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AGNP 1 > Exam 1 - GI, GU, STI > Flashcards

Exam 1 - GI, GU, STI Flashcards

1
Q

3 signs and symptoms of acute appendicitis

A
  1. Pain starting in epigastrium with migration to LLQ
  2. Abdominal rigidity
  3. Acute onset
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2
Q

Where is McBurney point

A

Area between the umbilicus and anterosuperior iliac spine

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3
Q

After acute onset pain from appendicitis, symptoms

A
  1. Anorexia
  2. N/V
  3. constipation
  4. Rarely diarrhea
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4
Q

What is rovsing sign

A

Palpate LLQ and illicit RLQ pain

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5
Q

What is obturator sign

A

Flex knee and hip, internally rotate, illicit pain

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6
Q

What is psoas sign

A

Raising straight and right leg against resistance, elicits pain

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7
Q

What are the 2 most common causes of peptic ulcers

A
  1. H pylori
  2. NSAIDs
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8
Q

2 Most common presenting symptoms of PUD

A
  1. Dyspepsia
  2. Epigastric pain
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9
Q

3 types of medication treatments for PUD

A
  1. H2RA antagonist (-tidine)
  2. PPI (-prazole)
  3. Prostaglandin therapy (misoprastol)
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10
Q

H pylori treatment for patients with risk factors for macrolide resistance

A

Bismuth quadruple therapy - bismuth, metronidazole, tetracycline, PPI

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11
Q

H. Pylori treatment in patients without risk factors for macrolide resistance

A

Clarithromycin based triple therapy - clarithromycin, amoxicillin, PPI

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12
Q

What is the most common reason for GERD

A

Transient lower esophageal sphincter relaxations (TLERs)

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13
Q

7 types of medications that lower esophageal sphincter tone

A
  1. Anticholinergics
  2. Morphine
  3. Theophylline
  4. Calcium channel blockers
  5. Nitrates
  6. Benzodiazepines
  7. Aspirin
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14
Q

What is 1st line treatment for GERD

A

Antacids, alginic acid, or H2RAs taken PRN

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15
Q

What is the criteria for starting 2nd line therapy for GERD

A

More days than not without symptoms, ex 4 or more days per week

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16
Q

What is treatment for moderate to severe GERD or GERD without any complication

A

PPI therapy - once daily for 8 weeks

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17
Q

What would u do if a patient only partially responded to a PPI

A

A dosage increase or change in PPI

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18
Q

What is phase 1 of constipation management

A

Lifestyle - diet, exercise, increase fiber, increase fluids

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19
Q

What is phase 2 of constipation management

A

Bulk forming laxatives - ex. Metamucil

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20
Q

What is phase 3 of constipation management

A

Stool softeners - ex. Colace

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21
Q

What is phase 4 of constipation management

A

Osmotic laxatives - ex. Mom, poylethylene glycol, lactulose

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22
Q

What is phase 5 of constipation management

A

Stimulant laxatives - ex. Senna, bisacodyl

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23
Q

What is phase 6 of constipation management

A

Intestinal secreatagogues - ex, lupiprostone, linaclotide

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24
Q

What is phase 7 of constipation management

A

Enemas/suppositories

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25
Which medication should not be given to pregnant women for constipation
Lubiprostone
26
Med Treatment for mild diverticulitis outpatient (there’s 2)
Cipro 500mg q12 or metro 500mg q8 or both for 7-14 days
27
What is Charcot triad and which duct is affected
RUQ pain, fever, jaundice - common bile duct
28
What is biliary colic and how does it present
Epigastric or RUQ pain for 30-60 min, cystic duct affected
29
What is +Murphy’s sign
Ask pt to exhale then palpate under right rib cage and ask to inhale. If pain with palpation it is positive for cholecystitis
30
Normal ph of vagina
3.8-4.5
31
What might an elevated ph of vagina indicate
BV
32
What might a ph less than 4.5 indicate
Yeast infection
33
Is BV symptomatic or asymptomatic
Most often asymptomatic
34
Type of discharge with BV
Heavy thin/grayish/yellowish/white malodorous
35
What are the 4 Amsels criteria for BV (need 3/4 to diagnose)
1. PH greater than 4.5 2. Clue cells 3. Amine odor, *whiff test 4. Homogeneous discharge (thin, white coats the walls)
36
Recommended treatment for BV (there are 3)
1. Metronadizole 500 PO BID for 7 days 2. Metronidazole gel 0.75% intravag daily for 5 days 3. Clindamycin cream 2% intravag qhs for 7 days
37
Treatment of BV in pregnant women (3 options)
1. Metronidazole 500 PO BID for 7 days 2. Metronidazole 250 PO TID for 7 days 3. Clindamycin 300 PO BID for 7 days
38
What do you give for recurrent BV treatment
Boric acid NOT PO
39
What is most often the cause of VVC (yeast infection)
Candida albicans
40
What kind of discharge present in yeast infection
Thick, non odorous, clumpy
41
Recommended treatment for VVC in pregnancy
NOT ANYTHING PO. Only topical azole therapy for 7 days
42
Uncomplicated VVC treatment
Oral fluconazole 150 PO for 1 dose and topical azole for 1-14 days
43
Complicated VVC treatment
Oral fluconazole 150mg on day 1 and 3 and topical azole for 1-14 days
44
How many times per year is considered recurrent candida
3 or more infections in 12 months
45
Should partner be treated for VVC
No - unless they have balanitis x- treat with topical antifungal
46
Do the majority of people have trichomonas symptoms
No - 70-85% have minimal to none
47
What type of discharge associated with trichomonas
Yellow-green, Frothy, profuse
48
What is the characteristic sign of trichomonas on cervix
Cervical petechiae “strawberry cervix”
49
What kind of ph would you see on a wet mount for trichomonas
Greater than 4.5
50
Recommended treatment for trichomonas among women
Metronidazole PO 500mg BID for 7 days
51
Recommended treatment for trichomonas among men
Metronidazole PO 2g in a single dose
52
How long after trichomonas treatment should re-testing occur
3 months
53
What classifies a UTI as recurrent (2 options)
1. Greater than or equal to 2 infections in 6 months Or 2. Greater than or equal to 3 infections in 1 year
54
Which medication not to be used during last trimester for UTI
Nitrofurantoin
55
1st line tx for UTI in pregnancy
Amox/amp/augmentin TID for 7-14 days
56
What is cremasteric reflex
Stroke inner thigh - normally testes should elevate on ipsilateral side
57
What is prehns sign
Elevation of scrotum causes pain relief (positive) - sign of epidydymitis
58
What is the causative agent for chlamydia
Bacteria - chlamydia trachomatis
59
What is the other type of STD caused by c. Trachomatis and what does it cause
Lymphogranuloma venereum - proctitis
60
1st line treatment for chlamydia
Doxycycline 100 mg PO BID for 7 days
61
What is the causative agent for gonorrhea
Neisseria ghonnorrhoeae - bacteria
62
Which 2 STDs do you treat for together in most cases
Gonnorrhea/chlamydia
63
Treatment for gonnorhea (2 types based on weight)
Ceftriaxone 500mg IM for less than 150 kg 1G for greater than 150 kg
64
Which HPV strains cause the highest risk of cervical cancers
16 & 18
65
Which HPV strains cause 90% of genital warts
6 & 11
66
How many HPV vaccines required for someone older than 15
3
67
HSV treatment for initial outbreak
Either acyclovir, famciclovir, or valacyclovir in different concentrations, varying frequencies based on dosage, for 7-10 days
68
What frequency of outbreaks warrants HSV suppressive therapy
Greater than 4 clinical infections in 12 months

AGNP 1 (2 decks)

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