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Nurse Practitioner exam > Genitourinary and Gynecologic problems > Flashcards

Genitourinary and Gynecologic problems Flashcards

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1
Q

White, clear, flocculent leukorrhea describes what?

A

normal vaginal discharge

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2
Q

Which diagnosis is found to have white, curdy, cottage cheese discharge with vagina pruritus and burning?

A

Vulvovaginitis 2/2 candida albicans

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3
Q

What treatment is prescribed for vulvovaginitis 2/2 candida?

A 
oral "zole"
diflucan/ fluconazole
or 
vaginal miconazole / monistat
terazol
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4
Q

What vaginal dysfunction is characterized by >20 clue cells found on microscopic exam and foul, gray/white, homogenous discharge ?

A 
Bacterial Vaginosis BV
polymicrobial likely
POSITIVE WHIFF TEST
fishy odor
TX- metronidazole
flagyl
clindamycin
cleocin
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5
Q

What presents as painful ulcerated lesions, lymphadenopathy, and in women you may see a thing vaginal discharge associated with vaginal lesion ?

A

Caused by the organism herpes simplex virus HHV-2 type 2

recurrence symptoms vary from above

asymptomatic transmission is possible

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6
Q

What is the treatment for herpes simplex type 2 or HHV-2 ?

A

acyclovir, famciclovir, valacyclovir VALTREX

dx herpes select PCR blood test

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7
Q

What is the presentation of chlamydia trachomatis and ureplasma urealyticum and mycoplasma genitalium?

A

nongonococcal urethritis and cervicitis
irritating voiding symptoms and /or mucopurulent discharge or recurrent UTI

cervicitis common in women ***

microscopic look at discharge = LARGE NUMBER OF WBC

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8
Q

TREATMENT FOR CHLAMYDIA

A

AZYTHROMYCIN 1G PO X 1 DOSE

ALT= DOXYCYCLINE , ERYTHROMYCIN, LEVOFLOXACIN = MORE THAN 1 DAY OF THERAPY

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9
Q

WHO DO YOU SCREEN FOR CHLAMYDIA

A

16-24 YEARS OLD, THOSE SEXUALLY ACTIVE OR HAVE A NEW PARTNER

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10
Q

GHONORRHEA PRESENTATION

A

IRRITATIVE VOIDING SYMPTOMS (SIMILAR TO CHLAMYDIA**)
COULD BE WITHOUT SYMPTOMS - OCCURS OFTEN

MICROSCOPIC EXAM = LARGE NUMBER OF WBCS

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11
Q

What is the first line therapy for gonorrhea ? a gram NEGATIVE bacteria

A

IM ceftriaxone 250 mg ONE TIME DOSE plus azithromycin 1 g PO x 1 dose

ALTERNATE would be cefixime 400 mg PO with azithro dose

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12
Q

A patient presents with yellow GREEN vaginal discharge, may be frothy, cervical petechiae hemorrhage or strawberry cervix, what is your diagnosis?

A

Trichomoniasis vaginitis

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13
Q

First line trichomoniasis therapy?

A

Metronidazole 2 g PO 1 time dose
AVOID ALOCHOL x 24 hours
no cough syrups

alternative = tinidazole

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14
Q

What is syphillis?

A

Baterium infection with CHANCRE. firm, roun, painless genital anal ulcers
indurated margins
accompanied localized lymphadenopathy

2nd stage = nonpruritis skin rash of PALMS, SOLES, MUCOUS PAM SELLS MUSTARD

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15
Q

what is pelvic inflammatory disease

A

could be –> gonorrheae, trachomatis, enterbacteriaceae, streptococci

key = cervical motion tenderness, CHANDELIER SIGN

PID shuffle = hard to walk, pain, guarding

50% of all ectopic pregnancy is linked to PID

get culture and CBC

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16
Q

First line treatment for PID

A

Ceftriaxone 250 mg IM single dose, PLUS doxycycline 100 mg PO BID x 14 days
with or without metronidazole 500 mg PO BID x 14 days

17
Q

What is clotrimazole cream used for?

A

Candida vulvovaginitis

18
Q

What is oral metronidazole and metronidazole gel used for

A 
gel = vaginosis 
oral = vaginosis and trich
19
Q

Treatment for syphillis

A

bicillin or injectable penicillin

20
Q

What is imiquimod used to treat?

A

external genital warts

HPV

21
Q

Is TCA or trichloroacetic acid safe in pregnancy?

A

yes

imiquimod is not

22
Q

What is CLUE CELLS associated with

A

Bacterial vaginosis

23
Q

what is pseudohyphae w/ KOH prep associated with ?

A

candida vulvovaginitis

24
Q

What is obliterated medial sulcus a sign of ?

A

Benign prostatic hyperplasia

25
Q

What effect may oxybutynin have on a patient who is taking it?

A

anticholinergic effects

antimuscarinic medication - control of detrusor muscle contraction

26
Q

What is the treatment for acute UNCOMPLICATED UTI in non pregnant patient?

A

TMP/SMX- DS PO BID x3 days
if e. coli resistant to TMP then
Nitrofurantoin MACROBID 100mg PO BID x 5 days

can also use levofloxacin, ciprofloxacin, moxifloxacin but growing concern about Floroquinoloine resistance

27
Q

What is the likely dx of a male who complains of irritative voiding symptoms, suprapubic pain, perineal pain, fever, boggy prostate, and is at a low risk for STI?

A

acute bacterial prostatitis
cause- likely e. coli
tx- ciprofloxacin 500mg PO BID

28
Q

Prehns sign

A

relief of scrotal pain with elevation

29
Q

What is the treatment for a gonorrheal or trachomatis infection in a male patient ?

A

Ceftriaxone 250 mg IM as a single dose plus doxycycline 100 mg PO BID x 10 days

30
Q

What is the US preventative services task force recommendations for cervical cancer screening in woman

A

initial screening at age 21
21-29- cytology alone q3 years
aged 30-65 - primary HPV testing alone every 5 years
cease testing at age 65 or greater

31
Q

What are the recommendations of the American Cancer Society from 2020 for Cervical Cancer screening in average-risk women?

A

Start screening at AGE 25 (differs from USPSTF saying 21)

also recommend NOT SCREENING 21-24

32
Q

What is the recommended treatment for gonorrhea or trachamotis in PID?

A

Ceftriaxone 250 mg IM 1 time plus doxycyline 100 mg PO x 10 days

33
Q

What is the recommended treatment for gonococcal urethritis or vaginitis?

A

ceftriaxone 250 mg IM as a one time dose plus azithromycin 1 g PO x 1 dose

34
Q

Breast cancer symptoms / history

A

NON TENDER painless mass
asymptomatic
symptoms LATER = pain, erythema, dimpling, ulceration, nipple retraction

35
Q

Fibrocystic breast disease symptoms

A

Breast tenderness related to cycle
nodularity with cyst formation / enlargment
may be breast discharge

36
Q

What is the difference between fibrocystic breast disease exam and breast cancer exam?

A 
fibrocystic = mobile mass, breast cancer = fixed or firm 
fibrocystic = no discharge, breast cancer = may have discharge, may be bloody 
fibrocystic = no lymphadenopathy, breast cancer = may have lymphadenopathy
37
Q

What is your breast cancer risk if a 1st degree relative has had it ?

A

INCREASES 2 TO 4 FOLD

38
Q

What is the lifetime risk for breast cancer in women ?

A

1:8 women have breast cancer

Nurse Practitioner exam (12 decks)

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