ACOG Notes UPDATED ACTUAL
Questions and CORRECT Answers
what is delayed puberty? - CORRECT ANSWER - no secondary sex characteristics age
14, no amenorrhea age 16
workup for delayed puberty? - CORRECT ANSWER - TSH
prolactin
bone scan
*add FSH to distinguish between brain and ovarian causes of delayed puberty
most important for androgen insensitivity? - CORRECT ANSWER - remove gonads to
prevent cancer
what precocious puberty causes DELAYED bone age? - CORRECT ANSWER -
hypothyroid (all others cause advanced)
trx precocious puberty? - CORRECT ANSWER - GnRH agonist CONTINUOUS
causes hypogonadotrophic hypogonadism - CORRECT ANSWER - eating disorder
stress
hypothyroid
cushing
putuitary adenoma
craniopharyngeoma
associations with BV? - CORRECT ANSWER - preterm delivery
postpartum endometritis
,PID
*trx = metronidazole
gold standard herpes diagnosis? - CORRECT ANSWER - NRT and culture
which syphilis antibody test will be positive for the rest of life? - CORRECT ANSWER -
specific (not VDRL or RPR)
what is trx for woman who had sex with HepB+ partner? - CORRECT ANSWER - give
immunization but ALSO give immunoglobulins
when does blindness present gonorrhea? chlamydia? - CORRECT ANSWER - gonorrhea
within first 5 days, chlamydia after 5 days
topical erythromycin only protects from gonorrhea
inpatient trx PID? - CORRECT ANSWER - IV cefotetan/cefoxitin + doxycycline
OR
clindamycin + gentamicin
*continue doxycyline as outpt for 14 days
outpt trx PID? - CORRECT ANSWER - Ceftriaxone, cefoxitin or other 3rd gen
cephalosporin (single injection IM) AND doxycycline for 2 weeks, with or without
metronidazole for 2 weeks.
,Follow up in 48 hrs!
signs TOA - CORRECT ANSWER - abdominal pain
diarrhea
nausea
fever
complex cysts on US
trx TOA - CORRECT ANSWER - clinda or metronidazole
what is differential for culture - urinalysis? - CORRECT ANSWER -
gonorrhea/chlamydia/trich
when do paps start - CORRECT ANSWER - 21 regardless of sexual activity
every 3 years cytology only until 30
30-65 cotesting every 5 years
when can paps stop? - CORRECT ANSWER - 3 consecutive - paps after 65
OR
2 consecutive cotestings
NO HISTORY OF HIGH GRADE OR CANCER
*still need bimanual
, what is done with ASGUS? - CORRECT ANSWER - do an HPV screen or repeat in 12
months, if positive do colpo
recommendations mammograms - CORRECT ANSWER - ACOG: yearly starting at 40
USPSTF: every 2 years starting at 50
colonoscopy ages - CORRECT ANSWER - start age 50 every 10 years (or
sigmoidioscopy at 50 every 5 years)
DEXA age - CORRECT ANSWER - 65 or early alcohol, smoking, hyperthyroid, family
hx, etc
*osteopenia = -1 to -2.5
*osteoporosis = less than -2.5
trx osteoporosis? - CORRECT ANSWER - bisphosphonates and repeat DEXA every 2
years
when do CV labs start? - CORRECT ANSWER - age 45 every 5 years through 75
when are fasting blood glucose levels drawn? - CORRECT ANSWER - starting at 45
every 3 years
when is urinalysis screening done? - CORRECT ANSWER - over age 65 because risk of
urosepsis
when do elderly get varicella vaccine? - CORRECT ANSWER - age 60 (even if they
already have shingles)
Questions and CORRECT Answers
what is delayed puberty? - CORRECT ANSWER - no secondary sex characteristics age
14, no amenorrhea age 16
workup for delayed puberty? - CORRECT ANSWER - TSH
prolactin
bone scan
*add FSH to distinguish between brain and ovarian causes of delayed puberty
most important for androgen insensitivity? - CORRECT ANSWER - remove gonads to
prevent cancer
what precocious puberty causes DELAYED bone age? - CORRECT ANSWER -
hypothyroid (all others cause advanced)
trx precocious puberty? - CORRECT ANSWER - GnRH agonist CONTINUOUS
causes hypogonadotrophic hypogonadism - CORRECT ANSWER - eating disorder
stress
hypothyroid
cushing
putuitary adenoma
craniopharyngeoma
associations with BV? - CORRECT ANSWER - preterm delivery
postpartum endometritis
,PID
*trx = metronidazole
gold standard herpes diagnosis? - CORRECT ANSWER - NRT and culture
which syphilis antibody test will be positive for the rest of life? - CORRECT ANSWER -
specific (not VDRL or RPR)
what is trx for woman who had sex with HepB+ partner? - CORRECT ANSWER - give
immunization but ALSO give immunoglobulins
when does blindness present gonorrhea? chlamydia? - CORRECT ANSWER - gonorrhea
within first 5 days, chlamydia after 5 days
topical erythromycin only protects from gonorrhea
inpatient trx PID? - CORRECT ANSWER - IV cefotetan/cefoxitin + doxycycline
OR
clindamycin + gentamicin
*continue doxycyline as outpt for 14 days
outpt trx PID? - CORRECT ANSWER - Ceftriaxone, cefoxitin or other 3rd gen
cephalosporin (single injection IM) AND doxycycline for 2 weeks, with or without
metronidazole for 2 weeks.
,Follow up in 48 hrs!
signs TOA - CORRECT ANSWER - abdominal pain
diarrhea
nausea
fever
complex cysts on US
trx TOA - CORRECT ANSWER - clinda or metronidazole
what is differential for culture - urinalysis? - CORRECT ANSWER -
gonorrhea/chlamydia/trich
when do paps start - CORRECT ANSWER - 21 regardless of sexual activity
every 3 years cytology only until 30
30-65 cotesting every 5 years
when can paps stop? - CORRECT ANSWER - 3 consecutive - paps after 65
OR
2 consecutive cotestings
NO HISTORY OF HIGH GRADE OR CANCER
*still need bimanual
, what is done with ASGUS? - CORRECT ANSWER - do an HPV screen or repeat in 12
months, if positive do colpo
recommendations mammograms - CORRECT ANSWER - ACOG: yearly starting at 40
USPSTF: every 2 years starting at 50
colonoscopy ages - CORRECT ANSWER - start age 50 every 10 years (or
sigmoidioscopy at 50 every 5 years)
DEXA age - CORRECT ANSWER - 65 or early alcohol, smoking, hyperthyroid, family
hx, etc
*osteopenia = -1 to -2.5
*osteoporosis = less than -2.5
trx osteoporosis? - CORRECT ANSWER - bisphosphonates and repeat DEXA every 2
years
when do CV labs start? - CORRECT ANSWER - age 45 every 5 years through 75
when are fasting blood glucose levels drawn? - CORRECT ANSWER - starting at 45
every 3 years
when is urinalysis screening done? - CORRECT ANSWER - over age 65 because risk of
urosepsis
when do elderly get varicella vaccine? - CORRECT ANSWER - age 60 (even if they
already have shingles)
