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Genitourinary > STDS, Vaginal, Pregnancy > Flashcards

STDS, Vaginal, Pregnancy Flashcards

1
Q

Strawberry Cervix

A

Trich

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2
Q

Clue cells and whiff test

A

BV
Clue cells have fuzzy edges from bacteria sticking to them, stain blue

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3
Q

friable cervix

A

Most likely Chlamydia, Gonorrhea or PID

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4
Q

Normal Vaginal pH

A

3.8-4.5

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5
Q

Treatment for Gonorrhea

A

Rocephin (ceftriaxzone) IM injection

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6
Q

Treatment for Chlamydia

A

Azithromycin

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7
Q

Treatment if patient has both Chlamydia and Gonorrhea (which often happen together)

A

Doxycycline.
This can also be used for Chlamydia or Gonorrhea on their own if the patient is allergic to other antibiotics.

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8
Q

Treatment for trich or BV and what side effect does this med have?

A

Flagyl (metronidazole) –Side effect (disulfram like reaction) Other name is metronidazole

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9
Q

Symptoms of syphillis

A

First symptom is PAINLESS canker 3-6 weeks). Second rash on palms and soles. Third stage havoc on neurosyphillis.

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10
Q

Test for syphillis

A

RPR (rapid plasma reagin), Confirmatory test is FTA-ABS

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11
Q

Treatment of syphillis

A

IM PCN, specifically Bicillin (Pen G)

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12
Q

Treatment for yeast infection

A

Fluconazole (diflucan)

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13
Q

Which contraception method can increase risk of osteoporosis?

A

Depo-provera (the shot)
Give vitamin D and calcium. Don’t prescribe for more than 5 years.

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14
Q

Which birth control should not be given to those with migraine with aura

A

any of the combo pills (estrogen/progesterone

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15
Q

Birth control with highest risk for blood clots

A

Ortho evra patch

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16
Q

Contraindications for taking hormonal birth control

A

current or hx of blood clot, migraine with aura, older than 35 and smoker, liver disease (Estrogen-containing oral contraceptives have been associated with cholestasis and development of hepatic adenoma and are contraindicated in women with acute liver disease.)

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17
Q

What should a woman do if she’s missed two contraception pills?

A

take the next pill immediately, use back up method

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18
Q

If a female of childbearing years is having GI complaint, what test should be run

A

pregnancy test - even if female says she hasn’t started her period

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19
Q

Should a pregnant woman with a asymptomatic UTI be treated with antibiotics

A

Absolutely!

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20
Q

Which antibiotics for pregnancy UTI

A

Think CAMP (pregnant woman don’t want to camp! lol)
Cephalosporins, Amoxicillian, Macrobid, Penicillians. Macrobid is generally avoided in the first trimester.

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21
Q

When is a pregnant woman screened for gestational diabetes?

A

24-28 weeks

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22
Q

When do we screen for Group B Strep

A

35-37 weeks

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23
Q

Treatment for Group B strep

A

PCN

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24
Q

When do pregnant woman get a RhoGam shot?

A

Week 28, then within 72 hours postpartum.

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25
Q

What is AFP testing and when do we do it?

A

alpha-feto protein, tests for down syndrome with low levels, high levels may detect neural tubal defects.
week 16-20

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26
Q

What 3 things are down syndrome patients at higher risk for?

A

Alzheimers. hypothyroid, cervical spine instability (need x-ray of cervical spine before playing sports)

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27
Q

Placental abruption

A

Placenta is separating from the inner wall of the uterus, incredibly painful. Uterus will be hard to the touch, bleeding involved. Only in 3rd trimester

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28
Q

Placenta previa

A

Placenta is covering the cervical opening. Light PAINLESS bleeding.

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29
Q

Antibiotic for mastitis while breastfeeding
(Think 2 boobs=di)
and two alternatives

A

dicloxacillin (PCN safe in pregnancy and breastfeeding). Alternatives are clindamycin, macrolides.

30
Q

What age do we start pap smears?

A

21 (regardless of sexual status), every 3 years until 30 at which time we can go to five years if we add in HPV testing

31
Q

Which pap smear results do we need to refer for colposcopy?

A

Low and high grade lesions.
LSIL, HSIL

LSIL= low grade squamous intraepithelial lesion

32
Q

What is colposcopy?

A

A colposcope is used outside the body to visualize the cervix up close. Sometimes a weak acetic acid is used to visualize abnormalities easier. If any abnormalities are seen, a biopsy will be taken.

33
Q

What does CIN mean? What are the levels and what do we do with each level? (diagnosed with colposcopy and biopsy)

A

cervical intraepithelial neoplasm. CIN 1=LSIL
CIN2=HSIL CIN3=HSIL
CIN 1 can be watched and might regress on it’s own, CIN 2 and CIN 3 refer immediately. CIN 3 is a direct precursor to cervical cancer, must be treated.
(CIN does not mean cancer, generally pre-cancer)

34
Q

What do we do with a positive HPV?

A

refer for colposcopy

35
Q

Atypical squamous cells of undetermined significance. (ASC-US)

A

atypical cells that don’t meet requirements to be labeled a lesion (LSIL or HSIL).
These patients must receive HPV screening regardless of age. If HPV is positive they need to be referred to colposcopy.

36
Q

What age do we recommend the Gardasil vaccine?

A

11 years old. It can be given as easy as 9 in certain situations.
Gardasil protects against the most common types of HPV that cause cervical cancer and the most common cause of HPV that causes genital warts.

37
Q

How do we treat genital warts? (caused by HPV, not herpes virus)

A

Clinician applied therapy: TCA (Trichloroacetic acid) is first line. If they are really bad they can be treated with cryo or surgically removed.
Patient applied : imiquimod cream 3.75% or 5%

38
Q

What do I do with a post-menopausal woman that has vaginal bleeding?

A

Refer for endometrial biopsy ASAP.
Could be underlying cancer.

39
Q

What is the best SSRI for hot flashes/night sweats

A

Paxil (paroxetine)

40
Q

Supplements for menopausal

A

black kohash, gingko,

41
Q

What type of cancer is more likely in women receiving HRT?

A

ovarian cancer

42
Q

What are PCOS patients at higher risk for (besides infertility)

A

Insulin resistance, hyperlipidemia and some cancers. (Metformin is a great drug for these patients)

43
Q

Is galactorrhea a sign of breast cancer? What lab should be checked?

A

Not usually, but a prolactin lab should be drawn to r/o a prolactnoma as the cause

44
Q

What medications are known for causing galactorrhea?

A

Atypical antipsychotics.

45
Q

You perform a DRE and find an symmetrically enlarged RUBBERY, prostate. Patient may complain of urinary frequency or hesitancy.

A

BPH is probably the cause

46
Q

What medication treats BPH

A

“zosins” (alpha blockers)
tamsulosin, doxyzosin, terazosin,

47
Q

When does the patient need to take the first dose of a “zosin”
tamsulosin, doxyzosin, terazosin,

A

At bedtime. Notorious for first time dose effect to cause orthostatic hypotension.

48
Q

Which medication can be used to shrink the prostate?

A

Finesteride (Proscar)

49
Q

What herbal supplement is good for BPH?

A

Saw palmetto

50
Q

What is normal PSA? What is the cut off for referral?

A

Refer for a PSA over 4 in men over 60, over 2.5 in men 40-50 for prostate cancer screening.

51
Q

What is Prehn’s sign, how do you perform it and what does it tell you

A

You lift up one testicle and see if patient has relief of pain. Do the same on the other side. Pain relief would indicate epididymitis. If the pain is made worse it would indicate testicular torsion.

52
Q

Which STI’s are often associated with epididymitis

A

Chlamydia and gonorrhea

53
Q

What antibiotics do we treat epididymitis with?

A

Under 35 doxycycline and rocephin
over 35 levofloxicin

54
Q

Which tests are for kidney function , rank them.

A

GFR
Creatinine
BUN -less specific for kidneys than the others.

55
Q

What do we think when we see WBC casts in the urine

A

pyelonephritis

56
Q

What do we think when we see RBC casts in the urine?

A

glomerulonephritis

57
Q

UTI treatment (regular and pregnant)

A

Macrobid (nitrofurantoin), Bactrim (Trimethoprim-sulfamethoxazole), Fosfomycin. If any concern of allergy or resistance use Cipro (but no Cipro in pregnancy!)

58
Q

If a patient is on Warfarin, which antibiotic would we avoid?

A

Bactrim (trimethoprim-sulfamethoxazole)

59
Q

What antibiotic class would we avoid if patient has had heel or achilles tendon pain in the past when taking it?

A

Fluroquinolones

60
Q

Antibiotics to use for UTI in pregnancy.

A

fosfomycin or another PCN, Macrobid or Bactrim can be used after first trimester. Keflex (cephalexine) would be fine also.

61
Q

If patient is having recurrent UTI’s what diagnostic test would be appropriate?

A

Kidney ultrasound

62
Q

If patient is having recurrent UTI’s what diagnostic test would be appropriate?

A

Kidney ultrasound

63
Q

PDE5 inhibitors

A

Pneumonic: Penis doesn’t erect lol
Viagara, meds that ends in “afil”
i.e. sildenafil, tadalafil, vardenafil

64
Q

Before prescribing anyone PDE5 inhibitors what test needs to be done?

A

EKG

65
Q

Before prescribing anyone PDE5 inhibitors what test needs to be done?

A

EKG. Careful giving Viagara to anyone with underlying cardiac issues

66
Q

What medication is absolutely contraindicated with PDE5 inhibitors?

A

Nitroglycerine-will bottom out their blood pressure completely, can be LIFE THREATENING!

67
Q

How do PDE5 inhibitors work?

A

By relaxing the smooth muscle of the corpus cavernosum in the penis, which enhances blood flow (also treats pulmonary hypertension)

68
Q

What is the difference between sildenafil and tadalafil?

A

Tadalafil lasts longer, so it can be taken longer before sex. Both meds should be taken at least one hour before sex.

Tadalafil can also treat BPH.

69
Q

What side effects can be seen with PDE5 inhibitors?

A

Flushing, hypotension, headache, dyspepsia, cyanopia (blue tinted vision)

70
Q

How many weeks pregnant does the fundal height start matching the weeks

A

16

Genitourinary (1 decks)

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