WH

Question 1

Prolactin

Answer 1

Assess pituitary function

A major endocrine gland. A pea-sized body attached to the base of the brain, the pituitary is important in controlling growth and development and the functioning of the other endocrine glands

Hyperlactinemia may can amenorrhea d/t pituitary tumor

Question 2

ACOG Pap Recommendations

Answer 2

30-65yo - Pap c HPV q5y or just pap q3y.
*>65yo c hx of 3 consecutive normals AND no abnormals in past 10y AND most recent in last 5y = stop screening

Begin routine HPV screening @21yo

Question 3

Risk factors for cervical cancer

Answer 3

1 = HPV Infection

Question 4

Dysmenorrhea

Answer 4

Tx: NSAIS (ibuprofen), exercise, OCPs & high fiber diet

Question 5

Trichomoniasis

Answer 5

Metronidazole 2g dose ONCE
OR
500mg BID x7d

Question 6

Bacterial Vaginosis

Answer 6

Metronidazole 500mg PO bid x7

Clindamycin

Question 7

Biphosphonate

Answer 7

Upright 30min after

Take on empty stomach and wait 1 hour before eating

May cause n, abd pain & loose BMs

Risedronic acid, alendronic acid (fosamax) & ibandronic acid are Biphosphonates used to tx osteoporosis

Question 8

Concerning breast exam findings

Answer 8

Nontender mass, >2cm, non mobile, irregular borders

Question 9

Metronidazole can be used to tx

Answer 9

BV, trichomoniasis, giardiasis

Question 10

Primary amenorrhea

Answer 10

PRIMARY = No menses by 15yo

• r/t anatomical or genetic abnormality
• r/o secondary causes b/f referring to endocrine

SECONDARY = pregnancy test, FSH (primary ovarian insufficiency), TSH, serum prolactin (hyperprolactinemia), physical exam (BMI >30 r/t PCOS; BMI

Question 11

Pap results that should be referred to a specialist

Answer 11

PCP may monitor:
Atypical squamous cells of undetermined significance
AND
CNI mild dysplasia

Refer to specialist:
CNII moderate dysplasia
AND
CNIII carcinoma in situ

FU abnormal pap in 3-6 months

Question 12

How to reduce fibrocystic breast changes

Answer 12

Decrease caffeine intake and dietary sodium

Warm compresses

Question 13

Calcium recommendations

Calcium rich foods

Answer 13

1000mg/day for women ages 50-64 who are on estrogen therapy

1500mg/day for women ages 50-64 who aren’t taking estrogen

1500mg/day for women >65

Leafy greens, dairy, sardines & salmon (oily fish)

Question 14

Trichomoniasis

BV

Candidiasis

Chlamydia

Answer 14

S/s: dyspareunia, greenish-yellow d/c, strawberry patches on cervix

BV: grayish, watery d/c

Candidiasis: thick white & curdy

Chlamydia: d/c

BB, candidiasis & trichomoniasis may lead to vulvovaginitis

Question 15

Premenstual syndrome

Vs

Dysmenorrhea

Answer 15

Body aches, breast tenderness & mood swings

HA, back aches & cramping

Question 16

Menopause

Answer 16

Absence of menses for >12 months

Elevation in FSH and LH indicates woman is approaching menopause

These two hormones are associated with reproduction, stimulation a development & release

Question 17

Preeclampsia

Answer 17

Risk factors: >40, 20wks, edema, proteinuria, HA, AMS, epigastric pain & visual disturbances

B-methasone injection for fetal lung maturation if delivery

Question 18

Naegele’s rule

Answer 18

LMP +1 year - 3 months + 7 days

Question 19

Pregnancy drug categories

Answer 19

Category A: no fetal risk, controlled human studies

Category B: animal studies show no risk, no controlled human studies

Category C: animal studies show fetal risk, no controlled human studies

Category D: positive evidence of human fetal risk

Category X: animal studies demonstrate fetal abnormalities

Question 20

Nausea

Answer 20

B6 found to reduce nausea

Smaller frequent low fat meals

Question 21

Placental abruption

Answer 21

Risk factors: smoking, AMA, HTN

Separation of placenta after 20th week

Question 22

Folic acid

Answer 22

No risk factors= 0.4-0.8 mg daily
*no increased dose d/t smoking, DM, twins

Hx of neural tube defects= 4mg starting 1 month before conception & for at least the first three month gestation

Question 23

GDM

Answer 23

Screen after 24 wk if no risk factors or 20 weeks if at risk

Risk factors: DM, AMA, hx GDM, obese, at risk ethnicity

Question 24

Weight gain

Answer 24

25-35lbs c BMI 19-25

15-25lbs c BMI 26-29

15lbs c BMI >29

35-45lbs c BMI

Question 25

Tay Sachs

Sickle cell

Answer 25

Tay Sachs: Ashkenazi Jew, French, Canadian, Cajun ancestry

Sickle cell: Africans & Latinos

Question 26

Stress incontinence

Answer 26

Caused by activities that increase intra-abdominal pressure such as sneezing, coughing, laughing

Tx: kegel exercises, biofeedback, peri urethral bulking agents and pessaries