Pregnancy Signs and STI Flashcards
What are Presumptive signs?
These are the symptoms and sensations that, while possibly indicating pregnancy, also could be caused by any number of other conditions. These are also some of the earliest pregnancy symptoms.
Absent menstrual periods (amenorrhea)
Nausea and/or vomiting (morning sickness)
Unexplained fatigue
Frequent urination
Breast tenderness and changes
Excessive salivation (ptyalism)
Skin changes
A sensation of movement in abdomen (quickening)
What are Probable signs?
Most of the time, these do indicate pregnancy – but, in certain cases, they might be false or caused by another condition.
Positive pregnancy test (presence of hCG detected, by blood or urine test)
Softening of cervix at six to eight weeks (Goodell’s sign)
Bluish coloration of cervix, vagina and vulva at six to eight weeks (Chadwick’s sign)
Enlarged abdomen
Braxton-Hicks contractions
Passive movement of the fetus during an exam (ballottement)
What are Positive signs?
These can’t be mistaken for any other condition. They’re considered absolute evidence that you are, in fact, pregnant. They rely on the senses – sound, sight and touch – as interpreted by your caregiver.
Fetal heart sounds heard by Doptone or Doppler
Fetus visible on ultrasound
Fetal movements felt by caregiver
Fetus visible on X-ray, MRI or other diagnostic imaging device (Note: Use of these devices is not recommended during pregnancy)
What are the value of the signs?
Even the presumptive signs are important to know because of the value of prenatal care. As soon as pregnancy is suspect
Patients should start taking extra-good care of themselves:
Avoid alcohol and cigarettes
eat well and get plenty of rest
start taking prenatal vitamins.
What are the ACOG guidelines for Pap smear?
Women ages 21 to 65
Screen with cytology (Pap smear) every 3 years. Grade: A
Women ages 30 to 65
Screen with cytology every 3 years or co-testing (cytology/HPV testing) every 5 years. Grade: A
Women younger than age 21
Do not screen. Grade: D
Women older than age 65 who have had adequate prior screening and are not high risk
Do not screen. Grade: D
What are Pap smear results?
ASC-US (Atypical Squamous Cells of Undetermined Significance)
ASC-H (Atypical Squamous Cells-can not exclude HSIL )
Low-Grade SIL (LSIL)
High-Grade SIL (HSIL)
What is a progesterone challenge?
Prescribe oral medroxyprogesterone acetate ( Provera) 10mg daily for 5 days
Positive : withdrawal bleeding or spotting within 7 days of last pill
Suggests anovulation
Negative: no withdrawal bleeding or spotting
suggest inadequate estrogen levels to prepare uterus
TX: wait 2 weeks then prescribe conjugated estrogen 1025mg daily for 21 days or 2mg estradiol daily for 21 days with provera 10 mg for the las 5 days of the estrogen or combo Oral contraceptives
How to treat Bacterial vaginosis?
Bacterial vaginosis- clue cells- odor fishy
Treatment:
flagyll ( metodiazole) 500mg po bid for 7 days and no alcohol
How to treat Yeast infection?
Yeast infection- itchy, cottage cheese appearance – white clumps
Treatment: dilucan 150mf po 1 tab now Gyne-Lotrimin or Mycelex (clotrimazole) Gynezol or Femstat (butoconazole) Monistat (miconazole nitrate) Vagistat-1 (tioconazole)S
How to treat Trichomoniasis?
Treatment:
Metronidazole 2 g orally in a single dose
OR
Tinidazole 2 g orally in a single dose
Alternative Regimen
Metronidazole 500 mg orally twice a day for 7 days
How to treat Uncomplicated Gonococcal Infections of the Cervix, Urethra, and Rectum?
Treatment:
Ceftriaxone 250 mg IM in a single dose
PLUS
Azithromycin 1g orally in a single dose
How to treat Chlamydia ?
Azithromycin 1 g orally in a single dose
OR
Doxycycline 100 mg orally twice a day for 7 days
What are the stages of Syphilis?
The initial infection causes an ulcer, or chancre, at the site of infection. This is called the primary stage of the disease. It is followed by three more stages, called, the secondary, latent and tertiary stages.
The secondary stage is characterized by a skin rash and a variety of other signs. Mouth ulcers and genital sores are frequently found. This stage lasts approximately one year.
This is followed by a latent stage in which no symptoms appear. This stage can last for years or even decades. Many people die of other causes, before the tertiary stage of syphilis sets in.
The tertiary stage of syphilis causes symptoms that can range from mild to extremely serious. The three main symptoms are syphilitic lumps, which can leave scars, heart problems, which could lead to heart failure, and neurosyphilis, of which hallucinations and delusions of grandeur are the most noticeable symptoms.
How to test for syphilis?
RPR (rapid plasma reagin) is a screening test for syphilis
How to treat syphilis?
Benzathine penicillin G 2.4 million units in a single intramuscular injection
