra

Question 30

what is the treatment of overflow incontinence

Answer 30

intermittent self-catheterization is the best management
- cholinergic agents (bethanechol) to increase bladder contractions
- alpha blockers (terazosin, doxazosin) to decrease spincter resistance

Question 31

what is functional incontinence

Answer 31

occurs in pts who have nromal voiding systems but who have difficulty reaching the toilet becaue of pysical or mental disabilities

Question 32

what is the treatment of functional incontience

Answer 32

scheduled voiding times

Question 33

what is first line for mixed incontience

Answer 33

lifestyle modifications and pelvic floor exercises