EM Rot OBGYN + GU
Help!
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| 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)
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| Tx for Gonorrhea | Ceftriaxone 125mg IM x 1
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| Tx for Chlamydia | Azithromycin 1 g PO x 1, or Doxycycline 100mg PO bid x7 days
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| Tx for genital herpes flare | Acyclovir 400mg PO tid x 10 days
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| 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.
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| Sx of chalmydia infxn | may be asymp in both men and women. May have mucopurulent discharge and red cervix similar to gonorrhea.
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| Dx of Gonorrhea | Culture of penile discharge or cervix mucous
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| Dx of Chlamydia | Polymerase Chain Reaction (PCR) or voided urine specimen is both sensitive and specific. OR culture of cervical or urethral swab
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| Yaws | a tropical dz caused by a spirochete related to the spirochete that causes syphilis. Yaws is caused by Treponema perenue.
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| Painless chancre is what stage of syphilis? | stage 1.
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| sore throat, malaise, fever, HA, dull red papular rash on palms, soles and trunks represents which stage of syphilis? | stage 2
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| Stage 3 syphilis is characterized by | Tabes dorsalis, luetic aortitis, paresis, and dementia.
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| A positive VDRL and RPR performed on blood or CSF must be confirmed with... | Flourescent treponemal antibody absorbed = FTA-Abs
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| Dx of herpes | Confirmed with Tzanck prep or PCR
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| Most common site of ectopic pregnancy | fallopian tubes (98%)
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| Labs to order if you suspect ectopic pregnancy | quantitative beta-hCG, CBC, type and screen, Rh status, and UA
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| In normal singleton pregnancies, beta-hCG levels double every.... | 48 hours. In ectopics, the levels rise at a much slower rate.
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| 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.
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| Gold standard for diagnosing ectopic pregnancy | Laparoscopy
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| Medical tx as an alternative to lapascopy in ectopic pregnancies where the woman is stable: | Methotrexate
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| A woman should receive RhoGAM when | she is Rh negative and her fetus is Rh positive.
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| All women with first trimester bleeding who are Rh-negative should be given | Rho-GAM therapy
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| ___ percent of women have bleeding during their first trimester, and ____ percent of these women will go on to have spontaneous abortions | 25%; 50%
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| 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
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| Risk factors for placenta previa | prior C-sections, uterine scars, advanced maternal age, and multiparous women.
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| Risk factors for placental abruption | htn, abdominal or pelvic trauma, cocaine or tobacco use, advanced maternal age
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| Dx of third trimester vaginal bleeding | No vaginal exam until US rules out placenta previa (b/c digital exam can trigger hemorrhage)
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| Preeclampsia definition | hypertension in pregnancy associated with proteinuria (>300mg/day) and nondependent edema (hands and face)
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| HELLP is a syndrome of preeclampsia and eclampsia stands for | Hemolysis, Elevated Liver enzymes, Low Platelets
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| The definitive management of preeclampsia is | delivery of the fetus. Obtain an emergent OB/GYN consult
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| _____ is used for seizure prophylaxis in severe preeclampsia | magnesium sulfate
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| Eclampsia definition | seizures in a patient with preeclampsia
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| _____ is the first-line agent for blood pressure control in preeclampsia and eclampsia | Hydralazine
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| Most common ages of testicular torsion | first year of life and around puberty.
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| The most common deformity that predisoposes testicular torsion is | "bell clapper" deformity
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| The first imaging study in testicular torsion | Color Doppler. The definitive tx is surgical exploration.
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| Most common site of impaction in nephrolithiasis (development of stones in the urinary tract) | Ureterovesicular junction
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| Most common and preventable risk factor in nephrolithiasis | low fluid intake
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| ______ account for 80-85% of urinary stones | Calcium stones composed of calcium oxalate or calcium phosphate or both. Radiodense (visible on radiograph).
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| Location of pain associated with nephrolithiasis | begins suddenly and soon becomes severe. Begins in flank and radiates anteriorly toward the groin
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| 90% of all patients with nephrolithiasis have | hematuria
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| Gold standard test for nephrolithiasis | CT without contrast can identify all types of stones.
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| Tx for nephrolithiasis | Analgesia, IV fluids, antiemetic
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| Stones less than ___ will pass on their own 90% of the time | <4mm
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| A positive UA in UTI is typically greater than | 10 WBC/HPF and includes the presence of any bacteria.
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| In uncomplicated UTI and acute pyelonephirits, is renal imaging needed? | NO!
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