Genitourinary/Reproductive Flashcards
what’s a normal vaginal pH?
3.8 to 4.5
When gonorrhea and chlamydia exist together, what are you going to prescribe to tx?
Doxycycline and Rocephin
syphilis: symptoms
screening test
confirmatory test
Tx
S/s:
1st: painless canker that takes 3 to 6 weeks to go away
2nd stage: rash on palms and soles
3rd stage: neurosyphilis
Screening: RPR
Confirmatory: FTA-ABS
Treat: PCN
What are 2 diseases where we will see a rash on the palms and soles?
rocky mountain spotted fever
2nd stage of syphilis
What method of contraception increases the risk for osteoporosis?
Depo-Provera
What supplements would you give someone that’s using Depo-Provera?
When should you stop it?
Ca and Vit D to prevent osteoporosis
After 5 years
What combination contraception open has the highest risk of blood clot?
ortho evra patch
What are contraindications for combination hormone contraception?
migraine with aura
current blood clot
liver disease
>35 years and smoker
What are presumptive signs of pregnancy?
subjective
patient reports breast tenderness, amenorrhea, nausea etc
what are probably signs of pregnancy?
HCG
urine test
Hegar’s sign- cervix softening
Chadwick’s - bluish
Goodell’s sign - hypertrophy
What are positive signs of pregnancy
palpation of fetus
US of fetus
fetal heart tones
What is the fundal height at 12 weeks of pregnancy?
symphysis pubis
What is the fundal height at 20 weeks of pregnancy
level of umbilicus
18 - 22
When are people screened for gestational diabetes?
24 - 28 weeks
When are pregnant people screened for group b strep?
35 - 37 weeks
When do you give Rhogam if needed?
Week 28 pregnancy
then within 72 hours post partum
If a pregnant person has an asymptomatic UTI do you treat?
What are your treatment options?
What can you not give?
CAMP
cephalosporin
amoxicillin
macrobid
PCN
DO NOT GIVE CIPRO
During pregnancy, when do you do AFP testing?
Between week 16 to 20
What does a high AFP mean?
neural tube defects
What do low AFP levels indicate?
Down syndrome
What are down syndrome patients at higher risk for? #3
Alzheimer’s
hypothyroidism
Cervical spine instability
How can you tell placental abruption from placental previa?
Abruption =
-painful bleeding (d/t placenta separating from the uterus)
-uterus is hard to touch
-occurs in 3rd trimester
Previa
-placenta covering cervical opening
-light, painless bleeding
how to tx mastitis?
1st: dicloxacillin
2nd: clinda or macrolide
What if someone is treated for mastitis but is still having symptoms?
Refer to GYN; mammogram
What pap smear result might indicate something serious might be going on?
What do you refer them to?
LSIL
HSIL
Refer for colposcopy
What colposcopy results indicate something serious is going on?
CIN 2 and 3
What do you do for an ASCUS result on colposcopy?
atypical squamous cells of undetermined significance
Get HPV testing regardless of age
Whenever there is a positive HPV screening regardless of age, what do you do next?
colposcopy
What age do you recommend the Gardasil vaccine?
Age 11 but can be given as early as 9
What is the typical tx for genital warts?
TCA acid
If a postmenopausal woman is bleeding, what do you do next?
Refer for endometrial biopsy ASAP
What can you order to help with hot flashes and night sweats?
Paxil
other options: OCP, IUD, vaginal cream, herbal supplements
What are some common herbal supplements use in menopause?
Black cohosh
Ginkgo
What type of cancer does hormone replacement therapy increase the risk for?
Ovarian cancer
What medications are notorious for causing galactorrhea?
atypical antipsychotics
What are first line meds for BPH?
Alpha blockers
“-zosins”
Terazosin
Doxazosin
When do we need to tell our BPH patients to take their first dose of alpha blocker and why?
Take at night d/t 1st dose effect
orthostatic hypotension
What medication can shrink down prostate?
Finasteride (Proscar)
What herbal supplement is commonly used by BPH patients?
Saw palmetto
Your patient has unilateral testicular pain with a +Prehn sign….what is going on?
Epididymitis
What is a positive Prehn sign and what does it indicate?
Positive sign is relief of pain with scrotal elevation
Epididymitis
How do you treat Epididymitis?
<35 years old = Doxycycline or Rocephin
> 35 years = Levofloxacin
What do RBC casts indicate on a UA?
glomerulonephritis
What do WBC casts indicate on a UA?
Pyelonephritis
If a patient is on Warfarin…what antibiotic do you want to avoid for a UTI?
Bactrim
If your patient with UTI had heel pain when they’ve taken a fluoroquinolone in the past…what abx do you want to avoid?
Cipro
levo
what if your pregnant patient has a UTI, what do yo prescribe?
Augmentin
What do you want to order for a patient that’s having a reoccuring UTI?
Kidney US
What is our first concern when a patient comes in with erectile dysfx?
Heart
What class of drug do you prescribe for erectile dysfx?
PDE 5
Viagra
What do you want to order before prescribing a PDE5 inhibitor?
EKG
What is secondary amenorrhea?
no menses for 3 months that have had a regular menstrual cycle
or no menses in 6 months for people with a history of irregular periods
What do you need in order to make the diagnosis of PCOS?
anovulation
increased androgen production
multiple cysts
NEED 2/3
Your patient’s pap smear shows AS-CUS…what are you going to do next?
HPV testing
Your patient’s pap smear shows AS-CUS…then their HPV was positive…what are you going to do next?
refer to gyn for possible colposcopy
Your patient’s pap smear shows LSIL/HSIL…what are you going to do next?
refer straight to colposcopy
According to USPSTF guidelines, when should a woman receive a mammogram and how often?
starting at age 50
every 2 years
when can we stop breast cancer screening?
when can we stop cervical cancer screening?
breast: 75
cervical: 65
describe fibrocytic breasts
firm lumps that are
TENDER
SORE
and moveable
enlarge with menstrual cycle
What is Chadwick’s sign?
bluish discoloration of the cervix
What is Goodell’s sign?
softening of the cervix
What is Naegele’s rule?
calculate due dates
date of their last menstrual period PLUS 9 months PLUS 7 days
if the date of the woman’s last menstrual period was August 5th 2021 what would her due date be using Naegel’s rule?
May 12th of 2022
date of their last menstrual period PLUS 9 months PLUS 7 days
how much should someone of normal weight, gain during pregnancy?
25 to 35 lbs
How do you screen for gestational diabetes?
24 to 28 weeks
one-step: 2 hour OGTT if >200 = diabetes
two-step: 1 hour OGTT if fails then 3 hour test
When do you screen for group b strep in pregnant women?
how do you treat?
35 to 37 weeks
administer PCN during labor
when is labor considered to be premature?
before 37 weeks
An IUD has to be placed with in ____ of birth
within 48 hours or the mother is going to have to wait up to 6 weeks post partum
what is stage 2 CKD
60 to 89
mild kidney dysfx
What is stage 3 CKD?
60-89
THIS IS WHEN SYMPTOMS USUALLY BEGIN
What will someone in stage 4 CKD present with?
GFR 15-29
fatigue
dry/itchy skin
hematuria
edema
pallor
depression/mood swings
