Urological/STD/Men and Women's Health

Question 1

Most common UTI bacteria

Answer 1

e. coli, p mirabilis, k pneumoniae, enterobacter, s. saprophyticus

Question 2

Midstream bacterial count for UTI

Answer 2

100,000 organisms

Question 3

Nitrites indicate what type of bacteria in sample?

Answer 3

Usually gram - nitrate producers

Question 4

Hyaline cast

Answer 4

most common, low urine flow, dehydration, vigorous exercise

Question 5

Type of cast - crystals

Answer 5

No clinical significance

Question 6

Type of cast - RBC

Answer 6

Always pathological, consider glomeruloneephritis, urinary tract injury

Question 7

Type of cast - WBC

Answer 7

Consider inflammation or infection such as pyelonephritis. Not a UTI

Question 8

Type of cast - epithelial

Answer 8

Acute tubular necrosis (poisoinng), hepatitis

Question 9

How long tx an uncomplicated UTI

Answer 9

3 days

Question 10

What should you always do before tx pylonephritis?

Answer 10

Get a culture

Question 11

Kegal exercises - How many?

Answer 11

3 sets of 8-12 3-4 times weekly for 15-20 weeks

Question 12

Hallmark finding on urolithiasis (stone formation)

Answer 12

Severe pain waxes and wanes, may radiate to groin, testicles, suprapubic area, and labia

Question 13

What is the gold standard for dx of urolithiasis?

Answer 13

Helical CT

Question 14

Dx HIV

Answer 14

Establish dx with EIA or ELISA, confirmed with Western Blot

Question 15

What live vaccines should you never give with HIV?

Answer 15

shingles, chicken pox, MMR

Question 16

Lab testing with HIV

Answer 16

CD4 counts and viral load at dx and every 3-4 months, screen for Hep A, B, C. Glucose and lipid panel, STD assessment

Question 17

When is HIV considered AIDS?

Answer 17

CD4 count less than 200

Question 18

Bacterial vaginosis

Answer 18

Polymicrobial clinical syndrome resulting from replacement of natural flora with high concentrations of anaerobic bacteria

Question 19

Hallmark sx of bacterial vaginosis?

Answer 19

Profuse grayish-white malodorous vaginal discharge

Question 20

Gold standard for dx of bacterial vaginosis

Answer 20

gram stain absence or decreased lactobacilli

Question 21

Treatment of bacterial vaginosis

Answer 21

metronidazole 500mg BID 7 days

Question 22

Chlamydia associated with

Answer 22

PID, infertility, ectopic pregnancy

Question 23

What age is Chlamydia most common in?

Answer 23

under 25 years old

Question 24

Sx Chlamydia

Answer 24

often asymptomatic, mucopurulent cervicitis, friable cervix with pain on movement

Question 25

What is important to do with dx of Chlamydia?

Answer 25

Retest in 3 months

Question 26

Dx studies Chlamydia

Answer 26

NAAT with urine or vaginal swabs, DNA probe, culture

Question 27

Tx Chlamydia

Answer 27

Doxycycline 100mg BID 7 days OR azithromycin 1 gram once

Question 28

Gonorrhea sx in males

Answer 28

purulent urethral discharge, dysuria, testicular pain, or no symptoms

Question 29

Gonorrhea sx in females

Answer 29

Often asymptomatic, endocervical discharge, dysuria, bartholins gland abcess

Question 30

Dx studies in Gonorrhea

Answer 30

Gram stain of exudate, DNA probe, culture

Question 31

Tx Gonorrhea

Answer 31

Ceftriaxone 250mg AND azithromycin 1gram OR doxycyline for 7 days

Question 32

Trichomoniasis sx in females

Answer 32

Asymptomatic, discharge that is frothy, diffuse, and yellow green in color, cervical petichiae (strawberry cervix)

Question 33

Trichomoniasis sx in males

Answer 33

asymptomatic, urithral discharge, dysuria, epididymitis, prostitis

Question 34

Dx studies for Trichomoniasis

Answer 34

Wet prep with flagilated motile cells, pH >4.5, POC test for women, PCR testing for men

Question 35

Tx Trichomoniasis

Answer 35

Metronidazole 2 grams single dose or Tinidazole 2 grams single dose

Question 36

Syphilis - Primary stage

Answer 36

Chancre at site of inoculation. Painless. 1-5 weeks then heals. Regional lymphadonopathy

Question 37

Syphilis - Secondray

Answer 37

Rash that is bilat symmetrical polymorphic, and not itchy. Soles and palms. 2-6 weeks then resolves.

Question 38

Condyloma lata

Answer 38

Secondary Syphilis sign. Pink peripheral warty lesions on genitals.

Question 39

Syphilis - Latent

Answer 39

Asymptomatic

Question 40

Syphilis - Tertiary

Answer 40

Cardiovascular - aortic valve disease and aneurisms Neurological - meningitis, encephalitis, tabes dorsalis, dementia Integumentary - Gummas Orthopedic - Charcot joints, osteomylitis

Question 41

Tx Syphilis

Answer 41

Benzathine PCN G IM | Doxycycline or tetracycline or erythromycin if PCN allergic

Question 42

HPV vaccine recommended at age?

Answer 42

11-12

Question 43

Age of initial cervical screening

Answer 43

Start age 21, screening at time of initial intercourse if < 21 yo ad HIV present or immunocommprimised post organ transplant

Question 44

Age to stop cervical screening

Answer 44

65 who have had adequate recent screening = 3 neg screening PAPS and 2 neg HPV/PAP co-tests within 10 years of stopping with at least one being in the last 5 years

Question 45

PAP screening

Answer 45

21-29 - every 3 years with cytology > 30 every 5 years with cytology and HPV Ex HIV, immunosuppression, every 6 months X2 then annually

Question 46

PAP after hysterectomy

Answer 46

benign disease - D/C | NON Benign - 3 annual neg tests ACS 20 years ACOG

Question 47

When do you refer with abnormal pap

Answer 47

LSIL, HSIL (CIN, CIN 1, CIN 2, CIN 3)

Question 48

PH with candidiasis (vaginal)

Answer 48

4.0 - 4.5

Question 49

When should you get an ultrasound with breast mass?

Answer 49

Pregnancy and < 30

Question 50

What finding suggests BPH?

Answer 50

Firm, smooth, symmetrically enlarged prostate

Question 51

Wat exam finding suggests bacterial prostititis?

Answer 51

Enlarged, boggy, and tender prostate

Question 52

What are risk factors for prostate cancer?

Answer 52

Older age African American Family hx of relative <65 BRCA1 or 2 genes

Question 53

Sx prostate ca

Answer 53

asymptomatic, prostate feels hard, nodular on exam

Question 54

Prostate screening according to ACS

Answer 54

Average risk starting age 50, high risk 40-45 | Initial PSA >2.5 screen annually, PSA < 2.5, every 2 years. PSA >4 refer

Question 55

What is common with epididymitis?

Answer 55

Prolonged sitting. Think truck driver.

Question 56

Prims sign

Answer 56

discomfort lessens with elevation of testes - epididymitis

Question 57

Risk factor - testicular cancer

Answer 57

Hx of cryptorchidism - Higher if uncorrected Testicular atropy Klinfelter's syndrome