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Women's Health > Women's Health > Flashcards

Women's Health Flashcards

1
Q

Thin white discharge
Fishy odor with KOH
Discharge pH > 4.5

A

BV

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2
Q

KOH prep….
Clue cells are seen in
Budding yeast and pseudohyphae

A
  1. BV

2. Candida

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3
Q

BV tx

  1. asxic women
  2. sxic women
  3. sxic pregnant women
A
  1. no tx
  2. topical or PO flagyl OR Clinda
  3. PO flagyl OR Clinda
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4
Q

Non-odorous, curd-like discharge

Discharge pH < 4.5

A

Candida

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5
Q

If symptoms are present but KOH is neg. But your suspicion for Candida is high?

A

Culture

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6
Q

Candida tx

  1. asxic women
  2. sxic women
  3. sxic pregnant women
A
  1. no tx
  2. 1 dose of fluconazole OR topical clotrimazole, miconazole, nystatin
  3. fluconazole is c/I in pregnancy
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7
Q

Frothy yellow discharge
Strawberry cervix
Discharge pH >4.5

A

Trichomonas

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8
Q

Which vaginitis infections needs testing for STI

A

Trichomonas

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9
Q

Trichomonas Tx

A

PO flagyl x 1 dose

Treat sexual partner

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10
Q

Can you infect your partner if Herpes lesion are not present?

A

YES; subclinical shedding without lesion occur

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11
Q

Why is suppressive therapy important in some cases of Herpes infection?

A

Decrease recurrences

Decrease risk of transmission to partners

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12
Q

Can you use topical acyclovir for treating genital herpes

A

NO

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13
Q

PID tx in ambulatory setting

A

Rocephin IM x 1 dose + Doxycyline x 14 Ds +/- Flagyl x 14 Ds

Cefoxitin x 1 dose + Probenecid (uric acid reducer) + Doxycycline x 14 days +/- Flagyl x 14 Ds

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14
Q

PID inpatient tx indications

A
  • inability to exclude surgical emergency
  • suspected tubo-ovarian abscess
  • PREGNANCY
  • failure to respond or tolerate PO theory
  • non-adherence
  • severe systemic symptoms
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15
Q

PID inpatient tx

A

IV Cefotetan or Cefoxitin + Doxycycline

IV Clinda + Genta

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16
Q

Do you treat male partners of women with PID presumptively for G&C

A

YES

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17
Q

Cervical cancer screening for women ages 21-29

A

Pap cervical cytology q 3 yrs ONLY

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18
Q

Cervical cancer screening for women ages 30-65

A

Pap cervical cytology q 3 yrs
OR
Cytology + HPV q 5 yrs

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19
Q

Mx of breast mass with normal mammogram and U/S

A

Biopsy

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20
Q

Breast lump < 30 yo and Pregnant women

A

U/S

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21
Q

Primary amenorrhea means

A

No menses by age 15 ys if normal secondary sexual development

No menses by age 13 ys if no breast development

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22
Q

Primary ovarian insufficiency

Short stature, neck webbing

A

Turner syndrome 45XO

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23
Q

MC CV findings with Turner syndrome

A

Aortic coarctation

Bicuspid aortic valve

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24
Q

Primary amenorrhea diagnostic workup

A
  1. serum HCG to exlude pregnancy
  2. TSH
  3. Prolactin (if elevated pituitary MRI)
  4. FSH (if elevated karyotype for Turner syndrome)
  5. Pelvic US (if absent uterus consider Mullerian genesis and complete androgen insensitivity)
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25
Q

PCOS tx

A
  • weight loss
  • if fertility not desired - combined hormonal contraception
  • if fertility desired - clomiphene citrate for ovulation induction
  • spironolactone to control hirsutism
  • metformin for T2DM
26
Q

Premenopausal abnormal uterine bleeding

PALM-COEIN

A 
P olyp
A denomyosis
L eiomyoma
M malignancy
C oagulopathy
O vulation dysfxn
E ndometrial
I atrogenic
N ot yet classified
27
Q

Premenopausal abnormal uterine bleeding classified into 2 major categories

A

Ovulatory bleeding - regular cycle but excessive

Anovulatory bleeding - irregular cycle and irregular flow

28
Q

3 MC ovulatory bleeding (regular but excessive) causes in premenoupsal bleeding

A

Structural abnormalities

Thyroid

Bleeding d/o

29
Q

Evaluation for pre-menopausal women age >45 ys with abnormal uterine bleeding

A

Endometrial biopsy

30
Q

Size of endometrial stripe that requires endometrial biopsy

A

4 / more mm

31
Q

Anovulatory bleeding tx

A

Progestin to maintain endometrial stability

OCP

To preserve fertility - Medroxyprogesterone acetate for the second half of the menstrual cycle

32
Q

Bloating, difficulty concnetrating, irritability, and depressive sxs beginning 3 days prior to menses and resolving several days after her periods ends

A

Premenstrual syndrome

33
Q

Mod-to severe Premenstrual syndrome tx

Mild Premenstrual syndrome tx

A

SSRI (1st line)
OCP

MILD - CBT, exercise, relaxation techniques

34
Q

Difference between Premenstrual syndrome vs Premenstrual dysphoric disorder

A

Premenstrual dysphoric disorder - causes significant distress and/or interference with work AND repeated occurrence of multiple symptoms

35
Q

Dysmenorrhea tx

A

NSAID / COX-2 inh is 1st line
If incomplete response

OCP
Systemic progestin only contraceptives
Levonorgestrel IUD

36
Q

Treatment of menopause symptoms

A

SSRI, SNRI, gabapentin

37
Q

Postmenopausal estrogen-progestin therapy for > 5yrs increases risk for?

A

Breast cancer

38
Q

Estrogen replacement therapy contraindications

A 
Preg
Undiagnosed abnormal vaginal bleeding
VTE
Hx of stroke
Hx of MI
Hx of breast cancer
Liver dz
39
Q

Tx for dyspareunia in post-menopausal (Genitourinary syndrome of menopause) or in women with Female Sexual Dysfunction

A

Ospemifene

Vaginal dehydroepiandrosterone

40
Q

Female Sexual Dysfunction consists of

A

Persistent or recurrent symptoms of

  • female orgasmic disorder
  • sexual interest/arousal d/o
  • genitopelvic pain/penetration d/o
41
Q

Tx for Premenopausal Sexual interest/arousal d/o

A

Flibanserin

42
Q

1st line treatment for OP

A

Bisphosphonates PO

IV Zoledronic acid (reclast) annually

43
Q

DEXA screnning for OP

A
  1. F ≥ 65 yo

2. Post-meno F <65 yo with FRAX score of >9.3%

44
Q

2nd line tx for OP

A

Denosumab- prolix (Ab to RANKL)

45
Q

Bisphosphonate contraindications

A

CKD
Esophageal dz
Osteonecrosis of jae
Atypical femur fracture with >5 ys of use

46
Q

Glucocorticoid induced OP tx
1st line
2nd line

A

1st line - PO bisphosphonates

2nd line - Teriparatide- forteo

47
Q

IUD contraindications

A

Active PID / cervical infection

Fibroids with distortion of uterine cavity

Severe anemia/thrombocytopenia

48
Q

OCP (combination estrogen-progesterone OR progesterone-only) contraindications

A 
Breast cancer
VTE
Smoke >15 cigarettes / day
Age >35
Uncontrolled HTN
Liver dz
Migraine with aura
49
Q

Which class of medications reduce effectiveness of hormonal contraceptives

A

Inducer of CYP3A

    • anti seizure meds
    • rifampin
    • griseofulvin
50
Q

Preferred emergency contraception

A

Levonorgestrel (taken within 5 Ds post-intercourse)

51
Q

Ectopic pregnancy tx

A

Methotrexate if fails or if hemodynamically unstable …

Surgery

52
Q

Tx BP —- ≥ in pregnancy

A

≥ 160/105 or end organ damage

53
Q

Antihypertensive meds that can be used in pregnancy

A

Labetalol
Nifedipine
Methyldopa

54
Q

Safe Abx for UTI tx in pregnancy

A

Augmentin
Cephalosporins
Nitrofurantoin

55
Q

DM target in pregnancy
A1c
fasting BS
1-hr postprandial

A

< 6-6.5%

<95

≤ 140

56
Q

DOC for pain during pregnancy?

A

Acetaminophen

NSAIDs up to 30 wks of gestation (but try to avoid use)

57
Q

Fetal problem with NSAID use during pregnancy especially > 30 wks of gestation

A

Risk for developing premature closure of the ductus arteriousus

58
Q

Urge incontinence is due to

A

Dextrusor Muscle overactivity

59
Q

When to start bisphosphonate therapy

A

Major osteoporotic fracture is greater than or equal to 20% or the risk of hip fracture is greater than or equal to 3%

60
Q

Hypergonadotropic hypogonadism in Male is c/w

A

Klinefelter syndrome 47XXY

  • -azoospermia, fatigue, low libido, infertility
  • -High LH/FSH
  • -Low testestorenone

Women's Health (1 decks)

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