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OB GYN > Test 3 Deck 4 > Flashcards

Test 3 Deck 4 Flashcards

(42 cards)

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1
Q

Stratifiied squamous epithelium produce __ that’s converted to __ __. In menopause __ production decreases.

A

Glycogen, lactic acid, decrease

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2
Q

Things that can offset the balance of vaginal microflora?

A 
Abx
Douching
Semen
Foreign bodies (tampons, diaphragm)
Hypoestrogenized (atrophic): menopause, high progesterone relative to estrogen (pregnancy/contraception)
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3
Q

What is the MC cause of vaginal discharge?

A

Bacterial vaginosis

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4
Q

What are the diagnosis requirements for bacterial vaginosis?

A

3 of 4

  1. Homogenous discharge
  2. Ph >4.5
  3. Positive whiff test
  4. Clue cells on wet prep
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5
Q

Pt. Presents w/ homogenous, profuse grey milky discharge and strong fishy odor especially after intercourse. What is the treatment?

A

Metronidazole

Metronidazole gel

Clindamycin cream

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6
Q

What is the treatment for chronic/recurrent w/ no prior long term treatment?

A

Vaginosis metrogel/ or metronidazole, oral tinidazole, or vaginal clindamycin for 2 weeks

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7
Q

What is the treatment for recurrent infection with hx of long-term treatment?

A

Vaginal metrogel, oral metronidazole, oral tinidazole, vaginal clindamycin for 2 weeks, then SUPPRESSION 1x weekly metrogel or 2x weekly oral metronidazole, or tinidazole 6 months

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8
Q

What are some consequences w/ BV?

A

Adverse pregnancy outcomes

PROM, preterm delivery, intra-amniotic infection, post-partum endometritis

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9
Q

Pt presents w/ vaginal burning/itching, irritatoion, post-voiding dysuria, odorless thick white cottage cheese discharge. DX?

A

Vuvovaginal candidiasis

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10
Q

What is the diagnosis of candidiasis?

A

Vulvovaginal erythema
Ph <4.5
Budding yeast/pseudohyphae on KOH

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11
Q

What is the treatment for isolated candidiasis infection?

A

Azole or nystatin intravaginal 3-7 days, or single oral dose of fluconazole

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12
Q

Risk factors for candidiasis?

A

Increased estrogen,
DM
Immunosuppressive
Abx

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13
Q

What is the treatment for acute recurrent infection of candidiasis?

A

Local intravaginal thearpy 7-14 days, oral fluconazole 1 pill q 72 hrs x 3 doses, 1,4,7

Suppressive
Oral fluconazole weekly for 6 months

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14
Q

What is considered chronic vaginal candidiasis?

A

> = 4 episodes per year

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15
Q

What is the treatment for recurrent vulvaginal candidiasis non-albicans species?

A

Oral fluconazole

Boric acid

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16
Q

Patient presents w/ frothy green-yellow discharge, odor is strong and musty, they have pain w/ intercourse and sometimes pain w/ peeing. Dx?

A

Trichomoniasis

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17
Q

What is the diagnosis for trichomoniasis?

Study These Flashcards
A 
Frothy discharge, strawberry cervix, 
Ph >4.5 
Trichomonads on wet prep, NAAT is gold standard 
Strawberry cervix
Motile Protozoa w/ flagellum
18
Q

What is the gold standard for dx of trichomoniasis?

19
Q

What is the treatment for trichomoniaisis?

Study These Flashcards
A

Metronidzaole 500 mg 2 weeks

20
Q

What else do you need to look and see is present if the patient has trichomoniasis?

Study These Flashcards
A

BV and if you don’t treat for it it might not heal

21
Q

What do yo need to do post treatment for trichomoniasis?

Study These Flashcards
A

TOC if prolonged or recurrent infection at 1 month and 6 months

22
Q

Which herpes virus causes more frequent recurrences?

23
Q

Patient presents w/ prodrome of tingling, itching, burning, fever, HA , malaise and inguinal lymphadenopathy. DX__ advice for sexual contact

Study These Flashcards
A

Herpes, do not have sex during prodrome

24
Q

Genital warts are caused by what types of HPV?

25
How is HPV transmitted?
Contact, inanimate objects, birth canal to larynx
26
Treatment for genital warts?
Provider: trichloroacetic acid, bichloracetic acid Patient: podofilox or imiquimod
27
What is the dx for primary syphilis?
Screening: RPR or VDRL Confirm: FTA-ABS
28
Pt presents w/ bacteremia 6 wks to 6 mos post painless chancre. The patient has maculopapular rash on palms, soles, mucous membranes. Complaining of fever, malaise. On PE you note lymphadenopathy and condylomata Lata. DX
Secondary syphilis
29
What is is considered early latent syphilis and late latent syphilis?
<1 yr or >1 year
30
Pt. Present w/ fever, malaise and HA after treatment w/ penicillin for syphilis.
Jarisch-Herxheimer Reaction w/ 8 hours of PCN treatment.
31
What is the treatment for syphilis <1 year?
Benzathine penicillin 2. 4 million units
32
What is the treatment for syphilis >1 year?
Pen G 2..4 million units IM weely x 3
33
What is the folllow up for syphilis and treatment if first fails?
Reevaluate at 6 mos intervals for serologic testing and clinical reevaluation. Weekly PCN injections for 3 weeks.
34
Pt. Presents w/ painful erythematous papules that becomes a pustule then ulcerated w/in 24 hours. The edges of the ulcer are erythematous. Dx__ trx__
Chancroid (haemophilus ducreyi) Azithromycin 1 gym orally or ceftriaxone
35
What is the treatment for chlamydia, PCR testing?
Azithromycin or doxy Treat other contacts and test for other STI’s. Abstinence for 7 days and rescreen in 3-4 months
36
What is the treatment for gonorrhea?
Ceftriaxone + azithromycin
37
Urethritis or cervicities are associated w/ what STIs?
Chlamydia and gonorrhea
38
Diagnostic criteria for PID?
Cervical motion tenderness in sexually active you women Lower abdominal pain Temp >101 Mucopurulent discharge Elevated ESR or CRP Diagnosed w/ chlamydia or gonnorhea
39
Patient presents w/ yellow vaginal discharge and lower abdominal/pelvic pain during/soon after mennstruation. DX__ trx__ concerns__
Cover for GC/chlamydia/anaerobes Inpatient: cefoxitin IV or cefotetan IV plus Doxy IV Outpatient: ceftrixaxone IM + doxy for 2 weeks +/- metronidazole 2 weeks if concomitant TRICH infection or recent instrumentation Infertility,ectopic pregnancy, chronic pelvic pain
40
When to admit for PID?
Pregnant, adolescents, drug addicts, WBC >15,000
41
PT presents w/ tender inflammatory adnexal mass that results of complication of PID. DX __ treatment__
Turbo-ovarian abscess Broad spectrum abx; surgical if no improvement in 24-48 hours
42
Pt. Presents w/ hx. Of fever, malaise, and diarrhea. This progresssed to a non-painful, non-pruritic rash, and orthostatic hypotension. DX__ trx__
Toxic Shock syndrome Fluids, abx while awaiting cultures, but ultimately none, just want to decrease the chance of recurrence

OB GYN (9 decks)

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