GU/Repro SM Flashcards
Strawberry cervix
trichomoniasis
clue cells, positive whiff test
bacterial vaginosis
Friable cervix
gonorrhea or chlamydia
too many WBCs to count
painful, burning vesicles
herpes
chlamydia treatment
doxycycline
azithromycin - pregnancy
gonorrhea treatment
ceftriaxone (Rocephin)
chlamydia and gonorrhea treatment
ceftriaxone & doxycycline
Trichomoniasis or bacterial vaginosis treatment
Metrondiazole (Flagyl)
do not drink alcohol - disulfiram-like reaction
Syphillis treatment and diagnosis? Confirmatory test? Symptoms
IM penicillin G (bicillin)
RPR, FTA-ABS
symptoms - painless chancre 3-6 weeks, rash on palms and soles, neurosyphilis
Non-hormonal option for contraception
paragard
What contraception causes osteoporosis?
depo-provera
stop after 5 years
supplement with calcium and vitamin D
What contraception is safe for breast feeding?
progestin only = mini pill
What contraception cannot be used in patients that have migraines with aura?
combination options
What specific type of birth control has the highest risk for clots?
ortho-evra patch
What are contraindications for combination OCP?
liver disease >35 and smoker history of clots/current - DVT, PE heart disease or uncontrolled HTN migraines with aura <6 weeks postpartum breast cancer
What should be done for a woman that misses two active birth control pills?
CDC take the most recent missed pill, get rid of other missed pills, use a back up method
Who should be given progestin-only options?
breastfeeding patients
What should be ordered for a childbearing age woman presenting with abdominal complaints?
hCG test
presumptive pregnancy signs
subjective
breast tenderness, nausea, amenorrhea
probable pregnancy signs
hcg, Hegar, Chadwick, Goodell
positive pregnancy signs
objective - PUFF
palpitation of fetus
ultrasound of fetus
fetal heart tones
fundal height at 12 weeks
rising above symphysis pubis
fundal height at 20 weeks
umbilicus, measuring +/- 2 cm as weeks of gestation = normal. Starts at 20 weeks, regresses starting at 36 weeks
What is completed 35-37 weeks gestation?
GBS
When is gestational diabetes?
24-28 weeks
When is Rhogam given?
week 28 and 72 hours postpartum
Asymptomatic UTI in pregnancy is treated with?
CAMP cephalosporins amoxicillin macrobid penicillin
What antibiotic cannot be administered in the 1st trimester? 3rd trimester?
1st = cephalosporins 3rd = macrobid
What antibiotic CANNOT be administered during pregnancy?
NO ciprofloxacin - fluoroqinolones, not safe <18 years of age (babies
When is AFP testing completed in pregnancy? What is this? high? low?
16-20 weeks gestation
alpha fetoprotein level
high - neural tube defect
low - down’s syndrome
What prevents neural tube defects?
folic acid
history of = 4 mg
no hx = 0.4 mg
What are down’s syndrome at higher risk of?
cervical spine instability
Alzheimer’s
hypothyroidism
What must be done if a child with Down’s syndrome wants to play sports?
Cervical spine XRAY
Describe placenta previa
pain-LESS bleeding, soft uterus, bleeding
Describe placenta abruption
PAINFUL bleeding, hard uterus, bleeding
What is the treatment for mastitis? Allergy? What if symptoms persist after treatment?
Dicloxicillin
allergic to pcn = clindamycin, macrolides
refer! may need mammogram
When are pap smears started? HPV?
age 21 regardless of sexual status, every 3 years
age 30, every 5 years if both pap and hpv
What results require referral immediately for colposcopy?
LISL - low grade
HISL - high grade
CIN 2 and 3 = BAD
Atypical squamous cells of undetermined significance
HPV screening regardless of age
colposcopy if positive HPV
What is the treatment for genital warts?
TCA acid
Is it normal to see vaginal bleeding in a post-menopausal woman?
NO!
refer for endometrial biopsy
What is hormone replacement therapy? Risks? Alternatives? (name the drug)
risks - diabetes, blood clots, CV disease
alternatives - SSRI (paroxetine/paxil), IUDs, vaginal creams, herbal supplements
What herbal supplements are commonly used for menopause?
ginseng - increases bleeding time
black cohash - hot flashes
Hormone replacement therapy increases risk of what type of cancer?
ovarian
PCOS are at a higher risk of
diabetes/insulin resistance
hyperlipidemia
certain cancers
What is galactorrhea? What should be ordered? What medication class causes this?
milky discharge expressed from breast
associated with breast stimulation
order prolactin (rule out prolactinoma)
atypical antipsychotics
What is found on digital rectal exam of a patient with benign prostatic hyperplasia?
symmetrically enlarged, rubbery prostate with urinary frequency and hesitancy
What medications treat BPH? side effect?
alpha blockers -zosins
terazosin, doxazosin
orthostatic hypotension, TAKE AT BEDTIME
What herbal supplement helps BPH symptoms? What medication shrinks the size of the prostate?
saw palmetto
Finasteride/Proscar
What is the PSA cutoff for referring?
4
must have greater than 10 years to live to treat prostate cancer, slow growing
Positive Prehn sign. Describe and what is this associated with?
relief of pain when elevating the scrotum and is associated with Epididymitis
What is the treatment of epididymitis for a patient <35 years old? >35 years old?
<35 = doxycycline or ceftriazone/rocephin >35 = levofloxacin (E.coli)
Severe unilateral testicular pain and absent cremasteric reflex is?
testicular torsion
REFER!
What labs are the best indicators of kidney function?
eGFR
creatinine
BUN - less specific
What indicates kidney damage on urinalysis and needs referral?
RBCs or WBCs casts
glomularnephritis vs pyelonephritis
What are first line medications for nonpregnant UTI patient?
Macrobid
Bactrim
Ciprofloxacin
What should be ordered for a recurring UTIs?
kidney ultrasound
What is the immediate concern with a patient has erectile dysfunction? What medications are used? What should be ordered before prescribing?
heart concerns, underlying cardiac issues
PDE-5 (penis does not erect)
order an EKG!
What medication cannot be given with PDE-5 inhibitiors?
nitroglycerin
