Ccs Cases Comprehensive Exam Study Guide With Complete Solutions

CCS CASES COMPREHENSIVE EXAM STUDY
GUIDE WITH COMPLETE SOLUTIONS

●● Antibiotic Management for Inpatient Tx of PID?
Answer: -IV Cefoxitin/Cefotetan plus IV/PO Doxycycline
-IV Clindamycin and Gentamycin
-IV Amp/Sul plus IV/PO Doxy
SWITCH to PO after 24hrs of improvement


●● Antibiotic Management for Outpatient Tx of PID?
Answer: -Ceftriaxone IM-1x plus Doxy PO(14d)
-Cefoxitin plus Probenecid -1x plus DoxyPO(14d)
-Metronidazole - if bacterial vag, trich or pelvic abcess or recent gyn
instrumentation
-72hr followup


●● PID Diagnostic Tests?
Answer: DO NOT WAIT TO START Emp TX
HCG, qualitative
Cervix - Gram, Gono/Chlam Cx
UA/UCx
VDRL or RPR

,HIV
PAP Smear
CBC
BMP


●● PID Counseling
Answer: Treat Partner
Contraception
Medication
Safe Sex
Smoking


●● PID Associated Symptoms tx?
Answer: Diet/Ambulation
NPO/Bedrest
Analgesic
-Morphine
N/V
-Promethazine (safe in preg)
Antipyretic
-Acetaminophen
Fluids while N/V

, -Normal Saline


●● 62 Diabetic with Constipation in Clinic.
Differential Diagnosis?
Answer: Fiber/Fluid, Medication, Obstruction - Tumor, Neuropathy,
Hypothyroid


●● Constipation - Clinic
Initial Tests?
Answer: CBC, BMP, FOBT, Mg, Phos, TSH. HBA1C, Microalbumin,
colonoscopy


●● Outpatient Constipation Mgmt?
Answer: High Fiber, Low Salt, Low Fat Diet
Oral Hydration
Med: 1st line: Psyllium, Methylcellulose, Milk of Mg
2nd line: Docusate, Lactulose, Sorbitol, Mg Citrate, Senna, Bisacodyl
Exercise Program
Counseling


●● Dysfunctional Uterine Bleeding.
Rule Out?
Answer: Pregnancy -B-HCG