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43 Cards in this Set
- Front
- Back
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ekg changes in anorexia |
st-segment depression, prolonged QT intervals (associated with inc risk vtach)
bradycardia, low voltage changes
uwaves if hypokalemia |
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what are anorexics at risk for after treatment? |
refeeding syndrome, electrolyte abnormalities
hypophosphatemia hypokalemia hypomangesemia vitamin and trace mineral deficiencies volume overload and edema |
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primary amenorrhea |
lack of menses by age 16 |
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causes of amenorrhea |
central (hypothalamic or pituitary) ovarian anatomic (imperforate hymen, vaginal atresia, absence/malformation of cervix or uterus) |
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functional hypothalamic amenorrhea |
inhibittion of gnrh due toe ating disorder, exercise, stress |
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gnrh deficiency + inability to smell |
kallman syndrome |
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most common pituitary cause of amenorrhea in women of reproductive age |
prolactinoma
(galactorrhea only in 60%) |
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most common tumor causing panhypopituitarism |
craniopharyngioma |
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laboratory value in PCOS |
LH:FSH > 2.5:1 in 50% elevated free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS) |
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what is the significance of high vs low FSH? |
high: primary ovarian failure
low or normal: functional hypothalamic amenorrhea, congenital gnrh deficiency, disorders of hypothalmic pituitary axis |
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definition of dysfunctional uterine bleeding |
cycles <20 days or >45 days last > 8 days blood loss > 80ml and/or anemia |
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most common cause of excessive bleeding at menarche |
von willebrand disease
also concider factor viii or ix deficiency, thrombocytopenia, platelet disorders, thalassemia major, leukemia |
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workup for testicular tumor |
hcg (increased in choriocarcinoma and mixed germ cell tumors)
alpha fetoprotein (yok sac tumors and embryonal carcinoma)
testicular ultrasound
ct scan chest/abd |
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causes of epididymitis |
chlamydia gonorrhoeae ecoli pseudomonas gpc |
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symptoms of epididymitis |
increased urniqry frequency, dysuria, urethral discharge, fever
swollen and tender epididymis, relieved by elevation of the testis |
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contraindications for OCP's |
absolute: abnormal vaginal bleeding of unknown cause, estrogen-depedent tumor, liver disease, thromboembolic disease, cerebrovascular events, migraine with aura
relative: DM, seizures, vascular headaches (includes migraines without aura), severe/moderate hypertension, tobacco use |
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which test to order in acute retroviral syndrome for HIV? |
hiv dna pcr or hiv plasma rna (viral load) |
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3 causes of genital ulcers |
herpes, syphilis, chancroid |
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drugs for genital herpes |
acyclovir famciclovir valacyclovir |
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what is a positive tzanck and what does it mean? |
multinucleated giant cells; herpes |
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rash of secondary syphilis |
scaly hperkeratotic palmar skin rash (nickel and dime)
pityriasis-like rash that follows lines of cleavage on the trunk |
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treatment of syphilis w/ and w/o allergy
(primary, secondary, early latent) |
benzathine penicillin g 2.4million unitis IM
doxycycline 100mg BID x 14 days or tetracycline 500mg QID x 14 days of non-pregnant and pcn allergic |
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treatment of neurosyphilis |
aqueous crystalline penicillin g 3-4 million units IV q 4 hours; can use ctx if allergic but more likely desensitize |
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clinical signs of neurosyphilis |
cognitive dysfunction, motor or sensory deficits, ophthalmic or auditory symtpoms, cranial nerve palsis, classic miengitis symptoms, uveitis
(ex: teen with 8th nerve deafness) |
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cause, signs, sx, treatment of chancroid |
haemophilus ducreyi
painful genital ulcers and tender, suppurative, usually unilateral inguinal lymphadenopathy
azithromycin 1g x 1 ctx 250mg im x 1 cipro 500mg BID x 3 days erythromycin 500mg TID x 7 days |
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cause, sx, tx of granuloma inguinale |
klebsiella granulomatis
painess, friable, progressive ulcerative lesion without regional LAD, easily bleed
dark staining donovan bodies on tissue prep or biopsy
doxy 100mg BID x 3 weeks |
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cause, sx, tx lymphogranuloma venereum |
chlamydia trachomatis L1, L2, OR L3
painless genital ulcer, unilateral tender inguinal and/or femoral LAD, usually no ulcer by time of tx
doxy 100mg BID x 21 days |
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treatment of chlamydial infections |
azithromycin 1g x 1 or doxy 100mg bid X 7 days
or: erythromycin, ofloxacin, levofloxacin |
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what causes recurrent or persistent urethritis? treatment? |
trichomonas vaginalis
metronidazole 2g x 1 dose or tinidazole 2g x 1 dose |
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treatment of mucopurulent cervicitis in pregnancy |
azithromycin 1g x 1 or amoxicillin 500mg TID x 7 days or erythromycin, but no erythromycin estolate (hepatotoxic) |
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treatment of gonorrhoeae |
ceftrixone 250mg IM x 1 azithromycin 1g PO x 1
(always treat for chlamydia) |
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clinical presentation of disseminated gonococcal infection |
tenoxynovitis and dermatitis associated with fever, chills, skin lesions, polyarthralgia, postiive blood cultures, engatie synovial ultures
supporative monoarticular arthritis (usu knee) with positive synovial culture and neg blood culture |
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treatment of disseminated gonococcal infection |
ceftriaxone 1gm q24h
or cefotax 1g q8 or ceftizoxime 1g q8 |
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vaginal discharge with ph> 4.5 |
bacterial vagionsis or trichomoniasis |
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amine odor after KOH added to vaginal discharge |
bacterial vaginosis |
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motile organisms on wet mount |
trichomonas vaginalisis |
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clue cells on wet mount |
bacterial vaginosis |
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bacterial vaginosis
cause, dx, treatment |
replacement of normal flora (lactobacillus) by anaerobes, gardnerella vaginalsis, mycoplasa hominis
thin, homogenous grayish-white discharge, fish odor
clue cells, pH > 4.5
metronidazole 500mg BID x 7 days or metrnidazole or clinda intravaginal cream |
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trichomoniasis
cause, dx, treatment |
thirchomonas vaginalis
diffuse bubbly, frothy malodorous yellow-green discharge with dysura, pruritis, vulvar irritation, strawberry cervix
motile organism on wet mount
flagyl 2g x 1, treat partners |
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vulvovaginal candidiasis
dx, treatment |
itching, intense burning, whitish curd like discharge
ph<4.5, budding yeast/pseudohyphae on koh
intravaginal antifungal or fluconazole 150mg X 1 |
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hpv types that cause disease |
6, 11 - warts 16, 18, 31, 33, 35 - neoplasia, carcinoma |
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therapy for hpv |
podofilox, imiquimod, sinecatchins, cryotherapy, trichloroacetic acid, bichloracetic acid |
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treatment for lice |
pmermethrin malathion lotion spinosad ivermectin (oral) |
