CCS - Questions With Fully Explained Solutions
Treatment of uncomplicated cystitis (normal healthy nonpregnant woman)
Correct Answer - 3 days of TMP-SMZ
-if allergic, 3 days of a fluoroquinolone (cipro)
Complicated cystitis and treatment Correct Answer - any of the
following
-male
-diabetic
-anatomic abnormality
-symptoms >7d
-recurrent UTI
-age >65
treat with 7 days of TMP-SMZ
Treating cystitis in pregnancy Correct Answer - 7 days of nitrofurantoin
-if allergic, 7 days of amoxicillin-clavulanate
-avoid TMP and fluoroquinolones
Management of pregnancy Correct Answer - 1. order beta hcg urine or
serum
2. ultrasound pelvis
3. prenatal labs: blood type, Rh, atypical antibody, CBC with diff, BMP, pap, UA,
urine culture, rubella antibodies, RPR, HBs anigen, HIV ELISA, chlamydia test
4. tx with prenatal vitamins, iron sulfate, folic acid, prenatal counseling
5. schedule f/u in 4 weeks
Management of ectopic pregnancy Correct Answer - -urine or serum
HCG
-admit to ward if positive
-STAT NPO, vitals q1, IV access, IV NS, bedrest, serum hcg, transvaginal
ultrasound
-labs: type and cross, blood group, Rh, CBC with diff, PT, PTT, BMP, LFT,
cervical gono/chlamydia cultures STAT
-if Rh+ no need for RhoGAM
, -OBGYN consult, methotrexate, morphine
-after consult, rest at home, counseling, appt in 4 days
Management of IBS Correct Answer - -order basic labs, TSH, FOBT, ESR,
stool o and p, stool wbc, stool bacterial culture, 72 hour stool fat, pap smear
-treat with lactose free diet, high fiber diet, loperamide
-biofeedback, reassurance, relaxation exercises, counseling
Management of depression Correct Answer - -CBC, BMP, TSH, B12,
depression index
-tx SSRI
-medication compliance, regular exercise, patient education
-follow up q1-2w for first 6-8w treatment
Treating vaginal candidiasis Correct Answer - vaginal miconazole or
clotrimazole or oral fluconazole
Treating trichomonas vaginalis Correct Answer - metronidazole
-avoid alcohol
-treat partner
-safe sex counseling
Treating BV Correct Answer - metronidazole
-avoid alcohol
Management of vaginal itching, discharge Correct Answer - vaginal pH
wet mount
gram stain
pap smear
gc culture
chlamydia culture
UA
management of dementia Correct Answer - -CBC, CMP, TSH, B12, MRI
head
-tx donepezil, vitamin E, atypical antipsychotic
cortical atrophy and periventricular leukomalacia Correct Answer -
Alzheimers disease
Treatment of uncomplicated cystitis (normal healthy nonpregnant woman)
Correct Answer - 3 days of TMP-SMZ
-if allergic, 3 days of a fluoroquinolone (cipro)
Complicated cystitis and treatment Correct Answer - any of the
following
-male
-diabetic
-anatomic abnormality
-symptoms >7d
-recurrent UTI
-age >65
treat with 7 days of TMP-SMZ
Treating cystitis in pregnancy Correct Answer - 7 days of nitrofurantoin
-if allergic, 7 days of amoxicillin-clavulanate
-avoid TMP and fluoroquinolones
Management of pregnancy Correct Answer - 1. order beta hcg urine or
serum
2. ultrasound pelvis
3. prenatal labs: blood type, Rh, atypical antibody, CBC with diff, BMP, pap, UA,
urine culture, rubella antibodies, RPR, HBs anigen, HIV ELISA, chlamydia test
4. tx with prenatal vitamins, iron sulfate, folic acid, prenatal counseling
5. schedule f/u in 4 weeks
Management of ectopic pregnancy Correct Answer - -urine or serum
HCG
-admit to ward if positive
-STAT NPO, vitals q1, IV access, IV NS, bedrest, serum hcg, transvaginal
ultrasound
-labs: type and cross, blood group, Rh, CBC with diff, PT, PTT, BMP, LFT,
cervical gono/chlamydia cultures STAT
-if Rh+ no need for RhoGAM
, -OBGYN consult, methotrexate, morphine
-after consult, rest at home, counseling, appt in 4 days
Management of IBS Correct Answer - -order basic labs, TSH, FOBT, ESR,
stool o and p, stool wbc, stool bacterial culture, 72 hour stool fat, pap smear
-treat with lactose free diet, high fiber diet, loperamide
-biofeedback, reassurance, relaxation exercises, counseling
Management of depression Correct Answer - -CBC, BMP, TSH, B12,
depression index
-tx SSRI
-medication compliance, regular exercise, patient education
-follow up q1-2w for first 6-8w treatment
Treating vaginal candidiasis Correct Answer - vaginal miconazole or
clotrimazole or oral fluconazole
Treating trichomonas vaginalis Correct Answer - metronidazole
-avoid alcohol
-treat partner
-safe sex counseling
Treating BV Correct Answer - metronidazole
-avoid alcohol
Management of vaginal itching, discharge Correct Answer - vaginal pH
wet mount
gram stain
pap smear
gc culture
chlamydia culture
UA
management of dementia Correct Answer - -CBC, CMP, TSH, B12, MRI
head
-tx donepezil, vitamin E, atypical antipsychotic
cortical atrophy and periventricular leukomalacia Correct Answer -
Alzheimers disease
