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Acute & Chronic II > Test 2 > Flashcards

Test 2 Flashcards

1
Q

caused by Treponema pallidum

A

syphilis

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2
Q

primary infection with syphilis

A

painless chancre that heals spontaneously

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3
Q

secondary infection with syphilis

A

nonpruritic rash on palms and soles

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4
Q

condylomata lata

A

gray colored genital warts that occur in syphilis

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5
Q

tertiary infection with syphilis

A

cardiac, neuro, ophthalmic disease

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6
Q

diagnostic for syphilis

A

screening with nontreponemal tests (VDRL and RPR); confirmed with treponemal test

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7
Q

trx for syphilis

A

Benzathine PCN G 2.4 million units IM x1

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8
Q

trx for syphilis if allergic to PCN

A

doxycycline 100 mg bid x 14 days

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9
Q

Do not give tetracyclines during

A

pregnancy

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10
Q

f/u for syphilis treatment

A

serology titers in 3, 6, 9, 12 months. avoid sex until titer has a 4-fold decrease

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11
Q

risk factors for PID

A

age less than 25, multiple sex partners, IUD

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12
Q

risk for PID is decreased if

A

taking oral contraception

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13
Q

Most common cause of PID

A

chlamydia and gonorrhea

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14
Q

s/s of PID

A

abnormal vaginal bleeding, low back/abd pain for less than 2 weeks, CMT and adnexal tenderness, fever greater than 101

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15
Q

diagnostics for PID

A
  • pregnancy test to r/o ectopic pregnancy
  • WBC on vaginal secretion
  • elevated ESR or CRP
  • endometrial biopsy
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16
Q

treatment for PID

A

ceftriaxone 250 mg IM and doxycycline 100 mg PO bid x 14 days with or without metronidazole 500 mg PO bid x 14 days

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17
Q

important with PID to

A

treat sexual partners in last 60 days

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18
Q

f/u with PID

A

f/u in 48-72 hours, then test for cure in 7-10 days and then 4-6 week after trx

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19
Q

HPV genital warts caused by

A

HPV 6 and 11

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20
Q

condylomata acuminate

A

HPV genital warts

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21
Q

painless, smooth, flat, skin-colored warts to fleshy papules that may become cauliflower-like growths.

A

condylomata acuminate in HPV warts

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22
Q

all women with HPV genital warts should undergo

A

pap smear for cervical HPV, gonorrhea/chlamydia, and HIV

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23
Q

treatment for HPV warts

A

Podofilox 0.5% gel; cryotherapy every 1-2 weeks

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24
Q

Mucopurulent cervicitis is caused by

A

chlamydia

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25
Q

risk factors for mucopurulent cervicitis

A

women less than 21 years old

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26
Q

Diagnostic for mucopurulent cervicitis

A

pap smear (make sure to remove discharge prior to specimen collection), NAAT

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27
Q

treatment for mucopurulent cervicitis

A

azithromycin 1 g PO x 1 or doxycycline 100 mg PO bid x 7 days

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28
Q

Characterized by clear/mucoid discharge and burning on urination.

A

nongonococcal urethritis

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29
Q

usually asymptomatic in women that can progress to PID

A

gonorrhea

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30
Q

Diagnostic for gonorrhea

A

NAAT

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31
Q

treatment for nongonoccoal urethritis

A

azithromycin 1 g PO x 1 or doxycycline 100 mg PO bid x 7 days

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32
Q

incidence of gonorrhea is highest in

A

women 15-19 years old

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33
Q

s/s of gonorrhea in men

A

purulent urethral discharge, dysuria

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34
Q

s/s of gonorrhea in female

A

often asymptomatic

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35
Q

treatment for gonorrhea

A

ceftriaxone 250 mg IM x 1 plus azithromycin 1 g PO x1 or doxycycline 100 mg PO bid x 7 days

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36
Q

Characterized by visible, painful genital or anal lesions or grouped vesicles at the site of inoculation and regional lymphadenopathy.

A

HSV

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37
Q

difference between HSV 1 and HSV 2

A

HSV1- oral herpes

HSV2- genital herpes

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38
Q

spread of HSV

A

asymptomatic shedding for up to 3 months

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39
Q

latency of HSV

A

establishes latency within sensory fibers for life

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40
Q

s/s of HSV

A

painful vesicles that ulcerate and resolve within 21 days

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41
Q

recurrent infection of HSV

A

prodrome phase of pain and burning over area prior to vesicle formation

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42
Q

Diagnostic of HSV

A

culture

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43
Q

treatment for HSV

A

acyclovir 400 mg PO tid x 7 days

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44
Q

treatment for recurrent HSV

A

acyclovir 400 mg PO tid x 5 days, start during prodrome or within one day of onset of lesion

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45
Q

transmission of HIV

A

sexually, injected drug use, blood transfusion, mother-to-baby

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46
Q

when should HIV testing be done

A

should be offered at least once in all people 13-64 years regardless of risk;
those with high risk should be screened annually

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47
Q

AIDS is diagnosed when CD4 is

A

below 200

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48
Q

is the best predictor of viral transmission in homosexuals. with HIV

A

viral load

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49
Q

s/s of early HIV

A

influenza-like symptoms that is self-limiting followed by an asymptomatic period.

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50
Q

s/s of late HIV/AIDS

A

anemia, thrombocytopenia, leukopenia, weight loss, TB

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51
Q

diagnostic of HIV

A

ELISA that is confirmed with Western blot

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52
Q

Management of HIV

A
  • CD4, viral load, and CBC every 3 months

- TB test annually

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53
Q

immunizations for HIV

A

Pneumovax every 5 years;

inactivated influenza annually

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54
Q

The role of oral contraceptives

A

suppress the release of FSH and LH, preventing ovulation

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55
Q

progestin role in contraception

A

thickens cervical mucus, prevents ovulation

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56
Q

provide a a constant dose of estrogen and progestin in each of the 21 active tablets.

A

monophasic OCP

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57
Q

phasic OCPs have

A

altering doses of progestin

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58
Q

women who miss one or two OCP tablets should

A

take 2 tablets for each missed day

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59
Q

s/s of too much estrogen in OCP

A

bloating, edema, nausea, breast tenderness

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60
Q

s/s of too little estrogen in OCP

A

breakthrough bleeding, increased spotting

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61
Q

s/s of too little progestin in OCP

A

breakthrough bleeding, amenorrhea

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62
Q

s/s of too much progestin in OCP

A

increased appetite, weight gain

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63
Q

OCPs result in a reduced risk of

A

ovarian and endometrial cancer, PID, and rheumatoid arthritis

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64
Q

OCPs are contraindicated in women who have

A
  • hx of thrombophlebitis, CVA, CAD, breast cancer;
  • active liver disease,
  • 20-year hx of DM,
  • gallbladder disease,
  • older than 25 who smoke
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65
Q

warning sign for OCP (ACHES)

A
  • Abd pain
  • Chest pain, SOB
  • Headaches, dizziness
  • Eye problems
  • Severe leg pain
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66
Q

Ortho Evra patch

A

estradiol and progestin

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67
Q

ortho evra patch application

A

lower abd, buttocks, upper arm or torso once a week for 3 weeks. 4th week is for bleeding.

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68
Q

Nuvaring contains d

A

estradiol and progestin

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69
Q

Nuvaring application

A

inserted into the vagina for 3 weeks, removed on week 4 for bleeding

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70
Q

teaching for Nuvaring

A

if it’s out for more than 3 hours, use backup contraception for 7 days

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71
Q

When to take emergency contraception

A

within 72 hours and then repeated 12 hours later

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72
Q

Side effects of emergency contraception

A

nausea/vomiting, bleeding and spotting

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73
Q

Nonhormonal IUD (Paraguard and Copper T) prevent fertilization by

A

creating a spermicidal enviornment

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74
Q

IUD can be changed every

A

5 years

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75
Q

advantage of hormonal vs nonhormonal IUD

A

hormonal can decrease bleeding whereas nonhormonal can increase bleeding

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76
Q

Mirena contraindications

A

hx of thromboembolism, acute liver disease, hx of breast cancer.

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77
Q

These women do not tolerate IUDs as well

A

nulliparous women

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78
Q

Mini pills are

A

progestin only

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79
Q

Mini pills administration

A

must be taken everyday

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80
Q

minipills are good option for those women who are

A

breasfeeding

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81
Q

OCP not associated with thromboembolic events or gallbladder disease

A

minipills d/t no estrogen

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82
Q

Depo Provera injection is

A

progestin

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83
Q

Dep Provera administration

A

IM every 12 weeks

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84
Q

side effects of Depo Provera

A

irregular period, weight gain, headache

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85
Q

Average return of fertility after d/c Depo Provera

A

5-7 months

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86
Q

Implanon/Nexplannon is

A

progestin

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87
Q

Implanon/Nexplannon administration

A

changed every 3 years

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88
Q

both diaphragms and cervical caps must be used with

A

spermicidal jelly

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89
Q

teaching with diaphragms

A

must be in place for 6 hours after intercourse but no more than 24 hours

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90
Q

risk with diaphragms and cervical caps

A

TSS, UTI

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91
Q

teaching for cervical cap

A

can be in place for 24 hours

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92
Q

mucus that is produced during fertile periods is

A

clear, slippery, and stretches

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93
Q

mucus that is produced during periods of infertility is

A

cloudy, sticky, and breaks when stretched.

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94
Q

Low temps are recorded ___ ovulation and higher temps recorded ____ ovulation.

A

before; after

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95
Q

dysparenuria involves

A

vaginismus, vulvar vestibulitis, and vulvodyna.

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96
Q

involuntary spasm of the muscles surrounding the outer third of the vagina brought on by real, imagined, or anticipated attempts at vaginal penetration.

A

vagismus

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97
Q

chronic vulvar discomfort that may involve complaints of rawness, burning, stinging, or irritation.

A

vulvodynia

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98
Q

Touching the vestibule and the hymen with a moistened cotton swab may elicit the pain of

A

vestibulitis

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99
Q

Bartholin glands are usually

A

not palpable

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100
Q

diagnostics for dysparenuina

A

Pap smear and pelvic exam, wet mount, KOH, culture of vaginal discharge, testing for gonorrhea/chlamydia, HCG to r/o ectopic pregnancy

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101
Q

treatment for vulvar vestibulitis and vulvodynia

A

TCA or gabapentin

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102
Q

causes of bartholin gland abscess

A

tight fitting panties, STDs, infection

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103
Q

s/s of bartholin abscess

A

unilateral, swollen, red mass that is tender and painful

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104
Q

nonpharm trx of bartholin abscess

A

moist heat, warm sitz bath, I&D

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105
Q

diagnostics for bartholin gland abscess

A

C&S, test for STDs

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106
Q

medical trx for bartholin abscess

A

metronidazole, erythromycin, doxycycline.

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107
Q

diagnostic for atrophic vaginitis

A

increased pH, FSH to confirm menopause, estradiol level.

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108
Q

pharm trx for atrophic vaginitis

A

low dose estrogen if hysterectomy; estrogen+progesterone if uterus present

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109
Q

estrogen therapy for atrophic vaginitis should be for no more than

A

3 months

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110
Q

risk factors for candida vulvovaginitis

A

recent atbx therapy, steroids, pregnancy, DM, hypothyroidism, iron deficiency anemia, oral contraceptives, obesity

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111
Q

s/s of candida vulvovaginitis

A

thick, white vaginal discharge, itching, no odor

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112
Q

diagnostic for candida vulvovaginitis

A

KOH- look for hyphae and budding yeast

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113
Q

in candida vulvovaginitis, the vaginal pH is

A

less than 4.5

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114
Q

prevention of candida vulvovaginitis

A

cotton underwear, avoid tight clothing, weight loss, unscented soap

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115
Q

treatment for candida vulvovaginitis

A 
fluconzazole 150 mg x1;
Miconazole nitrate (Monistat) cream
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116
Q

education for candida vulvovaginitis

A

avoid sex until symptoms resolve

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117
Q

caused by replacement of the normal, hydrogen-peroxide producing Lactobacillus in the vagina with high concentrations of anaerobic bacteria

A

bacterial vaginosis

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118
Q

risk factors for BV

A

multiple sex partners, black

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119
Q

s/s of bacterial vaginosis

A

odorous thin, white/gray vaginal discharge that is adherent to vaginal walls

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120
Q

Amsel criteria for bacterial vaginosis

A

pH is greater than 4.5;
“clue cells” on wet mount;
positive whiff test;
milky-white discharge adherent to vaginal walls.

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121
Q

pH in bacterial vaginosis is

A

greater than 4.5

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122
Q

Treatment for bacterial vaginosis

A

Metronidazole 500 mg Po bid x 7 days (avoid alcohol); OR

clindamycin cream x 7 days

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123
Q

bacterial vaginosis during pregnancy

A

can cause low birth weight and preterm delivery

124
Q

F/U with bacterial vaginosis

A

f/u in 2-3 weeks and test vaginal pH, whiff test, and wet mount.

125
Q

normal vaginal pH is

A

3.8-4.2

126
Q

avoid prescribing fluconazole for candida vulvovaginitis in

A

pregnancy and those with Dm who take oral hypoglycemics

127
Q

s/s of trichomoniasis

A

yellow-green, frothy discharge; strawberry cervix

128
Q

the pH in trichomoniasis is

A

greater than 4.5

129
Q

trx for trichomoniasis

A

metronidazole 2 g orally x 1

130
Q

trichomoniasis in pregnancy

A

can cause low birth weight and preterm

131
Q

education in trichomoniasis

A

treat sexual partners

132
Q

continuous, or episodic, non-menstrual pain of at least 6 months duration that occurs below the umbilicus, is severe enough to interrupt normal activities of daily life

A

chronic pelvic pain

133
Q

risk factors for chronic pelvic pain

A

sexually abused, PID, ectopic pregnancy, endometriosis, irritable bowel syndrome

134
Q

Treatment for chronic pelvic pain

A

NSAIDs, TCA, anticonvulsants, gabapentin

135
Q

median age of menopause

A

51

136
Q

diagnostic for menopause

A

FSH greater than 40, LH greater than 30.

137
Q

hormone therapy has been approved for

A

osteoporosis prevention but NOT treatment

138
Q

Estrogen therapy increases risk of

A

endometrial cancer and heart disease

139
Q

Hormone replacement therapy is approved for

A

vasomotor symptoms, vaginal atrophy, and prevention of osteoporosis

140
Q

absolute contraindications of hormone therapy are

A

vaginal bleeding, liver disease, thromboembolic disorders

141
Q

medications for menopause symptoms

A

clonidine, gabapentin, effexor, paxil

142
Q

this doubles the risk of developing ovarian cysts

A

smoking

143
Q

these decrease the risk of developing ovarian cysts

A

OCPs

144
Q

function or physiologic ovarian cysts are often asymptomatic and resolve in

A

60-90 days

145
Q

s/s of worsening ovarian cysts

A

unilateral pelvic pain

146
Q

diagnostic for ovarian cysts

A

r/o ectopic pregnancy, CBC, trasvaginal US, cervical cultures

147
Q

treatment for simple ovarian cysts

A

NSAIDs, rest

148
Q

pathophys of PCOS

A

high insulin levels cause ovarian cells to produce more androgens/testosterone. The liver compensates by decreasing secretion of sex hormone binding globulin (SHBG) that bind and excrete free testosterone.

149
Q

s/s of PCOS

A

hirsutism (acne, alopecia);
irregular menstrual cycles;
infertility

150
Q

diagnostics for PCOS

A

LH/FSH ratio greater than 2.5:1;
high testosterone;
high prolactin;
high insuiln

151
Q

treatment for PCOS

A

oral contraceptives- suppress LH to reduce testosterone secretion ;
Metformin, Clomid
Spironolactone

152
Q

ovarian cancer is more common in women

A

greater than 60 years old

153
Q

risk factors for ovarian cancer

A

hx of breast cancer or BRCA gene; nulliparity; pregnancy after 30, family hx; estrogen

154
Q

s/s of ovarian cancer

A

bloating, dyspepsia, abd pressure/pain, irregular vaginal bleeding

155
Q

Diagnostics for ovarian cancer

A

transvaginal US

156
Q

Treatment for ovarian cancer

A

total hysterectomy, radiation/chemo

157
Q

median age of endometrial cancer

A

61

158
Q

Type I endometrial cancer is associated with

A

excess estrogen that is unopposed by progesterone

159
Q

common presenting sign of endometrial cancer

A

perimenopausal woman has more frequent and heavier periods

160
Q

diagnostic of endometrial cancer

A

endometrial thickening greater than 5 mm; endometrial biopsy

161
Q

treatment for endometrial cancer

A

total hysterectomy, chemo

162
Q

high correlation of endometrial cancer with

A

breast and colon cancer

163
Q

Pap smear guidelines

A

21-29 every 3 years;

30-65 Pap + HPV every 5 years or Pap alone every 3 years.

164
Q

next step for ASC-US

A

HPV DNA testing or repeat pap in 1 year

165
Q

next step for ASC-H

A

colposcopy and biopsy

166
Q

next step for LSIL and HSIL

A

colposcopy and biopsy, with LEEP for abnormal findings

167
Q

Paps may be stopped at age 65 if

A

prior 3 normal paps, no hx of genital tract cancer

168
Q

cervical cancer is associated with

A

HPV 16 and 18

169
Q

the normal endocervix is covered with

A

columnar epithelium

170
Q

cervix in cervical cancer

A

enlarged (barrel cervix), friable tumor on cervix

171
Q

risk factors for breast cancer

A

age greater than 50, first degree relative, early menarche, late menopause, nulliparity, obesity

172
Q

s/s of breast cancer

A

painless, firm, fixed mass;
clear nipple discharge;
Peau d’orange appearance;
nipple retraction

173
Q

mammogram guidelines

A

every 1-2 years starting at 40, annual screening at 50

174
Q

s/s of fibrocystic breasts

A

smooth, moveable rope-like masses; breast tenderness that goes away after menses

175
Q

treatment for fibrocystic breasts

A

cold compresses, wear bra 24 hours a day, sodium and caffeine restriction.

176
Q

fibroadenoma most common in

A

women 20-30

177
Q

s/s of fibroadenoma

A

single, nontender, moveable mass

178
Q

diagnostics for fibroadenoma

A

US for women less than 35, mammogram for women older than 35

179
Q

intraductal papilloma mostly occurs at

A

age 40-50

180
Q

s/s of intraductal papilloma

A

bloody or serous nipple discharge

181
Q

treatment for intraductal papilloma

A

surgical excision

182
Q

causes of mastitis

A

Staph aureus or strep

183
Q

s/s of mastitis

A

breast tenderness, fever, erythema

184
Q

treatment for mastitis

A

warm compress, frequent nursing

185
Q

Meds for mastitis

A

Bactrim or clindamycin

186
Q

important teaching with mastitis

A

don’t stop breastfeeding

187
Q

for those who don’t respond to atbx for mastitis, consider

A

mammogram to r/o inflammatory breast cancer

188
Q

causes of amenorrhea

A

lactation induced; hypothyroidism, eating disorders, hyperprolactinemia

189
Q

management for amenorrhea

A

prevent bone loss, education that pregnancy can still occur

190
Q

s/s of dysmenorrhea

A

crampy, pelvic pain, back/thigh pain, N/V

191
Q

secondary dysmenorrhea occurs

A

women 30-40 years old

192
Q

causes of secondary dysmenorrhea

A

endometriosis, uterine fibroids, PID, ovarian cysts

193
Q

diagnostics for dysmenorrhea

A

pregnancy test, STD testing, pelvic US

194
Q

treatment for dysmenorrhea

A

NSAIDS (Cox-2) and oral contraceptives

195
Q

PMS and PMDD occurs mostly during the

A

luteal phase (5-11 days before menses)

196
Q

Treatment for PMS and PMDD

A

Vitamin B6, vitamin E, calcium, and Mg;
NSAIDs;
OCP

197
Q

Breast MRI is done to

A

localize staging of breast cancer

198
Q

MRI is not a screening tool for breast cancer because

A

it is expensive and labor intensive

199
Q

BRCA gene is

A

autosomal dominant, so only one defected gene is needed

200
Q

if BRCA gene present, then this should be done

A

annual mammograms and transvaginal ultrasound;

semiannual breast MRI and CA-125 starting at age 25

201
Q

Important teaching for endometrial biopsy

A

notify for any temp elevation as it may activate PID

202
Q

endometrial biopsy can be used to diagnose for

A

uterine cancer

203
Q

essential for a pelvic ultrasound

A

full bladder

204
Q

This is state mandated, but patient can opt out

A

HIV testing for prenatal visit

205
Q

Pregnancy should not be attempted for __ days after rubella vaccine.

A

28

206
Q

vaccines not recommended during pregnancy

A

MMR, varicella, smallpox, herpes zoster, live attenuated influenza, HPV

207
Q

Category C, D, and X

A

fluoroquinolones, lithium, tetracycline, warfarin, methotrexate

208
Q

softening of the isthmus of the uterus

A

Hegar’s sign

209
Q

softening of the cervix

A

Goodell’s sign

210
Q

dark blue to purplish-red color of vaginal mucosa

A

Chadwick’s sign

211
Q

painless uterine contractions that occur every 10-20 min after the 3rd month of pregnancy and do not represent true labor.

A

braxton hicks

212
Q

soft blowing systolic murmur heard down at the sides of the uterus.

A

uterine souffle

213
Q

the number of pregnancies (including the current one)

A

gravida

214
Q

Number of births (regardless if living) after 20 weeks gestation.

A

para

215
Q

GTPAL

A

Gravida, Term, Preterm, Abortion, Living

216
Q

Born at term is after

A

37 weeks

217
Q

Nagele’s rule

A

LMP minus 3 months + 7 days = EDC

218
Q

The BP is lowest in the

A

second trimester

219
Q

GI effects from pregnancy

A

increased acidity of gastric contents, relaxation of LES, prolonged emptying of gallbladder

220
Q

endocrine changes from pregnancy

A

TSH decreases, T4 increases, increased cortisol

221
Q

testing for Rh blood type

A

If mother is Rh negative, then check father. If he is Rh+, then an indirect coomb’s test is done to look for Rh antibodies

222
Q

If indirect coomb’s test is negative, then

A

recheck in 28-30 weeks and at 36 weeks

223
Q

If indirect coomb’s test is positive

A

then RHOGAM is given to mother at 28 weeks and then 72 hours after delivery or abortion.

224
Q

HBsAg generally indicates active

A

active Hep B infection.

225
Q

If a woman’s rubella titer is _____, she has immunity to rubella

A

greater than 1:10 to 1:20

226
Q

If a woman’s rubella titer is ___ she has no immunity to rubella

A

less than 1:8

227
Q

If woman’s rubella titer is low, then

A

she should get immunization before pregnant or after delivery

228
Q

Qualitative beta hCG testing is

A

rapid pregnancy test

229
Q

Quantitative hCG testing is

A

more accurate pregnancy test

230
Q

This pregnancy test is more accurate because hCG levels are higher

A

serum hCG

231
Q

Cystic fibrosis screening should be done in

A

there is a family hx, caucasian or jewish descent

232
Q

Tay Sachs and Cystic fibrosis is

A

autosomal recessive (baby would need to receive both genes)

233
Q

Normal weight gain in pregnancy is

A

25-35 lbs

234
Q

follow up visits for prenatal care

A

every 4 weeks until 28 weeks;
every 2 weeks between 28 and 36 weeks
every week after 36 weeks

235
Q

folic acid requirements

A

0.8-1.0 mg

236
Q

first ultrasound/sonogram at

A

20 weeks

237
Q

should be done in 15-21 weeks

A

screen for neural tube defects and down syndrome

238
Q

should be done in 24-28 weeks

A

1 hour glucose screen, repeat CBC and RPR; draw indirect Coombs or administer Rhogam

239
Q

should be done at 36 weeks

A

repeat CBC, chlamydia, RPR

240
Q

Group B beta strep should be done at

A

35-37 weeks

241
Q

Leopold’s maneuver to determine fetal position is usually done at

A

36 weeks

242
Q

In true labor, discomfort begins in this area

A

back and radiates around abd

243
Q

Breastfeeding should be done for the first

A

6 months to 1 year

244
Q

Breastfeeding has been associated with a decreased risk of

A

SIDS

245
Q

A newborn should have up to this many feedings in 24 hours

A

8-12

246
Q

The stool in a newborn will start off ____, then become ____

A

dark and tarry; yellow and milky

247
Q

For the first week of life, the number of stools and the number of voids should approximately match ____

A

the infants age in days.

248
Q

Infants may lose up to ___ of the body weight in the first week of life.

A

8-10%

249
Q

For irritated nipples, breastfeeding should be held for ____; and the mother should pump every ____.

A

24 hours; 3 hours

250
Q

Breast engorgement can be minimized by

A

frequent feedings

251
Q

nonpharm options for nausea during pregnancy

A

vitamin B6, increase intake of nuts and protein

252
Q

pharm option for nausea during pregnancy

A

doxylamine or H1 blockers + vitamin B6; zofran

253
Q

pharm options for constipation during pregnancy

A

psyllium, MOM, prune juice.

Avoid PEG

254
Q

pharm options for GERD during pregnancy

A

antacids

255
Q

Increased mucus formation by the cervix in response to elevated estrogen levels in the 1st trimester causes

A

leukorrhea

256
Q

Nasal congestion and epistaxis during pregnancy results from

A

increased estrogen

257
Q

trx for round ligament pain during pregnancy

A

heating pad to abd, knee-chest position

258
Q

if mother c/o decreased fetal movement, then

A

order a non-stress test

259
Q

When the patient presses a button that marks the tracing of fetal monitor every time she feels fetal movement.

A

non-stress test

260
Q

Reassuring or reactive non-stress test shows at least ___ accelerations in fetal heart rate lasting at least ____ in a ____ period

A

15 beats per min; 15 seconds; 20 min

261
Q

common indications for non-stress test

A

decreased fetal movement, PIH, DM, post-date after 40 weeks, IUGR

262
Q

elements of biophysical profile

A
  1. fetal tone
  2. gross body movements
  3. breathing
  4. amniotic fluid volume
263
Q

Scoring in biophysical profile

A

each is worth 2 points.

8-10 is reassuring

264
Q

anemia in pregnancy is Hgb less than

A

11

265
Q

Premature separation fo the placenta form the uterine wall.

A

placenta abruptio

266
Q

s/s of placenta abruptio

A

board like uterus, uterine tenderness

267
Q

management of placenta aburptio

A

emergency

268
Q

characterized as abnormal development of placenta that causes severe N/V at 12-16 weeks gestation with brown discharge

A

molar pregnancy (gestational trophoblastic disease)

269
Q

mangaement for molar pregnancy

A

immediate evacuation of uterus

270
Q

incompetent cervix management

A

refer to have cerclage placed by 12 weeks

271
Q

management for prolapsed umbilical cord

A

emergency– place pt in knee chest position or trendelenberg, apply oxygen

272
Q

spontaneous abortion occurs

A

before 20 weeks gestation

273
Q

Treatment for preeclampsia is

A

methyldopa with or without hydralazine or labetalol

274
Q

PIH/preeclampia is BP

A

greater than 150-160/90-100

275
Q

HELLP syndrome

A

hemolysis
elevated liver enzymes
low platelet count

276
Q

neonates of gestational diabetes can have

A

hypoglycemia, hypocalcemia, polycythemia, jaundice

277
Q

diagnostics of gestation diabetes

A

done at 24-48 weeks;
50-g glucose tolerance test;
1 hour glucose > 130

278
Q

treatment of gestational diabetes

A

insulin, glyburide

279
Q

common sign in ruptured ectopic pregnancy

A

pain radiating to shoulder

280
Q

trx for ectopic pregnancy

A

if not ruptured, methotrexate.

if ruptured, laparoscopy

281
Q

caused by implantation of the placenta near or across the cervical os. It

A

placenta previa

282
Q

s/s of placenta previa

A

painless bleeding at end of 2nd trimester

283
Q

This should not be done if placenta previa suspected

A

vaginal exam

284
Q

risk factors for placenta previa

A

age > 35, multiparity, previous c-section

285
Q

Defined as uterine contractions that cause cervical change and dilation before 37 weeks gestation.

A

preterm labor

286
Q

injectable steroids for preterm labor is given at

A

24-32 weeks

287
Q

When does the mother feel “quickening”?

A

20 weeks

288
Q

More common in primigravidas, with age extremes (teen or >35), and Blacks

A

PIH or preeclampsia

289
Q

A variant of PIH with abnormal LFTs and poor clotting

A

HELLP

290
Q

Caused by chronic uteroplacental insufficiency (UPI)

A

IUGR

291
Q

Characterized by PAINLESS bright bleeding, associated with prior C/S and multipartiy

A

Previa

292
Q

these can lead to preterm labor

A

BV, trich, and UTI

293
Q

In OCT or contraction stress test, a positive result is ____ with ___ contractions.

A

more than 2 fetal heart rate decelerations; 3

294
Q

the “rule of thumb” is that number of _____ = the number of ______ plus or minus 3 cm.

A

weeks gestation; centimeters of fundal height

295
Q

the rule of thumb only applies during weeks

A

20-36

296
Q

if the uterus is too large, then consider that the

A

EDC is wrong and get a sonogram

297
Q

FHTs are best heard from

A

the fetus’s back

298
Q

it is normal for this lab value to be elevated during pregnancy

A

WBC

299
Q

a non-stress test can be done after

A

28 weeks

300
Q

After a progestin challenge, a woman with PCOS will

A

bleed since they have a lot of estrogen

301
Q

potential effect in Yaz and Yasmin

A

hyperkalemia

302
Q

IUD care with PID

A

do not have to remove IUD, atbx

303
Q

most common sign of chlamydia

A

post-coital spotting

304
Q

most common s/s in HSv

A

dysuria, pain/tenderness

305
Q

when does woman need to have c-section with HSV?

A

active lesions

306
Q

Involution of the uterus postpartum should be at

A

6 weeks

Acute & Chronic II (4 decks)

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