what conditions must be met for the Lactational amenorrhea method of birth control to be effective? (select all that apply)
must be > 6 months Post partum
used effectively intermittently
full-time breastfeeding
no return of menses
Your patient who is breastfeeding asks about hormonal contraceptive selection what would you inform this patient?
Micronor a Progestin-only oral birth control is appropriate for her
The patient should attempt lactational amenorrhea method
Xulane a combined hormonal patch would be appropriate for her
She may select whatever method she likes but she will have to stop breastfeeding
what is the maximum time frame that treatment should be initiated for EC?
72-120hrs
24-48hrs
12-24hrs
5-7days
which of the following statements about EC is FALSE
ECPs disrupt follicular by blunting the LH surge required for ovulation, resulting in anovulation or delayed ovulation
will not harm developing embryo
Treatment initiated ASAP after unprotected IC, and definitely within 120 hours
hormonal IUDs are approved for EC use
which of the following has the highest efficacy of the listed EC
Levonorgestrel only (Plan B)
Hormonal IUD
Copper IUD
Ulipristal
Your patient with a BMI of 36 presents to the clinic requesting emergency contraception which of the following will you offer to her
Ulipristal acetate (ella)
Progestin only minipills
which of the following statements are TRUE about EC?
pregnancy test is required prior to use
Combination pills preferred w/ history of thromboembolic disease
No significant interaction with antibiotics
Ulipristal: can be used for breastfeeding women
which of the following is NOT a risk factor for breast cancer?
HRT use
avoiding breastfeeding
Fibrocystic changes
obesity
which of the following is NOT a treatment option for Hidradenitis suppurativa
steroids
warm compresses
antibiotics
antibacterial soap
your 25yo 8week pp pt presents to the clinic for a breast mass that she noticed in the shower. she states that she has stopped breast feeding due to work. the mass is firm, without pain, not mobile, and does not increase in size with her menses, symmetrical and about the size of a dime. ultrasound shows that it contains fluid. which of the following is the most likely diagnosis?
Fibroadenoma
Galactocele
Fibrocystic Breast
Bartholin gland cyst
Based on United States STD surveillance data, which age group has the highest rates of infection with Chlamydia trachomatis?
males aged 15-24 years
Females aged 15-24 years
Females aged 25-40 years
males aged 25-40 years
Which one of the following best describes the most common clinical presentation of chlamydial urethral infection in males?
Yellow urethral discharge
Dysuria
Asymptomatic
Scrotal pain
appropriate first-line therapy for urogenital infection due to Chlamydia trachomatis in an adult?
Ceftriaxone 250 mg intramuscularly
Azithromycin 1 gram orally in a single dose
doxycycline 1 gram orally in a single dose
Ceftriaxone 250 mg intramuscularly in a single dose plus Azithromycin 1 gram orally in a single dose
A 26-year-old male has two new recent sexual partners and presents with urethral discharge. Which one of the following tests is preferred for detecting Chlamydia trachomatis?
Urethral swab Gram's stain
Urethral swab culture
First catch urine nucleic acid amplification test
First catch urine culture
A 19-year-old woman has Chlamydia trachomatis detected on a screening test of a self-collected vaginal swab. She has a pregnancy test, which is negative. Which one of the following medications is recommended for treatment in this case?
Doxycline 200 mg orally in a single dose
Ciprofloxacin 500 mg orally twice daily for 5 days
Azithromycin 1 g orally in a single dose
Levofloxacin 250 mg orally once a day for 5 days
best describes the clinical sign and symptoms of urethritis caused by infection with Neisseria gonorrhoeae in men?
non-healing sores
urethral discharge
asymptomatic
A 19-year-old man is evaluated in the clinic with a purulent urethral discharge. A Gram's stain is performed on a sample of the discharge. Which one of the following is most consistent with a diagnosis of gonorrhea?
Extracellular gram-positive cocci in chains
Extracellular gram-negative rods in rows
Gram-negative diplococci within white blood cells
Abundant white blood cells with no visible organisms
A 23-year-old woman is diagnosed with gonococcal cervicitis based on purulent discharge and Gram's stain findings. Results for chlamydia are pending. Which one of the following regimens is recommended?
Cefixime 400 mg orally in a single dose plus Doxycycline 100 mg twice
Ceftriaxone 250 mg IM in a single dose plus Azithromycin 1 g orally in a single dose
Ceftriaxone 500 mg IM in a single dose plus Azithromycin 1 g orally in a single dose
Cefixime 1000 mg orally in a single dose plus Doxycycline 100 mg twice daily
Which one of the following combinations of clinical and laboratory findings most accurately describes primary HSV-2 infection?
No lesions or symptoms, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present
Lesions present, symptoms usually severe, HSV-1 and HSV-2 antibodies not present
Lesions present, symptoms usually mild, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present
Lesions present, symptoms usually moderate, HSV-1 antibodies present, HSV-2 antibodies are not present
Which one of the following options is a preferred therapy for both episodic and suppressive treatment of recurrent genital herpes infections?
Topical cidofovir
Oral acyclovir
Oral valganciclovir
Topical imiquimod
Which one of the following statements about suppressive antiviral therapy for HSV-2 is TRUE?
Suppressive acyclovir therapy will cause acyclovir resistance in about 30% of patients therapy
Suppressive antiviral therapy with daily valacyclovir decreases the rate of HSV-2 transmission to susceptible heterosexual partners
Suppressive antiviral therapy reduces the frequency of genital herpes recurrences by 25%
Suppressive acyclovir therapy cannot be used in patients with renal impairment
A 38-year-old man is seen with an episode of recurrent genital herpes. Which one of the following treatment options would be considered a recommended regimen for this man in this situation?
Valacyclovir 1000 mg orally as a single dose
Acyclovir 800 mg orally as a single dose
Valacyclovir 500 mg orally twice a day for 3 days
Acyclovir 400 mg orally once a day for 3 days
Which one of the following regimens has been shown to reduce transmission of HSV in heterosexual HSV-2 discordant heterosexual couples?
Famciclovir 250 mg orally once daily taken by the HSV-seropositive partner
Famciclovir 500 mg orally once daily taken by the HSV-seronegative partner
Acyclovir 800 mg orally once daily taken by the HSV-seronegative partner
Valacyclovir 500 mg orally once daily taken by the HSV-seropositive partner
Which one of the following statements regarding anogenital human papillomavirus transmission is TRUE?
Transmission occurs predominantly via sexual activity and only in persons with visible genital lesions.
Transmission via fomites accounts for up to 25% of cases.
Use of condoms reduces, but does not eliminate the risk of sexual transmission of HPV.
Approximately 50% of mothers with genital HPV at the time of delivery transmit HPV to their newborn.
Which one of the following statements is TRUE regarding the natural history of HPV infection?
More than 90% of HPV infections are cleared within 2 years.
Persistent HPV infection consistently leads to development of HPV-related cancer within 10 years.
Clearance of HPV infection only slightly reduces a person’s risk of developing HPV-related cancer.
The average time from infection with HPV until the development of HPV-related cancer is 6.5 years.
Which one of the following statements is TRUE regarding clinical presentations of anogenital warts?
Bleeding is not a known symptom associated with anal warts
Vulvovaginal warts may cause dyspareunia, pruritus, or burning discomfort
Anogenital warts rarely regress without treatment
Anogenital warts always cause significant clinical symptoms
Which one of the following would be an indication to perform a biopsy of an anogenital wart?
A wart is larger than 3 cm
A wart is larger than 5 cm
A wart is persistently ulcerated or bleeding
A wart resolves with treatment but later returns at the same location
Which treatment is considered a recommended patient-applied treatment for external anogenital warts?
Trichloroacetic acid (TCA) 80-90% solution
Cidofovir 1% gel
Imiquimod 3.75% cream
Bichloroacetic acid (BCA) 10-20% solution
A pregnant women has multiple vulvar warts that she wants to have treated. Which one of the following choices is considered an acceptable option for this woman?
Imiquimod
Podofilox
Trichloroacetic acid
Which one of the following is TRUE regarding the HPV vaccine dosing schedule for healthy boys and girls?
Boys and girls ages 9 through 14 require only 2 doses
Boys and girls ages 17 and older require only 1 dose
Boys and girls younger than age 11 require 4 doses
Boys and girls ages 15 and older require only 2 doses
How is acute PID defined?
Acute is less than or equal to 7 days in duration
Acute is less than or equal to 30 days in duration
Acute is less than or equal to 14 days in duration
Acute is less than or equal to 21 days in duration
select The most common pathogens associated with PID, (select all that apply)
Chlamydia trachomatis
Streptococcus pneumoniae
Group B streptococcus
Neisseria gonorrhoeae
Which one of the following is considered a known chronic sequela following acute pelvic inflammatory disease (PID) in a young woman?
Cervical incompetence
Increased risk for ovarian cancer
Uterine prolapse
Infertility
Treatment Guidelines recommend presumptive PID treatment for sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more minimum clinical criteria are met. Which one of the following is included under "Minimal Clinical Criteria"?
Purulent discharge from the cervical os
Cervical motion tenderness occurring in the absence of any other explanation
Cervical petechiae without evidence of thrombocytopenia or cervical trauma
Erythema of the vaginal wall
Which one of the following statements is TRUE regarding appropriate follow-up for PID?
All women treated for PID should have a one-time visit with a reproductive health specialist
Patients should be re-examined within 72 hours after initiation of therapy
All women treated for PID should receive antimicrobial prophylaxis for major dental work
All women treated for PID should undergo yearly pelvic ultrasound every 5 years until age 45 to monitor for possible long-term sequelae
A 26-year-old woman is diagnosed with pelvic inflammatory disease. She has no antibiotic allergies. The decision is made to treat her as an out-patient. Which one of the following regimens is recommended?
Ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg twice a day for 14 days plus metronidazole 500 mg orally twice a day for 14 days
Ceftriaxone 250 mg IM in a single dose plus azithromycin 1 g orally in a single dose
Moxifloxacin 400 mg orally in a single dose plus doxycycline 100 mg twice a day for 14 days
Ceftriaxone 1 g IM in a single dose plus moxifloxacin 400 mg orally in a single dose plus doxycycline 100 mg twice a day for 14 days
A 22-year-old man is diagnosed with syphilis and condylomata lata. What is condylomata lata?
A term used to describe patients with large, irregular chancres in patients with primary syphilis.
Multiple cauliflower-like warts that emerge in secondary syphilis as a result of Treponema pallidumu
Moist, wart-like papular lesions that develop in 10-20% of patients with secondary syphilis.
A rare cutaneous disorder manifested as growths on the scalp in patients with tertiary syphilis
A 31-year-old woman had a negative screening syphilis test 9 months ago. Five months ago she developed a maculopapular rash that resolved on its own; she now has a Rapid Plasma Reagin (RPR) titer of 1:128. How would you classify the current stage of syphilis for this patient?
Syphilis of unknown duration
Late latent
Very late latent
Early latent
A 29-year-old man develops a diffuse rash 5 weeks after having sexual contact with a new male partner. Testing for syphilis shows a positive Venereal Diseases Research Lab (VDRL) test of 1:256. He is diagnosed with secondary syphilis. He does not have any antibiotic allergies. What is the recommended treatment for this patient?
Azithromycin 1 g orally as a single dose
Benzathine penicillin G 2.4 million units IM in a single dose
Ceftriaxone 1 g IV as a single dose
Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1-week intervals
Which one of the following best describes a primary syphilis (chancre) lesion?
A painless, well-circumscribed ulcer that has a clean base and persists for 1 to 6 weeks
Multiple painful shallow ulcers that have an erythematous base and persist for 3 to 4 days
A large serpiginous ulcer that has a soft, beefy edge and persists for 2 to 4 days
A painful soft ulcer that persists for 2 to 4 days
Which one of the following is TRUE regarding a definition of latent syphilis?
Late latent refers to syphilis infection of at least 1 year in duration
Early latent refers to syphilis infection of less than 6 weeks in duration
Late latent refers to syphilis infection of at least 5 years in duration
Early latent refers to syphilis infection of less than 12 weeks in duration
A 24-year-old man presents with a diffuse macular and papular rash on his chest, back, hands and feet. He had 2 new male sexual exposures approximately 6 weeks ago. He now has a positive Venereal Diseases Research Laboratory (VDRL) test with a titer of 1:256. He had a negative syphilis test about 3 months ago. He has no other symptoms and his neurologic examination is normal. He has no known antibiotic allergies. What treatment is indicated?
Benzathine penicillin G 2.4 million units IM weekly for 3 total doses
Doxycycline 200 mg twice a day for 3 days
What is the normal vaginal pH in most healthy women?
Acidic, between 3.8 and 4.5
Acidic and less than 2.2
Alkaline, between 5.8 and 6.2
Alkaline and greater than 6.2
Which of the following is the most common cause of vaginitis in reproductive-aged women?
Candidiasis
Trichomoniasis
Bacterial vaginosis
Atrophic vaginitis
What is the most likely diagnosis based on the following criteria: pH 5.0; clue cells greater than 20% per high power field, potassium hydroxide (KOH) "whiff test" positive with an fishy odor, and homogenous discharge?
Chlamydia
Which one of the following is a recommended treatment regimen for non-pregnant women with symptomatic bacterial vaginosis?
Metronidazole 2 grams orally in a single dose
Metronidazole 500 mg orally twice a day for 7 days
Tinidazole gel 0.75%, 5 grams intravaginally as a single application
Clindamycin 300 mg orally twice a day for 14 days
Which one of the following best describes the signs and symptoms of trichomoniasis in women?
Dysuria, itching, and thin milky white vaginal discharge
Foul, fishy odor and thick, clumpy white vaginal discharge
Asymptomatic, or frothy gray or yellow-green vaginal discharge
Mucosal ulcerations associated with pain and radicular symptoms
Which one of the following adverse clinical outcomes is associated with Trichomonas vaginalis infection in women?
Ectopic pregnancy
Ovarian cancer
Premature rupture of membranes and preterm labor
Which one of the following is considered a preferred regimen for the treatment of trichomoniasis in a 28-year-old woman who is not pregnant and has not antimicrobial allergies?
Metronidazole 500 mg orally in a single dose
Amoxicillin 500 mg three times a day for 5 days plus metronidazole 500 mg twice a day for 5 days
Tinidazole 2 grams orally in a single dose
Doxycycline 100 mg twice a day for 3 days plus metronidazole 500 mg twice a day for 3 days
Which one of the following women would be considered to have complicated vulvovaginal candidiasis?
a 67-year old woman
A 29-year-old woman with three episodes of vulvovaginal candidiasis in 1 year
34-year-old woman with diabetes mellitus
diagnosed in a woman who has experienced symptoms for 8 days
A 29-year-old woman with a malodorous, homogenous gray vaginal discharge is diagnosed with bacterial vaginosis. She is not pregnant. What is the recommended treatment for this woman?
Clindamycin 450 mg three times a day for 7 days
Doxycycline 100 mg twice a day for 7 days plus Clindamycin 450 mg three times a day for 7 days
Doxycycline 100 mg twice a day for 7 days
A 30-year-old woman is 28 weeks pregnant and presents with severe vulvar itching and burning, along with thick white clumpy vaginal discharge. Which one of the following is a recommended regimen for this woman?
Clotrimazole 1% cream 5 g applied intravaginally daily for 7 days
Fluconazole 150 mg orally in a single dose
Fluconazole 150 mg orally once daily for 7 days
Clotrimazole 500 mg orally once
what should be done for a 36yo woman complaining of diffused breast tenderness who has had a normal screening mammogram result 6 months ago?
diagnostic mammogram
Supportive, soft bra (sports bra)
Decrease caffeine intake
Decrease salt, particularly 2 weeks before menses
your 34yo pt calls with complaints of breast/nipple pain only on the left with a clear, sometimes blood streaked discharge. she has had her mammogram this year with normal findings. what is the best thing to be done with this pt?
that it is likely benign causes, follow up in 3 months
it is a benign Intraductal papilloma that should be left in place
you should assess for recent trauma to that side
ductogram/possibly MRI
You're breastfeeding patient calls complaining of painful red left breast that is hot to the touch, she states that she feel terrible, and that her temp this morning was 101.5 before taking Tylenol, what should be prescribed for this pt?
doxycycline 500 mg 2 times per day for 5-14 days
Keflex 500 mg 1 time a day for at least 3 days.
Dicloxacillin 500 mg 4 times per day for 5-14 days
doxycycline 125mg 4 times per day for 5-14 days
select the TRUE statement about Breast cancer(select all that apply)
1 in 8 lifetime risk of breast cancer
80% of women who develop breast CA have no FH
2nd leading cause of death among women ages 40-59
80% of breast CA lumps occur in the upper outer quadrant of the breast
98% of breast cancers are PAINLESS
what are the most dangerous types of HPV
6, 11
16, 18
8, 19
16,17
