GU/GYN Flashcards
Dx criteria for candida
Vaginal pH-
Treatment of candida
1st choice vaginal insert med
-azole antifungal, oral (Diflucan), vaginal (miconazole, terconazole)
Dx criteria of bacterial vaginosis
Vaginal pH- >4.5
Thin, homogeneous, white/gray discharge
Positive Whiff test-fishy odor
>20 clue cells, few or no WBC’s
Treatment of bacterial vaginosis
Metronidazole (topical Metrogel), or oral Flagyl.
Clindamycin vaginal cream or ovules (Cleocin)
Dx criteria for atrophic vaginitis
Vaginal pH- >5
Scant, white-clear discharge
Few or absent lactobacilli
Sx-itching/burning but often without sx
Treatment of atrophic vaginitis
Topical and/or vaginal estrogen if sx are recurrent or if recurrent UTI
Ex- Premarin cream (conjugated estrogen), estrace cream
Acute, uncomplicated UTI treatment
Primary- TMP/SMX-DS x 3days, nitrofurantoin (Macrobid) 100mg BID x5days or fosfomycin (Monurol) 3gram X1 dose
*all with pyridium (phenazopyridine)
Alternative tx for UTI (for e-coli resistance to Bactrim or sulfa allergy)
Ciprofloxacin 250mg BID, ciprofloxacin ER 500mg QD, Levofloxacin 250mg QD, Moxifloxacin 400mg QD, (all x 3days plus pyridium)
Epididymoorchitis definition
Organisms?
Upper reproductive tract infection with inflammation of epididymis/testis
35= enterobacteriaceae
Tx of epididymoorchitis
35- Levofloxacin 500mg po QD or Ofloxacin 300mg po BID for 10 days.
Prehn’s test
Relief of discomfort with scrotal elevation
Organisms with acute bacterial prostatitis?
35- Enterobacteriaceae
Treatment of acute bacterial prostatitis?
35- ciprofloxacin 500mg po BID or Ofloxacin 200mg po for 14 days
Urge incontinence sx/tx
Reports of strong sensation of needing to void.
Tx- anticholinergics=tolterodine (Detrol), oxybutynin (Ditropan), solifenacin succinate (Vesicare)
Stress incontinence sx/tx
Associated with lifting
Tx- support with use of vaginal tampon, urethral stents, and pessary use. Kegel exercises, pelvic floor rehabilitation and bladder training. Surgical intervention in select patients.
Functional incontinence sx/tx
Often occurs in presence of mobility problems
Tx- Ameliorated by having assistant who is aware of voiding cues available to help with toileting.
Transient incontinence sx/tx
Occurs during an acute illness
Tx- treat underlying process, discontinuation of offending medications.
Phimosis
The foreskin cannot be pulled back to expose the glans
Paraphimosis
Retracted foreskin that cannot be brought forward to cover the glans
Variocele
A palpable “bag of worms” scrotal mass that is only evident in standing position.