last minute Flashcards
Explain the MOA of Danazol and why it’s not preferred over GnRH agonists
synthetic androgen that induces amenorrhea
side effects of hypo estrogen and androgens
more side effects than GnRH agonists-especially the deep voice that won’t go away
How do you appropriately administer goserelin?
GnRH agonist which needs to be accompanied by add back therapy of hormones similar to those used in HRT. Eliminate menopausal symptoms including vaginal atrophy and bone demineralization without diminishing the effect of endometrial inhibition.
chronic use of GnRH agonist can be described as affecting the ovaries in what way?
like a medical oophorectomy
Describe the treatments for endometriosis
NSAID COC POPs GnRH Danazol
tranexamic acid can also be called what? Name another similar drug
lysine analogue
Aminocaproic acid
tinidazole same MOA as metronidazole how is it administered?
oral or intravaginal
Trichomonas vaginitis should be treated with tinidazole or metronidazole how:
oral IV IM Sub cutaneous transvaginal
oral only
What is liberal? how should it be used?
continuous COC
no bleeding regular except BTB occurs
drospirenone is a spironolactone analogue with what type of activity?
antimineralcorticoid and antiandrogenic
potassium sparing diuretic
What are some risk factors for acquiring PID? Which type of infection is more likely to lead to infertility; N. Gonorrhea or a NGI?
Anything that transmits to the upper vagina: Tampons, douching, IUD, intercourse, and within 7 days of menses the cervical mucus thins helping both bacteria and sperm to enter the endometrium.
Infertility is more likely in NGI; and is the most common cause of involuntary infertility in women
Patient presents with lower abdominal pain 3 days after her LMP. In addition she has a moderate fever, and increased vaginal discharge. While questioning her about her hx she says she feels nauseous. You palpate a tender adnexal mass. How should you treat this patient?
Likely has PID treat as a mixed infection. Typically Nisseria Gonorrhea or Chlamydia T.
what do you think of with violin strings between liver and abdominal wall, and guitar strings on anorectal exam?
violin Fitz Hugh Curtis syndrome
Anorectal endometriosis
What bacteria exibits molar tooth colonies?
actinomyces israelii
What cancers are associated with HPV infection
Cervix, oropharynx, anus
Most genital HPV infections are:
- transient, asymptomatic, or subclinical
- ASC-H and require a colposcopy
- 6, 11 and require only “wart removal” or Rx Tx
- cancer causing and not covered by gardazil
1 transient asymptomatic or subclinical
Whats the natural course of HVP infection?
Infection
wks-months first lesion
wks-months CIN1 or warts (immune response)
Remission or persistence with risk CIN2,3
Low risk usually clears in 4-9months
High risk 12-18 months
HPV to become cancer requires what?
persistant infection
interference with pRb and p53
pRb cell cycle regulation
p53 induce apoptosis
How does the body fight HPV?
usually it’s cleared by cell mediated immunity
Inhibits viral infection but doesn’t kill virally infected cels. No activated T-cells just plasma cells.
what’s the composition of gardasil?
Proteins from outer membrane of virus
not live no DNA
How does the innate host defense recognize foreign material?
PRR
HPV is implicated in what percentage of cervical and anal cancer? A patient of yours has anal cancer likely from having sex with men why is this likely so common?
99% cervical, 80% anal
men with penile HPV are often asymptomatic
your in the pediatric unit and notice that one of the crying babies has what looks like a laryngeal papilloma. what’s the likely etiology?
Mom had HPV warts and gave it to the kid
Name the vegetable that looks most like condylomata acuminate?
cauliflower
How does chronic inflammation and immunosuppression come into play with HPV?
Increases the risk of cancer development in these oncogenic viruses. Trauma or inflammation at the transition zone increase risk of an effective infection from HPV. Especially on an immunocompromised background.
Match the following E6,7 with pRB, P53. What are the functions of these proteins?
E6 with p53 apoptosis
E7 with pRb cell cycle reg.
How do you diagnose HPV?
clinical visualization of warts, or colposcopy and biopsy
DNA probes and PCR of cervical swabs is method of choice for dx and typing
Dejango is a 24 y/o, iliterate, former sex worker, of african american decent who grew up in a Detroit getto and was recently released from a correctional facility. He likes to meet new partners on the internet and has a long STI hx, as well as some minor illicit drug use. He’s unmarried and recently hooked up with someone in the past 60 days. what is he at risk for? What’s your advice?
MORE STIs has all the risk factors!
wrap it, test it, treat it, and call your partner
Describe the vaginal pH, discharge, amine/fish test, and microscopy for normal vaginal discharge, bacterial vaginosis, trichomoniasis, and mycotic vulvovaginitis
Normal, vaginosis, protozoan, yeast
pH 3.8-4.2, >4.5
Discharge- thin white flocculent, thin white milky or gray, yellow green and frothy, white cottage cheese like
Amine- absent, Fishy, Fishy, absent
micro- lactobacilli epithelial cells, clue cells no WBC,
Trichomonads and WBC, Budding yeast pseudohyphae
