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NP course > Urological/STD/Men and Women's Health > Flashcards

Urological/STD/Men and Women's Health Flashcards

1
Q

Most common UTI bacteria

A

e. coli, p mirabilis, k pneumoniae, enterobacter, s. saprophyticus

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2
Q

Midstream bacterial count for UTI

A

100,000 organisms

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3
Q

Nitrites indicate what type of bacteria in sample?

A

Usually gram - nitrate producers

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4
Q

Hyaline cast

A

most common, low urine flow, dehydration, vigorous exercise

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5
Q

Type of cast - crystals

A

No clinical significance

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6
Q

Type of cast - RBC

A

Always pathological, consider glomeruloneephritis, urinary tract injury

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7
Q

Type of cast - WBC

A

Consider inflammation or infection such as pyelonephritis. Not a UTI

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8
Q

Type of cast - epithelial

A

Acute tubular necrosis (poisoinng), hepatitis

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9
Q

How long tx an uncomplicated UTI

A

3 days

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10
Q

What should you always do before tx pylonephritis?

A

Get a culture

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11
Q

Kegal exercises - How many?

A

3 sets of 8-12 3-4 times weekly for 15-20 weeks

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12
Q

Hallmark finding on urolithiasis (stone formation)

A

Severe pain waxes and wanes, may radiate to groin, testicles, suprapubic area, and labia

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13
Q

What is the gold standard for dx of urolithiasis?

A

Helical CT

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14
Q

Dx HIV

A

Establish dx with EIA or ELISA, confirmed with Western Blot

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15
Q

What live vaccines should you never give with HIV?

A

shingles, chicken pox, MMR

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16
Q

Lab testing with HIV

A

CD4 counts and viral load at dx and every 3-4 months, screen for Hep A, B, C. Glucose and lipid panel, STD assessment

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17
Q

When is HIV considered AIDS?

A

CD4 count less than 200

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18
Q

Bacterial vaginosis

A

Polymicrobial clinical syndrome resulting from replacement of natural flora with high concentrations of anaerobic bacteria

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19
Q

Hallmark sx of bacterial vaginosis?

A

Profuse grayish-white malodorous vaginal discharge

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20
Q

Gold standard for dx of bacterial vaginosis

A

gram stain absence or decreased lactobacilli

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21
Q

Treatment of bacterial vaginosis

A

metronidazole 500mg BID 7 days

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22
Q

Chlamydia associated with

A

PID, infertility, ectopic pregnancy

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23
Q

What age is Chlamydia most common in?

A

under 25 years old

24
Q

Sx Chlamydia

A

often asymptomatic, mucopurulent cervicitis, friable cervix with pain on movement

25
Q

What is important to do with dx of Chlamydia?

A

Retest in 3 months

26
Q

Dx studies Chlamydia

A

NAAT with urine or vaginal swabs, DNA probe, culture

27
Q

Tx Chlamydia

A

Doxycycline 100mg BID 7 days OR azithromycin 1 gram once

28
Q

Gonorrhea sx in males

A

purulent urethral discharge, dysuria, testicular pain, or no symptoms

29
Q

Gonorrhea sx in females

A

Often asymptomatic, endocervical discharge, dysuria, bartholins gland abcess

30
Q

Dx studies in Gonorrhea

A

Gram stain of exudate, DNA probe, culture

31
Q

Tx Gonorrhea

A

Ceftriaxone 250mg AND azithromycin 1gram OR doxycyline for 7 days

32
Q

Trichomoniasis sx in females

A

Asymptomatic, discharge that is frothy, diffuse, and yellow green in color, cervical petichiae (strawberry cervix)

33
Q

Trichomoniasis sx in males

A

asymptomatic, urithral discharge, dysuria, epididymitis, prostitis

34
Q

Dx studies for Trichomoniasis

A

Wet prep with flagilated motile cells, pH >4.5, POC test for women, PCR testing for men

35
Q

Tx Trichomoniasis

A

Metronidazole 2 grams single dose or Tinidazole 2 grams single dose

36
Q

Syphilis - Primary stage

A

Chancre at site of inoculation. Painless. 1-5 weeks then heals. Regional lymphadonopathy

37
Q

Syphilis - Secondray

A

Rash that is bilat symmetrical polymorphic, and not itchy. Soles and palms. 2-6 weeks then resolves.

38
Q

Condyloma lata

A

Secondary Syphilis sign. Pink peripheral warty lesions on genitals.

39
Q

Syphilis - Latent

A

Asymptomatic

40
Q

Syphilis - Tertiary

A

Cardiovascular - aortic valve disease and aneurisms
Neurological - meningitis, encephalitis, tabes dorsalis, dementia
Integumentary - Gummas
Orthopedic - Charcot joints, osteomylitis

41
Q

Tx Syphilis

A

Benzathine PCN G IM

Doxycycline or tetracycline or erythromycin if PCN allergic

42
Q

HPV vaccine recommended at age?

A

11-12

43
Q

Age of initial cervical screening

A

Start age 21, screening at time of initial intercourse if < 21 yo ad HIV present or immunocommprimised post organ transplant

44
Q

Age to stop cervical screening

A

65 who have had adequate recent screening = 3 neg screening PAPS and 2 neg HPV/PAP co-tests within 10 years of stopping with at least one being in the last 5 years

45
Q

PAP screening

A

21-29 - every 3 years with cytology
> 30 every 5 years with cytology and HPV
Ex HIV, immunosuppression, every 6 months X2 then annually

46
Q

PAP after hysterectomy

A

benign disease - D/C

NON Benign - 3 annual neg tests ACS 20 years ACOG

47
Q

When do you refer with abnormal pap

A

LSIL, HSIL (CIN, CIN 1, CIN 2, CIN 3)

48
Q

PH with candidiasis (vaginal)

A

4.0 - 4.5

49
Q

When should you get an ultrasound with breast mass?

A

Pregnancy and < 30

50
Q

What finding suggests BPH?

A

Firm, smooth, symmetrically enlarged prostate

51
Q

Wat exam finding suggests bacterial prostititis?

A

Enlarged, boggy, and tender prostate

52
Q

What are risk factors for prostate cancer?

A

Older age
African American
Family hx of relative <65
BRCA1 or 2 genes

53
Q

Sx prostate ca

A

asymptomatic, prostate feels hard, nodular on exam

54
Q

Prostate screening according to ACS

A

Average risk starting age 50, high risk 40-45

Initial PSA >2.5 screen annually, PSA < 2.5, every 2 years. PSA >4 refer

55
Q

What is common with epididymitis?

A

Prolonged sitting. Think truck driver.

56
Q

Prims sign

A

discomfort lessens with elevation of testes - epididymitis

57
Q

Risk factor - testicular cancer

A

Hx of cryptorchidism - Higher if uncorrected
Testicular atropy
Klinfelter’s syndrome

NP course (12 decks)

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