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Primary PNP > Gynecological Issues and Disorders > Flashcards

Gynecological Issues and Disorders Flashcards

1
Q

Parasitic sexually transmitted disease; intracellular obligate which closely resembles a gram-negative bacterium

A

Chlamydia

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2
Q

Most common bacterial STI in the US between ages 14-24 years

A

Chlamydia

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3
Q

The most common cause of cervicitis and urethritis in adolescence

A

Chlamydia

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4
Q 
Dysuria
Intermenstrual spotting
Postcoital bleeding
Dyspareunia (painful intercourse)
Vaginal discharge
Lower abdominal/pelvic pain
Rectal tenesmus
A

Signs and symptoms of chlamydia in females

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5
Q

Dysuria
Thick, cloudy, penile discharge
Testicular pain
Rectal tenesmus

A

Signs and symptoms of chlamydia in males

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6
Q

What is rectal tenesmus?

A

The feeling of being unable to empty the large bowel of stool

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7
Q

What is the management for chlamydia?

A

Azithromycin [Zithromax] 1 g orally in a single dose
Doxycycline [Vibramycin] 100 mg orally twice a day x 7 days
Azithromycin, Erythromycin, or Amoxicillin if pregnant

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8
Q

Bacterial STD caused by Neisseria gonorrhoeae (gram-negative diplococci) that can be cultured from genitourinary tract, oropharynx, conjunctiva, and/or anorectum

A

Gonorrhea

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9
Q 
Most are asymptomatic
Dysuria
Urinary frequency
Mucopurulent vaginal discharge
Labial pain/swelling
Lower abdominal pain
Fever
Dysmenorrhea
Nausea/vomiting
A

Signs and symptoms of gonorrhea in females

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10
Q

What is the leading cause of infertility among females?

A

Gonorrhea

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11
Q 
Most are asymptomatic
Dysuria
Frequency
White/yellow-green penile discharge
Testicular pain
A

Signs and symptoms of gonorrhea in males

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12
Q

What will diagnostics show for gonorrhea?

A

Gram-negative diplococci and white blood cells

Cervical culture for N. gonorrohoeae using Thayer-Martin or Transgrow media

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13
Q

What is the treatment for gonorrhea?

A

Ceftriaxone [Rocephin] 500 mg IM x 1 dose + Doxycycline 100 mg orally twice daily for 7 days for chlamydia

All contacts should be treated

REPORT TO HEALTH DEPARTMENT

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14
Q

How do you treat gonorrhea in pregnancy?

A

Ceftriaxone 500 mg in a single IM dose and azithromycin [Zithromax] 1 gram PO as a single dose

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15
Q

What illnesses must be reported to the state health department?

A

Gonorrhea, Syphillis, Chlamydia

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16
Q

Sexually transmitted disease involving multiple organ systems and caused by Treponema pallidum

A

Syphilis

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17
Q

Chancre present at the site of inoculation 2-6 weeks after exposure
Chancre indurated and painless
Regional lymphadenopathy

A

Primary stage of syphilis

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18
Q

Occurs 6-8 weeks later
Flu-like symptoms
Generalized lymphadenopathy
Generalized maculopapular rash (especially on palms and soles)

A

Secondary stage of syphilis

19
Q

Seropositive, but asymptomatic

About 1/3 of untreated cases develop tertiary syphilis

A

Latent stage of syphilis?

20
Q

Leukoplakia
Cardiac insufficiency–aortitis, aneurysms, aortic regurgitation
Infiltrative tumors of skin, bones, liver
CNS involvement–meningitis, hemiparesis, hemiplegia, others

A

Tertiary stage of syphilis

21
Q

What are the diagnostic tests for syphilis?

A

Venereal Disease Research Laboratory (VDRL)
Rapid plasma reagin (RPR)
Confirmed with treponemal tests

22
Q

What is the management of syphilis?

A

Benzathine penicillin G

23
Q

What do you treat syphilis with a penicillin allergy?

A

Doxycycline

Erythromycin

24
Q

Vaginal infection in which several species of bacteria interact to alter the vaginal flora

A

Bacterial vaginosis

25
Q

What is the most prevalent vaginal infection in women of reproductive age?

A

Bacterial vaginosis

26
Q

Increased milky discharge
May have pruritis
Malodorous “fishy” discharge most evident after sexual intercourse

A

Signs and symptoms of bacterial vaginosis

27
Q

How do you treat bacterial vaginosis?

A

Metronidazole PO
Clindamycin PO
Intravaginal metronidazole or clindamycin

28
Q

What do diagnostics show for bacterial vaginosis?

A

Wet shows clue cells (epithelial cells covered with bacteria appear stippled with poorly defined borders); decreased/absent lactobacilli; few or absent WBC

Positive amine “whiff’ test

29
Q

Recurrent, viral sexually transmitted disease that is associated with painful lesions

A

Herpes

30
Q

How is herpes transmitted?

A

Direct contact with active lesions or by virus-containing fluid (saliva, cervical secretions)

31
Q

Fever, malaise, dysuria, painful/pruritic ulcers for 12 days

A

Initial herpes reaction

32
Q

What are the signs and symptoms of recurrent herpes reaction?

Less painful/pruritic ulcers for 5 days

A

Recurrent herpes reaction

33
Q

What are the diagnostics for herpes?

A

Papanicolaou or Tzanck stain

Viral culture is the most definitive

34
Q

What is the treatment options with herpes?

A

Acyclovir [Zovirax] for topical, oral, IV routes

Valacyclovir is usually for asymptomatic viral shedding of HSV-2

35
Q

Characterized by immunodeficiency as the result of infections by human immunodeficiency virus (HIV)

A

Acquired Immune Deficiency Syndrome (AIDS)

36
Q

What is the primary postnatal vertical route for HIV transmission?

A

Breastfeeding

37
Q 
Low birth weight and the falling ratio of head circumference to height/weight
Recurrent infections
Diminishing activity
Developmental delay
Hepatosplenomegaly
Generalized lymphadenopathy
A

Signs and symptoms of AIDS

38
Q

In infants what diagnostic screening should be used for HIV?

A

HIV polymerase chain reactions (PCR)

39
Q

In older children what diagnostic screening should be used for HIV?

A

Enzyme-linked immunosorbent assay (ELISA) screening

40
Q

What is confirmatory testing for HIV?

A

Western blot test

41
Q

What shows progression to AIDS?

A

Absolute CD4 lymphocyte count (normal > 800)
CD4 lymphocyte percentage of WBC (at risk when higher than <20%)
Viral load (should be < 5,000 copies or “zero/undetectable”

42
Q

What is used for prevention against opportunistic infections in HIV/AIDS?

A

Bactrim for PJP prevention

Monitor for cytomegalovirus

43
Q

What is the treatment for HIV/AIDS?

A

Usually started at diagnosis of HIV positivity irrespective of CD4 count
Drug resistance develops rapidly so stress importance of taking medication exactly as prescribed

Primary PNP (8 decks)

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