WH Dx 7 Flashcards
1
Q
preeclampsia
A
multisystem progressive disorder characterized by new onset of HTN and proteinuria or the new onset of HTN plus significant end-organ dysfunction with or without proteinuria
2
Q
multisystem progressive disorder characterized by new onset of HTN and proteinuria or the new onset of HTN plus significant end-organ dysfunction with or without proteinuria
A
preeclampsia
3
Q
preeclampsia - typically presents when
A
after 20 weeks gestation or PP
4
Q
preeclampsia risk factors
6
A
- past hx of preeclampsia
- pre-existing medical conditions - gestation DM, chronic HTN, lupus, pre-pregnancy overweight or obesity, CKD
- multifetal pregnancy
- nulliparity
- family hx of preeclampsia
- advanced maternal age >35
5
Q
preeclampsia clinical prestation (mains)
3
A
- bad headache
- change in vision (blurry vision, flashes of lights, spots)
- belly pain
6
Q
preeclampsia s/sx
7
A
- HA - severe and/or persistent
- changes in vision
- belly pain - upper, epigastric
- HTN >140/90
- severe HTN >160/110
- AMS
- new dyspnea, orthopnea
7
Q
preeclampsia DD
3
A
- HELLP syndrome
- Chronic HTN
- CKD
8
Q
preeclampsia education
6
A
- this is a dangerous condition that some people get when they’re pregnancy and starts after 20 weeks typically
- typically you have THN and protein in your urine
- preeclampsia has been linked to other health conditions
- lower your risk of getting this condition again by not smoking, eating healthy foods, keeping a healthy weight, and being active
- restricted activity is recommended - no heavy lifting, daytime rest with feet elevated, relaxation techniques
- monitor BP twice daily
9
Q
preeclampsia meds
A
none -
delivery for 37 weeks or greater with preeclampsia with or without severe features;
before 34 weeks, close monitoring;
34-36 weeks delivery or monitor with severe features;
<34 weeks pre term labor
10
Q
preeclampsia tests
4
A
CBC
serum creatinine levels
liver panel
urinary protein test
11
Q
preeclampsia f/u
A
twice weekly for labs and fetal monitoring; q3-4 weeks for US to assess fetal growth
12
Q
preeclampsia red flags
4
A
- severe HTN
- bleeding from vagina
- notice your baby is moving less than normal
- thinking you might be in labor
13
Q
pregnancy first trimester - timing starts when
A
a normal pregnancy starts the first day of your LMP
14
Q
pregnancy first trimester cardinal presenting ysmptoms
A
amenorrhea and suspicion increased if they also report any sexual activity while not using contraception
15
Q
pregnancy first trimester s/sx
6
A
- amenorrhea
- not using protection
- NV
- breast enlargement and tenderness
- increased urinary frequency without dysuria
- fatigue
16
Q
pregnancy first trimester DD
5
A
PCOS
poor nutrition
depression
anxiety
premature menopause
17
Q
pregnancy first trimester education
8
A
- a normal pregnancy starts the clock at the first day of your LMP
- pregnancy is officially 40 weeks
- 1st trimester is frist day of LMP to 13 weeks and 6 days
- prenatal care should be started in the first trimester, preferably before 10 weeks
- eat a well balanced diet
- stay active
- avoid smoking and drinking
- get certain vaccines
18
Q
pregnancy first trimester - how to help nausea
4
A
- avoid trigger foods/drink
- eat before, or as soon as you feel hungry to avoid empty stomach
- consume fluids at least 30 minutes before or after solid food
- ginger supplements may help
19
Q
pregnancy first trimester meds
A
prenatal vitamin
20
Q
pregnancy first trimester tests
5 (labs = 8)
A
- pregnancy test, urine
- calculate the EDD
- transvaginal US to help estimate gestational age
- starting at 10 weeks we can do genetic testing to assess for risk of developing birth defects
- standard panel of labs - h/h, CMV, ferritin, screening for rubella immunity, urine protein sample, urine culture, cervical cancer screening, STD testing
21
Q
pregnancy first trimester f/u
A
every 4 weeks until 28 weeks
22
Q
pregnancy first trimester AG
2
A
tdap vaccine
flu shot
23
Q
pregnancy first trimester red flags
5
A
- unable to eat or drink for long periods of time d/u NV
- vomiting more than 2-3 times each day on most days
- temp 100.4 or more
- HA that doesn’t go away with Tylenol
- bleeding and cramping
24
Q
pyelonephritis
A
bacterial infection that causes inflammation in the kidneys
25
bacterial infection that causes inflammation in the kidneys
pyelonephritis
26
pyelonephritis s/sx
7
fever
flank pain
nausea
vomiting
burning with urination
increased frequency
urgency
27
pyelonephritis DD
3
appendicitis
PID
STD
28
pyelonephritis education
4
1. you should start to feel better 48-72 hours after abx tx
2. drink more fluids to help decrease bladder infections
3. take cranberry supplements
4. always urinate after intercourse
29
pyelonephritis meds
2
empiric abx
tylenol
30
pyelonephritis test
urinalysis with culture
31
pyelonephritis f/u
48-72 hours after abx start
32
pyelonephritis AG
2
STD screening
get vaccinated (HPV)
33
pyelonephritis red flags
3
1. worsening symptoms following abx
2. persistent symptoms 48-72 hours after starting therapy
3. recurrent sx within a few weeks of treatment
34
rectocele
anterior protrusion of the rectum, tissue herniates through a defect in the rectovaginal septum into the vaginal lumen
35
anterior protrusion of the rectum, tissue herniates through a defect in the rectovaginal septum into the vaginal lumen
rectocele
36
rectocele risk factors
8
advanced age
genetics
greater parity
hx of vaginal delivery
hx of pelvic surgery
obesity
constipation
COPD
37
rectocele s/sx
7
1. pelvic pain or pressure
2. posterior vaginal bulge
3. obstructive defecation
4. incomplete defecation
5. constipation
6. dyspareunia
7. erosions and bleeding of mucosa
38
rectocele PE should include
anal sphincter
vaginal exam
39
rectocele DD
3
1. enterocele
2. uterine prolapse
3. cystocele (bladder prolapse)
40
rectocele education
4
1. implement lifestyle changes
2. eat a well balanced diet with enough fiber
3. drink plenty of fluids to help with constipation
4. do pelvic floor exercises such as kegels
41
rectocele meds
no meds - treatment is based on severity of rectocele;
conservative mgmt - eating a high fiber diet, increasing water intake, performing kegels;
next is vaginal pessary - helps hold rectocele up and prevent it from protruding forward;
last is surgery
42
rectocele tests
clinical dx - can do a defecography which is an x ray with contrast to determine the size of the rectocele but is not needed for dx
43
rectocele f/u
2 weeks to assess interventions
44
rectocele red flags
4
1. worsening s/sx
2. abd pain
3. inability to defecate
4. change in urinary pattern
45
Gonorrhea s/sx in females
6
1. cervicitis - vaginal pruritis, mucopurulent discharge
2. intermenstrual bleeding
3. menorrhagia
4. urethritis - dysuria
5. PID - pelvic/abd pain, abnormal vaginal bleeding, dyspareunia, abd tenderness, cervical motion tenderness
6. bartholinitis - perilabial pain and discharge, edema of the labia, enlargement and tenderness of gland
46
gonorrhea s/sx in males
2
urethritis
epididmyitis
47
gonorrhea can infect what additional areas
2
rectum
pharynx
48
chlamydia - most females are ___
asymptomatic
49
chlamydia - most commonly infected site
cervix
50
chlamydia s/sx in females
7
1. change in vaginal discharge
2. intermenstrual vaginal bleeding
3. post-coital bleeding
4. dysuria
5. pyuria
6. PID
7. purulent endocervical discharge
51
chlamydia s/sx in men
4
1. urogenital infections - urethritis, epididymitis
2. testicular pain/tenderness
3. hydrocele
4. prostatitis
52
chlamydia - other common infections in males and females
3
1. conjunctivitis
2. pharyngitis
3. proctitis (inflammation of distal rectal mucosa)
53
trichomoniasis s/sx in females
9
1. purulent, malodorous, thin vaginal discharge
2. vaginal burning
3. pruritis
4. dysuria
5. urinary frequency
6. lower abd pain
7. dyspareunia
8. erythema of vulva and vaginal mucosa
9. vaginal discharge is green-yellow and frothy
54
trichomoniasis s/sx in males
3
1. urethritis
2. clear or mucopurulent urethral discharge
3. dysuria
55
STDs DD
5
gonorrhea -> chlamydia
chlamydia -> gonorrhea
trichomoniasis
PID
BV
56
STD education
5
1. many STDs can be transmitted through any type of sex
2. get screened for STDs if you suspect you have one, have multiple sex partners, or have a new sex partner
3. there is no definitive way to prevent STDs if you are sexually active
4. wear a condom every time
5. get vaccinated
57
gonorrhea tx
abx
58
chlamydia tx
abx
59
trichomoniasis tx
abx
60
gonorrhea test
female - NAAT vaginal swab
males - NAAT first catch urine sample
61
chlamydia test
female - NAAT vaginal swab
males - NAAT first catch urine
62
trichomoniasis test
female - NAAT vaginal swab
male - NAAT urethral swab
63
STDs f/u
48-72 hours
64
STDs AG
3
1. <25 years, get screened annually for chlamydia, gonorrhea, and HIV
2. > 25 get screened at least once for HIV
3. do sexual activity counseling
65
STDs red flags
5
worsening sx
persistent or recurrent symptoms
change in bladder or bowel function
fever
increased bleeding
