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GYN Textbook Chapter 5,6,7,17,21 > Chapter 21,22 Gynecologic Condition > Flashcards

Chapter 21,22 Gynecologic Condition Flashcards

1
Q

Vaginal pH normal
Dominant organism of vagina
What acid is produced in vagina

A

3.5-4.5
Lactobacillus
Lactic acid

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2
Q

Vaginitis

A

Inflammation of the vagina
increased vaginal discharge
increased WBC

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3
Q

Vaginosis

A

Not associated with wbc. Vaginal environment is altered.

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4
Q

Vulvovaginitis

A

Inflammation of vulva and vagina c/b vaginal infection and leukorrhea

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5
Q

Bacterial Vaginosis

s/s

speculum finding

vaginal wall color

A

Gardanella
Vaginal pH more alkaline

s/s: fishy odor , mild irritation, vulvular pruritic, postcoital spotting, irregular bleeding episode, vaginal burning, urinary discomfort

speculum: thin white, grey milky discharge

vaginal wall color: pale and pink

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6
Q

BV dx (Amsel criteria)

How much to diagnose

A

1) White thin,yellow vaginal discharge
2) ph >4.5
3) Positive whiff/KOH test (fishy)
4) Clue cell on microscopic exam

3/4 must be to diagnose

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7
Q

BV Medication Treatment (non pregnant)

Primary treatment

Treatment if you are allergic
what can tx weaken?

A

Metronidazole (Flagyl) 500 mg orally BID for 7 days
Metronidazole gel 0.75% one applicator (5g) vaginally bedtime for five days
Clindamycin cream 2% one full applicator (5 g) intra vaginally at bedtime for seven days

ALT: Clindamycin 300 mg PO BID for seven days
Clindamycin ovules 100 mg intravaginally once at bedtime for three days
Secnidazole 2 g oral granules in a single dose (sprinkled onto applesauce or yogurt)
Tinidazole 2 g orally once daily for two days
Tinidazole 1 g orally once daily for five days

Tx can weaken latex condom/contraceptive

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8
Q

BV Medication Treatment (pregnant)

A

Metronidazole (Flagyl) 500 mg orally BID for 7 days
Metronidazole (Flagyl) 250 mg orally TID for 7 days
Clindamycin 300 mg orally BID x 7 days

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9
Q

BV Med Tx RECURRENT

A

Retreat with original therapy

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10
Q

BV should partners be treated

A

NO

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11
Q

BV patients should be screened for

A

STI/HIV

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12
Q

What should you avoid when taking metrodinazole and tinladinozole?

A

Avoid alcohol 24/72 hours

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13
Q

Is VVC an STD?

A

NO

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14
Q

VVC pathogen

A

Candida albicans

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15
Q

VVC s/s
Discharge description

A

Vaginal pruritis
Thick, white, curdlike
Dyspareunia , vaginal irritation

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16
Q

Uncomplicated VVC

tx

A

Sporadic VVC , Mild to moderate

tx: Oral fluconazole 150 mg SINGLE DOSE

17
Q

Complicated VVC

A

Recurrent, Severe VVC, non-albicans candidiasis
DM, immunocompromised

tx: oral fluconazole 150 mg every 72 hours 2-3 doses

18
Q

Recurrent VVC

A

4 or more episodes in 1 YEAR

2 weeks topical therapy OR fluconazole THEN Fluconazole 150 mg weekly x 6 months

19
Q

VVC topical therapy OTC

A

Topical clotrimazole , miconazole (Momistat)

20
Q

Atrophic Vaginitis

what is a high risk of getting

A

Menopause (pre & post) and lactating

s/s: vaginal dryness, discharge, odor, urinary fequency, nocturia, UTI

dryness with intercourse

21
Q

AV Speculum

Cervic

vaginal pH

A

small narrow speculum instrument

Cervical stenosis, petechiae on the cervix

pH >5.0
Vaginal maturation index test

22
Q

Atrophic Vaginitis primary treatment

A

Low dose vaginal estrogen and can be used in breastfeeding females

23
Q

Atrophic Vaginitis Vaginal estrogen therapy contraindications

high risk of what

A

breast ca******* , estrogen ca, liver dz, PE, DVT, use of vaginal estrogen

high risk of endometrial cancer

24
Q

AV
Moderate to severe dyspareunia tx (SERM)

(OTR) ***

A

Ospemifine ( Osphena) 60 mg PO daily

DONT TAKE Fluconazole + Ketoconazole

Tamofixen & Raloxifene

25
Q

AV
Decrease pain with sexual activity

A

Dehydroepiandrosterone (intrarosa)

Intravaginal suppository nightly 6.5 mg

26
Q

Bartholin Duct Abscess

A

Abscess on Bartholin duct transport fluid become ducts

Ecoli, MRSA

Culture with I+D

27
Q

Bartholin Duct Cyst

Management

A

Non tender swollen
Unilateral
No erythema

Mgmt: Cyst <2 cm no sx. Sits bath & NSAIDS

28
Q

Bartholin Duct Abscess

A

Mass, tender, erythema, >5 cm swollen

29
Q

Bartholin Duct Abscess MED TX

First Line
Second Line

A

First: BACTRIM****
Seconds: Amoxicillin, Doxycycline, Cefixime

30
Q

Bartholin Duct Abscess Surgical TX (4)

In office:
Recurrent mass:
Cancer concern:
Culturing:

A

In office: Fistulation
I+D
Marsupialization: Recurrent mass
Excision of bartholin: Cancer concern

GYN Textbook Chapter 5,6,7,17,21 (7 decks)

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