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Women's Health Flashcards

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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
PCOS tx
- 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
Premenopausal abnormal uterine bleeding | PALM-COEIN
``` P olyp A denomyosis L eiomyoma M malignancy C oagulopathy O vulation dysfxn E ndometrial I atrogenic N ot yet classified ```
27
Premenopausal abnormal uterine bleeding classified into 2 major categories
Ovulatory bleeding - regular cycle but excessive Anovulatory bleeding - irregular cycle and irregular flow
28
3 MC ovulatory bleeding (regular but excessive) causes in premenoupsal bleeding
Structural abnormalities Thyroid Bleeding d/o
29
Evaluation for pre-menopausal women age >45 ys with abnormal uterine bleeding
Endometrial biopsy
30
Size of endometrial stripe that requires endometrial biopsy
4 / more mm
31
Anovulatory bleeding tx
Progestin to maintain endometrial stability OCP To preserve fertility - Medroxyprogesterone acetate for the second half of the menstrual cycle
32
Bloating, difficulty concnetrating, irritability, and depressive sxs beginning 3 days prior to menses and resolving several days after her periods ends
Premenstrual syndrome
33
Mod-to severe Premenstrual syndrome tx Mild Premenstrual syndrome tx
SSRI (1st line) OCP MILD - CBT, exercise, relaxation techniques
34
Difference between Premenstrual syndrome vs Premenstrual dysphoric disorder
Premenstrual dysphoric disorder - causes significant distress and/or interference with work AND repeated occurrence of multiple symptoms
35
Dysmenorrhea tx
NSAID / COX-2 inh is 1st line If incomplete response OCP Systemic progestin only contraceptives Levonorgestrel IUD
36
Treatment of menopause symptoms
SSRI, SNRI, gabapentin
37
Postmenopausal estrogen-progestin therapy for > 5yrs increases risk for?
Breast cancer
38
Estrogen replacement therapy contraindications
``` Preg Undiagnosed abnormal vaginal bleeding VTE Hx of stroke Hx of MI Hx of breast cancer Liver dz ```
39
Tx for dyspareunia in post-menopausal (Genitourinary syndrome of menopause) or in women with Female Sexual Dysfunction
Ospemifene Vaginal dehydroepiandrosterone
40
Female Sexual Dysfunction consists of
Persistent or recurrent symptoms of - female orgasmic disorder - sexual interest/arousal d/o - genitopelvic pain/penetration d/o
41
Tx for Premenopausal Sexual interest/arousal d/o
Flibanserin
42
1st line treatment for OP
Bisphosphonates PO IV Zoledronic acid (reclast) annually
43
DEXA screnning for OP
1. F ≥ 65 yo | 2. Post-meno F <65 yo with FRAX score of >9.3%
44
2nd line tx for OP
Denosumab- prolix (Ab to RANKL)
45
Bisphosphonate contraindications
CKD Esophageal dz Osteonecrosis of jae Atypical femur fracture with >5 ys of use
46
Glucocorticoid induced OP tx 1st line 2nd line
1st line - PO bisphosphonates 2nd line - Teriparatide- forteo
47
IUD contraindications
Active PID / cervical infection Fibroids with distortion of uterine cavity Severe anemia/thrombocytopenia
48
OCP (combination estrogen-progesterone OR progesterone-only) contraindications
``` Breast cancer VTE Smoke >15 cigarettes / day Age >35 Uncontrolled HTN Liver dz Migraine with aura ```
49
Which class of medications reduce effectiveness of hormonal contraceptives
Inducer of CYP3A - - anti seizure meds - - rifampin - - griseofulvin
50
Preferred emergency contraception
Levonorgestrel (taken within 5 Ds post-intercourse)
51
Ectopic pregnancy tx
Methotrexate if fails or if hemodynamically unstable ... Surgery
52
Tx BP ---- ≥ in pregnancy
≥ 160/105 or end organ damage
53
Antihypertensive meds that can be used in pregnancy
Labetalol Nifedipine Methyldopa
54
Safe Abx for UTI tx in pregnancy
Augmentin Cephalosporins Nitrofurantoin
55
DM target in pregnancy A1c fasting BS 1-hr postprandial
< 6-6.5% <95 ≤ 140
56
DOC for pain during pregnancy?
Acetaminophen NSAIDs up to 30 wks of gestation (but try to avoid use)
57
Fetal problem with NSAID use during pregnancy especially > 30 wks of gestation
Risk for developing premature closure of the ductus arteriousus
58
Urge incontinence is due to
Dextrusor Muscle overactivity
59
When to start bisphosphonate therapy
Major osteoporotic fracture is greater than or equal to 20% or the risk of hip fracture is greater than or equal to 3%
60
Hypergonadotropic hypogonadism in Male is c/w
Klinefelter syndrome 47XXY - -azoospermia, fatigue, low libido, infertility - -High LH/FSH - -Low testestorenone

Women's Health (1 decks)

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