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GU/GYN Flashcards

1
Q

How many Tanner stages of development

A

5

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2
Q

Tanner stage 1

A

pre-puberty

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3
Q

Tanner stage 2

A 
testes inlarge
hair growth at base of penis
scrotal reddening
breast buds
pubic hair along labia
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4
Q

Tanner stage 3

A

onset of growth spirt
increase in penile length
pubic hair gets darker
breast enlargement

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5
Q

Tanner stage 4

A

peak of growth
increase in penile width and development of glans
menarche
areola and papilla elevation

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6
Q

Tanner stage 5

A

look like adults

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7
Q

Normal vaginal findings

A

pH 3.8-4.2

lactobacilli

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8
Q

Vaginal findings with Candida vulvovaginitis

A

pH pseudohyphae
itching/burning
Tx with azole
clotrimazole creat

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9
Q

Vaginal findings with Bacterial vaginosis

A 
pH > 4.5
Thin grey adherent d/c
fishy odor
clue cells
itching/odor
Tx with metronitazole, flagyl, clinda or tindamax
oral, creams, gels as options
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10
Q

Vaginal findings with atrophic vaginitis

A 
pH > 5 
scant, white discharge
absent of odor
few lactobacilli
can have itching, burning
vaginal estrogen
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11
Q

Organism of genital herpes

A

Human herpes visurs 2 or herpes simple type 2

simplex 1 can also be present

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12
Q

clinical findings with genital herpes

A

can be asymptomatic
painful ulcerated lesion
marked lymphadenopathy

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13
Q

Tx for genital herpes

A

acyclovir
famciclovir
valcyclovir

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14
Q

organism of nongonococcal urethritis and cervicitis (Chlamydia)

A

chlamydia trachomatis
ureaplasma
mycoplasma

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15
Q

clinical findings with nongonococcal urethritis

A

irritative voiding
mucopurulent d/c
cervicitis
large WBCs under microscope

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16
Q

Tx nongonococcal urethritis

A

azithro 1g PO x1
doxy
erthro
lebofloxacin

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17
Q

organism of gonococcal urethritis and vaginitis

A

neisseria gonorrhoeae

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18
Q

clinical findings with gonococcal urethritis

A

irritative voiding
purulent d/c
gram negative

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19
Q

Tx gonococcal urethritis

A

ceftriaxone IM x 1 plus azithro x1 or doxy x7 days

cefixime 1x dose if option #1 not available

azithro 2g single dose with severe beta-lactam allergy

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20
Q

organism of trichomoniasis

A

trichomonas vaginalis

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21
Q

clinical findings with trich

A 
dysuria
itching
vulvovaginal irritation
yellow/green discharge
strawberry spots on cervix
alkaline pH
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22
Q

Tx of Trich

A

metronidazole 1 dose

no alcohol for 24 hours

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23
Q

organism of syphilis

A

treponema pallidum

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24
Q

clinical findings of syphilis

A

primary: chancre, painless ulcers lasting about 3 weeks and resolve without tx
secondary: nonpruritic skin rash on palms and soles. fever sore throat, hair loss, muscle ache.

latent

25
Tx syphilis
antimicrobial therapy PCN Doxy
26
organism of genital warts
human papillomavirus | HPV
27
clinical findings with genital warts
verruca-form lesions | put white vinegar and water on. It will blanch if warts
28
Tx genital warts
trichloroacetic acid or cryo with pregnancy podophyllin resin imiquimod
29
organism of pelvic inflammatory disease
N gonorrhoeae C. trachomatis bacteroides enterobacteriacae
30
clinical symptoms of PID
``` irritative voiding fever abdominal pain cervical motion tenderness increased risk for ectopic pregnancy ```
31
Tx PID
Ceftriaxone 250mg IM x 1 with doxy 100 BID x14 days | with or without metronidazole 500 BID x 14
32
Genital Candida albicans in men presents with
balanitis or inflammation of glands groin fold involvement scrotal excoriation NO discharge
33
Tx of genital candidiasis in a man
topical or oral antifungals | you should consider HIV or DM if recurrent
34
What is the pathogen of an acute uncomplicated UTI
E coli (gram neg) S. saprophyticus (gram pos) Enterococci (gram pos)
35
Tx of uncomplicated UTI
TMP/SMX Bactrum BID x3 days nitrofuratoin (macrobid) 100 BID x 5 days fosfomycin 3g x1 Cipro 250, 500 BID x 3 days NO gemifloxacin or moxifloxacin
36
Pathogen of acute uncomplicated pyelonephritis
e coli enterococci get urine and blood cultures
37
Tx phyeo
Cipro 500 BID x 7 days Levoflaxacin 250 X 5 Amox-clavulanate, bactrum x 14 days
38
classic signs of pyelo
women 18-40 fever CVA tenderness
39
What is epididymo-orchitis and what is the causative organism in a male < 35
an upper reproductive tract infection with inflammation of testis/epididymis N. gonorrhoeae C. trachomatis
40
What is the causative organism for epididymo- orchitis in a male > 35
enterobacteriaceae (coliforms)
41
Clinical presentation of epididymo- orchitis
irritative voiding fever painful swelling of qpididymis and scrotum possible infertility following infection
42
Tx epididymo- orchitis
Ceftriaxone (Rocephin) 250 IM plus doxy 100 BID x 10 Cipro 500 Levofloxacin scrotal elevation: if relief this = prehn's sign
43
Causative organism of acute bacterial prostatitis
N. gonorrhoeae in younger C. trachomatis in younger enterobacteriaceae (coliforms) in those with low risk STD
44
clinical presentation of bacterial prostatitis
``` irritative voiding suprapubic perineal pain fever tender/boggy prostate (Chandellear sign) leukocytosis ```
45
Tx bacterial prostatitis
ceftriaxone 250 IM plus doxy x 10 days cipro ofloxacin
46
What is consistant with benign prostate hyperplasia (BPH)
obliterated median sulcus size 2.5cm or > present in 50% men 50-59 and 80% age 70-79
47
Prostate exam of cancer
nodule, non-tender
48
Urge incontinence
strong sensation of needing to void
49
Stress incontinence
associated with lifting
50
functional incontinence
occurs in presence of mobility problems
51
Transient incontinence
during an acute illness
52
Hydrocele
collection of serous fluid that causes painless scrotal swelling recognized by transillumination
53
Varicocele
nest of worms evident in standing position
54
Testicular torsion
scrotal pain and loss of cremasteric reflex
55
Phimosis
the foreskin can not be pulled back to expose the glans
56
Paraphimosis
retracted foreskin that can not be brought forward to cover the glans
57
Cryptorchidism
testicle in inguinal canal or abdomen
58
What has the greatest risk for contracting HIV
receptive anal intercourse
59
How to test for HIV
rapid western blot very accurate

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