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FNP Review > Women's Health > Flashcards

Women's Health Flashcards

1
Q

A NP suspects ovarian cancer in a patient. What should be ordered before referral?

A
  1. Transvaginal U/S

2. Order Lab: Cancer Antigen (CA-125)

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2
Q

As a NP working with women’s health, a NP knows the leading cause of death in maternal patient in the first trimester of pregnancy ____________.

A

Ectopic Pregnancy

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3
Q

A NP suspects ectopic pregnancy, what is the pain-pattern for ectopic pregnancy?

A

Patient will report pain for 6-7 weeks. The pain will be located in the lower-abdominal area or right-shoulder. The aggravation factors will be laying supine. It will be described as jarring.

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4
Q

A NP is reviewing a patient’s medical history, what diagnoses will place concern for ectopic pregnancy for the NP.

A
  1. History of PID
  2. History tubal ligation
  3. Previous ectopic pregnancy
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5
Q

A NP has a follow-up with a patient. The NP suspects ectopic pregancy. What labs need to be ordered? What is the interpretation?

A
  1. Quantitative HCG (Beta HCG) - with 48 hours the HCG level should double in a normal pregancy
  2. Progesterone- 5-20 % , if it is less than 5 it is considered abnormal
  3. Ultrasound
  4. CBC
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6
Q

A 30 year old patient is receiving a cervical screen on this visit. How should it be ordered?

A

In the same collection,

  1. PAP
  2. HPV DNA test
  3. F/U 5 years if patient has negative results
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7
Q

A NP diagnosed patient with pelvic inflammatory disease. Given no contraindication, what should be ordered?

A
  1. Rocephin
  2. Doxycycline
  3. Flagyl
  4. F/U in 48-72 hours
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8
Q

What are the strains of HPV that cause cervical cancer? What are the top two?

A

Top Two:

  1. most common 16
  2. 18
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9
Q

What is the gold standard for diagnosing cervical cancer? What is the procedure called?

A
  1. Gold: Cervical biopsy

2. Procedure: Colposcopy (viewing of the cervix) with biopsy

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10
Q

According to USPTF, when do you start and stop breast cancer screening for patient without risk factors.

A

Mammogram

Start at 50
Stop at 75

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11
Q

According to the USPTF, when do you start cervical screenings and stop without any risk factors.

A

Pap Smear and /or HPV DNA testing starts at 21 and stops at 65

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12
Q

Which vaccine pregnant patients cannot have?

A
  1. Live Vaccines
  2. HPV
  3. MMR
  4. Live influenza (Nasal Flu-mist)
  5. Varicella
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13
Q

A pregant patient wants to travel out the country. She ask about vaccines for travel. What should the NP teach?

A

The patient cannot have yellow-fever, typhoid fever, and Jan encephalitis vaccine are travel vaccines, BUT pregnant women cannot have because they are live vaccines.

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14
Q

A newly diagnosed pregnant patient ask about vaccines. Which ones should be recommended?

A

It is encourage for a pregancy patient to have a up-to-date influenza and COVID-19 vaccine.
She will also received TDaP every pregancy at 27-36 weeks of gestation.

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15
Q

If a pregnant patient is not immune to varicella, when will she take the vaccine?

A

Varicella is live. She will not take it during pregancy. She can have it after giving birth.
The two doses will 4-8 weeks apart

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16
Q

A NP palpates a ovary in a post-menopausal woman, what is the suspected diagnosis? What needs to be ordered?

A
  1. Ovarian Cancer
  2. Transvaginal U/S
  3. Order BRCA 1 and BRCA 2
  4. Oncology or OB-GYN referral
17
Q

What medications are contraindicated in pregnant women?

A
  1. Diflucan
  2. ACEI (even during breastfeeding)
  3. ARBS (even during breastfeeding)
  4. Live vaccines
  5. HPV Vaccine
  6. Tetracyclines
  7. Macrolids
  8. Fluoroquinolones ( even during breastfeeding)
18
Q

Pregnant patient has a UTI. What is used to treat UTI in pregnant women?

A

Amoxicillin or Cephalexin

19
Q

A new patient comes into your office. She informs you that she is positive for BRCA mutations. How would you care this patient?

A
  1. Referral to Breast Specialist
  2. Screen them using Mammogram and MRI
  3. Genetic counseling
  4. Monitor or ovarian cancer
20
Q

When does the NP know a female pediatric patient is starting puberty? Which stage on Tanner?

A

Breast buds
Tanner Stage 2

Ends at Stage 5

21
Q

What are the three phases of menstruation?

A

Follicular Phase Day 1-14
Mid-Cycle Day 14
Luteal Phase 14-28

22
Q

A NP is education a patient about the window of fertility and the Mid-cycle stage. What facts are important?

A

Mid-Cycle stage is day 14 out 28. This is called the Ovulatory Phase. During this stage, the LH hormone is secreted by the anterior pituitary gland. This hormone induces ovulation of the dominant follicles. The follicles migrates to the fimbriae of the Fallopian tube.

Coitus is best 1-2 days before ovulation.

23
Q

A NP knows that a patient younger than 21 years of age cannot have a cervical screening. Which patient can have cervical screening ( PAP ) before the age of 21?

A

HIV patients

24
Q

A NP is treating a patient for their annual gynecological exam. She is due for a PAP smear. She has been diagnosis with a infection on this visit. What should the NP do?

A

Treat the infection.

Bring patient back in for PAP after the infection clears.

25
Q

A NP is reviewing a patient’s DEXA Scan results. The results are -2.5 or lower> DX it?

A

Osteoporosis

26
Q

NP is reviewing a patient’s DEXA Scan results. The results are between -1.5 to -2.5. DX it?

A

Osteopenia

27
Q

When do you order a DEXA scan again?

A

If on treatment: 1-2 years

No treatment: 2 to 5 years

28
Q

How to treat chronic prostatitis?

A

Bctrium or Levaquin

29
Q

How to treat Acute Prostatitis?

A

35 or younger; STI cotreatment

Older the 35 Cipro or Levaquin

30
Q

How to treat epididymitis?

A

<35 Doxycycline

Or than 35 Levaquin

31
Q

Chlamydia TX?

A

Doxycycline first line

OR

Z-pack

32
Q

Gonorrhoeae tx?

A

Rocephin

or
Zpack

33
Q

A patient is dx with Syphilis with a PCN allergy. What is the treatment.

34
Q

Harish Herxheimer Reaction is associated with what treatment

A

Syphilis treatment with the first 24 hour

supportive therapy

35
Q

A patient comes in the clinic with PID ss. RUQ pain. Recent STI infection. What’s the treatment?

A

Check Liver enzymes
Treatment the same as STI or PID but its for 14 days

Perihepatitis

36
Q

Patient comes into the clinic with pustular form lesion creating pain. Soft ulcer with necrotic base.

what is this STI and what is the treatment?

A

Chancroid
Culture it: come back positive for h. ducreyi

Zpack
Cipro
Rocephin

Full STI screen. Hep. B treat partners

37
Q

Define primary amenorrhea?

A

A female patient that has not had a menstrual cycle but has sexual characteristics by 15 years old

38
Q

A patient reported they missed one birth control pill. What to include in education?

A

Take pill as soon as you remember

Resume regular schedule

39
Q

A patient reported they missed 2 birth control pills. What to include in the patient education?

A

Take a pill at 2am and 2pm resume normal schedule with back up for 1 cycle

Or take 2 pills for 2 days and backup for one cycle

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