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PNP II > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Disequilibrium, unsteadiness (can be uni-/bilateral)

Vertigo, nausea

A

Vestibular Ataxia

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2
Q

Patho of Vestibular Ataxia

A

Drugs & Alcohol are most common

Menieres Disease: unilateral symptoms

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3
Q

Wide-base steps

Drunk appearance

A

Truncal or gait ataxia (vermic cerebellar lesions)

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4
Q

Dysmetria (poor judge of distance-finger nose test)
Dysdiadochokinesia (deficit in patterned movements - clap/slap test)
Variation in speech (amplitude, speed)

A

Appendicular Ataxia

hemispheric cerebellar lesions

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5
Q

Postural instability

Impaired eye movement control

A

Vestibulocerebellar (flocculonodular) Ataxia

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6
Q

Patho of Cerebellar Ataxia

A

Stroke, deymyelination, tumors, genes, and SUDs can all be causes

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7
Q

Inability to stand with eyes closed (negative Romberg sign)

Stumble in the dark

A

Sensory Ataxia (proprioceptive deficit)

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8
Q

Patho of Sensory Ataxia

A

Inflammation, deymyelenation, vitamin deficiencies, infections, inherited disorders

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9
Q

Hypotonia w/ hx of birth depression, seizures, or encephalopathy
Fisting past 3 months

A

CNS lesion in the newborn

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10
Q

Hyptonia w/
Hx of Breech presentation
Global Developmental Delay
Early Handedness

A

Upper motor neuron lesion

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11
Q

Hypotonia
Weakness
Age-Appropriate Cognition

A

Peripheral nervous deficit

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12
Q 
Multiorgan involvement
Feeding issues
Breathing issues
Family history
Dysmorphic features
A

Points of assessment useful in diagnosing Hypotonia, when Neuromuscular presentation is vague

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13
Q

Leg scissoring in vertical suspension

A

Lower Motor Neuron Lesion

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14
Q

Sensory-level hypotonia w/ bladder/sphincter abnormalities

A

Spinal cord lesion

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15
Q

Depressed/absent DTRs

A

Peripheral lesion

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16
Q

Fasciculations

A

Motor unit lesion

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17
Q

Primitive reflex deficit

A

PNS deficit

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18
Q

Causes of IICP

A

Trauma
Tumors
Severe URI/Gastric Infections (Meningitis)

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19
Q

Irritability, feeding problems, and/or inconsolable and/or high-pitched crying, tense/bulging fontanels, separated sutures, setting sun sign, bulging scalp veins

A

IICP presentation in infants

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20
Q

Best circumstance under which to assess fontanels/sutures

A

Calm baby, or between sobs of a crying baby

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21
Q

Irritability, hands on head, vomiting w/ or w/o nausea

A

Headache presentation in toddlers

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22
Q

Headache, vomiting w/ or w/o nausea, diplopia/blurred, inability to follow instructions, somnolence seizure activity

A

IICP presentation in toddlers/young children

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23
Q

Headache:
Wakens from sleep
Vomiting w/o nausea
Pain increases w/ pressure: Strain, Sneeze, Cough
Occipital/neck pain
Cognitive, personality, behavioral changes
Sz
Instability of thought (schizoid behavior)

A

Red Flags for Tumor or Pathology

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24
Q

Triad of headache, N/V, imbalance

+ early morning vomiting

A

Posterior fossa tumor

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25
Q 
Papilledema
Nystagmus
Gait, motor changes
Arrest of pubescence/growth
1. Abrupt onset, severe HA
Pattern changes to chronic progressive
A

Indications for imaging in patients with headache

1. Emergency, send to ER

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26
Q

Migraine Prevention

A

Lifestyle: hydration, exercise, sleep, diet, and stress management

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27
Q

Hydration for Migraine Prevention

A

1 oz/lb max 100; no artificial sweeteners

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28
Q

Exercise for Migraine Prevention

A

3+ days/week x 30 minutes

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29
Q

Sleep for Migraine Prevention

A

11-12 hours for infant & young
10-11 for school-age
8-10 for teens, regularity is key

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30
Q

Pharmacological Treatment of Migraine

A

High-dose: 10 mg/kg up to 800 mg ibuprofen Q6 oral, take at first sign of migraine or aura;
Goal: abort
NSAIDs, NOT acetaminophen, especially Tylenol

Imitrax (sumatriptan) intranasally (5-10) or PO (11+)

Prophylaxis: Topamax, Elavil, Periactin, propranolol (not if asthmatic)

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31
Q

Daily, non-progressive headaches (chronic daily headaches) with intermittent spikes between periods of complete normalcy
moderate to severe
Worsened by activity
Throbbing

A

Migraine

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32
Q 
Chronic daily, "tight" or "pressure" mild-moderate headaches:
without spikes
possible vision changes
do not respond to triptans
Not worsened by activity
Non-throbbing
1. Bilateral, vague presentation
2. Ipsilateral, focal presentation
Photophobia, phonophobia, or neither, not both
A
  • Tension headaches*
    1. adolescents & adults
    2. children
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33
Q

Sudden onset headaches followed by chronic daily recurrence is likely due to

A 
Viral infections (meningitis, encephalitis, etc) or
Injury (SAH, SDH, concussion, etc)
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34
Q

Headache with tender sinuses on exam

A

Sinusitis/sinus headache

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35
Q

Sharp recurrent pain localized to the orbital region

A

Cluster headache

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36
Q

Types of disability brought on by IM or CDH

A

Intermittent Migraines or Chronic Daily Headaches:
Absenteeism: School, Summer activities
Presenteeism: Drop in grades; There, not participating

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37
Q

Treatment plans for pediatric migraines

A

One for home, and one for school; involve teachers/school nurse staff

Imitrax (sumatriptan) intranasally (5-10) or PO (11+)

Prescribe with adherence in mind, who is administering meds?

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38
Q

Migraine Prophylaxis

A

Journal: patterns to inform need for/effectiveness of prophylaxis (even if just a week)

Topamax, Elavil, Periactin, propranolol (not if asthmatic)

OTC: K, Mg(O), B2, melatonin

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39
Q

Migraine Referral

A

Imaging is needed
6 mo. persistence through standard treatment (LSM & abortive)
Worsening disability (ab-/presenteeism)

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40
Q

CDH Management

A 
Imaging? (Pattern changed to CD)
ID subpattern (TM, CTT, new daily persistent)
Stop overused meds
Healthy habits/non-pharm
School connection
Pharm (abortive)
Psych assessment/Tx
Need for referral?
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41
Q
  1. Paroxysmal abdominal crampy/dull pain lasting 1+ hours, ages 7-12, lasting up to 72 hours; hx of motion sickness; resolves with sleep. Repeated episodes (2+) separated by weeks-months. 2+ of headache, photophobia, N/V, loss of appetite, pallor
  2. Sudden vertigo in toddlers/young children; pallor; irritability; wide, unstable gait; nystagmus, vomiting; resolves with sleep; normal ECG
  3. Recurrent vomiting (6/hour; 25 total on average), discreet, hours-days, can be assoc. with 1; 2.5-3 years old; exhaustion/fatigue, pallor, abdominal pain
    All with symptom-free intervals, and possibly alongside headache
A

Migraine Variants in Children, History of Migraine is at least supportive if not necessary for diagnosis

  1. Abdominal migraine
  2. Benign Paroxysmal Vertigo
  3. Cyclic Vomiting Syndrome
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42
Q

When to refer for CVS

A

Severe dehydration/electrolyte imbalance
Hematemesis
Weight loss

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43
Q

What history questions are relevant to a child presenting with a headache?

A 
Onset time of HAs?
Location on head?
Duration of HAs?
Characteristics of pain?
Alleviation of HA? Aggravation/triggers?
Related symptoms: nausea, light/sound sensitivity, Sz?
Temporal pattern, frequency? Prodrome? Present in AM
Severity: wakens you from sleep?
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44
Q

Headache types:
Chronic, recurrent, frontal, throbbing, anytime, varied frequency, hours-days, nausea w/o vomiting, aura, photophobia & phonophobia
or
> 6 mo, daily, temporal, squeezing, anytime, varied frequency, hours-days, nausea w/ vomiting, aura, photophobia w/o phonophobia
vs

A

Primary headache

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45
Q

Subacute, progressive, posterior, pressure-type pain, waking, constant, nausea w/ vomiting, diplopia, phonophobia w/o photophobia
OR
Acute, progressive, posterior, pressure-type pain, early-morning, constant, vomiting w/o nausea, and diplopia

A

Secondary headache

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46
Q

Management of Anaphylaxis

A

Remove/discontinue trigger

1: 1000 epinephrine solution
- 0.01 mg/kg; max: 0.5 mg
- Autoinjector:
- > <25 kg children - 0.15 mg dose
- > >25 kg: 0.3 mg dose

Diphenhydramine 1-2mg/kg up to 50 PO, IM, IV

Bronchodialators (albuterol 0.5 jet neb) if wheezing

Serum Tryptase positive after three hours, only test if diagnosis is in question

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47
Q

Biphasic Reaction Treatment notes

A

Carry 2 doses of the autoinjector: suboptimal reponse/progressing symptoms take second dose
Preferred over adjunctive therapies

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48
Q 
local redness/erythema
abd tenderness
watery eyes
hives
(wheezing)
A

Wasp/Bee Sting - Severe

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49
Q

Wasp/Bee Sting - Severe - Treatment

A

Anaphylaxis management

Epinephrine IM immediately
Oral diphenhydramine
Bronchodialators (albuterol 0.5 jet neb) if wheezing

50
Q

Animal bite concerns

1. open, gaping, evolving

A
  1. Irrigate (animal or human) w/ >5 psi NS
51
Q

Early Lyme/Late Lyme Disease Diagnostics, Treatment

A

Serum Lyme Ab Assay, Amoxicillin or Doxycycline (late: consult with ID)

52
Q

Lyme Arthritis w/o evidence of CNS involvement treatment

  1. Joint swelling or persistant
  2. Second line treatment
A

doxy, amox, cefuroxime PO x 2 weeks

    • 4 weeks
  2. 2-4 weeks IV ceftriaxone
53
Q

ITP patho

A

Bleeding disorder: platelets < 100,000 w/ otherwise WDL CBC
Follows viral infection
Autoimmune destruction of platelets (spleen)

54
Q

Bruising, petechiae; negative for splenomegaly or hepatomegaly

A

ITP

55
Q 
Purpura w/o thrombocytopenia
abdominal pain
arthritis
GI Bleed
[orchitis, nephritis, preceded by URI, Low fever (<38), recurrent]
A

HSP

56
Q

HSP Treatment

A

Most: self-limiting, supportive symptom treatment only

57
Q

Iron Deficiency Anemia Prevention, Treatment, and Follow-up

A

Exclusive breastfeeding: 1mg/kg/day of supplemental iron STARTING AT 4 MONTHS until iron foods given
Treatment of pathological IDA: FeSO4 3mg/kg for 2-3 months, +2-4 months to replace stores
not necessary to monitor asympomatic children
Therapeutic Hgb: (over 11 g/dL), should rise >1g/dL in 2-4 weeks depending on severity (under 9 vs. under 11)
Therapeutic Retic count: back to 0.5-1.5% after 1 week (predates Hgb, predicts recovery)

58
Q

Microcytic Hypochromic anemia, hx of inadequate iron intake, or excessive milk intake
Dx

A

Iron deficiency anemia

CBC w/ diff, retic count, ferritin level, TIBC, serum iron

59
Q

Malaria

A

more common in culturally diverse urban areas (esp. w/ international travellers)
high fever, diphoresis, rigor, HA as symptoms
TRAVEL HISTORY
COVID exposure

60
Q

Antihistamines for 6+ mo. children

A

These are approved: Zyrtec (cetirizine), Clarinex (desloratadine), Allegra (fexofenadine)
DO NOT DELAY EPINEPHRINE esp. in favor of antihistamines, not an alternative, an adjunct

61
Q

Allergic rhinoconjunctivitis symptoms

A

Mucus secretion or discharge, sneezing, irritation, and swelling (periorbital edema, cyanosis: allergic shiner)
Itching of the nose (paroxysmal sneezing and epistaxis), eyes, palate, or pharynx and loss of smell or taste

62
Q
  1. irritability, lethargy, or poor feeding, a-/febrile, vomiting
    Later: bulging / tense fontanel (IICP), high-pitched cry, seizures
    Less likely to see + Brudzinski / Kernig
    signs
  2. Fever, chills, headache, vomiting; nuchal rigidity (stiff neck), seizures; +/- Purpuric rash (50%); Altered mental status, extremely irritable; Photophobia
A

Meningitis

  1. in infants
  2. in children/adolescents

Brudzinski: Bend the knee
Kernig: Krick the neck

63
Q

Sudden fever, headache (3-12 days after tick bite)

Purpuric rash, petichiae 2-4 days later; wrists/ankles/soles spreads to trunk

A

RMSF

Pseudopurpura, petichiae

64
Q

RMSF Tx

A

Immediate treatment with doxycycline (treat before you confirm, deadly disease

65
Q

Wasp/Bee/Ant Stings

A

Systemic reactions from venom
IgE-mediated allergic reaction/anaphylaxis
Symptoms can DIFFER

66
Q

Snake bite

A

AMBULANCE, esp. w/ edema, intense pain
Especially if snake species is unknown/copperhead/around a body of water
Then, intermediary assessment

67
Q

Lyme disease prevention education

A

Tick Sprays: OTC, use for children - DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone
DO NOT use products containing OLE or PMD on children UNDER 3 years old.
Treat clothes with a 0.5% permethrin spray

68
Q

When do S/S of Malaria appear?

A

Usually >14 days, as early as 7 days, as late as several months

69
Q

Cyclic paroxysms of fever, chills, malaise, and headache
Abdominal pain, nausea, vomiting
1. Recurrent fever, irritability, poor feeding, vomiting, jaundice, and splenomegaly
2. Splenomegaly and mild pallor

A

Malaria S/S

  1. in infants
  2. In some uncomplicated cases
70
Q

Tick bite, asymptomatic, no tick present

A

Educate parents as to S/S

No prophylaxis if type of tick is unknown

71
Q

Zika virus transmission and sequelae

A

Transmitted by Aedes mosquitos (same vector as dengue and chikungunya), sexual intercourse, and vertically (mother-to-child) during pregnancy.

Vertical transmission to fetus during pregnancy may result in congenital Zika syndrome.

72
Q

Usually mild rash, fever, and conjunctivitis

A

Zika, Dengue, Chikungunya infections

73
Q

Infantile dietary concerns for:

  1. Vegetarian diet
  2. Goat’s milk
  3. Cow’s milk
A

1 & 2. Iron, folate, b12 deficiency

3. Iron deficiency (cow’s milk iron is lower, less absorbable)

74
Q

HPV Vaccine details

A

9-valent (covers for vaginal/vulvar/cervical, penile, oral, and anal cancer - 7 types; and female/male genital warts - types 6 & 11)
2 doses before 15, 3 after, 5 months apart minimum
15 minutes of rest to avoid most common side effect: syncope

75
Q

Bacterial Meningitis is always an

A

EMERGENCY

76
Q

The most common cause of meningitis < 5

A

S. pneumoniae; (Hib was before vaccination)

77
Q

1 month + w/ meningitis, the organism is likely

1. if immunocompromised

A

N. meningitidis

1. Listeria

78
Q

0-28 days old, the most common causes of meningitis are

A
  1. Group B Strep

2. E. coli is second

79
Q

Meningococcal Prevention

A

Vaccines: Hib, prevnar, PCV13, Pneumovax for high-risk groups, ACWY: age 11 (+1; same product!); B: age 16
Chemoprophylaxis: Rifampin to any contact if 4-year-old in their house (not immunized against Hib), w/in 24 hours

80
Q

Important meningitis complications for primary care

A

Deafness and developmental delay; close monitoring required

81
Q

[Cough, headache, sore throat], followed by a few days of URI symptoms, fever (38.5+), chills; malaise, weakness, myalgia, HA, N/V, arthralgia

A

[Prodrome of] vague meningococcemia symptoms

82
Q

Pallor, mottling –> short-lived erythematous or maculopapular rash (face –> body) –> non-blanching red or brown petechiae/purpura

A

Rash progression specific to meningococcemia

83
Q

A febrile child who has had purpura or petechiae for fewer than 12 hours should be

A

managed as medical

emergency sent to the hospital

84
Q

What are the most common infectious causes of Aseptic meningitis?

A
  1. Enteroviruses and Parechoviruses account for most of all known cases.
  2. Arboviruses (especially West Nile virus and La Crosse virus - Mosquitoes)
  3. Borrelia burgdorferi (Lyme Disease - ticks)
85
Q

Highest incidence of aseptic meningitis is when and in whom?

A

In Summer & Fall in those under 4 years of age

86
Q

Noninfectious causes include

A

Medications, autoimmune and auto-inflammatory diseases, and neoplasms.

87
Q

Herpes simplex virus (HSV) is a cause of life-threatening meningeal infection in

A

Neonates

88
Q
  1. Direct coagulation of skin and subcutaneous
    fat; microvascular vasoconstriction and thrombosis in peripheral tissue; necrosis
  2. Response to a complex array of changes and insults, which can include neurohormonal changes, fluid loss, hypoproteinemia, and hypotension
    2a. High fever and multi-organ dysfunction without infection
A
  1. Local and 2. systemic physiologic changes caused by
    burns
    2a. Large Burns
89
Q

Essential components of outpatient care of small burns

A

Assessment: “A Second Degree Concern”
assess integrity of the Airway
organized Secondary survey - wound size (rule of 9s only applies to adults) & depth
Debridement (clean technique/saline & thin blister removal/soap & water): analgesics/anxiolytics, distraction, tetanus update
Compartment syndrome risk assessment

Dressings: 1st & 2nd degree - abx ointment/silver dressing x up to 72 hours - repeat exam
Maintenance of cleanliness (family, outpatient services PRN)
Heal within 3 weeks

90
Q

Long-term physical and emotional outcomes can be enhanced through participation in burn aftercare programs that include…

A

…scar management, burn-specific physical and
occupational therapy, ready access to burn reconstruction, emotional
counseling, and family and peer support.

PT, Counseling, Family/Peer Support, OT, Reconstruction, Management = PC FORM

91
Q

Referring children with ___ to pediatric burn centers

enhances survival.

A 
large burns (>20% of the total
body surface area [TBSA])
92
Q

Nonburn conditions commonly treated in

burn units

A 
TEN (med reaction)
Staph scalded skin syndrome
Purpura fulminans (sepsis)
Tar/Chemical/Electrical/Crush/Blast Injuries
Frostbite
Soft Tissue Infections
93
Q

Epidemiology of human and animal bites in children

A

250,000 human bites, 400,000 cat bites, and 4.5 million dog bites (1 to 3 per 1,000 children per year; peak incidence in 5- to 9-year-olds) occur each year in the United States in adults and children.

94
Q

Common etiologic pathogens associated with 1. human and 2. animal bite wound infections

A

Usually polymicrobial; strep & staph; fusobacterium spp., prevotella spp.

  1. E. corrodens, Haemophilus spp., peptostrep, veillonella
  2. Both: Pasteurella spp.; Bacteroides, Porphyromonas, Propionobacterium. Dog: C. canimorsus, peptostrep. Cat: Moraxella spp.
95
Q

Strategies to prevent bite wound infections and to decrease the risk of fatal infections such as: 1. rabies or 2. tetanus

A

Prophylactic antibiotics (Augmentin) if:
✓ Immunocompromised or asplenic
✓ Moderate to severe puncture wounds
✓ Injuries to the bone/joint/tendons
✓ Wounds in the face/hand/genitals
1. Assess rabies immunization/prophylaxis indication: mainly risk/vaccination status of animal; call public health PRN
2. Tetanus immunization status: < 3 or unknown = TIG & age appropriate Tvax; 3+ = nothing if last Tvax w/in 5 y; booster if not

96
Q

Manage bite wounds

A

Irrigate wounds other than puncture using splashguards with 250+ mL of normal saline

Imaging?
Debridement and removal of foreign material

Cultures if evaluation occurs >8 h after the event or if the wound has signs of infection

Early closure if: face/neck wound, not hand (surgeon), signs of infection or at risk for infection

No SubQ sutures

Recheck in 48 hours regardless of treatment

97
Q

Education and anticipatory guidance to children and their caregivers regarding safety with pets and animal contact

A

Use AAP resources/handouts
Include school-age or older children in conversation
No non-traditional pets in house with children

98
Q

Ticks typically bite humans in the seasons of ___ because this is when they are in the ___ stage of their lifecycle

A

Late spring & summer; nymph (egg, larvae, nymph, adult)

99
Q

The four main diseases transmitted by ticks

A

Lyme disease, ehrlichiosis, tularemia, & RMSF

100
Q

Labs for Lyme Disease

A

Serology not useful for several weeks (IgM: 2-4 weeks; IgG 4-6 weeks)
Serum ELISA at 2 weeks –> IgM/IgG Western blot if symptoms persist beyond 30 days

101
Q

Malaria Treatment

A

Early, three-day atovaquone-proguanil or artemether-lumefantrine regimen

If either was used for prophylaxis use the other (it wasn’t effective against the plasmodium sp. which is causing the active infection)

102
Q

Intensely pruritic, erythematous papules associated with excoriations, vesiculations, and serous exudate
Chronically relapsing course
Infants: face, scalp, and extensor surfaces of the extremities

A

Atopic Dermatitis

103
Q
  1. Recent viral infection

Wheals with reflex erythema that are pruritic and transient (hours) w//w/o concurrent asymmetrical, nonpitting edema not occurring predominantly in dependent areas

A

Urticaria & Angioedema

1. Acute (6- weeks)

104
Q

Urticaria & Angioedema Management

A

Avoid triggers, treat any underlying/exacerbating infection
IgE if allergic origin is suspected to confirm, direct treatment
2nd-gen PO H1-antihistamine (ongoing); up to 4 x dose as secondary
Omalizumab - effective for antihistamine-refractory urticaria

105
Q

Hx of rapid onset of urticaria/angioedema, respiratory compromise, hypotension, and/or GI symptoms after exposure to a common trigger

A

Anaphylaxis

106
Q

Atopic Dermatitis Management

A
  1. Trigger Avoidance
  2. Hydration
  3. Moisturization (lotions, creams, ointments)
  4. Topical Corticosteroids (desonide/fluticasone approved down to 3 mo. old x 28 days)
  5. Severe: Tacrolimus and pimecrolimus (topical calcineurin inhibitors) - caution for photosensitivity
107
Q

Concerning patients for Eligibility for Contraceptive Use

A

Gastric bypass/malabsorptive; rifampin/rifabutin; severe hypertension (160+/100+): no combo or progestin pill

Anticonvulsant therapy: 30+mcg of estrogen if pill

Lamotrigine, migraines w/ aura, gallstones or hormone related cholestasis, moderate hypertension (<159/99): no combo

108
Q

The Shot - frequency with which it must be administered/changed

A

Every three months

109
Q

The Implant - frequency with which it must be administered/changed

A

Every 5 years

110
Q

The Patch - frequency with which it must be administered/changed

A

Q3 wk x 3 wk, skip a week

111
Q

Oral Estrogen-Progestin - frequency with which it must be administered/changed

A

Daily as prescribed

112
Q

Jaya is a 16-year-old female in for her well-check. During the history, she reveals that she is using a progestin-only oral contraceptive (which she has finished), and mother is supportive. She mentions that she is having trouble taking the pill every day and would like to try the Progestin implant. The first day of her LMP was a little under two weeks ago, and she has had unprotected sex since then. Her urine pregnancy test is negative. What is the next step to determine whether she can get her implant?

A

Determine whether she will bridge on the pill, or if she wants to get the implant today despite the risk of early pregnancy

113
Q

3 mainstays of treatment for emergency contraception

A

copper IUD, ulipristal acetate, and levonorgesterel

114
Q

Copper IUD emergent contraception time frame, efficacy, BMI limit

A

The copper IUD is the most efficacious form of emergency contraception. It can be used up to 5 days after unprotected sex to prevent pregnancy, and it works for patients of all BMIs.

115
Q

Ulipristal emergent contraception MOA, time frame, counseling

A

Ulipristal Acetate mimics and blocks progestin, thereby delaying ovulation; it can be used for emergency contraception up to 5 days after unprotected sex.
Clinicians should counsel patients that starting hormonal contraception immediately after taking ulipristal acetate may make both medications less effective.

116
Q

Levonorgestrel, emergent contraception: reasons to recommend

A

Levonorgestrel does NOT require a prescription and is available over-the-counter for people of all ages.

117
Q

Screening for cervical cancer includes:

A

Routine Pap Test only

118
Q

Screening for Trich includes:

A

Asymptomatic screening: Polys, MSMs, Hx of STI, HIV +, and those who present to STD clinics.
Symptomatic screening: women with vaginal discharge

119
Q

Treatment for Trich includes:

A

Metronidazole (2g-500mg); (albicans: clotrimazole cream)

120
Q

Herpes treatment

A

Acyclovir (400-400), valacyclovir (1g-500), or famciclovir (250-125)

121
Q

Screening for 1. Chlamydia and 2. Gonorrhea includes:

A

Annual screening of all sexually active women younger than 25 years

Annual screening is recommended for men presenting to clinical settings with a high prevalence of patients with chlamydia, and in MSM (genital and rectal)

  1. Pregnant women younger than 25 years, screening
    should be performed in the first and third trimesters
  2. Annually in HIV-positive individuals
  3. Men with eurethritis
122
Q

Treatment for 1. Chlamydia and 2. Gonorrhea are primarily

A

azithromycin 1 g x 1

2. ceftriaxone 250 mg IM; 1 g if conjunctivitis

PNP II (2 decks)

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