Reproductive Health Flashcards
good for N522 AU midterm as well,: pregnancy, STIs, contraception (156 cards)
1
Q
What does HELLP stand for
A
Hemolysis
Elevated Liver enzymes
Low Platelets
2
Q
Bright red bleeding with intercourse in pregnancy with no abdominal hardening can mean
A
placenta previa
3
Q
abrupt onset of abd pain with hypertonic uterus with/without bleeding
A
placental abruption
4
Q
HTN after 20 weeks gestation with urine protein, headache, epigastric pain, visual issues
A
preeclampsia
5
Q
Bright red bleeding in pregnancy but no hypertonic tender uterus
A
placenta previa
6
Q
Bright red bleeding with hypertonic hard and tender uterus
A
placenta abruptio
7
Q
what lab results increase in baseline in pregnancy
A
alk phos (2-3 trimester)
lipid profile
t3
wbc
plts
sed rate
gfr
8
Q
BHcG does what in 1st 12 weeks of pregnancy
A
doubles every 24-72 hrs
9
Q
what causes alk phos to increase in pregnancy
A
growth of fetal bones
10
Q
when can amniocentesis and chorionic villus sampling be done
A
amnio - 15-18
chorio 10-12
11
Q
what lab result to use in pregnancy to dx anemia
A
mcv
12
Q
what genetic disorder screening should be done european jewish decent
A
tay-sachs
13
Q
what does alpha fetoprotein measure
A
risk of downs syndrome, neural tube defects and abdominal wall defects
14
Q
low AFP means
A
possibilty of downs syndrome
15
Q
high AFP means
A
possible neural tube defects, gastroschisis, omphalocele
16
Q
folic acid dose all women
A
400mcg daily
17
Q
what STIs should be screened for in pregnancy
A
Hep B, HIV, gonorrhea, chlamydia, syphilis, HSV 1 and 2
18
Q
when to screen for GBS
A
35-37 weeks
19
Q
what drug is used to treat GBS
A
Pen G 5 mill unit IV x1 then 2.5 mill units q4 hrs until birth
if allx to pcn clinda or erythromycin
20
Q
category A drugs in pregnancy are considered
A
no risk
21
Q
category B drugs in pregnancy are considered
A
no risk, no data
22
Q
category C drugs in pregnancy are considered and examples
A
adverse effects, no data
sulfa drugs in 3rd trimester,
sudafed
23
Q
category d drugs in pregnancy are considered and examples
A
fetal risk: benefits must outweigh risk
ACE ARB
fluoroquinolones
tetracyclines
NSAIDS
24
Q
category x drugs in pregnancy are considered and examples
A
fetal risks outweigh benefits
methotrexate
misoprostol
proscar
25
drugs to avoid in 3rd trimester
sulfa dtugs
NSAIDS
ASA
26
are live attenuated vaccines safe in pregnancy, give examples of these
no
MMR, varicella
27
how long after receiving live attenuated vaccine should pregnancy be avoided
4 weeks (MMR), 3 months (varicella)
28
what are teratogens and give examples
drugs that cause fetal abnormalities
paroxetine, fluoxetine
Alcohol
aminoglyclosides
cocaine
lithium
29
cat litter or raw undercooked meat can cause what
toxoplasmosis
30
what does zika virus do
cause severe birth defects with neurodevelopmental abnormalities
31
how long to avoid becoming pregnant if travelled to area with zika virus exposure
both partners or just male: 3 months
only female: 2 months
32
best weight gain if healthy weight before pregnancy
25-35lbs
33
BMI <18.5 best weight gain in pregnancy
28-40lbs
34
obese pt weight gain in pregnancy
11-20 lbs
35
what age for geriatric pregnancy
35
36
advanced maternal age pregnancy at risk for:
chromosomal abnormalities
preeclampsia
LGA
misscarraige
preterm birth
complications
37
positive pregnancy signs
palpation of fetus
ultrasound
fetal heart tones
38
probable signs of pregnancy (remember surnames)
goodell, chadwick, hegar
ballottment
urine HcG
39
chadwicks sign
cervix softening
40
goodells sign
blue discoloration of cervix
41
hegars sign
softening or uterine isthmus
42
presumptive pregnancy signs
amenorrhea
nausea and vomitting
breast changes
fatigue
urinary frequency
quickening
43
fundal height at 12 weeks
symphysis pubis
44
fundal height at 16 weeks
halfway between symphysis pubis and umbilicus
45
fundal height at 20 weeks
umbilicus
46
fundal height at 20-35 weeks
within 2 cm +/- of gestation
47
naegeles rule
add 9months and 7 days
or
- 3 months and + 7 days
48
is S3 heart sounds considered normal in pregnancy
yes
49
HTN medications in pregnancy
labatelol
nifedipine
methhyldopa
metoprolol
50
what is chloasma/melasma and what causes it
hyperpigmentation on forehead, cheeks, nose and upper lip
caused by high estrogen levels
51
what does GTPAL stand for
G gravida
T term
P preterm
A abortion
L living
52
Is clicking noises while breastfeeding considered normal or abnormal
abnormal due to poor latch
53
should a woman stop breastfeeding due to sore nipples
no, advise to continue, not supplement and have latch assessed
54
exclusively breastfeeding amenorrhea (lactational amenorrhea contraception method)
low chance of ovulation in first 6 months due to low estrogen levels
55
birth control contraindicated with breastfeeding
COC or estrogen containing
56
how long does uterine involution take
6 weeks
57
what is uterine atony
boggy uterus, full bladder or possible PPH
58
bleeding and cramping with placenta and fetus expelled
complete abortion
59
diabetes diagnosed in 1st trimester
Type 2 diabetes
60
Goal A1C levels for AGA baby
<6
61
2methods for screening of GDM
1 STEP 75 gm GTT (screening and diagnosis)
2 step 50 gmGTT (screening)
62
if 2 step GTT GDM screening is abnormal what is the next step
100gm GTT (3 hour with fasting)
63
1st line treatment for GDM
lifestyle modifications
64
2nd line treatment for GDM
insulin
65
risk factors for GDM
GDM previously
obesity
ethnicity
macrosomic infant
advanced maternal age
66
vaginal bleeding with cramping, open cervical is with partial products of contraception remaining
incomplete abortion
67
vaginal bleeding, open cervical os
inevitable abortion
68
treatment for mastitis
dicloxacillin 500mg po QID or keflex 500mg po QID
if risk for MRSA Bactrim or clindamycin
continue to breastfeed
u/s if abscess suspected
NSAIDS for pain with cold compresses
69
HTN, proteinuria, rapid weight gain are symptoms or what in pregnancy
preeclampsia
70
HTN before 20 weeks gestation
chronic HTN
71
amniotic fluid levels less than normal
oligohydramnios
72
amniotic fluid levels higher than normal
polyhydramnios
73
action of RhoGAM
immunoglobulin that decreases risk of isoimmmunization by destroring RH positive RBCs that cross the placenta
74
frequency of RhOGAM
28 weeks gestation and 72 hoours post delivery or if bleeding
75
misscaraige <20 weeks gestation
spontaneous abortion
76
pregnancy loss after 20 weeks
stillbirth
77
vaginal bleeding with closed cervical os
threatened abortion
78
chlamydia treatment
doxy 100mg po BID x 7 days
pregnant: azithromycin 1 gm x1
79
testing for chlamydia and gonorrhea
NAAT
80
are UTIs in pregnant women complicated or uncomplicated
complicated
81
UTIs can cause what in pregnancy
preterm birth
LGA
perinatal mortality
82
lab results for diagnosis of UTI in pregnancy
10(3) cfu in symptomatic
10(5) cfu in asymptomatic
83
treatment for UTI in pregnancy
macrobid (not in last trimester)
amox/clav
keflex
fosfomycin
84
menstrual cycle phases
follicular phase 1-14
ovulatory phase 14
luteal phase 14-28
menstruation
85
when is the fertile time period
1-2 days before ovulation
86
what HPV types are oncological
16 and 18
87
when can gardisil be given
11-12 years old (2 doses before 15, 6 months apart)
no need to restart vaccine schedule if missed dose
88
KOH slides used for
candida
89
whiff test used for
BV
90
tzanck smear used for
genital herpes
91
birth control recommended for acne
combined estrogen progestin (monophasic, biphasic, triphasic)
92
what oral contraceptive allows for only 4 periods a year
seasonale
93
contraindications for birth control
hx clots
smoker
hx stroke
elevated LFTs or liver dysfunction
94
absolute contraindications pneumonic for contraception
MY migraine with aura
C CAD or CVA
U undiagnosed genital bleeding
P pregnancy
L liver tumor or elevated Liver enzymes
E estrogen dependent tumors
T thrombus
S smoker aged 35 or older
95
low dose birth control contains how much estrogen
20-35 mcg
96
if missing 2 consecutive days of birth control what do you do?
take most recent missed pill (including taking 2 the same day), discard any other missing pills, resume next day and use backup contraception
97
drugs that interact with birth control
anticonvulsants
antifungals
HIV HEP C inhibitors
certain antibiotics (ampicillin, tetracyclin, rifampin, clarithromycin)
st johns wort
98
birth control danger signs pneumonic
A abdominal pain
C chest pain
H headaches
E eye problems
S severe leg pain
99
who should not receive depo-provera
anorexic or bulimic ( high risk of osteoporosis)
100
box warning for depo provera
not to be used longer than 2 years
101
how is plan B taken
1st dose within 72 hours, next dose 12 hours later
if vomits within 1 hour of taking, then take another dose
102
what birth control causes a delay in return of fertility for 12 months after stopping
depo provera
103
contraindications for IUD
PID currently or past year
pregnant
cervical abnormalities
hx ectopic pregnancy
undiagnosed vaginal bleeding
104
how long do iud lasts
copper 10 years
mirena 3-5 years
105
vaginal discharge with fish odour, worse after intercourse, milk like consistency, white to light grey discharge no vulvar or vaginal redness
BV
106
vaginal pH >4.5 and positive whiff test
BV
107
Vaginosis treatment
Flagyl ( gel in pregnancy)
108
what are these and what do they diagnosis
clue cells and BV
109
white curd like vaginal discharge with pruritis, swelling and redness
candidiasis
110
treatment for candidiasis
miconazole
111
grey and frothy vaginal discharge, strawberry cervix, dysuria
trichomoniasis
112
treatment for trichomoniasis
flagyl 2gm x1 or 500mg BID x7 days
113
NAAT testing used for what
Gonorrhea and Chlamydia, Trichomoniasis
114
vaginal dryness, itching and dyspareunia, atrophic labia with decreased rugae
atrophic vaginitis
115
1st line treatment for atrophic vaginitis
vaginal moisturizers and lubricants
116
treatment for severe vulvovaginal atrophy
topical estrogen
117
when is prophylaxis advised for pneumocytis pneumonia
CD4 <200
118
Purple to bluish red bumps on the skin of pt with aids
Kaposis sarcoma
119
infectious HIV with flu like symptoms
primary HIV infection
120
STD symptoms (mainly gonnorhea) with swollen red joint on one side
disseminated gonococcal infection or reactive arthritis
121
5 Ps for STD screening
partners
practices
protection
past history of STI
prevention of pregnancy
122
NAAT is positive for chlamydia only: treatment
doxycycline
123
plan for pregnant pt with chlamydia
azithromycin and test for cure in 3-4 weeks
124
NAAT specimen of choice for men
first catch urine
125
HSV 1 and 2 sites
1: oral mucosa
2: genitals
126
acute onset of small vesicles one reddened base that rupture easily and develop into painful shallow ulcers
Genital herpes
127
when you find multinucleated giant cells on a tzank smear
genital herpes
128
treatment for first episode of genital herpes
valcyclovir BID x 7-10 days or acyclovir TID
129
treatment for genital herpes flareup
valcyclovir 500 BID x 3 or 1000mg daily x5
acyclovir 800 TID x2 or 800 BID x5
130
rule out what if hairy leukoplakia, recurrent candidiasis or thrush
HIV
131
test for HIV
HIV 1/2 antibodies and p24 with reflexes
132
CD4 count increasing on ART means
Immune system improving
133
Pneumocystitis pneumonia medication not for G6PD anemia
dapsone
134
treatment and prophylaxis for Pneumocystitis pneumonia
Bactrim DS (trimethoprim-sulfamethoxazole)
if allergy use dapsone with trimethoprim
135
Can HIV pregnant patients get treatment
yes, AZT asap
136
oncogenic types of HPV
16 and 18
137
soft white fleshcolored or brown pedunculated papular growths that may me flat or cauliflower like
condyloma acuminata (warts)
138
Treatment for genital warts in non pregnant patient
imiquimod (immune modulator)
139
treatment for genital warts for pregnant patient
mechanical methods only
140
when to screen for gonorrhea and chlamydia in pregnancy
1st and 3rd trimester
141
cervix may appear normal or with purulent green discharge
Gonorrhea
142
treatment for gonorrhea
ceftriaxone 500mg IM x1 (if >150kg 1gm)
143
Proctitis treatment
ceftriaxone and doxycycline
144
risk factors for pelvic inflammatory disease
sex
hx of PID
multiple partners
age 15-25
disruption of vaginal ecosystem
145
lower back and/or abd pain with pain of cervical motion, uterine or adnexal tenderness
pelvic inflammatory disease
146
treatment of PID
ceftriaxone, doxycycline and flagyl
147
inflammation of liver capsule with RUQ pain in pt with PID
fitz-hugh-curtis
148
syphillis with painless chancre
primary
149
systemic syphilis with rash (condyloma lata)
secondary
150
screening tests for syphilis
RPR and VDRL
151
if RPR or VDRL positive for syphilis what next
confirm with treponemal test (FTA-ABS)
152
early syphillis treatment
Pen G 2.4 mill unit IM
153
Late syphilis treatment
Pen G 2.4 mill unit IM weekly x3
pr doxyn100mg po BID x28 days
154
self-limited febrile reaction after spirochete infection treatment
jarisch herxheimer reaction
155
infection with spirochete on microscope
syphilis
156
treponema pallidum causes what
syphilis
