Women Flashcards
61 yo women with menopause - USPS recommendation on hormonal therapy for prevention of chronic dz?
USPSTF recommends against use of both unopposed estrogen and progestin for prevention of chronic dz. Research shows hormone therapy increase risk for a/e
greyish vaginal discharge, dysuria, vaginal disorder, high pH >4.5, clue cells—– diagnosis?
bacterial vaginosis
wells score used for?
prediction for DVT
whiff test is?
amine test reveal fishy order
thick, cruddy, white discharge, vaginal BURNING, and itching, LOW pH < 4.5, pseudohyphae — diagnosis?
Candidiasis
green/yellow, motile/flagella on wet mount — diagnosis?
trichomoniasis
abnormal vaginal discharge, cervicitis, abdominal pain, maybe asymptomatic — diagnosis?
chlamydia
bacterial infection present with fever, abdominal pain if ascending, purulent discharge — diagnosis?
gonorrhea
bacterial vaginosis treatment?
metronidazole 500mg PO BID for 7 days
or
clindamycin 100mg vaginal suppository nightly for 3 nights
chancroid presentation and caused by which organism?
a gram negative coccobacillus.
sexually transmitted dz that cause pustule and progress to multiple, painful operations with sharply demarcated purulent bases. and assoc with painful inguinal lymphadenopathy (aka bubo)
chancroid treatment
azithromycin 1 gm PO once
ceftriaxone 250mg IM once
ciprofloxacin 500mg PO BID for 3 days
or erythromycin 500mg PO four times a day for 7 days
pregnant women should consume which vitamin?
folic acid 4mg PO QD.
consume diet of folate-rich foods and daily oral supplements of folic acid until 12 weeks of gestations. after a decrease to 0.4mg ad.
folate is?
water-soluble vitamin B9
folic acid is?
synthetic
folic acid intake can mask?
b12 deficiency
Gonorrhea treatment
ceftriaxone (Rocephin)
Chlamydia treatment
with ceftriaxone PLUS azithromycin
treatment for preeclampsia to reduce risk of seizures?
magnesium sulfate
clomiphene citrate
given to women with infertility d/t anovulation (ovaries not releasing oocytes) with normal hormone levels.
treatment for 10 week pregnant patient with HYPerthyroidism?
PRopylthiouracil (PTU)
If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days?
Secretary luteal phase under the influence of estrogen and progesterone.
The endometrial changes seen in the latter half of the cycle are under the influence of both estrogen and progesterone from the corpus luteum. During this phase, the endometrium becomes more vascularized and slightly edematous.
what test do you check at 24-28 weeks of gestation?
1 hr post Glucola blood glucose
what is salpingitis?
inflammation of the fallopian tube
dysuria, fever, malaise, myalgia, headache and lesions on genitalia, multiple clear vesicles, and erythematous ulcers with tender bilateral inguinal adenopathy – diagnosis?
herpes genitalis
treat with valacyclovir
Rho gram is given to mother with what blood type and when to give?
AB negative mother, spontaneous abortion
give at 28 weeks gestation and within 72 hours of delivery with Rh-positive infant.
what medication is given to enhance fetal lung maturity at 24-34 weeks gestation?
corticosteroids
What should be the initial evaluation of the etiology of infertility in a 25 year-old female who has been trying to conceive for 1 year
Serum progesterone levels.
LH and mid luteal phase progesterone (to determine ovulatory function) and transvaginal ultrasound (to rule out the possibility of fibroids or polycystic ovaries), are first-line investigations.
A 56 year-old female patient comes to the office for evaluation. She complains of dyspareunia and a thin vaginal discharge. On physical examination atrophic vulvar changes are noted associated with vaginal petechiae and a thin clear discharge. What medication is recommended to treat this patient’s symptoms?
This patient has atrophic vaginitis which is very common in postmenopausal patients. The vagina will appear atrophied, will look pale, and thin and dry in appearance. Best to treat with topical or oral estrogen preparations.
progesterone peaks?
after ovulation
luteinizing hormone peaks?
at the time of ovulation/ responsible for ovuation
s/sx of pre-eclapmsia
high blood pressure, headache, blurred vision, right upper quadrant discomfort, brisk patellar reflexes, proteinuria, elevated fetal heart rate
diagnostic test for hyperandrogenism?
free testosterone, show elevated free testosterone, and supports diagnosis of polycystic ovarian syndrome.
What is is typically caused by reduced estrogen levels producing intense itching and thin vaginal mucosa with a resultant yellowish discharge that has a pH > 5.5.
Atrophic vaginitis
A 25 year-old G2P2 married female presents to the clinic for birth control counseling. Her past history includes deep vein thrombosis with her last pregnancy. She does not want another pregnancy for at least 4 years. The birth control method that would be best for this patient is which of the following?
Levonorgestrel releasing IUD
IUD releases potent progestin only; is not a combination contraceptive. WHO rates progesterone only contraception as a “2”. A 2 means that progesterone only contraception can general be used after DVT but should be monitored and followed up with caution
A 48 year-old G3P3003 female presents to the office complaining of severe secondary dysmenorrhea and menorrhagia over the last 6 months. On physical examination her uterus feels enlarged and irregular. Which of the following is the most likely diagnosis?
uterine leiomyomata
severe dysmenorrhea, menorrhagia, irregular uterus
test performed at 10-13 weeks gestation?
Pregnancy-associated plasma protein A (PPA), beta-hCG, and ultrasound of nuchal transparency
define menorrhagia
long and heavy flow menstrual flow
define oligomenorrhea
menstrual periods that occur more than 35 days apart
define metrorrhagia
is bleeding that occur at any time between menstrual periods
define hypomenorrhea
light flow, sometimes only spotting
A 45-year-old woman is noted to have four yeast infections in 1 year. Appropriate management of this patient should b
Recurrent vulvovaginal candidiasis is defined as four or more yeast infections in 1 year. The possibility of uncontrolled diabetes mellitus or immunodeficiency should be considered in women with recurrent vulvovaginal candidiasis. When it has been determined that no reversible causes are present (e.g., antibiotic therapy, uncontrolled diabetes, OCP use) and initial therapy has been completed, maintenance therapy may be appropriate. Selected long-term regimens include the use of clotrimazole and fluconazole. The role of boric acid and lactobacillus therapy remains in question