Genitourinary/Reproductive Flashcards by Ashlyn Taylor

what’s a normal vaginal pH?

3.8 to 4.5

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When gonorrhea and chlamydia exist together, what are you going to prescribe to tx?

Doxycycline and Rocephin

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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

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What are 2 diseases where we will see a rash on the palms and soles?

rocky mountain spotted fever
2nd stage of syphilis

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What method of contraception increases the risk for osteoporosis?

Depo-Provera

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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

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What combination contraception open has the highest risk of blood clot?

ortho evra patch

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What are contraindications for combination hormone contraception?

migraine with aura
current blood clot
liver disease
>35 years and smoker

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What are presumptive signs of pregnancy?

subjective
patient reports breast tenderness, amenorrhea, nausea etc

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what are probably signs of pregnancy?

HCG
urine test
Hegar’s sign- cervix softening
Chadwick’s - bluish
Goodell’s sign - hypertrophy

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What are positive signs of pregnancy

palpation of fetus
US of fetus
fetal heart tones

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What is the fundal height at 12 weeks of pregnancy?

symphysis pubis

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What is the fundal height at 20 weeks of pregnancy

level of umbilicus
18 - 22

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When are people screened for gestational diabetes?

24 - 28 weeks

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When are pregnant people screened for group b strep?

35 - 37 weeks

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When do you give Rhogam if needed?

Week 28 pregnancy
then within 72 hours post partum

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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

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During pregnancy, when do you do AFP testing?

Between week 16 to 20

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What does a high AFP mean?

neural tube defects

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What do low AFP levels indicate?

Down syndrome

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What are down syndrome patients at higher risk for? #3

Alzheimer’s
hypothyroidism
Cervical spine instability

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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

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how to tx mastitis?

1st: dicloxacillin
2nd: clinda or macrolide

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What if someone is treated for mastitis but is still having symptoms?

Refer to GYN; mammogram

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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