MISC 1
Mention two scenarios in which cefazolin should be redosed during the surgery ?
EBL > 1500mL
> 4hrs of surgery
Which is the most and least effective tubal ligation technique?
Bipolar electrocautery 3.2-6.3
Spring clips 36.5
Recommended Daily intake of Calcium and Vitamin D for patient > 65 yo
Calcium 1300 mg
Vitamin D 600 IU ; > 70 y/o 80 IU
How many doses of human papillomavirus vaccine are necessary prior to the age of 15?
What is the schedule time of each doses ?
two dose
0 , 6-12 months apart
The USPSTF recommendations on Chlamydia and Gonorrhea testing?
screening is recommended for all sexually active women aged 13 to 24 years and for those older than 24 years who are at increased risk.
What is the most common cause of cuff cellulitis?
Gardnerella vaginalis
A 57 yo female report ongoing vulvar itching . Examination at her visit 6 weeks ago revealed findings consistent with lichen sclerosus and she was treated with topical clobetasol and given hygiene recommendations. At today's visit , she says her symptoms have persisted despite having used the medications? What is the best next step ...
biopsy
At what chronological age does a woman obtain maximum bone density?
19 year old
A healthy 55-year-old woman presents for her routine annual exam. She reports she is up-to-date on her screening mammogram, colonoscopy, and pap smear, but she is unsure of her vaccination schedule. When would you recommend that she receive the pneumococcal vaccination?
65 y/o
When is recommended to start cervical cancer screening started in HIV patients ?
21 y/o
When is risk reducing BSO offered to patients with BRCA1/2 mutations?
RISK REDUCING BRCA 1 35- 40 y/o
RISK REDUCING BRCA 2 40-45 y/o
What are the components of cryoprecipitate?
fibrinogen, Factor V, VIII and XIII, VWF
Increase fibrinogen by 10-15mg/dL
With what FRAX score is DEXA recommended in women < 65 yo ?
Women < 65 yo DEXA is indicated either in the presence of risk factors for accelerated bone loss or if a fracture risk assessment tool (FRAX) score for fracture is 9.3% or higher.
When is the Shingles vaccines recommended?
Shingrix (recombinant zoster vaccine) should be administered to immunocompetent adults aged 50 years and older
≥19 years who are or will be immunodeficient or immunosuppressed because of disease or therapy
two-dose series 2 to 6 months apart (0; 2-6 months)
A 23-year-old woman presents to your office to establish care. She was diagnosed with ulcerative colitis 2 months ago. When should screening colonoscopy for colorectal cancer commence?
8 years of the disease onset
Bonus: when is colonoscopy recommended in the general population ?
A patient presents with difficulty rotating and adducting her thigh after hysterectomy. Which nerve was injured?
Obturator
You see a patient for a postop visit after TAH-BSO at age 52. She tells you she remembers having a colpo with CIN1 a few years ago. Her last pap prior to hysterectomy was normal. How long should she continue screening? How does your recommendation change if she had a history of CIN3 immediately prior to her hysterectomy?
In women who have had a hysterectomy with removal of the cervix (total hysterectomy) and have never had CIN 2 or higher, routine cytology screening and HPV testing should be discontinued and not restarted for any reason.
Women should continue to be screened if they have had a total hysterectomy and have a history of CIN 2 or higher in the past 20 years or cervical cancer at any point.
The risk of Hip fracture and major osteoporotic based on the FRAX tool for osteopenic patients that would warrant treatment ?
3% Hip Fracture
20 % Major osteoporotic fracture
A 31-year-old G2P1001 at 39 weeks 2 days presents to labor and delivery in labor. She recently was infected with the chicken pox. What is the maximum number of days before delivery that the presence of maternal symptoms would necessitate a recommendation of administering the varicella-zoster immune globulin to her baby?
5 days and 2 days after delivery
Breast Cancer screening in BRCA 1/2 patients?
For women aged 25–29 years with known BRCA mutations, recommended breast cancer surveillance includes clinical breast examination every 6–12 months and annual radiographic screening (preferably, magnetic resonance imaging [MRI] with contrast)
For women aged 30 years and older with known BRCA mutations or other actionable breast cancer mutations, recommended breast cancer surveillance includes annual mammography and annual breast MRI with contrast, often alternating every 6 months
What time frame should elapse before a patient can be considered to have a "new visit"
3 years
When is screening for lipid disorders recommended in women ?
Lipid abnormalities screening is advised to be undertaken once in children aged 9–11, young adults aged 18–21, and after the age of 40 then every 5 years.
USPTF 20-45 Y/O women with increased risk of coronary heart disease
Which biphosphonate decrease the risk of non vertebral and hip fractures respectively?
risedronate reduces the risk of non-vertebral fractures
alendronate and zoledronic acid significantly decrease incidence of hip fractures specifically
Which three recommended vaccines should be given to most susceptible women before or after pregnancy, but should not be given during pregnancy?
Varicella, measles-mumps-rubella, and human papillomavirus
What is the definition of metabolic syndrome?
1. Elevated waist circumference
(>88cm, ≥35 inches)
2. Elevated Triglycerides ≥150mg/dL
3. Reduced HDL < 50mg/dL
4. Elevated BP (mmHg) ≥130 systolic ≥85 diastolic
5. Elevated Fasting Glucose ≥100mg/dL
3/5 required for diagnosis