Adolescent/Gynecology Flashcards
Inability to maintain healthy body weight
Anorexia nervosa
Diagnostic criteria for anorexia nervosa
1) distorted body perception
2) restriction of energy intake
3) intense fear of gaining weigh
Highest fatality rate of any mental health disorder
Anorexia nervosa
Binge eating with Compensatory mechanism
Bulimia nervosa
Binge eating without compensatory mechanism
Binge eating disorder
When parental consent is not required
Life threatening emergencies
Medical care during pregnancy
Treatment for STI
Treatment for substance abuse
Emancipated minor
Onset of menses
2 years after thelarche
After peak height velocity
SMR stage 3 or 4
White odorless mucous discharge that precedes menarche by 3-6 mo
Treatment
Physiologic leukorrhea
No intervention
First Pap smear
21 yo
Lack of menses by age 15
Or 3 years following breast development
Primary amenorrhea
3 mo amenorrhea after onset of menses
Secondary amenorrhea
Amenorrhea
DUB
obesity
Hirsutism
Acne
Elevated testosterone levels
Management
Polycystic ovary disease (PCOS)
Diet/exercise
Low androgen OCP
Spironolactone
Metformin for obese
Female athletic triad
Amenorrhea
Osteoporosis
Disordered breathing
Management for female athletic triad
Increase caloric intake
Reduction in training intensity
Calcium supplements
Smoking cessation
NOT OCPs
Etiology of primary dysmenorrhea
Management
Prostaglandins produced during ovulation cycle
NSAIDs
Management for labial adhesions with Dysuria or secondary bacterial infection
Estrogen cream
Full sexual maturity
No menarche
Cyclical abdominal pain
Abdominal mass
Bluish bulging hymen
Imperforate hymen
Abdominal pain
No palpable midline mass
Turbo-ovarian abscess
Vaginal irritation
Pain
Pruritus
Dysuria
Vulvovaginitis
Non sexually transmitted causes of vulvovaginitis
Enterobius vermiculariS
GAS
Staph
Candida
sexually transmitted causes of vulvovaginitis
Gonorrhea
Chlamydia
Trichomonas
HSV
Milk curd discharge
Itchy
Management
Candida vaginitis
Topical clotrimazole
Malodorous
Fishy
Amine odor
“Whiff test”
Clue cells
Management
Bacterial vaginosis
(Gardenella vaginalis, ureaplasma, mycoplasma hominis)
Metronidazole
Diagnostic criteria for bacterial vaginosis
Copious grey-white vaginal discharge
Vaginal pH > 4.5
Clue cells
Fish odor on KOH
Flat papular warts
Pedunculated
Sexual contact
Management
Condyloma acuminata
(HPV)
Chemical cauterization
(Podophyllin or podofilox)
Diagnostic evaluation for HSV
Viral culture
Red crusted suprapubic macules
Blue-gray dots (maculae cerulae)
Slow/sluggish
Management
Pediculosis pubis (pubic lice)
Permethrin
Most prevalent no viral STD in US teens
Trichomonas vaginalis
Burning. Itching
Abnormal vaginal odor
Dyspareunia
Flagellated organisms
Frothy yellow discharge
Strawberry cervix
Management
Trichomonas vaginalis
Flagyl
Abstinence until both partners are treated
Repeat test 3mo later
Most common reportable STD
Chlamydia trachomatis
Treatment for chlamydia
Doxycycline x 7 days
Or
Azithromycin 1g x 1
Lower abdominal pain
Shuffling gait
Cervical motion tenderness
Pelvic inflammatory disease
Most appropriate STI screening for asymptomatic sexually active person
Urine PCR Chlamydia and gonorrhea
Serum HIV and syphilis
Treatment for gonorrhea STI
ceftriaxone IM x 1
<150 kg: 500mg
>150 kg: 1g
RUQ pain
Sexually active
Fitz-high Curtis syndrome
(Perihepatitis)
Unilateral abdominal discomfort
Fluid filled ovarian cyst
Management
Ovarian cyst
<6cm: f/u US
>6cm or Sx: laparoscopic cyst aspiration
Sudden lower abdominal pain
Radiates to back, side, groin/leg
N/V
Ovarian torsion
Definition of abnormal uterine bleeding
Occurs in cycles < 20 days or > 45 days apart
Lasts > 7 days
Large amount of blood loss per episode
(>80mL or > 10 saturated pads/tampons per day)
Disulfiram-like reaction
Alcohol + metronidazole
Large LAD in groin
“Groove” sign
Management
Lymphogranuloma venereum
(Chlamydia trachomatis)
Doxycycline 100mg PO BID x 3 wks
Pituitary infarction (necrosis)
Postpartum hemorrhage/shock
Hypopituitarism
Sheehan Syndrome
(Postpartum hypopituitarism)
