Primary Care Flashcards
primary dysmenorrhea w/up after OCP and NSAID failure
requires dx L/S (cannot empirically tx for endo like adults)
contraception and HTN
even well controlled hypertension is a contraindication to estrogen containing methds (including patch, ring).
NNT formula
ARR = control - tx NNT = 1/ARR
HSV suppressive tx w/ discordant partner
daily suppressive tx reduces recurrenc by 80%. also reduces transmission to uninfected partner by 50% (3.6 to 1.9%). there is no role for treating the nonaffect partner.
what is the most common congenital anomaly of the female reproductive tract? how is it managed? what is the most common obstructive anomaly? how is it managed?
incomplete perforation of the hymen. can be excised in the office w/ local anesthetic. imperforate hymen is the most common obstructive cause and needs to be treated in the OR.
To be an eligble professional through the medicaid EHR incentive program, the volumed covered by medicaid must be at least
30%
what is the most common d/i in the IVF population compared w/ general obstetric population
congenital cardiac defects (1-3%)
exposure to varicella w/o evidence of immunity?
vaccinate w/in 3-5 days as long as no contraindictions. 90% effective w/in 3 days. 70% effective w/in 5 days.
threatened AB when plans to terminate?
pregnancy termination ( do not need to confirm viability first- do not expectantly manage)
define osteoporosis, osteopenia. what is the recommended tx for each?
osteopenia -1 to -2.5. Osteoporosis -2.5 or less. Osteopenia- SERM. Osteoporosis- bisphosphonate.
“most likely” fetal karyotype w/ cardiac malformation?
The risk of anuploidy w/ cardiac malformations are identified is about 30; however, most fetuses w/ ISOLATED cardiac malformations are euploid.
when would you start breast cancer chemoprevention?
when a pt’s 5 yr breast ca risk is ≥ 1.67% or if her lifetime risk if ≥ 20%
most common abnormality of the female urethra? how is it managed?
urethral caruncle. for asumptomatic pts no tx is needed, if sx (bleeding, pain) tx would be vaginal estrogen
zika testing in pregnancy
PCR is diagnostic but needs to collected w/in 3-7 days of when symptoms arise. IgM Ab testing can be used after 4 days.
most common cause of precocious puberty. how is this dx’d?
idiopathic central precocious puberty. however need to r/o primary cause (pituitary tumor etc). An LH over 5-8 after GnRH stim test would be diagnostic.
what is the most important modifiable risk factor for stroke in women?
HTN
describe the structure of HSV
ds DNA
tx most likely to reduce vaginal atrophy sx in breast ca hx pt
vaginal estrogen (no increased recurrence)
what is the leading cause of disability in women?
depression. 30% of women affected in their lifetime, 15% postpartum
edinburgh PND score cutoff for abnormal, postpatum depression?
10 and 13 respectively
cause of macrocytic anemia in elderly?
b12 deficiency. need to r/o folate deficiency before tx can mask cause.
evaluation for PCOS must include what? best tx for PCOS and insulin resistance?
TSH, prolactin, AM 17OHP, non-classical CAH. other cv risk factors should be screen for- t2DM, CHTN. dyslipidemia, PSA, obesity
- best tx = diet, lifestyle modification
what are the three labs for APS? Who should be screened?
lupus anticoagulant, anticardiolipin antibody, anti-b2 glycoprotein.
- venous/arterial thrombus OR 1+ 2nd TM loss morho normal fetus, 3+ 1st TM losses, HDP prior to 34 wk gestation
best lifestyle modification to decrease blood pressure?
weight loss. one out of three adult deaths is relatable to elevated blood pressure!
safe tx for HPV warts in pregnancy?
cryotherapy ahd TCA are both safe.
DMPA and BMD
black box warning re DMPA and deceased BMD after 2 years, however, can continue if pt prefers this form of tx b/c the loss is reversible. There have been no well-desifned studies that demonstrate a higher fx risk.
what percentage of endometrial adenocarcinoma cases are accompanied w/ bleeding? what percentage are not? what is the most common finding to explain PMB?
90% associated w/ bleeding, 1-12% are not. The MC cause is endometrial atrophy.
