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EM Rot OBGYN + GU
| Question | Answer |
|---|---|
| Signs of infxn with Neisseria Gonorrhea | Men: dysuria and purulent discharge 1 wk after infxn. Women: may be asymp (40%). Mucopurulent discharge and inflamed friable cervix (Strawberry Cervix) |
| Tx for Gonorrhea | Ceftriaxone 125mg IM x 1 |
| Tx for Chlamydia | Azithromycin 1 g PO x 1, or Doxycycline 100mg PO bid x7 days |
| Tx for genital herpes flare | Acyclovir 400mg PO tid x 10 days |
| Tx for syphilis | Stage 1 and 2: Benzathine penicillin G 2.4 million units IMx1. Stage 3: Benzathine penicillin G once a week for 3 weeks. |
| Sx of chalmydia infxn | may be asymp in both men and women. May have mucopurulent discharge and red cervix similar to gonorrhea. |
| Dx of Gonorrhea | Culture of penile discharge or cervix mucous |
| Dx of Chlamydia | Polymerase Chain Reaction (PCR) or voided urine specimen is both sensitive and specific. OR culture of cervical or urethral swab |
| Yaws | a tropical dz caused by a spirochete related to the spirochete that causes syphilis. Yaws is caused by Treponema perenue. |
| Painless chancre is what stage of syphilis? | stage 1. |
| sore throat, malaise, fever, HA, dull red papular rash on palms, soles and trunks represents which stage of syphilis? | stage 2 |
| Stage 3 syphilis is characterized by | Tabes dorsalis, luetic aortitis, paresis, and dementia. |
| A positive VDRL and RPR performed on blood or CSF must be confirmed with... | Flourescent treponemal antibody absorbed = FTA-Abs |
| Dx of herpes | Confirmed with Tzanck prep or PCR |
| Most common site of ectopic pregnancy | fallopian tubes (98%) |
| Labs to order if you suspect ectopic pregnancy | quantitative beta-hCG, CBC, type and screen, Rh status, and UA |
| In normal singleton pregnancies, beta-hCG levels double every.... | 48 hours. In ectopics, the levels rise at a much slower rate. |
| What tests must be ordered in ectopic pregnancy? | Transvaginal US to rule out. In women with beta-hCG levels <2,000mIU/mL, US is not as sensitive. |
| Gold standard for diagnosing ectopic pregnancy | Laparoscopy |
| Medical tx as an alternative to lapascopy in ectopic pregnancies where the woman is stable: | Methotrexate |
| A woman should receive RhoGAM when | she is Rh negative and her fetus is Rh positive. |
| All women with first trimester bleeding who are Rh-negative should be given | Rho-GAM therapy |
| ___ percent of women have bleeding during their first trimester, and ____ percent of these women will go on to have spontaneous abortions | 25%; 50% |
| Two most common causes of third trimester bleeding | placenta previa and placental abruption. Placenta previa usually presents with: painless, bright red blood without fetal distress. Placental Abruption sx: pain, cramping, dark blood, fetal distress |
| Risk factors for placenta previa | prior C-sections, uterine scars, advanced maternal age, and multiparous women. |
| Risk factors for placental abruption | htn, abdominal or pelvic trauma, cocaine or tobacco use, advanced maternal age |
| Dx of third trimester vaginal bleeding | No vaginal exam until US rules out placenta previa (b/c digital exam can trigger hemorrhage) |
| Preeclampsia definition | hypertension in pregnancy associated with proteinuria (>300mg/day) and nondependent edema (hands and face) |
| HELLP is a syndrome of preeclampsia and eclampsia stands for | Hemolysis, Elevated Liver enzymes, Low Platelets |
| The definitive management of preeclampsia is | delivery of the fetus. Obtain an emergent OB/GYN consult |
| _____ is used for seizure prophylaxis in severe preeclampsia | magnesium sulfate |
| Eclampsia definition | seizures in a patient with preeclampsia |
| _____ is the first-line agent for blood pressure control in preeclampsia and eclampsia | Hydralazine |
| Most common ages of testicular torsion | first year of life and around puberty. |
| The most common deformity that predisoposes testicular torsion is | "bell clapper" deformity |
| The first imaging study in testicular torsion | Color Doppler. The definitive tx is surgical exploration. |
| Most common site of impaction in nephrolithiasis (development of stones in the urinary tract) | Ureterovesicular junction |
| Most common and preventable risk factor in nephrolithiasis | low fluid intake |
| ______ account for 80-85% of urinary stones | Calcium stones composed of calcium oxalate or calcium phosphate or both. Radiodense (visible on radiograph). |
| Location of pain associated with nephrolithiasis | begins suddenly and soon becomes severe. Begins in flank and radiates anteriorly toward the groin |
| 90% of all patients with nephrolithiasis have | hematuria |
| Gold standard test for nephrolithiasis | CT without contrast can identify all types of stones. |
| Tx for nephrolithiasis | Analgesia, IV fluids, antiemetic |
| Stones less than ___ will pass on their own 90% of the time | <4mm |
| A positive UA in UTI is typically greater than | 10 WBC/HPF and includes the presence of any bacteria. |
| In uncomplicated UTI and acute pyelonephirits, is renal imaging needed? | NO! |
Created by:
ltm12