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Reproductive Medicine Exam 2 > Cervical Disorders > Flashcards

Cervical Disorders Flashcards

(48 cards)

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1
Q

What is used for STD testing?

A

Nucleic Acid Amplification Test (NAAT)

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2
Q

What is a “chandelier sign”?

A

Cervical Motion Tenderness (CMT) on bimanual pelvic examination

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3
Q

_______ _____ is a polymicrobial syndrome that results in replacement of normal flora (lactobacillus) of the vagina with anerobic bacteria.

Sx include…..

Watery/Grey Discharge
Absence of urinary Sx
Absence of pain
“Fishy” Odor

A

Bacterial Vaginosis

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4
Q

In bacterial vaginosis…..

Would the pH of the vagina be more acidic or basic than baseline?

A

More Basic ( >4.5)

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5
Q

What criteria is used to diagnose bacterial vaginosis?

A

Amsel Criteria (Need 3 of 4)

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6
Q

The presence of what on wet prep would be diagnostic of bacterial vaginosis?

A

Clue Cells

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7
Q

What medication is first line for treatment of Bacterial vaginosis?

A

Metronidazole (Flagyl) 500 mg BID x7 days

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8
Q

What STD results from a protozoan infection?

A

Trichomonas Vaginalis

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9
Q

What would be seen on wet prep in a patient with trichomonas?

A

Numerous WBC

Motile Trichomonads

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10
Q

What are TWO first line treatments for Trichomonas?

A

2 g of Metornidazole x1 dose

OR

2 g of Tinidazole x1 dose

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11
Q

In which STD would you more likely expect to have colored/purulent discharge…..

Trichomonas or Bacterial Vaginosis?

A

Trichomonas

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12
Q

What is the most commonly reported bacterial infection in the US?

A

Chlamydia

Gonorrhea is 2nd most

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13
Q

Are males or females more likely to be asymptomatic with chlamydia infections?

A

Females are more likely to be asymptomatic

Males often have dysuria

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14
Q

What are long term sequelea of chlamydial infections in females?

A 
PID
Infertility
Ectopic Pregnancy
Chronic Pelvic Pain 
Neonatal Infection
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15
Q

How is chlamydia diagnosed?

What would be observed on a wet prep?

A

NAAT

Wet Prep: WBCs

(Use these in combination with clinical suspicion)

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16
Q

T/F: Routine annual STD screening should occur in all sexually active females <25 y.o.

A

True

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17
Q

During what trimester should all pregnant women be screened for STDs?

A

1st

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18
Q

How is Gonorrhea treated?

A

25 mg of Ceftriaxone IM

PLUS

1 g Azithromycin PO

(*both given in a single dose)

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19
Q

How is chlamydia treated?

A

1 g Azithromycin PO

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20
Q

_______ _______ is described as a sporadic, uncomplicated fungal overgrowth

Study These Flashcards
A

Vuvlovaginal Candidiasis

21
Q

What is the most common causative agent of Vuvlovaginal Candidiasis

Study These Flashcards
A

Candida Albicans

22
Q

T/F: Abx use is NOT a risk factor for developing Vuvlovaginal Candidiasis

Study These Flashcards
A

False

It is a risk factor

23
Q

What are common symptoms of Vuvlovaginal Candidiasis?

Study These Flashcards
A

Pruritis
Burning
Thick, White Discharge

24
Q

What may be seen on wet prep in Vuvlovaginal Candidiasis?

25
What medication is typically used to treat Vuvlovaginal Candidiasis?
150 mg of Fluconazole PO x1 dose
26
An 18 year-old female comes to the clinic with the complaint of increased vaginal discharge and vaginal odor. She also complains of urinary frequency and dysuria. On physical examination there is evidence of thin, gray, frothy discharge in her vagina. The cervix appears erythematous and the vaginal pH is 6. Which of the following is the most likely diagnosis and how would you treat it? A. Candida vulvovaginitis, treat with Terconazole B. Bacterial vaginosis, treat with Metronidazole C. Trichomonas vaginitis, treat with Metrogel D. Chlamydia trachomatis, treat with Azithromycin E. Trichomonas vaginitis, treat with Tinidazole
E. Trichomonas vaginitis, treat with Tinidazole
27
Is genital HSV more commonly related to HSV 1 or HSV2?
HSV 2
28
How can HSV 1 or HSV 2 cervicitis/vaginitis be dianosed?
Culture | *DNA polymerase chain reaction can also be used and more sensitive
29
T/F: topical acyclovir is effective for treating HSV cervicitis/vaginitis
False It is not effective
30
What medications can be used to treat HSV cervicitis/vaginitis?
Oral Acyclovir/Famicyclovir/Valcyclovir
31
T/F: Patients who have a prodrome with HSV cervicitis/vaginitis should practice abstinence to prevent spreading
True
32
A 54 year old married menopausal female presents complaining of vaginal pruritis, dyspareunia and thin discharge. On examination her vulva is smooth and shiny, the vaginal mucosa is pale and thin and a small amount of yellow discharge is present with a pH of 6.0. Wet prep shows WBCs and fewer than normal superficial epithelial cells. What is the suspected diagnosis and treatment? A) Vulvovaginal candidiasis/OTC antifungal agent B) Trichomonas vaginalis/oral Metronidazole C) Genitourinary Syndrome of Menopause/topical Estrogen D) Bacterial vaginosis/Metrogel vaginal
C) Genitourinary Syndrome of Menopause/topical Estrogen
33
What is genitourinary syndrome of menopause?
Decreased estrogen stimulation of the vulva, vagina, and lower urinary tract resulting in dryness and thinness
34
What is a common physical examination finding in genitourinary syndrome of menopause?
Vulvar Atrophy
35
What are common urinary symptoms of genitourinary syndrome of menopause? Vaginal Symptoms?
Urinary Sx: Urgency Frequency Dysuria Recurrent UTIs Vaginal Sx: Dryness Discharge Dyspareunia Spotting
36
T/F: Pelvic organ prolapse is not associated with genitourinary syndrome of menopause
False It is
37
What is the mainstay of genitourinary syndrome of menopause treatment?
Estrogen replacement
38
What would a nulliparous appearance to the cervic indicate? Parous cervix?
Nulliparous: No prior pregnancies/babies Parous: Previous vaginal delivery or close to vaginal delivery
39
What is the most common benign neoplasia of the cervix?
Polyps
40
Can cervical polpys be asymptomatic?
Yes, but they can present with abnormal bleeding
41
How are cervical polyps treated?
Avulsion with polyp forceps or cautery
42
A _________ cyst is described as a mucinous retention or epithelia inclusion cyst on the ectocervix
Nabothian Cyst
43
How are nabothian cysts treated?
There is no treatment
44
How does a Bartholian Gland Cyst occur? When does it become an abscess?
The Bartholin Duct becomes occluded with mucus These become abscesses once they get infected
45
How does a Bartholian Cyst present?
These are typically asymptomatic and are found incidentally
46
Where can Bartholian Cysts be palpable on PE?
Lower medial labia majora
47
How are Bartholian Cysts managed in patients < 40 y.o? > 40 y.o?
<40 y.o: No Treatment >40 y.o: I&D with biopsy to rule out malignancy
48
How would a Bartholian Gland Abscess be treated? should you give ABx?
I&D with placement of a Word Catheter ABx should only be considered for recurrent abscesses, MRSA suspicion, or STI +

Reproductive Medicine Exam 2 (7 decks)

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