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AGNP 1 > Exam 1 - GI, GU, STI > Flashcards

Exam 1 - GI, GU, STI Flashcards

1
Q

3 signs and symptoms of acute appendicitis

A
  1. Pain starting in epigastrium with migration to LLQ
  2. Abdominal rigidity
  3. Acute onset
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2
Q

Where is McBurney point

A

Area between the umbilicus and anterosuperior iliac spine

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3
Q

After acute onset pain from appendicitis, symptoms

A
  1. Anorexia
  2. N/V
  3. constipation
  4. Rarely diarrhea
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4
Q

What is rovsing sign

A

Palpate LLQ and illicit RLQ pain

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5
Q

What is obturator sign

A

Flex knee and hip, internally rotate, illicit pain

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6
Q

What is psoas sign

A

Raising straight and right leg against resistance, elicits pain

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7
Q

What are the 2 most common causes of peptic ulcers

A
  1. H pylori
  2. NSAIDs
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8
Q

2 Most common presenting symptoms of PUD

A
  1. Dyspepsia
  2. Epigastric pain
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9
Q

3 types of medication treatments for PUD

A
  1. H2RA antagonist (-tidine)
  2. PPI (-prazole)
  3. Prostaglandin therapy (misoprastol)
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10
Q

H pylori treatment for patients with risk factors for macrolide resistance

A

Bismuth quadruple therapy - bismuth, metronidazole, tetracycline, PPI

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11
Q

H. Pylori treatment in patients without risk factors for macrolide resistance

A

Clarithromycin based triple therapy - clarithromycin, amoxicillin, PPI

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12
Q

What is the most common reason for GERD

A

Transient lower esophageal sphincter relaxations (TLERs)

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13
Q

7 types of medications that lower esophageal sphincter tone

A
  1. Anticholinergics
  2. Morphine
  3. Theophylline
  4. Calcium channel blockers
  5. Nitrates
  6. Benzodiazepines
  7. Aspirin
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14
Q

What is 1st line treatment for GERD

A

Antacids, alginic acid, or H2RAs taken PRN

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15
Q

What is the criteria for starting 2nd line therapy for GERD

A

More days than not without symptoms, ex 4 or more days per week

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16
Q

What is treatment for moderate to severe GERD or GERD without any complication

A

PPI therapy - once daily for 8 weeks

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17
Q

What would u do if a patient only partially responded to a PPI

A

A dosage increase or change in PPI

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18
Q

What is phase 1 of constipation management

A

Lifestyle - diet, exercise, increase fiber, increase fluids

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19
Q

What is phase 2 of constipation management

A

Bulk forming laxatives - ex. Metamucil

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20
Q

What is phase 3 of constipation management

A

Stool softeners - ex. Colace

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21
Q

What is phase 4 of constipation management

A

Osmotic laxatives - ex. Mom, poylethylene glycol, lactulose

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22
Q

What is phase 5 of constipation management

A

Stimulant laxatives - ex. Senna, bisacodyl

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23
Q

What is phase 6 of constipation management

A

Intestinal secreatagogues - ex, lupiprostone, linaclotide

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24
Q

What is phase 7 of constipation management

A

Enemas/suppositories

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25
Q

Which medication should not be given to pregnant women for constipation

A

Lubiprostone

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26
Q

Med Treatment for mild diverticulitis outpatient (there’s 2)

A

Cipro 500mg q12 or metro 500mg q8 or both for 7-14 days

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27
Q

What is Charcot triad and which duct is affected

A

RUQ pain, fever, jaundice - common bile duct

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28
Q

What is biliary colic and how does it present

A

Epigastric or RUQ pain for 30-60 min, cystic duct affected

29
Q

What is +Murphy’s sign

A

Ask pt to exhale then palpate under right rib cage and ask to inhale. If pain with palpation it is positive for cholecystitis

30
Q

Normal ph of vagina

A

3.8-4.5

31
Q

What might an elevated ph of vagina indicate

A

BV

32
Q

What might a ph less than 4.5 indicate

A

Yeast infection

33
Q

Is BV symptomatic or asymptomatic

A

Most often asymptomatic

34
Q

Type of discharge with BV

A

Heavy thin/grayish/yellowish/white malodorous

35
Q

What are the 4 Amsels criteria for BV (need 3/4 to diagnose)

A
  1. PH greater than 4.5
  2. Clue cells
  3. Amine odor, *whiff test
  4. Homogeneous discharge (thin, white coats the walls)
36
Q

Recommended treatment for BV (there are 3)

A
  1. Metronadizole 500 PO BID for 7 days
  2. Metronidazole gel 0.75% intravag daily for 5 days
  3. Clindamycin cream 2% intravag qhs for 7 days
37
Q

Treatment of BV in pregnant women (3 options)

A
  1. Metronidazole 500 PO BID for 7 days
  2. Metronidazole 250 PO TID for 7 days
  3. Clindamycin 300 PO BID for 7 days
38
Q

What do you give for recurrent BV treatment

A

Boric acid NOT PO

39
Q

What is most often the cause of VVC (yeast infection)

A

Candida albicans

40
Q

What kind of discharge present in yeast infection

A

Thick, non odorous, clumpy

41
Q

Recommended treatment for VVC in pregnancy

A

NOT ANYTHING PO. Only topical azole therapy for 7 days

42
Q

Uncomplicated VVC treatment

A

Oral fluconazole 150 PO for 1 dose and topical azole for 1-14 days

43
Q

Complicated VVC treatment

A

Oral fluconazole 150mg on day 1 and 3 and topical azole for 1-14 days

44
Q

How many times per year is considered recurrent candida

A

3 or more infections in 12 months

45
Q

Should partner be treated for VVC

A

No - unless they have balanitis x- treat with topical antifungal

46
Q

Do the majority of people have trichomonas symptoms

A

No - 70-85% have minimal to none

47
Q

What type of discharge associated with trichomonas

A

Yellow-green, Frothy, profuse

48
Q

What is the characteristic sign of trichomonas on cervix

A

Cervical petechiae “strawberry cervix”

49
Q

What kind of ph would you see on a wet mount for trichomonas

A

Greater than 4.5

50
Q

Recommended treatment for trichomonas among women

A

Metronidazole PO 500mg BID for 7 days

51
Q

Recommended treatment for trichomonas among men

A

Metronidazole PO 2g in a single dose

52
Q

How long after trichomonas treatment should re-testing occur

A

3 months

53
Q

What classifies a UTI as recurrent (2 options)

A
  1. Greater than or equal to 2 infections in 6 months
    Or
  2. Greater than or equal to 3 infections in 1 year
54
Q

Which medication not to be used during last trimester for UTI

A

Nitrofurantoin

55
Q

1st line tx for UTI in pregnancy

A

Amox/amp/augmentin TID for 7-14 days

56
Q

What is cremasteric reflex

A

Stroke inner thigh - normally testes should elevate on ipsilateral side

57
Q

What is prehns sign

A

Elevation of scrotum causes pain relief (positive) - sign of epidydymitis

58
Q

What is the causative agent for chlamydia

A

Bacteria - chlamydia trachomatis

59
Q

What is the other type of STD caused by c. Trachomatis and what does it cause

A

Lymphogranuloma venereum - proctitis

60
Q

1st line treatment for chlamydia

A

Doxycycline 100 mg PO BID for 7 days

61
Q

What is the causative agent for gonorrhea

A

Neisseria ghonnorrhoeae - bacteria

62
Q

Which 2 STDs do you treat for together in most cases

A

Gonnorrhea/chlamydia

63
Q

Treatment for gonnorhea (2 types based on weight)

A

Ceftriaxone

500mg IM for less than 150 kg

1G for greater than 150 kg

64
Q

Which HPV strains cause the highest risk of cervical cancers

A

16 & 18

65
Q

Which HPV strains cause 90% of genital warts

A

6 & 11

66
Q

How many HPV vaccines required for someone older than 15

A

3

67
Q

HSV treatment for initial outbreak

A

Either acyclovir, famciclovir, or valacyclovir in different concentrations, varying frequencies based on dosage, for 7-10 days

68
Q

What frequency of outbreaks warrants HSV suppressive therapy

A

Greater than 4 clinical infections in 12 months

AGNP 1 (2 decks)

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