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MVU Adult 1 > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

A 23 year old, sexually active presents for her first pap smear. Her history includes no pregnancies. Her first intercourse was at age 14 and has had at least 10 sexual partners if not 12 since. Which condition do you want to be alert for during her exam?-

A

HPV

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2
Q

A 20 year old, sexually active female seen in the clinic because her boyfriend was diagnosed with gonorrhea. What is the treatment of choice for gonorrhea?

A

Ceftriaxone

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3
Q

A 24 year old female with complaints of dysuria, pain with sex and mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What STIs has she most likely been exposed to?

A

Chlamydia

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4
Q

45 year old woman with complaints of vaginal discharge. You identify clue cells on the vaginal smear. What is the diagnosis?

A

Bacterial Vaginosis

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5
Q

Which of the following medications is the treatment of choice for Trich?

A

Flagyl

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6
Q

A 26 year old woman presents with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority

A

Pregnancy test

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7
Q

A 36 year old woman with complaints of vaginal itching, burning, and discharge. On wet mount, you notice hyphae. Which treatment would be appropriate?

A

Fluconazole for candida vaginitis

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8
Q

21 yo woman requesting birth control. Which of the following tests would be essential before prescribing oral contraceptives?-

A

Urine pregnancy/HCG

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9
Q

A 40 year old woman who sees you yearly for exams. She is single, not in a monogamous relationship. She smokes occasionally and drinks 2 beers a day. Her BMI is 25. She is requesting birth control. Which is appropriate for her?

A

IUD

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10
Q

What is the most common cause of secondary amenorrhea?-

A

Pregnancy

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11
Q

A 22 year old woman is dx with PMS. Which of the following lifestyles changes to minimize symptoms?-

A

Regular exercise

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12
Q

A 25 yo woman complaining of painful menstruation. Which pelvic pathology is the most common cause of dysmenorrhea?

A

Endometriosis

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13
Q

A male patient comes in with complaints of painful penile lesions. Small fluid filled vesicles that are painful to touch. Which treatment would you give?

A

Acyclovir

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14
Q

What is the most common serious gyencological complication in women

A

Pelvic inflammatory disease

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15
Q

When providing education to a woman about the use of plan b, the NP knows to tell the patient that the latest it can be used after intercourse and be effective is

A

72 hours

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16
Q

Male pt presents with painful lesions on the penis. They are small-fluid fulled vesicles clustered to the shaft of the penis. What is the dx?-

A

Herpes

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17
Q

What medication would an NP prescribe for a patient diagnosed with primary syphilis who has no known drug allergies?

A

PCN G

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18
Q

What age should women receive their first pap smear regardless of sexual activity?-

A

21 years

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19
Q

A 24 year old female comes in with complaints of dysuria, pain with sex, and mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What medication would you treat her with?

A

Azithromycin (for Chlamydia)

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20
Q

A 36 yo woman with vaginal itching, burning, and discharge. On wet mount you see hyphae. Based on clinical symptoms and findings, what would your dx be?

A

Candida

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21
Q

27-year-old female with complaints of no menstrual cycle for 6 months. What would be the most appropriate test to order?

A

Prolactin

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22
Q

Which of the following is contraindicated to estrogen containing contraceptive methods?

A

Factor 5 Leiden

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23
Q

You are counseling a patient on oral combination contraceptive treatment. She wants to know what to do if she misses a pill.

A

Take the last missed pill along with today’s pill

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24
Q

In providing contraceptive counseling to a patient on dilantin for a seizure disorder, which would you recommend?

A

Depoprovera

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25
Q

Which of the following is a common side effect reported after one use of depo?

A

Weight gain

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26
Q

With a hormonal IUD, which of the following is commonly reported by patients?

A

Reduction in menstrual flow

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27
Q

A patient wants to become pregnant and wants to stop oral combination contraceptives. When is it safe for her to try and conceive?-

A

Immediately

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28
Q

Perimenopause in women usually starts between

A

40-45 years

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29
Q

When checking hormone levels in 42 year old woman who reports hot flashes and no menstrual cycle for 6 months, what would you expect to find?

A

Increased LH

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30
Q

A patient has 101.5 fever, abdominal pain and vaginal discharge for 3 days. What medications would you prescribe?

A

Clindamycin and azithromycin

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31
Q

IV drug user presents for routine blood tests, her HIV is negative today. What would you advise her to do?

A

Repeat in 1 year

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32
Q

A nurse presents after an accidental needle stick. Her HIV test in negative today. What would you counsel her to do?

A

Repeat in 2 months

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33
Q

A 33 year old woman who had a negative pap last week, with two negative paps prior. When would you have her return for a pap?

A

5 years

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34
Q

A woman presents to discuss contraceptive options. She is breast feeding on demand. She wishes to continue. What is the most appropriate contraceptive for her to use?

A

Progesterone only oral contraception

35
Q

What is the recommended treatment for chlamydia?

A

Azithromycin 100 mg once or doxycycline BID for 7 days

36
Q

What are some of the consequences of chlamydia?

A

PID, infertility, ectopic pregnancy

37
Q

Most common STI reported in the U.S.

38
Q

A patient is being treated with Metronidazole for Bacterial Vaginosis, why should you counsel them to avoid alcohol?

A

Mixing the two can cause, headache, nausea/vomiting, chest pain, and or hypertension.

39
Q

Most common cause of vaginal odor and discharge

A

Bacterial vaginosis

40
Q

One of the most common reasons for amenorrhea?

41
Q

Patient who use depo contraception should be counseled about what?-

A

Taking calcium supplements at least 1200 mg daily due to risk of bone loss

42
Q

20-year-old woman with allergy to azithromycin- How would you treat for chlamydia?

A

Doxycycline 100 mg BID for 7 days

43
Q

Hyphae on vaginal smear would indicate?

A

Yeast infection

44
Q

How long without a period to be classified as secondary amenorrhea?

45
Q

What are risk factors for PMS symptoms?

A

Caffeine, alcohol, nutrition, stress, smoking, family history

46
Q

27-year old with painful menstruation. Most likely cause?

A

Endometriosis

47
Q

Lesion on penis with no pain. Lesion is flat, indurated margins. What is the most likely diagnosis?

48
Q

Treatment for syphilis if the patient has PCN allergy?

A

Doxycycline

49
Q

Cervical caner screening and guidelines

A

<21: no screening
21-29: cytology every 3 years
30-65: cytology every 3 years or HPV testing every 5 years or both every 5 years
>65: no screening after adequate negative results

50
Q

What would protozoa on vaginal smear indicate?

A

Trichomoniasis

51
Q

25-year old with irregular periods, facial hair, obesity, elevated blood sugar. What is the most likely diagnosis?

A

Polycystic Ovarian Syndrome

52
Q

What to avoid in patients seeking birth control with Factor V Leiden?

53
Q

Treatment option for a menopausal woman with terrible hot flashes and hesistancy to be on hormone replacement therapy due to hx of breast cancer

A

Antidepressants (Effexor/Venlafaxine)

54
Q

What is the average age for menopause in the US?

A

51-52 years

55
Q

How long without a period till a woman will be considered in menopause?

56
Q

What hormone increases in women that are perimenopausal?

57
Q

Average age for girls to start menstrual cycle

A

11-14 years

58
Q

When is primary amenorrhea considered?

A

If no menstruation by age 15 years

59
Q

What are the four most common STIs?

A

Chlamydia, gonorrhea, syphilis, and trichomoniasis

60
Q

Most common cause of urethritis in men?

61
Q

Use of spermicide can increase what?

A

Transmission of STIs, including HIV

62
Q

How long should a patient use condoms for backup after missing a birth control dose?

A

7 days of no missed pills

63
Q

Indication for progestin only birth control pills

A

-If estrogen in contraindicated
-If breastfeeding

64
Q

Contraindications for nexplanon

A

pregnancy, DVTs, liver disease, breast CA, unexplained bleeding

65
Q

Contraindications for IUD

A

Hx of PID, risk of STIs, pregnancy, undiagnosed bleeding

66
Q

Difference in presentation between bacterial vaginosis, candidiasis, and trichomoniasis

A

-BV: Elevated pH, thin, white discharge with fishy odor, clue cells
-Candidiasis: Normal pH, pseudohyphae, thick, cottage-cheese discharge
-Trich: motile, pear-shaped, flagellated trichomonads, elevated pH, strawberry cervix, yellow-green, frothy discharge

67
Q

What to be aware of when prescribing Ketoconazole for Tx of vaginal candidiasis?

A

The patient’s liver function

68
Q

Causes of dysmenorrhea

A

Endometriosis (most common), ovarian cysts, ectopic pregnancy, PID, vaginitis

69
Q

Absolute contraindications for combination estrogen/progestin BC

A

Clotting disorders or family hx, CV disease, stroke, cancer, liver disease, pregnancy, undiagnosed vaginal bleeding

70
Q

What medications can decrease the effectiveness of birth control?

A

Anticonvulsants (dilantin) and antibiotics

71
Q

What medication is good for BC in women who are breastfeeding?

A

Progestin- only pill

72
Q

Treatment for bacterial vaginosis

A

Flagyl 500 mg BID for 7 days or Metrogel 0.75% for 5 nights

73
Q

Tx for syphilis if PCN allergy

A

Doxycycline 100 mg BID for 14 days

74
Q

Epithelial cell abnormality grading

A

ASC-US: atypical cells of undetermined significance
ASC-H: cannot exclude high-grade lesion
LSIL: low-grade, mild dysplasia, CIN 1
HSIL: high-grade, mod-severe dysplasia
CIS: carcinoma in situ

75
Q

Diagnostics for amenorrhea

A

Urine pregnancy, CMP, thyroid, vaginal smear, FSH, LH, prolactin, androgen, progesterone challenge test

76
Q

Tx for primary amenorrhea

A

estrogen therapy to develop secondary sex characteristics and prevent osteoporosis

77
Q

Tx for secondary amenorrhea

A

oral contraceptives, periodic or cyclic progesterone 10 mg PO daily for 10 days

78
Q

Tx of PCOS

A

Exercise, diet, weight control
Metformin can treat underlying metabolic disorder
Provera to start cycle and try for contraception
Contraceptives

79
Q

Describe the climacteric phase of menopause

A

Occurs 10 years before menopause, ovulation becomes less frequent, shortening of the menstrual cycle and increased menstrual bleeding

80
Q

Hormones during perimenopause

A

-Decreased estrogen
-Elevated FSH (above 40 mlu/ml = fast approaching menopause)/LH secretion

81
Q

S&S of menopause

A

vasomotor symptoms: hot flashes, night sweats, insomnia, sleep distrubances, mood disorders, vaginal dryness or atrophy, decline in sexual desire, decreasing bone mass

82
Q

Management of menopause

A

-Aerobic exercise (decreases hot flashes, insomnia)
-High complex carb and low fat diet
-Smoking cessation
-Stress reduction
-Herbal therapies: black cohosh

83
Q

Pharmacological treatment for menopause

A

-Antidepressants- hot flashes and mood swings
-HRT (Estrogen therapy, Estrogen + progestin therapy)

MVU Adult 1 (4 decks)

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