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Gyn 3 (contraceptn)

Step-2

QuestionAnswer
In which pts is bubropion contraindicated? seizure disorders, withdrawal from BZD or alcohol, eating d/o, MAOIs in the last 2 weeks
What is the treatment for serotonin syndrome? stop serotonergic, supportic care, possible sedation and intubation, BDZ
A middle-aged man presents for knee pain, and xray reveals b/l calcifications of the articular cartilage. What is the treatment? Condrocalcinosisi seen in pseudogout. treatment is NSAIDS or colchicine
Combined OCPs reduce the risk of _______and _________ cancer. endometrial and ovarian.
What type(s) of liver pathology is associated with OCP use? reversible cholestasis, hepatic adenoma, budd-chiari syndrome, veno-occlusive dz(of terminal hepatic venules and hepatic sinusoids), HCC, resulting cirrhosis/portal HTN/Liver failure from one of the above listed.
What medications are well known for reducing the effectivelness of oral combination contraceptive pills through changes in liver metabolism? Abx such as Rifampin (griseofulvin to less degree), anti-epileptics(phenobarbital, phenytoin, carbamazepine, topiramate, oxcarbazepine, primidone), and st. john's wort
What are 4 different options for emergency contraception? combo OCPs taken in large doses, progestin-only (Plan B) levonorgestrel, copper IUD, selective progesterone receptor modulatus (ulipristal)
What are the mechanisms of action of OCPs? inhibit follicle development and ovulation, change endometrial quality, increase cervical mucus viscosity.
What are the first steps in the w/u of a woman with primary amenorrhea? H&P look for congenital defects (imperforate hymen), signs of hyperandrogenism(testosterone & DHEA-S), check for galactorrhea(prolactin and thyrotropin). Do pelvic sono, if absent karyotype and testosterone, if present b-hCG and FSH.
If a patient with primary amenorrohea has an absent uterus on sono. What tests will you order and what are you looking for? order karyotype and serum testosterone. You are testing for androgen insensitivity syndrome(46 XY, elevated testosterone) or Abnormal mullerian development (46XX normal female testosterone levels)
If a patient with primary amenorrohea has a uterus on sono. What tests will you order and what are you looking for? B-hCG and FSH. If B-hCG is high then she is pregnant. If FSH is high then karyotype for turners syndrome (45XO, non functioning ovaries). If FSH is low then do cranial MRI for hypothalamic or pituitary dz. If FSH nl then check prolactin and thyrotropin
A 15 y/o girl comes in for evaluation of primary amenorrhea and on PE, a bluish bulge is evident where the vaginal orifice should be. What is the dx? imperforate hymen
A woman presents with primary amenorrhea, absent secondary sexual characteristics and anosmia. What is the dx? Kallmann syndrome
What is the definition of premature ovarian failrue? absence of menses for 6 months in a woman <40 yrs.
What is the mcc of secondary amenorrhea? pregnancy
What is the intial step in the management of a woman presenting with secondary amenorrhea and new galactorrhea when the b-hCG is negative? check TSH and prolactin level
What are the basic components of a work-up for secondary amenorrhea? B-hcg, prolactin, TSH, FSH. If signs of hyperandrogenism check testosterone and DHEA-S. Progestin withdrawal test.
What are the absolute contraindications for OCPs? pregnancy, history of thromboembolism or inherited thrombophilia, history of estrogen-dependent tumor, history of cerebroascular dz of CAH, poorly controlled HTN, Smoker>35, hepatic dz, abdnormal vag bleeding of unknown etiology, migraine with aura
The rate of pregnancy in one year without any contraception is ______% 85%
Which method of contraception is less effective in heavier women due to diffusion into adipose tissue? Trandermal patch
Which contraceptive method has been linked to osteoporisis with long term use and is also associated with a 3-5 pound weight gain? Medroxyprogesterone acetate (Depo-Provera)
Scarring of the uterus that follows infection or postpartum infection and/or D&C. This is called _________syndrome. Asherman's syndrome
What is always the first step in the workup of any type of amenorrhea B-hCG pregnancy test
Testicles are present in an XY pt with androgen insensitivity syndrome. What cancer is this patient at an increased risk for? What should be done to prevent cancer? testicles should be removed at an early age because of increased risk of testicular cancer.
Created by: shelybel