GU/GYN Flashcards
Involuntary urination that occurs at an age when voluntary control should be present?
Enuresis
Children who have never established control have _____ enuresis
Primary
Children who have been dry for more than 6-11 months and then begin bedwetting is called:
Secondary enuresis
Enuresis can occur in up to __% of 10-year olds
3%
What lab/diagnostic tests do you order for a child experiencing enuresis?
UA and culture
What medications can be helpful in the treatment of enuresis?
Imipramine, DDAVP, oxybutynin (ditropan)
Bacterial infections of the urinary tract are more common in ____ that are ______ in the first year of life. This then increases to ______ with a 10:1 ratio throughout the lifespan
males; uncircumcised
females
What does the UA show if positive for UTI? (3)
Leukocytes, erythrocytes, nitrites
If the patient has a UTI and is febrile, they should receive a renal/bladder __________.
US
Oral antibiotics are given for 10-14 days. Top choice is:
Trimethroprim/sulfamethoxazole
If no improvement is seen after ___ days, change ABX
2 days
Children less than __ months with UTI will require hospitilization for IV ABX
2 months
If renal US is abnormal, what is the next test you will order?
VCUG
A relatively common congenital abnormality in which the urethral opening is on the ventral surface of the penis.
Hypospadias
S/Sx of hypospadias include: dorsally _____ _____, urinary stream that aims ________, and ______ (ventral bowing of the penis).
Dorsally hooded foreskin
downward
chordee
This occurs when fluid collects in the thin sheath that surrounds the testicles
Hydrocele
Hydrocele can either be _____ or open to the abdomen, which is referred to as _______.
sealed (non-communicating)
Communicating
Which type of hydrocele requires surgical intervention?
Communicating hydrocele
Absence of one or both of the testes from the scrotal sac due to failure to descend from abdomen in utero.
Cryptorchidism
When should your refer a patient to urology if testes are still undescended?
1 year old
Twisting and strangulation of the spermatic cord characterized by acute pain; constitutes a surgical emergency to prevent necrotic testicle and infertility
Testicular torsion
In testicular torsion, pain is not relieved by elevating the scrotum. This is called _____ sign
Prim Sign
Pain and cramping associated with menstruation
Dysmenorrhea
Absence of any pelvic pathology which is most commonly seen in adolescent is called ______ dysmenorrhea.
Primary
_____ dysmenorrhea results from an underlying cause such as pregnancy, PID, and endometriosis.
Secondary
Ibuprofen is helpful in dysmenorrhea because it blocks _________.
prostaglandin
A parasitic STI; produces serious reproductive complications in either sex
Chlamydia
What is the most common bacterial STD in the US?
Chlamydia trachomatis
Chlamydia remains one the most common causes of ____ and ____ in adolescents.
Cervicitis
Urethritis
Females and males can often be _________
asymptomatic
What color is penile discharge with Chlamydia
thick and cloudy
What is the medical treatment for chlamydia?
1 gram azithromycin in a single dose OR doxycycline 100 mg BID x 7 days
A bacterial STI caused by a gram-negative diplococci and can be cultured from the genitourinary tract, oropharynx, conjunctiva, and/or anorectum
Gonorrhea
Gonorrhea is the leading cause of ______ among females
infertility
80% of females with gonorrhea are ________
asymptomatic
What is the vaginal discharge with gonorrhea?
Mucopurulent (copious)
In males with gonorrhea, the penile discharge is what color
White/yellow/green
What is the treatment for gonorrhea?
ceftriaxone IM single dose
When treating gonorrhea, what other STI will you also treat?
Chlamydia
True or False: Gonorrhea should be reported to the health department.
True
An STI caused by Treponema pallidum, a sphirocete
Syhplis
What occurs during primary syphilis infection?
painless indurated chancre
What occurs in secondary syphilis?
Strong reactive syphilis infection with flu-like symptoms. Maculopapular rash, especially on the palms and soles
In _______ syphilis, the patient is seropositive but asymptomatic. About ___ of untreated cases develop tertiary syphilis.
Latent syphilis
1/3
In tertiary syphilis there becomes __ __ __ involvement
Central nervous system
Serological tests for syphilis includes:
RPR
What test is used for the confirmatory test for syphilis
Treponemal tests
Treatment option for syphilis:
Benzathine penicillin G (IM)
What drugs can you use to treat syphilis if the patient is allergic to penicilin?
Doxycycline
Erythromycin
A vaginal infection in which several species of bacteria interact to alter the vaginal flora.
Bacterial vaginosis
The cause of BV is from _______ pH and ______ lactobacilli
increased pH and decreased lactobacilli
Is BV an STI?
NO, vaginal infection
What is the discharge appear like with BV
Milky white discharge
Discharge smells like what after sexual intercourse?
Fish
The Wet mount is performed for BV, which reveals ____ cells (epithelial cells covered with bacteria appear stippled with poorly defined borders).
Clue Cells
What test produces a fishy odor when potassium hydroxide to the slide with cells on it?
Amine “whiff” test
Treatment for bacterial vaginosis?
Metronidazole PO
Clindamycin PO
OR either above intra-vaginally
Recurrent, viral STI that is associated with painful lesions
Herpes
This type of herpes is found on the lips, face, and mucos
Type 1
This type of herpes is found on the genitalia
Type 2
The initial symptoms for herpes includes fever, malaise, dysuria, painful/pruritic uclers for ___ days
12 days
What is the most definitive lab/diagnostic test
Viral culture
A disorder characterized by immunodeficiency as the result of infections by human immunodeficiency virus.
Acquired Immune Deficiency Syndrome (AIDS)
What is the primary postnatal route of infection?
Breastfeeding
What screening test is is used in infants to detect HIV?
HIV polymerase chain reaction (PCR) testing
What screening test is used in infants for AIDS?
ELISA (enzyme linked immunosorbent assay)
What is the confirmatory test for HIV/AIDS
Western blot
What antibiotic is given for prevention of pneumocystis pneumonia?
Bactrim
