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FNP Review > Reproductive Health > Flashcards

Reproductive Health Flashcards

good for N522 AU midterm as well,: pregnancy, STIs, contraception

You may prefer our related Brainscape-certified flashcards:
Family Nurse Practitioner (FNP) flashcards
1
Q

What does HELLP stand for

A

Hemolysis
Elevated Liver enzymes
Low Platelets

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2
Q

Bright red bleeding with intercourse in pregnancy with no abdominal hardening can mean

A

placenta previa

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3
Q

abrupt onset of abd pain with hypertonic uterus with/without bleeding

A

placental abruption

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4
Q

HTN after 20 weeks gestation with urine protein, headache, epigastric pain, visual issues

A

preeclampsia

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5
Q

Bright red bleeding in pregnancy but no hypertonic tender uterus

A

placenta previa

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6
Q

Bright red bleeding with hypertonic hard and tender uterus

A

placenta abruptio

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7
Q

what lab results increase in baseline in pregnancy

A

alk phos (2-3 trimester)
lipid profile
t3
wbc
plts
sed rate
gfr

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8
Q

BHcG does what in 1st 12 weeks of pregnancy

A

doubles every 24-72 hrs

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9
Q

what causes alk phos to increase in pregnancy

A

growth of fetal bones

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10
Q

when can amniocentesis and chorionic villus sampling be done

A

amnio - 15-18
chorio 10-12

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11
Q

what lab result to use in pregnancy to dx anemia

A

mcv

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12
Q

what genetic disorder screening should be done european jewish decent

A

tay-sachs

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13
Q

what does alpha fetoprotein measure

A

risk of downs syndrome, neural tube defects and abdominal wall defects

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14
Q

low AFP means

A

possibilty of downs syndrome

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15
Q

high AFP means

A

possible neural tube defects, gastroschisis, omphalocele

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16
Q

folic acid dose all women

A

400mcg daily

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17
Q

what STIs should be screened for in pregnancy

A

Hep B, HIV, gonorrhea, chlamydia, syphilis, HSV 1 and 2

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18
Q

when to screen for GBS

A

35-37 weeks

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19
Q

what drug is used to treat GBS

A

Pen G 5 mill unit IV x1 then 2.5 mill units q4 hrs until birth
if allx to pcn clinda or erythromycin

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20
Q

category A drugs in pregnancy are considered

A

no risk

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21
Q

category B drugs in pregnancy are considered

A

no risk, no data

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22
Q

category C drugs in pregnancy are considered and examples

A

adverse effects, no data
sulfa drugs in 3rd trimester,
sudafed

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23
Q

category d drugs in pregnancy are considered and examples

A

fetal risk: benefits must outweigh risk
ACE ARB
fluoroquinolones
tetracyclines
NSAIDS

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24
Q

category x drugs in pregnancy are considered and examples

A

fetal risks outweigh benefits
methotrexate
misoprostol
proscar

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25
Q

drugs to avoid in 3rd trimester

A

sulfa dtugs
NSAIDS
ASA

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26
Q

are live attenuated vaccines safe in pregnancy, give examples of these

A

no
MMR, varicella

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27
Q

how long after receiving live attenuated vaccine should pregnancy be avoided

A

4 weeks (MMR), 3 months (varicella)

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28
Q

what are teratogens and give examples

A

drugs that cause fetal abnormalities
paroxetine, fluoxetine
Alcohol
aminoglyclosides
cocaine
lithium

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29
Q

cat litter or raw undercooked meat can cause what

A

toxoplasmosis

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30
Q

what does zika virus do

A

cause severe birth defects with neurodevelopmental abnormalities

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31
Q

how long to avoid becoming pregnant if travelled to area with zika virus exposure

A

both partners or just male: 3 months
only female: 2 months

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32
Q

best weight gain if healthy weight before pregnancy

A

25-35lbs

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33
Q

BMI <18.5 best weight gain in pregnancy

A

28-40lbs

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34
Q

obese pt weight gain in pregnancy

A

11-20 lbs

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35
Q

what age for geriatric pregnancy

A

35

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36
Q

advanced maternal age pregnancy at risk for:

A

chromosomal abnormalities
preeclampsia
LGA
misscarraige
preterm birth
complications

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37
Q

positive pregnancy signs

A

palpation of fetus
ultrasound
fetal heart tones

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38
Q

probable signs of pregnancy (remember surnames)

A

goodell, chadwick, hegar
ballottment
urine HcG

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39
Q

chadwicks sign

A

cervix softening

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40
Q

goodells sign

A

blue discoloration of cervix

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41
Q

hegars sign

A

softening or uterine isthmus

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42
Q

presumptive pregnancy signs

A

amenorrhea
nausea and vomitting
breast changes
fatigue
urinary frequency
quickening

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43
Q

fundal height at 12 weeks

A

symphysis pubis

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44
Q

fundal height at 16 weeks

A

halfway between symphysis pubis and umbilicus

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45
Q

fundal height at 20 weeks

A

umbilicus

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46
Q

fundal height at 20-35 weeks

A

within 2 cm +/- of gestation

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47
Q

naegeles rule

A

add 9months and 7 days
or
- 3 months and + 7 days

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48
Q

is S3 heart sounds considered normal in pregnancy

A

yes

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49
Q

HTN medications in pregnancy

A

labatelol
nifedipine
methhyldopa
metoprolol

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50
Q

what is chloasma/melasma and what causes it

A

hyperpigmentation on forehead, cheeks, nose and upper lip
caused by high estrogen levels

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51
Q

what does GTPAL stand for

A

G gravida
T term
P preterm
A abortion
L living

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52
Q

Is clicking noises while breastfeeding considered normal or abnormal

A

abnormal due to poor latch

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53
Q

should a woman stop breastfeeding due to sore nipples

A

no, advise to continue, not supplement and have latch assessed

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54
Q

exclusively breastfeeding amenorrhea (lactational amenorrhea contraception method)

A

low chance of ovulation in first 6 months due to low estrogen levels

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55
Q

birth control contraindicated with breastfeeding

A

COC or estrogen containing

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56
Q

how long does uterine involution take

A

6 weeks

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57
Q

what is uterine atony

A

boggy uterus, full bladder or possible PPH

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58
Q

bleeding and cramping with placenta and fetus expelled

A

complete abortion

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59
Q

diabetes diagnosed in 1st trimester

A

Type 2 diabetes

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60
Q

Goal A1C levels for AGA baby

A

<6

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61
Q

2methods for screening of GDM

A

1 STEP 75 gm GTT (screening and diagnosis)
2 step 50 gmGTT (screening)

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62
Q

if 2 step GTT GDM screening is abnormal what is the next step

A

100gm GTT (3 hour with fasting)

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63
Q

1st line treatment for GDM

A

lifestyle modifications

64
Q

2nd line treatment for GDM

A

insulin

65
Q

risk factors for GDM

A

GDM previously
obesity
ethnicity
macrosomic infant
advanced maternal age

66
Q

vaginal bleeding with cramping, open cervical is with partial products of contraception remaining

A

incomplete abortion

67
Q

vaginal bleeding, open cervical os

A

inevitable abortion

68
Q

treatment for mastitis

A

dicloxacillin 500mg po QID or keflex 500mg po QID
if risk for MRSA Bactrim or clindamycin
continue to breastfeed
u/s if abscess suspected
NSAIDS for pain with cold compresses

69
Q

HTN, proteinuria, rapid weight gain are symptoms or what in pregnancy

A

preeclampsia

70
Q

HTN before 20 weeks gestation

A

chronic HTN

71
Q

amniotic fluid levels less than normal

A

oligohydramnios

72
Q

amniotic fluid levels higher than normal

A

polyhydramnios

73
Q

action of RhoGAM

A

immunoglobulin that decreases risk of isoimmmunization by destroring RH positive RBCs that cross the placenta

74
Q

frequency of RhOGAM

A

28 weeks gestation and 72 hoours post delivery or if bleeding

75
Q

misscaraige <20 weeks gestation

A

spontaneous abortion

76
Q

pregnancy loss after 20 weeks

A

stillbirth

77
Q

vaginal bleeding with closed cervical os

A

threatened abortion

78
Q

chlamydia treatment

A

doxy 100mg po BID x 7 days
pregnant: azithromycin 1 gm x1

79
Q

testing for chlamydia and gonorrhea

A

NAAT

80
Q

are UTIs in pregnant women complicated or uncomplicated

A

complicated

81
Q

UTIs can cause what in pregnancy

A

preterm birth
LGA
perinatal mortality

82
Q

lab results for diagnosis of UTI in pregnancy

A

10(3) cfu in symptomatic
10(5) cfu in asymptomatic

83
Q

treatment for UTI in pregnancy

A

macrobid (not in last trimester)
amox/clav
keflex
fosfomycin

84
Q

menstrual cycle phases

A

follicular phase 1-14
ovulatory phase 14
luteal phase 14-28
menstruation

85
Q

when is the fertile time period

A

1-2 days before ovulation

86
Q

what HPV types are oncological

A

16 and 18

87
Q

when can gardisil be given

A

11-12 years old (2 doses before 15, 6 months apart)
no need to restart vaccine schedule if missed dose

88
Q

KOH slides used for

A

candida

89
Q

whiff test used for

A

BV

90
Q

tzanck smear used for

A

genital herpes

91
Q

birth control recommended for acne

A

combined estrogen progestin (monophasic, biphasic, triphasic)

92
Q

what oral contraceptive allows for only 4 periods a year

A

seasonale

93
Q

contraindications for birth control

A

hx clots
smoker
hx stroke
elevated LFTs or liver dysfunction

94
Q

absolute contraindications pneumonic for contraception

A

MY migraine with aura
C CAD or CVA
U undiagnosed genital bleeding
P pregnancy
L liver tumor or elevated Liver enzymes
E estrogen dependent tumors
T thrombus
S smoker aged 35 or older

95
Q

low dose birth control contains how much estrogen

A

20-35 mcg

96
Q

if missing 2 consecutive days of birth control what do you do?

A

take most recent missed pill (including taking 2 the same day), discard any other missing pills, resume next day and use backup contraception

97
Q

drugs that interact with birth control

A

anticonvulsants
antifungals
HIV HEP C inhibitors
certain antibiotics (ampicillin, tetracyclin, rifampin, clarithromycin)
st johns wort

98
Q

birth control danger signs pneumonic

A

A abdominal pain
C chest pain
H headaches
E eye problems
S severe leg pain

99
Q

who should not receive depo-provera

A

anorexic or bulimic ( high risk of osteoporosis)

100
Q

box warning for depo provera

A

not to be used longer than 2 years

101
Q

how is plan B taken

A

1st dose within 72 hours, next dose 12 hours later
if vomits within 1 hour of taking, then take another dose

102
Q

what birth control causes a delay in return of fertility for 12 months after stopping

A

depo provera

103
Q

contraindications for IUD

A

PID currently or past year
pregnant
cervical abnormalities
hx ectopic pregnancy
undiagnosed vaginal bleeding

104
Q

how long do iud lasts

A

copper 10 years
mirena 3-5 years

105
Q

vaginal discharge with fish odour, worse after intercourse, milk like consistency, white to light grey discharge no vulvar or vaginal redness

A

BV

106
Q

vaginal pH >4.5 and positive whiff test

A

BV

107
Q

Vaginosis treatment

A

Flagyl ( gel in pregnancy)

108
Q

what are these and what do they diagnosis

A

clue cells and BV

109
Q

white curd like vaginal discharge with pruritis, swelling and redness

A

candidiasis

110
Q

treatment for candidiasis

A

miconazole

111
Q

grey and frothy vaginal discharge, strawberry cervix, dysuria

A

trichomoniasis

112
Q

treatment for trichomoniasis

A

flagyl 2gm x1 or 500mg BID x7 days

113
Q

NAAT testing used for what

A

Gonorrhea and Chlamydia, Trichomoniasis

114
Q

vaginal dryness, itching and dyspareunia, atrophic labia with decreased rugae

A

atrophic vaginitis

115
Q

1st line treatment for atrophic vaginitis

A

vaginal moisturizers and lubricants

116
Q

treatment for severe vulvovaginal atrophy

A

topical estrogen

117
Q

when is prophylaxis advised for pneumocytis pneumonia

A

CD4 <200

118
Q

Purple to bluish red bumps on the skin of pt with aids

A

Kaposis sarcoma

119
Q

infectious HIV with flu like symptoms

A

primary HIV infection

120
Q

STD symptoms (mainly gonnorhea) with swollen red joint on one side

A

disseminated gonococcal infection or reactive arthritis

121
Q

5 Ps for STD screening

A

partners
practices
protection
past history of STI
prevention of pregnancy

122
Q

NAAT is positive for chlamydia only: treatment

A

doxycycline

123
Q

plan for pregnant pt with chlamydia

A

azithromycin and test for cure in 3-4 weeks

124
Q

NAAT specimen of choice for men

A

first catch urine

125
Q

HSV 1 and 2 sites

A

1: oral mucosa
2: genitals

126
Q

acute onset of small vesicles one reddened base that rupture easily and develop into painful shallow ulcers

A

Genital herpes

127
Q

when you find multinucleated giant cells on a tzank smear

A

genital herpes

128
Q

treatment for first episode of genital herpes

A

valcyclovir BID x 7-10 days or acyclovir TID

129
Q

treatment for genital herpes flareup

A

valcyclovir 500 BID x 3 or 1000mg daily x5
acyclovir 800 TID x2 or 800 BID x5

130
Q

rule out what if hairy leukoplakia, recurrent candidiasis or thrush

A

HIV

131
Q

test for HIV

A

HIV 1/2 antibodies and p24 with reflexes

132
Q

CD4 count increasing on ART means

A

Immune system improving

133
Q

Pneumocystitis pneumonia medication not for G6PD anemia

A

dapsone

134
Q

treatment and prophylaxis for Pneumocystitis pneumonia

A

Bactrim DS (trimethoprim-sulfamethoxazole)
if allergy use dapsone with trimethoprim

135
Q

Can HIV pregnant patients get treatment

A

yes, AZT asap

136
Q

oncogenic types of HPV

A

16 and 18

137
Q

soft white fleshcolored or brown pedunculated papular growths that may me flat or cauliflower like

A

condyloma acuminata (warts)

138
Q

Treatment for genital warts in non pregnant patient

A

imiquimod (immune modulator)

139
Q

treatment for genital warts for pregnant patient

A

mechanical methods only

140
Q

when to screen for gonorrhea and chlamydia in pregnancy

A

1st and 3rd trimester

141
Q

cervix may appear normal or with purulent green discharge

A

Gonorrhea

142
Q

treatment for gonorrhea

A

ceftriaxone 500mg IM x1 (if >150kg 1gm)

143
Q

Proctitis treatment

A

ceftriaxone and doxycycline

144
Q

risk factors for pelvic inflammatory disease

A

sex
hx of PID
multiple partners
age 15-25
disruption of vaginal ecosystem

145
Q

lower back and/or abd pain with pain of cervical motion, uterine or adnexal tenderness

A

pelvic inflammatory disease

146
Q

treatment of PID

A

ceftriaxone, doxycycline and flagyl

147
Q

inflammation of liver capsule with RUQ pain in pt with PID

A

fitz-hugh-curtis

148
Q

syphillis with painless chancre

A

primary

149
Q

systemic syphilis with rash (condyloma lata)

A

secondary

150
Q

screening tests for syphilis

A

RPR and VDRL

151
Q

if RPR or VDRL positive for syphilis what next

A

confirm with treponemal test (FTA-ABS)

152
Q

early syphillis treatment

A

Pen G 2.4 mill unit IM

153
Q

Late syphilis treatment

A

Pen G 2.4 mill unit IM weekly x3
pr doxyn100mg po BID x28 days

154
Q

self-limited febrile reaction after spirochete infection treatment

A

jarisch herxheimer reaction

155
Q

infection with spirochete on microscope

A

syphilis

156
Q

treponema pallidum causes what

A

syphilis

FNP Review (3 decks)

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