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OB/GYN stuff > week 6 primary care women's health/OB > Flashcards

week 6 primary care women's health/OB Flashcards

1
Q

True or false: acute pelvic pain is defined as pain in the lower abdomen or pelvis lasting less than 3 months.

A

True

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2
Q

What are red flags for pelvic pain? 5 of these to know.

A 
Ectopic pregnancy
appendicitis
ruptured ovarian cyst
pelvic inflammatory disease
ovarian torsion
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3
Q

What is the recommended tx regiment for outpatient, oral PID treatment?

A

IM Ceftriaxone 500mg PLUS doxy 100 mg BID 14 days OR cefoxitin 2 g IM and Probenecid 1 g in a single dose PLUS doxy 100 mg BID for 14 days with metronidazole 500 mg BID x14 days

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4
Q

What are possible causes of anovulatory vaginal bleeding?

A 
polycystic ovarian syndrome
uncontrolled diabetes
Hypo or hyperthyroidism 
hyperprolactinemia
antiepileptics
antipsychotics
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5
Q

What are possible causes of ovulatory vaginal bleeding?

A

Hypothyroidism
end-stage liver dx
bleeding disorders
structural changes: fibroids or endometrial polyps

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6
Q

What are manifestations of PCOS?

A

irregular menstrual cycles, hirsutism, acne, and, frequently, obesity

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7
Q

What causes hot flashes?

A

Vasomotor instability- it coincides with a surge of LH and decrease in estrogen levels that is then followed by a measurable increase in body surface heat and a fall in core temp.

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8
Q

for cervical cancer screening, when would a Colposcopy be indicated?

A

When a woman has two consecutive unsatisfactory cytology tests.

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9
Q

What does PALM-COEIN stand for?

A

P: polyp
A: adenomyosis
L: leiomyoma (submucosal or other)
M: malignancy & hyperplasia

C: coagulopathy
O: ovulatory dysfunction
E: endometrial 
I: atrogenic
N: not yet classified
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10
Q

What are structural causes of abnormal uterine bleeding?

A

Endometrial polyps, Adenyomyosis (endometrial tissue present IN the muscle of the uterus), Leiomyomas (or fibroids, which are noncancerous tumors of the uterine muscle), and Malignancy (endometrial hyperplasia or cancer)

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11
Q

What are non structural causes of abnormal uterine bleeding?

A

C: systemic conditions or coagulopathies
O: ovulatory dysfunction such as PCOS or an endocrine disorder (thyroid or pituitary)
E: endometrial such as endometritis or PID
I: iatrogenic which are anticoagulants, hormonal contraception, hormone therapy, etc.
N: not yet classified

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12
Q

What are the three most common causes of vaginitis?

A

Yeast infection
Trichomonas
Bacterial vaginosis

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13
Q

What is the Amine test and what does a positive result indicate?

A

it is when cells are lysed with KOH and a fishy odor is present; this is characteristic of bacterial vaginosis and Trichomonas can also have a positive amine test.

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14
Q

What is the treatment for yeast infections?

A

Various creams OR 1 dose oral Fluconazole 150 mg

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15
Q

what is the treatment for bacterial vaginosis? 3 of these.

A
  1. Metronidazole 500 mg PO BID x 7days
  2. Metronidazole gel intravaginally once a day x5 days
  3. Clindaymycin cream intravaginally at bedtime x7days
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16
Q

What is the treatment for Trichomoniasis? 3 of these.

A
  1. Metronidazole 2g POx1
  2. Tinidazole 2 g PO x1
  3. Metronidazole 500 mg PO BID x7 days
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17
Q

What are the red flags of Pelvic pain?

A 
Ectopic pregnancy
Appendicitis
Ruptured ovarian cyst
PID 
Ovarian torsion
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18
Q

What are the primary clinical signs of a UTI?

A

Dysuria, frequency, urgency, suprapubic pain, hematuria

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19
Q

When might a provider consider hospitalization of a patient with a UTI?

A

Persistently high fever (>101), pain, marked weakness, or inability to maintain oral hydration or take oral medications

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20
Q

What are the three types of urinary incontinence

A
  1. Urge incontinence: the urge to void immediately preceding or accompanied by involuntary leakage of urine
  2. Stress incontinence: occurs with increase in intra-abdominal pressure
  3. Overflow incontinence: continuous urinary leakage or dribbling in the setting of incomplete bladder emptying
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21
Q

When is neural tube closure complete?

A

28 days after conception.

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22
Q

Does initiating folic acid supplementation after neural tube closure have benefit in preventing a neural tube defect?

A

NO

23
Q

What is the recommended calcium intake for teens and women <50?

A

Teens: 1300 mg/day

women <50: 1000 mg/day

24
Q

What is the recommended folic acid supplement for women?

A

400 mcg/day through fortification or supplement

25
Q

When does a woman receive the TDAP vaccination during pregnancy?

A

between 27 and 36 weeks. Otherwise it should be given q10 years

26
Q

What is the CAGE questionnaire?

A

its an ETOH survey. Questions:
Have you ever felt you should CUT down on your drinking?
Have people ANNOYED your by criticizing your drinking?
Have you ever felt bad or GUILTY about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (EYE opener)?

27
Q

What are the most common signs and symptoms of early pregnancy?

A

Amenorrhea, Nausea with or without vomiting, breast tenderness/enlargement, increased frequency of urination w/o dysuria, fatigue

28
Q

What is the most common method for diagnosing pregnancy in the office setting?

A

Urine pregnancy test. Detects hCG levels of 25-50 IU/mL.

29
Q

What is the most sensitive method for detecting early pregnancy?

A

the serum pregnancy test. it detects hCG levels of 1-3 IU/mL.

30
Q

True or false. the diagnosis of pregnancy is based on the presence of: detection of hCG in blood or urine, identification of pregnancy by US and identification of fetal cardiac activity by US.

A

True!

31
Q

What does GTPAL stand for?

A 
G: gravidity
T: term births
P: preterm births
A: abortions and miscarriages
L: living children
32
Q

What is the typical prenatal visit schedule for an uncomplicated pregnancy?

A

Every 4 weeks until 28 weeks.
THEN every 2 weeks from 28-36 weeks
THEN every week 36 weeks to delivery. At this point will be seen by MD

33
Q

What are recommended prenatal genetic screening tests for Caucasian ethnic backgrounds?

A

Cystic fibrosis

34
Q

What are recommended prenatal genetic screening tests for African descent ethnic backgrounds?

A

Sickle hemoglobinopathies, betal thalassemia, alpha thalassemia

35
Q

What are recommended prenatal genetic screening tests for European Jewish ethnic backgrounds?

A

Tay-Sachs disease, familial dysautonomia, cystic fibrosis, Canavan disease

36
Q

What are recommended prenatal genetic screening tests for Southeast Asian ethnic backgrounds?

A

Beta-thalassemia, alpha-thalassemia

37
Q

What are recommended prenatal genetic screening tests for French Canadian and Cajun ethnic backgrounds?

A

Tay-sachs disease

38
Q

What is the caffeine recommendation for pregnant women?

A

Limit intake to 200 mg per day, which is equivalent to 1 12-oz serving of coffee.

39
Q

What is the recommended total weight gain for a normal prepregnancy weight?

A

25-35 lbs

40
Q

What is the recommended total weight gain for an overweight prepregnancy weight?

A

15-25

41
Q

What is the recommended total weight gain for an obese prepregnancy weight?

A

11-20

42
Q

True or false: low levels of Estriol may suggest the fetus has trisomy 21 (Down syndrome)

A

True

43
Q

True or false: high levels of MSAFP may suggest that the fetus has a neural tube defect such as spina bifida or anencephaly

A

True

44
Q

T or F: High levels of MSAFP may suggest that the fetus has trisomy 21, trisomy 18 or another type of chromosomal abnormality.

A

False! It is low levels of MSAFP

45
Q

T or F: low levels of Inhibin-A and hCG may suggest the fetus has trisomy 21.

A

False. HIGH levels of these may suggest they has trisomy 21.

46
Q

When can an amniocentesis be performed?

A

At 15-20 weeks.

47
Q

When should pregnant women be screened for gestation diabetes?

A

Between weeks 24-28

48
Q

What blood pressure medications are safe for a woman in pregnancy?

A

Labetalol, nifidepine, methyldopa

49
Q

What is HELLP syndrome?

A

Hemolysis, Elevated, Liver enzyme levels low and Low Platelet count. This is considered a variant of preeclampsia but it can occur on its own as well.

50
Q

T or F: a normal transvaginal US with doppler flow study rules out an ovarian torsion.

A

False! this test has a high positive predictive value and a high false-negative rate. It does not necessary rule it out if the US is negative.

51
Q

T or F: if a female patient has adnexal tenderness with cervical motion tenderness, PID should be considered as a likely diagnosis.

A

True!

52
Q

T or F: Transvaginal US should be the initial imaging test in pregnant women who present with acute pelvic pain.

A

True

53
Q

T or F: if transvaginal US is nondiagnositic in pregnant women and additional imaging is required, CT should be the next imaging to be ordered.

A

False. The next test should be MRI not a CT.

54
Q

T or F: CRP is recommended in the routine evaluation of acute pelvic pain.

A

False. It has a high false-negative rate for acute conditions.

OB/GYN stuff (2 decks)

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