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ABOG written boards > Outpatient > Flashcards

Outpatient Flashcards

1
Q

Lichen planus

A

Wickham striae
Oral and non-genital lesions
Erythematous shiny plaques, ulcers, loss of architecture
Rx high dose topical steroids, tacrolimus

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2
Q

Lichen simplex chronicus

A

Vulvar irritation> persistent scratching
Scaly plaques, thickened leathery appearance
Rx hygiene, treat underlying cause, topical steroids

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3
Q

LNG-IUD failure rate

A

0.2%

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4
Q

Copper IUD failure rate

A

0.8%

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5
Q

Nexplanon failure rate

A

0.05%

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6
Q

Vasectomy failure rate

A

0.15%

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7
Q

Female sterilization failure rate

A

0.5%

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8
Q

Depo failure rate

A

6%

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9
Q

OCP/patch/ring failure rate

A

9%

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10
Q

Diaphragm failure rate

A

12%

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11
Q

Metabolic syndrome

A

Presence of 3/5 of the following:
- waist circ >88 cm or 35 in
- TG >150 or on meds for elevated TGs
- HDL <50 or on meds
- BP >130/85 or on meds
- fasting BG >100 or on meds

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12
Q

BRCA1/2 cancer risks

A

Breast
- BRCA1 55-70%
- BRCA2 45-70%
Ovarian
- BRCA1 35-45%
- BRCA2 15-20%

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13
Q

Criteria for annual breast MRI screening

A
  • 1st degree relative of carrier for breast CA mutation
  • 20% lifetime risk of breast CA
  • Chest radiation between 10-30yo
  • 25-29yo with BRCA variant
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14
Q

IBS diagnostic criteria

A

Recurrent abdominal pain 1+ day/wk in past 3 months with 2+ of the following:
- related to defecation
- change in stool frequency
- change in form of stool

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15
Q

Most common causes of vaginitis prior to puberty

A
  1. improper hygiene
  2. sexual abuse
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16
Q

Medications that can cause hyperprolactinemia

A

Elevations to 25-100 ng/mL
- Antipsychotics
- Domperidone
- Metoclopramide
- Methyldopa
- Verapamil
- Opioids

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17
Q

21-hydroxylase deficiency inheritance

A

Autosomal recessive

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18
Q

Duchenne’s muscular dystrophy inheritance

A

X-linked recessive

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19
Q

PTU side effect

A

Agranulocytosis

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20
Q

Kallman syndrome

A

Primary amenorrhea
Anosmia
Hypogonadotropic hypogonadism
Cleft lip/palate

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21
Q

Sensitivity formula

A

a/a+c
test’s ability to correctly identify pts with a disease

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22
Q

Specificity formula

A

d/b+d
test’s ability to correctly identify pts without a disease

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23
Q

PPV

A

a/(a+b) x100
likelihood that a pt with a positive test actually has the disease

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24
Q

NPV

A

d/(c+d) x100
likelihood that a pt with a negative test is disease free

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25
Q

Odds ratio

A

ad/cb

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26
Q

Accuracy

A

(a+d)/(a+b+c+d) x100

27
Q

FMR1 trinucleotide repeats (intermediate, premutation, full mutation)

A

CGG repeats, fragile X syndrome
Unaffected: <45
Intermediate: 45-54
Premutation: 55-200
Full mutation: >200

28
Q

Fragile X syndrome

A

Most common form of intellectual disability, X-linked
Males with long narrow face, prominent ears, large testes, joint/skin laxity, hypotonia, speech delay, MVP
Premutation associated with female premature ovarian insufficiency, male tremor/ataxia

29
Q

HSV vertical transmission rates (primary vs. recurrence)

A

Primary: 40-80%
Recurrence: 1.3-3%

30
Q

Copper IUD failure rate

A

Typical 0.8%
Perfect 0.6%

31
Q

LNG-IUD failure rate

A

0.2%

32
Q

Nexplanon failure rate

A

0.05%

33
Q

CHCs and POPs failure rate

A

9% typical
0.3% perfect

34
Q

Female sterilization failure rate

A

0.5%

35
Q

Male sterilization failure rate

A

0.15% typical
0.1% perfect

36
Q

TTP

A

Absence of ADAMTS-13 (vWF cleaving protease)
Symptoms: hemolytic anemia (schistocytes, elevated bili), thrombocytopenia, neuro abnormalities, fever, renal dysfunction
Rx plasmapheresis

37
Q

Androgen insensitivity vs. Swyer

A

Both 46 XY female phenotype, absent body hair

AIS:
- nonfunctional androgen-R, normal male testosterone, absent AMH/uterus/cervix, +breast development
- remove testes after puberty

Swyer:
- SRY mutation, streak gonads, low testosterone, absent AMH/breasts, uterus/cervix present
- remove testes at diagnosis

38
Q

MRKH

A

46 XX, female phenotype
- no paramesonephric development> absent uterus/cervix/AMH
- Breast development and body hair present

39
Q

NSAID mechanism of action

A

Inhibits COX1 and COX2
- COX1 affects platelet aggregation, GI mucosal integrity, renal function
- COX2 affects growth, regulation of female reproduction, bone formation, renal function

40
Q

Gonorrhea treatment

A

Single dose of ceftriaxone 500 mg IM (1000 mg if >150 kg or 300 lbs)
- If chlamydia not excluded include doxy 100mg BID x7d
Cephalosporin allergy: gent 240mg IM + azithro 2g PO
- EPT: cefixime 800mg PO +/- doxy depending on chlamydia status

41
Q

Adnexal mass malignant features

A
  • Irregular solid tumor
  • Ascites
  • 4+ papillary structures
  • Irregular, multilocular, solid, diameter 10+ cm
  • High color doppler content
42
Q

Adnexal mass benign (B) features

A
  • Unilocular
  • Solid components, largest <7cm
  • Acoustic shadows
  • Smooth multilocular
  • No doppler flow
43
Q

Amsel criteria

A

Thin gray discharge
pH >4.5
Positive whiff
>20% clue cells

44
Q

MDD diagnosis

A

5 or more symptoms lasting for at least 2 weeks
- one must be depressed mood or diminished interest

45
Q

Bisphosphonates

A

Antiresorptive/osteoclast inhibition, used for osteoporosis prevention and treatment
- side effects: GI upset, atypical femoral fractures, osteonecrosis of jaw

46
Q

Denosumab

A

Osteoporosis treatment, blocks RANKL (osteoclast)
- Side effects: rash, infections, atypical femoral fractures, osteonecrosis of jaw, hypocalcemia

47
Q

Raloxifene

A

Osteoporosis prevention and treatment, SERM (agonist at bone, antagonist at uterus/breast)
- Side effects: VTE, vasomotor symptoms

48
Q

Ulipristal mechanism, timing

A

30 mg, SPRM (selective progesterone receptor modulator)
Inhibits follicle rupture to delay ovulation
up to 5d after unprotected intercourse

49
Q

Plan B mechanism/timing

A

Progesterone/levonorgestrel 1.5 mg once or 0.75mg x2
Delays follicle development
Up to 3d after unprotected intercourse

50
Q

HPV vaccine timing

A

Ideally begin between 11-12y
Give as early as possible if hx sexual abuse starting at 9yo
<15yo: 2 doses at 0 and 6-12 months
15-45yo: 3 doses at 0, 1-2, and 6 months

51
Q

Risk factors for early bone density screening <65y

A

History of fragility fracture
Weight <127 lb
Secondary causes of bone loss
History of parental hip fracture
Smoker, Alcoholism
Rheumatoid arthritis

52
Q

Pneumococcal vaccine recs

A

2 regimens: either 1 dose of PCV15 then PPSV23 1 year later OR 1 dose of PCV20
- all pts 65+ yo
- immunocompromised
- medical risk - alcoholism, heart/liver/lung disease, renal failure, smoking, diabetes

53
Q

Methimazole mechanism and fetal risks

A

Inhibits TPO
- fetal effects: aplasia cutis, esophageal atresia, choanal atresia
- agranulocytosis rare
- transition from PTU in second trimester

54
Q

PTO mechanism and fetal risks

A

Inhibits TPO and conversion of T4 to T3
- side effect: hepatotoxicity
- agranulocytosis rare

55
Q

Outpatient PID treatment

A

Ceftriaxone 500mg (1g if >150 kg) + doxy 100mg BID x14d + flagyl 500mg BID x14d

56
Q

Sexual assault prophylaxis

A

Treat chlamydia, gonorrhea, trich
- HIV if high risk
- hep B vaccine if non-immune
Chlamydia: doxy x7d preferred, azithro x1 alternative
Gonorrhea: IM ceftriaxone preferred, IM gent+azithro x1 if allergic to penicillin
trich: flagyl x7d

57
Q

NYHA functional classes

A

I: cardiac disease without limitation of physical activity
II: slight limitation of physical activity; ordinary activity leads to fatigue, palpitations, dyspnea, angina. Comfortable at rest
III: marked limitation of physical activity; less than ordinary activity causes symptoms. Comfortable at rest
IV: inability to carry on any physical activity without discomfort; symptoms can occur at rest, worse with activity

58
Q

Ulcerative colitis

A

Mucosal layer only
Almost always involves the rectum
Protective factors: smoking, appendectomy

59
Q

Crohn’s disease

A

Skip lesions, transmural involvement
- All areas of GI tract (mouth to proximal colon)
- Increased risk with smoking, appendectomy increases risk

60
Q

Normal hCG rise in early pregnancy

A

Up to 1500: 49%
1500-3000: 40%
>3000: 33%

Discriminatory level 3500

61
Q

DCIS breast biopsy management

A

Mastectomy with or without radiation
Endocrine therapy if ER+

62
Q

Lymphogranuloma venereum

A

C. trachomatis L1-3
Urethritis, inguinal lymphadenopathy, rectal ulcers/pruritis
Rx doxy 100 BID x21d

63
Q

H. ducreyi

A

Painful, non-indurated ulcer with friable base and exudate, tender lymphadenopathy
Rx aspiration of buboes, Rx azithro or ceftriaxone IM x1

64
Q
A

ABOG written boards (5 decks)

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