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CREOG Study > Truelearn 3 > Flashcards

Truelearn 3 Flashcards

1
Q

Patients with provoked PE should be anticoagulated for how long generally

A

3 months

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2
Q

What is the most common cause of procedure related death in laparoscopic tubal sterilization?

A

Cardiopulmonary arrest

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3
Q

How do you repair an abdominal ureteral injury ?

A

Ureteroureterostomy

Transureteroureterostomy

Ureteral reimplantation

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4
Q

How do you repair pelvic ureteral injuries?

A

Ureteral reimplantation with/without psoas hitch and or Boari flap

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5
Q

What is the greatest risk factor for the development of epithelial ovarian cancer?

A

Family history of ovarian cancer

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6
Q

Patients with a history of cryptorchidism have fertility rates of ______ for unilateral and _____ for bilateral compared to fertile males

A

80% unilateral

50% bilateral

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7
Q

What’s the rate of expulsion of postpartum IUDs ?

A

10 - 27 %

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8
Q

The FDA banned transvaginal mesh for what purposes ?

A

Repair of cystocele ( anterior compartment)

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9
Q

On ultrasound, the corpus luteum is usually what size?

A

< 2.5 cm

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10
Q

Granulosa and theca cells surrounding a centra blood clot describes what structure responsible for making progesterone in a pregnancy before 10 weeks?

A

Corpus luteum

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11
Q

In a patient with BRCA1 what are the most common associated cancers ? (4)

A

Breast
Ovarian
Uterine serous papillary
Prostate

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12
Q

What’s the risk of Breast and Ovarian cancer in BRCA 1?

A

60 % Breast
40% Ovarian

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13
Q

What are the most commonly associated cancers for people with BRCA 2 mutation? (6)

A

Breast
Ovarian
Uterine
Prostate
Pancreas
Melanoma

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14
Q

What’s the lifetime risk of breast and ovarian cancer ( by age 70) in women with BRCA 2 mutation?

A

Breast 50%
Ovarian : 20%

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15
Q

How do you reduced ovarian cancer risk in patients with BRCA1? BRCA 2?

A

BRCA 1 - ppx BSO age 35 - 40

BRCA 2 - ppx BSO age 40 - 45

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16
Q

What kind of breast cancer is typically found in BRCA 1 carriers? BRCA 2 carriers?

A

BRCA1 - Most commonly triple negative

BRCA 2 - Most commonly ER/PR +

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17
Q

According to ADA diabetes screening should be performed in whom?

A

BMI >/= 25 with additional risk factors

Start at age 35 yrs and go every 3 years if results are normal

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18
Q

A fever within the first 3 days of surgery is most often related to _______ or ________

A

Atelectasis

Pneumonia

Remember, WIND!

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19
Q

What’s the mnemonic for remembering causes of postoperative fevers and associated time we can typically see these occurrences?

A

Wind (0 - 3 days)

Water (3 - 7 days)

Wound (5 - 7 days)

Walking (Anytime)

Wonder drugs ( Anytime)

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20
Q

What’s the typical size of pituitary macroadenoma?

A

> 10 mm

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21
Q

The CDC recommends empiric treatment for what three STDs in the setting of sexual assault?

A

Gonorrhea
Chlamydia
Trichomonas

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22
Q

Gonorrhea treatment dosing empirically for sexual assault

A

Ceftriaxone 500 mg IM x 1
Give 1g if ppt is > 150 kg

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23
Q

Chlamydia treatment consists of _____ or ______ ( and which one is preferred)

A

Doxycycline 100 mg BID x 7 days

Azithromycin 1g PO once can be given

Doxy is preferred over azithromycin because of microbial efficacy but azithromycin can be given for those who adherence is a concern or they are unlikely to complete the 7 day course

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24
Q

Treatment for trichomonas includes

A

Metronidazole 500 BID for 7 days
** be sure to tell patents to avoid alcohol **

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25
Q

What is the way to proceed with HIV prophylaxis discussion in a patient with sexual assault?

A

Risk of transmission is pretty low but prophylaxis with antiretrovirals are usually offered to patients
Meds best started within 4 hours and no later than 72 hours

26
Q

What does the CDC recommend course for post exposure prophylaxis for HIV in Sexual assault victims

A

Initial supply for 3 - 7 days ( starter pack) OR the supply needed for an entire treatment course (28 days)

Short term close follow up is recommended

27
Q

Max dose of lido without epi? LIDO WITH epi?

A

4.5 mg/kg

7 mg/kg

28
Q

How is 5 alpha reductase deficiency inherited and what is the Karyotype?

A

Autosomal recessive

46 XY

29
Q

What is abnormal in a patient with 5 alpha reductase deficiency?

A

Defective conversion of testosterone to dihydrotestosterone

30
Q

In 5 alpha reductase deficiency what anatomical structures are affected ?

A

External genitalia (penis, scrotum)
Prostate
Urethra

  • the external structures require the DHT in order to virilize normally, the internal structures are stimulated by testosterone and are able to develop normally*
31
Q

What are contraindications for in office LEEP ? (4)

A

Significant anxiety
Limited Pain tolerance
Bleeding/coagulation disorders
Current menses ( active bleeding obscures view of the cervix)

32
Q

Per the guidelines CIN 2 or 3 should be treated with ______

A

LEEP or Cold knife cone biopsy

33
Q

What is the treatment for cervical adenocarcinoma in situ

A

Hysterectomy if the patient has completed childbearing , but an excisional procedure should be done to rule out invasive cancer

34
Q

Patients younger than 25 yrs with HSIL pap should have what done next ?

A

Colposcopy

35
Q

Patient older than 25 years old, HSIL pap can be treated with ______ or _______

A

Colposcopy or excision ( LEEP or CKC)

36
Q

Describe Factitious disorder ( also known as Munchausen Syndrome)

A

Women of reproductive age intentionally faking medical or psych symptoms to assume the sick role with no external rewards

Usually will readily accept diagnostic and therapeutic procedures

37
Q

How do you describe malingering ?

A

Faking illness in order to obtain obvious external rewards ( time off work, child custody etc )

Often times diagnostic and therapeutic procedures will be avoided in this individual

38
Q

What does Munchausen by proxy refer to

A

Factitious disorder imposed on another person

39
Q

What is the risk of CIN 3 progressing to cancer?

A

40%

40
Q

What is the risk of CIN I and CIN 2 proceeding to cancer?

A

CIN 1 - 1%

CIN 2 - 5%

41
Q

What is the risk of leiomyoma containing an underlying leiomyosarcoma ?

A

1/2000 cases or 0.05%

42
Q

Earliest age it consider herpes zoster vaccine in a patient?

A

50 years old

43
Q

What can hep decrease ovarian cancer risk in women with BRCA 1 or BRCA2 who aren’t candidates or who don’t desire prophylactic BSO ?

A

Combine oral contraceptives - 50% decreased risk of ovarian cancer

44
Q

What med is approved as add back therapy in patients taking Leupron ( Leuprorelin) for more than 6 months?

A

Norethindrone 5 mg daily

45
Q

Clonidine can be used to treat both ______ and _______

A

Hypertension and Vado motor symptoms of menopause

46
Q

Is clonidine FDA approved for hot flash use?

A

No but it is often used off label

Meta analysis has shown that it is less effective than hormone replacement therapy (estradiol+/- progestin) but superior to placebo

47
Q

What are some side effects of clonidine

A

Dry mouth
Insomnia
Drowsiness
Rebound hypertension if abruptly stopped

48
Q

First line treatment for lichen planus?

A

High potency topical steroids ( like clobetasol or halbetasol)

49
Q

Physical exam highlights for lichen planus

A

5 Ps ( pruritic, purple, papular, polyhedral papules, plaques)

It can also have white, lacy, reticulate striae

50
Q

How do you manage cyclic mastalgia?

A

OCPs or supplemental progestins given during secretory phase of the cycle

51
Q

How do you manage refractory mastalgia?

A

Danazol

** 90% of patients have relief but don’t use for more than 6 months because it van cause hirsutism**

If Danazol fails, can do a course of bromocriptine or tamoxifen

52
Q

Leuprolide acetate also known as Lupron is what category of drug ?

A

GnRH agonist

53
Q

Orilissa also known as elagolix is in what drug family ?

A

GnRH antagonist

It suppresses estrogen and inhibits endometriosis proliferation

54
Q

When should test of cure be performed after chlamydia is diagnosed and treated in pregnancy?

A

4 weeks

Then reset 3 months after treatment

55
Q

Pregnant and postpartum people who experience IPV are how many times more likely to be victims of homicide compared to non pregnant/postpartum women?

A

2 times

56
Q

What is the risk of renal anomaly in women with unicorn usage uterus?

A

40%

57
Q

What is management for unicornuate uterus with pregnancy in rudimentary horn?

A

Termination recommended due to risk of uterine rupture

58
Q

What percent of women with fibroids report mild pelvic pain ?

A

20%

59
Q

What are the recommendations for Calcium and vitamin D supplementation in post menopausal women < 70 years ?

A

1200 mg calcium per day

600 IU Vitamin D

60
Q

What are the recommendations for Calcium and vitamin D supplementation in post menopausal women OVER age 70?

A

1200 mg calcium

800 IU of vitamin D

CREOG Study (8 decks)

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