What are 3 ways to manage aborption? expectant, medical and surgical, success rates
depend on type of abortion
In children with vaginal discharge, besides treating, what else should you do? r/o STI,
abuse, and foreign body
do you have to treat unpregnant women with BV or candidiasis? no, BV if symptomatic,
metro 500mg bid X 7
16 yo female presents with change in her vaginal bleeding, more heavier than usual. What should
you order first? bhcg, r/o ectopic pregnancy
What are indications for endometrial biospy? 1. postmenopausal, any uterine bleeding 2.
age 40 to menopause, more frequent bleeding, heavier bleeding, or prolonged. 3. < 40 yrs, obese
women, or persistent in healthy women
,what are basic investigations to do in a healthy 16 yo female for AUB? bhcg! hgb, TSH,
ferritin, coags, PT, PTT and VWF.
what are basic investigations to do in a healthy 41 yo female for AUB? bhcg, cbc, tsh,
pelvic u/s +/- endometrial biopsy
What is the diagnostic criteria for PCOS? 1. ovulatory dysfunction-oligomenorrhea or
amenorrhea ( 3 mo without menses), 2. hyperandrogenism 3. u/s >= 12 follicles
What should you make sure of in a patient with PCOS? they have a bleed q3 months,
because of anovulation, the estrogen can build their endometrium up, hyperplasia. can give
provera for w/d bleed.
In a patient with postmenopausal bleeding, what investigations should you do? 1. pap
smear, pelvic u/s, endometrial biopsy, pelvic exam
when should bhcg double during early pregnancy? every 2-3 days
,how should you monitor medical miscarriages? serial wkly bhcgs and pelvic u/s at 4
weeks.
What substances can affect male fertility? Opioids, alcohol, marijuana, spirnolactone,
smoking
What three main diagnosis should you consider in women with infertility? 1. PCOS, 2.
prolactinoma 3. thyroid disease 4. endometriosis
When should you initiate investigation for infertility? 1. <35, after 1 year of trying >35,
after 6 months >40 immediate, later, less chance of pregnancy
what investigations would you do for female investigation for infertility? 1. day 3 fsh ( to
test for ovarian reserve), LH, TSH, testosterone, prolactin, day 21 serum progesterone, pelvic
ultrasound
what investigations would you do for male investigation for infertility? 1. semen analysis
( with sperm count and motility), 2. free testosterone 3. karyotyping ( Klinefelter)
, What is the most common cause of anovulation? PCOS
In asking for an allergy history, what should you always ask/ 1. identifiable triggers, 2. hx
of anaphylaxis and if so, epipen present 3. treatments tried
How long do you observe post giving epi? 2-3 hours for a delayed reaction
What are types of macrocytic anemia? megaloblastic and non megaloblastic ( alcohol,
liver disease, thyroid),
how do iron deficiency anemia and anemia inflammatory differ in lab studies? iron
deficiency, TIBC is high, anemia of chronic disease, TIBC low
Name 5 symptoms of vit b12 deficiency paresthesia in hands and feet, muscle cramps,
dizziness, ataxia, fatigue
What are the alarm symptoms of dyspepsia? VBAD (vomit, blood, anemia, age, abdo
mass dysphagia)