Office Flashcards
(44 cards)
What are the most common causes of chronic pelvic pain?
Endometriosis
Adhesions
Interstitial Cystitis
Irritable Bowel Syndrome
What triad of symptoms are commonly associated with interstitial cystitis?
Urinary frequency, urgency, pain
How is interstitial cystitis diagnosed?
History, PE, rule out other etiologies
Can do cystoscopy with hydrodistention: may see petechiae/glomerulations or Hunner ulcers (not required for dx)
What is the definition of vulvodynia?
Vulvar pain not attributed to an identifiable cause or due to specific lesions (such as infections dystrophies ulcers, VIN, masses, varicosities, and bx negative)
What are some treatments for vulvodynia?
- Vulvar care (local anesthetics, estrogen cream, topical TCA, trigger point injections, botox)
- Oral TCAs or anticonvulsants
- Biofeedback and pelvic PT
- Transcutaneous nerve stim
- Vestibulectomy
What are some theories behind the pathophysiology of endometriosis?
- Retrograde menstruation
- Hematologic spread
- Lymphatic spread
- Coelomic metaplasia
Frequency of testing for:
GC/CT
13-24 if sexually active > 25 if high risk
Frequency of testing for:
glucose and FBS
Annually if high risk
Every 3 yrs beginning at age 45
Frequency of testing for:
Lipid profile
5 yearly beginning at age 21
Frequency of testing for:
DEXA
Age 65 or sooner with risk factors, repeat every 2 yrs as needed
Frequency of testing for:
HIV
At least once in lifetime, consider annual if high risk
Describe the TACE questionnaire
Tolerance
Annoyed
Cut down
Eye opener
What are the 5 As for (smoking cessation) counseling?
Ask
Advise
Assess
Assist
Arrange
What are the effects of smoking in pregnancy?
FGR, LBW, PPROM, previa, abruption, ectopic, recurrent SAB
What is the recommended amount of Ca intake/supplementation per day?
18yo and under 1300mg
19-49yo 1000mg
50yo and over 1200mg
What is the recommended amount of Vit D intake/supplementation per day?
600-800iu
How long do you continue cervical ca screening in women with hx of CIN2/3 or AIS?
25 years of post treatment surveillance (even if that goes past age 65)
What are the cervical ca screening recommendations for immunosuppressed or HIV positive patients?
Screen annually for life, beginning within 1 yr of initiation of sexual activity
What is the post-hyst screening after treatment of CIN2/3 or AIS?
Annually x 3 yrs
After 3 neg screens, screen every 3 yrs for 25 yrs
What are some reasons to consider CKC instead of LEEP?
Positive ECC
Positive margins on LEEP
Carcinoma or adenocarcinoma in situ
Discrepancy btwn Pap and less severe Colpo
Inadequate colpo
Completion of childbearing
At what age do you start colon cancer screening?
Age 45, or 10 yrs prior to colon ca dx in family member
- Continue to age 85, but with R/B/A assessment in 76-85yo
What are some options for colon cancer screening?
Colonoscopy
Sigmoidoscopy
CT colonography
Fecal occult blood testing (guiac FOBT)
Fecal immunochemical testing (FIT)
Sigmoidoscopy + FIT
How often to repeat colonoscopy?
Baseline: q 10 yrs
One 1st deg relative: 5 yrs
> One 1st deg relative: 3 yrs
Benign colonic polyp 3-5 yrs
Polyp with atypia 3 yrs
When to screen for lung cancer?
Low dose CT annually in adults 50-80yo with smoking hx
20 py hx and current smoker, or, quit < 15 yrs ago
