AANP U WORLD Flashcards
Post partum depression timeline
4-6 weeks
MUST have >/= 2 weeks of SIGECAPS
Treatment of N/V in pregnancy –> 1, 2, 3, 4
Dietary changes
vitamin B6, H1 antihistamine
Oral dopamine and serotonin antagonists
N/V with > 5% body weight loss from prepregnancy weight
Hyperemesis gravidarum
RF for hyperemesis gravidarum
multiple gestation
migraines
GERD
Target BG levels in pregnancy :
Fasting
1 hour postprandial
2 hour postprandial
Fasting -
Intrahepatic cholestasis in pregnancy treatment
delivery at 37 weeks
Ursodeocholyic acid
Antihistamines
When to screen for asymptomatic bacteriuria in pregnancy
12-16 weeks gestation
Does test of cure need to be completed for pregnant people w/ UTI?
yes, 1-2 weeks following treatment
magnesium toxicity symptoms
loss of DTR and reduced RR
Cervical cancer screening age
> 21
Pain w/ in first 2-3 days of menses
N/V/D
Normal pelvic exam
Primary dysmennorhea
Annual chlamydia screening in what age group?
< 25 years
Pattern of angry irritable mood and argumentative behaviours towards authority. No stealing or aggressive violations of others
ODD
DIGFAST mneumonic for mania
Distractibility Impulsivity Grandiosity Flight of ideas Activity increased Decreased need for sleep Talkativeness/pressured speech
Adult version of CD that requires evidence before age 15
Antisocial personality disorder
A 1 time hep c screening is reccomended for adults ages ___ to ____
18-79 years
What is a fibroadenoma?
Benign breast lump commonly occuring in upper outer quadrant, rubbery mobile and well circumscribed that decreases in size after menses
U/S indicated if < 30 years and ? aspiration if > 5 cm or persistent lesions
Raw scaly vesicular lesion to nipple and spreads to areola of 1 breast
Pagets disease
Diagnosis of pagets disease of the breast
Skin biopsy
Bilateral diagnostic mammogram +/- US
Screening for BRCA1 & 2
at 30 yrs or 5-10 years before first diagnosis of breast or ovarian cancer
Palpable ovary in menopausal woman
Always abnormal - rule out ovarian cancer –> pelvic/intravaginal ultrasound and referral to gyne
When to perform PAP test:
1) during menstrual cycle
2) 10-20 days after menses
3) following douching or intercourse
2)
HPV testing
30-65 every 5 years if cotesting w/ HPV or PAP every 3 years if not co-testing
For pts age 21-24 w/ LSIL PAP result –>
Repeat PAP in 12 months
For pts w/ LSIL 25-29 years
Follow up colposcopy w/ cervical biopsy
If endometrial cells are seen in PAP test –> next steps
refer for endometrial biopsy
Progestin oral pills how to take
When backup is needed for 48 hours
Same time each day
If missed dose >/= 3 hours
CI to oral contraceptives
DVT/VTE, smoking > 35 years (> 15 cigarettes per day), migraine w/ aura, hx or current breast ca, uncontrolled HTN (> 160/100), liver disease Known or suspected CVD Known or suspected pregnancy Undiagnosed PV bleeding < 21 days post-partum
When starting COC how long to use backup
7 days
Follow up after starting COC
2-3 months to check BP
Missed 1 day of COC
take 2 pills/ double up
Missed 2 consecutive days
take 2 pills the next 2 days to catch up and use condoms during current pill cycle
Drug interactions w/ COC
anticonvulsants, antifungals, abx - ampicillin/tetracyclines/rifampin, st johns wort - BTB
CI to IUD
PID Confirmed pregnancy STI Uterine or cervical abnormality (ie. bicornate uterus) Undiagnosed vag bleed Hx of ectopic pregnancy
What contraceptive should be avoided in women that want to become pregnant in 12 months
Depo provera
How long can you wear cervical cap
72 hours
How long should diaphragm be left in vagina after intercourse
6-8 hrs
What form of contraceptive has higher level of estrogen than COC
patch
Ovulation may not occur for few weeks to 12 months after removal of this contraceptive option
Implant
How long is implanon/Nexplanon used for
3 years
Plan B - how to take if 2 pills and when to follow up
take 1st pill w/ in 72 hours and 2nd pill 12 hours following
Evaluate for pregnancy, spontaneous abortion or ectopic pregnancy if normal (expected) menstrual period is delayed for ≥1 week following emergency contraception, or if lower abdominal pain or persistent irregular bleeding develops `
Missed abortion
Asymptomatic w/ closed cervix
class of medication of flomax/tamosulin
alpha 1 blocker
What medication for HTN slow calcium loss by stimulating osteoclasts
HCTZ
Normal JVD
< 4 cm
ABI score is diagnostic
< 0.9
