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45 Cards in this Set
- Front
- Back
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what is the most frequently repoted bacterial STD in the US?
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chamydia, it is known as the "silent killer" bc 3/4 of infected women & 1/2 of infected men have NO SYMPTOMS
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who have the highest incidence of infection of chlamydia?
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blacks & females
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in 2002, in what order of decreasing incidence are the following STDs?
syphilis chlamydia gonorrhea |
2002: highest to lowest incidence:
chlamydia (on the rise!!) gonorhea syphilis this has changed from the 90's; gonorrhea used to be higher than chlamydia |
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what race has by far the highest incidence of gonorrhea?
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blacks
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what is the recommended treatment of gonorrhea?
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levofloxacin
if chlamydia is NOT ruled out: add Azithromycin or Doxycycline |
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what is a potential dissemination location of gonorrhea?
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the knee.
painful & swollen |
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what is the MC CC of vaginitis?
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abnormal vaginal discharge
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what is the mechanism of bacterial vaginosis?
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alteration in normal flora
loss of H2O2 producing bacteria leads to overgrowth of anaerobic bacteria |
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TQ what is the MCC of bacterial vaginosis?
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gardnerella vaginalis
pt is at increased rist for: PID premature labor & delivery vaginal cuff infections endometrITIS |
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what are the risk factors for bacterial vaginosis?
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pregnancy
IUD insertion douching |
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what are the bacterial vaginosis diagnostic test and labs that he stressed in class?
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saline mounts (WET PREP)
KOH mount (WHIFF TEST) fishy odor secondary to release of amines |
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what are the Amsels Criteria?
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BV diagnosis: 3 out of 4 needed:
thin white-grey malodorous discharge pH > 4.5 "CLUE CELLS" present & WBCs mostly absent fishy odor on KOH prep after intercourse (+ AMINES TEST) |
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T or F:
infant mortality due to herpes simlex is increasing |
false
it is decreasing (yay!) |
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T or F: there is no vertical transmission of herpes
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false
there is and it still happened during births, increased risk in c-sections |
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in what race is genital herpes highest?
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blacks
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in what age bracket & gender is herpes highest?
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females 40-49
then females 30-39 |
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what STD presents with small frothy foam and vaginal dischage?
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trichomonas infection
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what is the MC office visit reason at gyn office?
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vaginitis
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normal vaginal pH
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< or = 4.5
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what is the tx for BV?
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metronodazole
oral 500 mg for a week, or oral 2 g single dose -or- clindamycin intravaginally |
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what STD?
> 4.5 pH thin, white-grey discharge fishy odor, worse after intercourse CLUE CELLS no WBCs |
bacterial vaginosis
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which of the following is WRONG about trichomonas vaginitis?
<4.5 pH yellow-green frothy discharge WBCs > 10 per hpf |
pH is > 4.5
not less |
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what STD?
< 4.5 pH white "cottage cheese" odorless labia dysurea budding yeast with KOH prep |
candida vulvovaginitis
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TQ info: T or F:
tichomonads are FLAGELLATED parasits, have a high transmission rate, & pts are often asymptomatic |
true!!!
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what STD has "strawberry cervix" that is 2-5% specific?
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trichomonas vaginitis
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TQ?: pH & diagnosis for trich?
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pH 5-7
motion seen in wet mount (FLAGELLATED) DIAMOND AUGAR!! for diagnosis |
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tx for trichomnas?
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metronidaole 2 g single dose
**partner should be tx'd also** |
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T or F:
yeast is the 2nd MCC of vaginitis? |
true
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which STD is "whiff test negative?"
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vulvovaginal candidiasis
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tx of vulvovaginal candidiasis?
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**azole** (3-7 days)
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list all the CDC STD diseases
(i could see this as a "which is not" question..) |
bacterial vaginosis
chlamydia genital herpes genital warts (HPV) gonorrhea PID syphilis trichomoniasis candidiasis vulvovaginitis scabies pediculosis pubis |
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STDs with asymptomatic infections:
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HSV
gonorrhea HIV HPV chlamydia treponema pallidum |
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moral hazard
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when attitudes have been changed by the fact that you have insurance. insured pts have an incentive to over-consume care, not follow healthy lifestyle, and not prevent disease. "fix it when it's broken"
doctors are also affected by moral hazard. they over-treat and overcharge |
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what two things cause significant market failure?
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moral hazard
adverse selection a free market in health care requires an effective health care insurance market. unfortunately, it's inefficient. |
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adverse selection
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process whereby the low risks select themselves out of the insured group.
this is why most insurance companies offer non-smokers a lower premium. this happens becuase in order to set a premium at an average risk level, the policy is expensive for low risk customers, who may therefore choose not to buy |
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what is cherry picking or cream skimming and what does it cause?
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offering lower premium to low risk groups.
this causes high premiums to high risk groups (elderly & chronically sick) |
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what is a normative statement vs. positive statement
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+ statement = can be shown to be T or F and is NOT dependent on value system of observer
normative statement = cannot be proved T or F & our view depends on value system |
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what did the stak amendment do?
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stopped physician owned
(conflicts of interest) |
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what are the "two sides of scarcity?"
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the infinite nature of human wants, and
the finite or limited nature of resources available to produce goods & services resources: 1. land 2. labor 3. capital 4. enterprise |
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what are PPFs?
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production possiblity frontiers
(graph about surgeons & sx's, only so many different combinations of operations per week bc resources are limited) |
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what is the term for the multidimensional trade-off between two possibilities?
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marginal rate of transformation, MRT
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TQ maybe??: how is the efficiency of the health care system judged?
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producing the right quantitiy of the different combination of healthcare activities that society woud want, and doing this at the lowest possible cost (REGARDLESS OF OUTCOMES)
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what is opportunity cost?
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benefit given up by not choosing the next best alternative
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when did the supreme court outlaw AMA's ban on physician advertising, ending monopoly power?
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1982
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T or F: internal economies of scale and economies of scope has to do with the emergence of one large hospital in an area rather than a large number of small ones
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true
large hospitals: -bulk buying -grow by lowering unit costs -more use of specialization -one place for tx -prevents wasteful duplication |
