PHYA 524: IPE + PH Exam 86 Questions with Verified Answers,100% CORRECT

PHYA 524: IPE + PH Exam 86 Questions with Verified Answers What education and certification do OBGYNs need? What is their certification board? - CORRECT ANSWER medical school + 4-year ob/gyn residency + board certified by American Board of Obstetrics and Gynecology (ABOG) do not do internal med first Board certified physician (MD, DO) who specializes in women's reproductive health - CORRECT ANSWER OBGYN compare obstetrics vs gynecology and the roles that OBGYNs have in each area - CORRECT ANSWER Obstetrics - medical and surgical care before, during and after a woman gives birth ◦Pre-natal/pregnancy, labor, delivery, post-partum ◦Management of normal pregnancy, as well as any pregnancy-associated complications (hypertension, pre-term labor, infection, etc.) Gynecology - medicine related to the treatment of female reproductive organs ◦Health maintenance/routine screening - pap smears, mammograms ◦Family planning, counseling, menopause ◦Treatment of reproductive organ disorders What are some subspecialties within obstetrics and gynecology? - CORRECT ANSWER - female pelvic medicine and reconstructive surgery - gyn onc - hospice and palliative medicine - maternal-fetal medicine - reproductive endocrine and infertility An endocrinologist who specializes in infertility for both men and women - CORRECT ANSWER reproductive endocrinologist Subspecialty of obstetrics and gynecology What are the roles of a reproductive endocrinologist? - CORRECT ANSWER ◦Identifies and treats infertility in both men and women ◦Provides work up and interventions What is the education and board certification of a reproductive endocrinologist? - CORRECT ANSWER 4-yr OB-GYN residency + 3-year reproductive endocrinology fellowship after + Board certification: American Board of Obstetrics & Gynecology Provides care for patients with high-risk pregnancies What subspecialty is this? - CORRECT ANSWER Maternal-fetal medicine A subspecialty of obstetrics Pregnant women with chronic problems or unexpected complications (high-risk pregnancies) should go to what subspecialties? - CORRECT ANSWER Maternal-fetal medicine What is the education of a physician in maternal fetal medicine - CORRECT ANSWER 4-yr OB-GYN residency + 3-year fellowship after + Board certification: American Board of Obstetrics & Gynecology physician in maternal fetal medicine works alongside what other profession? - CORRECT ANSWER Work in conjunction with obstetrician Uro-gynecology is a subspecialty of ___ - CORRECT ANSWER Subspecialty of OB/GYN and Urology Surgeon who specializes in the care of women with pelvic floor disorders - CORRECT ANSWER Uro-gynecologist they can treat incontinence, prolapse, emptying disorders, pain, overactive bladder, fistulas Who does this: Female pelvic medicine (non-operative) and reconstructive surgery of the bladder, uterus, vagina and rectum. - CORRECT ANSWER Uro-gynecologist what is the education of a Uro-gynecologist - CORRECT ANSWER 4-yr OB-GYN residency + 3-year fellowship in uro-gyn after + Board certification after uterus cancer (or another pelvic reproductive cancer) who do you go to for reconstruction of the pelvic area? - CORRECT ANSWER Female Pelvic Medicine & Reconstructive Surgery = urogynecology what are the 4 types of APRNs? - CORRECT ANSWER NP CNM CRNA CNS (certified nurse specialist) Licensed Advanced practice registered nurse (APRN) whose medical practice focuses on the reproductive health of a patient - CORRECT ANSWER Certified nurse midwife (CNM) what is the practice and prescriptive authority of CNMs? - CORRECT ANSWER considered primary care providers under federal law in all 50 states + prescriptive authority certified nurse midwives must have what career/certification first? - CORRECT ANSWER must be RN first! what is the role of CNMs, what do they do? - CORRECT ANSWER ◦Health maintenance ◦Prenatal education and care ◦Post-partum education and care ◦Care and counseling during infancy ◦May be present during labor and delivery Primary care providers throughout a woman's lifespan what education is required for a CNM? - CORRECT ANSWER Completion of an accredited master's degree program upon completion of a bachelor's degree in NURSING!!! most CMNs work in ... a. home b. hospitals c. birth centers - CORRECT ANSWER hospitals do CNMs get medicaid reimbursement? - CORRECT ANSWER YES Medicaid reimbursement is mandatory in all 50 states. what is the difference between a CNM and a certified midwife? - CORRECT ANSWER CM does NOT have to have a nursing background** which requires a masters: CM or CMN - CORRECT ANSWER both require masters! (just CM does not need nursing degree) CMNs can practice in all 50 states. Is this the same for CMs? - CORRECT ANSWER NO CMs only in a few states! what are 2 "direct entry midwife" pathways? - CORRECT ANSWER CMs Certified Professional Midwife (CPMs) what education is required for certified professional midwives (CPMs)? - CORRECT ANSWER High school diploma/equivalent + Can attend a Midwifery Education Accreditation Council approved program which may grant a Certificate, Bachelor's, Master's or doctorate. ***There is NO SINGLE STANDARD of education "lay midwives" - CORRECT ANSWER CPMs CPMs are in what setting? - CORRECT ANSWER out of hospital Most work in client homes and private birthing centers. Nurse who specializes in obstetrics - CORRECT ANSWER OB nurse majority of care of OB nurses is provided during what stage of labor? - CORRECT ANSWER Majority of care is provided during the first stage of labor Continuous monitoring ◦Fetal heart tones ◦Signs of impending labor ◦Patient's vital signs ◦Pain management Assist during delivery ◦Provide support and encouragement for the mother ◦Assist the delivery practitioner Be prepared for potential emergencies in addition to helping during the delivery, OB nurses also do what after delivery? - CORRECT ANSWER Upon delivery, OB nurse helps care for the baby, as well + Help the mother with recovery from childbirth and education regarding infant care what education is required of an OB nurse? What are some optional OB nurse educaiton? - CORRECT ANSWER ◦Nursing degree (trend is moving toward bachelor's degree) ◦On-the-job training ◦Certification available with 24 months experience: Inpatient Obstetric Nursing (RNC-OB) T/F: doulas are considered maternity care providers - CORRECT ANSWER NOT considered maternity care providers. they do NOT provide medical care ____ provide emotional and physical support for the patient who is pregnant, laboring, and post-partum + looks for health-related signs to seek medical care - CORRECT ANSWER doulas what can the doula do during antepartum - CORRECT ANSWER Support women on bedrest: Help with housework and childcare what can the doula do for labor and birth? - CORRECT ANSWER perform tasks to create a calming birthing environment: facilitates communication between hospital staff and patient, ADVOCATES for patient what can the doula do post partum? - CORRECT ANSWER support during the first few weeks after birth: Help with care and feeding of the baby; Help with household tasks do a lot of states cover doula services under the Medicaid programs? - CORRECT ANSWER NO - only like 4 **BUT several states are expressing interest in coverage for doula benefit - because better outcomes Ex: CT is looking to regulate certifications on doulas (so far the doula advisory committee has passed legislation) ***currently not regulated though several states are expressing interest in coverage for doula benefit. Why? - CORRECT ANSWER to improve maternal and fetal outcomes! (bc we have a high maternal birth rate) Provide clinical support to breastfeeding mothers - CORRECT ANSWER Lactation consultant When you need someone to provide patient education and help nursing mothers address lactation issues, who do you call - CORRECT ANSWER Lactation consultant what is the board certification of Lactation consultant - CORRECT ANSWER International Board-Certified Lactation Consultants (IBCLCs) do Lactation consultants work independently? - CORRECT ANSWER yes! how many hours lactation consultants need in didactic learning? - CORRECT ANSWER 90 hours of didactic learning in lactation. Professionals with advanced training in medical genetics and counseling help make informed decisions about preconception or during pregnancy - CORRECT ANSWER genetic counselor Who might want to be referred to a genetic counselor? (what are some indications) - CORRECT ANSWER ◦Personal or family history of a known or suspected condition ◦Abnormal ultrasound findings ◦Discussion of testing options and types of tests available during pregnancy ◦Discussion of positive and negative test results ◦Advanced maternal or paternal age ◦Exposures during pregnancy which may cause birth defects ___ Help patients understand how family and personal history of disease might affect their families and family planning, and help decide which genetic tests to order and what information the tests may or may not provide. - CORRECT ANSWER genetic counselors education required to be a genetic counselor - CORRECT ANSWER Bachelor's + Master's degree in genetic counseling + Most employers require certification from ACGC + Most states require licensure to practice except WY and VT most states require genetic counselors to have ____ - CORRECT ANSWER licensure (except WY and VT!) What is the position statement on PAs from the American college of obstetricians and gynecologists? - CORRECT ANSWER PAs are a part of team based care! Increase in rates of STDs are highest in what population? - CORRECT ANSWER racial and ethnic minority groups (highest rate increase in black patients) 26% of the total cost of STDS is allocated to what patient population? - CORRECT ANSWER Age 15-24 15-24yos account for ___% of all new STD infections? - CORRECT ANSWER 50% - lack of access (cannot drive themselves) - don't want parents to know What are the consequences of undiagnosed STDs in women? - CORRECT ANSWER infertility what STD is most prominent in the 15-24yo population? - CORRECT ANSWER gonorrhea What factors place youth more at risk for STIs? - CORRECT ANSWER - confidentiality (don't want parents to know) - no car to get there = lack of access - biology of women is more susceptible to STIs What age group should receive screening for STD and why? - CORRECT ANSWER screen ALL sexually active pts <25yo bc of increased rates of new STDs in this population what women should you screen for chlamydia and gonorrhea? - CORRECT ANSWER all sexually active women <25yrs old what might be a barrier for males being tested for STDs? - CORRECT ANSWER swab must be inserted 2-4cm into urethra for males Why might a dedicated STD clinic create a barrier? - CORRECT ANSWER this will be a barrier bc people wont want to go in for fear of stereotype Gay bisexual and MSM have higher rates of ___ - CORRECT ANSWER STDs (esp syphilis and HIV) Patient is a female who is monogamous with one male but mentions this male partner engages in sex with other males. The patient should be tested for ..? - CORRECT ANSWER syphilis and HIV Patient is a female who is HIV (+) who is pregnant. How can she prevent spread to the baby? - CORRECT ANSWER PrEP can HIV be transmitted to baby through breast feeding? - CORRECT ANSWER risk of transmission is <1% but not zero for those consistently taking HIV meds w/ undetectable levels of HIV in their blood Is HIV and syphilis higher in transgender women population? - CORRECT ANSWER yes What is Expedited Partner Therapy (EPT)? - CORRECT ANSWER Giving the patient who is (+) a prescription for the partner, give a Rx in the name of the partner Who can get the HPV vaccine? - CORRECT ANSWER can start at age 9 - 26 (but usually 11-12yo) What is SOGIESC - CORRECT ANSWER (1) SO sexual orientations (2) GIE gender identities and expression (3) SC sex characteristics When you take a sexually history, what do you ask? - CORRECT ANSWER 5 P's Partners? Practices? (so that you can recommend appropriate protection) Protection from STIs? Past history of STIs? Pregnancy intention? *now there is 6 P's (added pleasure) Why do you want to ask your patient if they meet their partners online? - CORRECT ANSWER safety -- increased risk of STIs and sexual violence What is the CARS program? - CORRECT ANSWER Community Approach to Reducing STDs = using select leaders in the community to educate the community + increasing education in specific populations on the high-prevalence STDs in the area = "targeting the community you are trying to go after" What are the concerns regarding STDs and Pregnancy - CORRECT ANSWER STDs can complicate pregnancy as well as have serious, long term effects on the unborn baby. How do we detect STDs in pregnant women, and when> - CORRECT ANSWER Pregnant women can and should get tested/screened; the earlier the better. Which STDs can we treat in pregnant women? Which STDs can we not treat? - CORRECT ANSWER •STDs, such as chlamydia, gonorrhea, syphilis, trichomoniasis and Bacterial Vaginosis can all be treated and cured with antibiotics that are safe to take during pregnancy . •STDs that are caused by viruses, like genital herpes, hepatitis B, or HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to the baby. most perinatal HIV diagnoses were among what population? - CORRECT ANSWER black or African American children what are the 3 T's of preventing congenital syphilis? why is this so imperative to do right now? - CORRECT ANSWER talk, test, treat - we should be testing ALL pregnant women for syphilis and treating any infected partners syphilis cases among newborns have increased by 203% Impact of syphilis on fetus - CORRECT ANSWER Low birth weight Fetal demise/stillbirth Premature labor An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies can have health problems such as cataracts, deafness, or seizures, and can die. highest risk for contracting syphilis a. sex with anonymous partners b. sex while intoxicated c. sex exchanged for drugs/money - CORRECT ANSWER sex with anonymous partners When do we test for syphilis in pregnant women? - CORRECT ANSWER first prenatal visit (first semester) and again at delivery Lead exposure prenatally will have affects on ___ - CORRECT ANSWER neurodevelopment issues in early childhood Zika causes ___ - CORRECT ANSWER microcephaly --> can live but are intellectually challenged How do you contract zika? How can we prevent getting Zika? - CORRECT ANSWER most transmission is from mosquitos but can also be from sexual contact - don't travel to endemic areas - use condoms - do not engage in unprotected sex w people who traveled to those areas What is the difference between equality, equity and justice? - CORRECT ANSWER