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139 Cards in this Set

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What is a physical injury or wound caused by external force or violence to the kidney?
Renal trauma
What is the most common injury of the urinary system?
Renal trauma
Renal trauma from blunt injuries account for what percent of pt.'s in urban hospitals?
80%
What are the physical findings in renal trauma?
CVA trauma
Possible ecchymosis
Extravasation of urine
What are the classification scales for renal injuries?
Grades 1-5
I, II are minor
III, VI, V are major.
What are 2 possible DDX for renal trauma?
Paraspinal muscle spasm
Muscle contusion
What complications can develop from renal trauma?
Shock, Abcess formation, Hypotension
What signs and symptoms are readily apparent in penile fracture?
Avulsion, Crushing type injuries, and penetrating type wounds
Elevation of a testicle is a physical finding in what?
Testicular torsion
What is a DDX for scrotal trauma/ testicular pain?
Urolithiasis, Epididymitis
What is a physical injury or wound caused by external forces or violence to the bladder?
Bladder trauma
What is inflammation of a testis due to trauma or infection.
Orchitis
In dealing w/ Breast Mass Assessment, what is the goal of your diagnostic approach?
Determine the nature of the mass and r/o cancer
Conduct a complete hx, ROS, work up, and exam
What is a malignant neoplasm of the breast?
Breast carcinoma
Breast cancer is the most common invasive cancer in women in what age group?
15 to 54
What is the most common cause of death in women age 55 to 74?
Breast cancer(carcinoma)
What physical findings will you see in the early stage of breast carcinomas?
Single, non-tender, firm mass, w/ ill-defined margins
What are physical findings that you will see in the late stage of breast carcinomas?
Ulcerations
Supraclavicular LAD
Edema of the arm
Bone, lung, liver, brain, or other distant metastases
What is the most common pre-menopausal disorder in women age 30 to 50?
Mammary dysplasia (fibrocystic change)
What disorder that has a familial tendency that will usually abate after menopause?
Mammary dysplasia (fibrocystic change)
A common benign neoplasm of glandular epithelium is defined as?
Breast Fibroadenoma
What disorder occurs in young women, within 20 yrs of puberty?
Breast Fibroadenoma
The flowing away of secretion from the vaginal canal is defined as?
Vaginal discharge
What is the goal of your approach in the dx's of a pt w/ vaginal discharge?
Determine the cause of the discharge
What are the possible cause of non-infectious vaginal discharge?
Allergic
Fungal 2nd to abx
Hormonal
What is inflammation of the vagina, due to a fungal infection?
Vaginal Candidiasis
What is a term that encompasses a broad range of clinical entities, involving an infection of the urinary tract by microorganisms?
Urinary tract infection (UTI)
What is the most common bacterium isolated in a UTI?
Escheria Coli
E. coli accounts for what percentage of all cases of an UTI
80%
What is a DDX of A UTI?
Cystitis
PID
Etopic pregnancy
What is the TX for a UTI
Cipro 250 BID x 7d
Whats is an inflammation of the bladder?
Cystitis
What is the result of an ascending UTI, most commonly caused by E. coli, and its sx's follow sexual activity?
Cystitis
Cystitis following sexual intercourse can also be termed what?
Honeymoon cystitis
What are physical findings of cystitis?
Dysuria
Suprapubic PX
What are possible DDX for cystitis?
Etopic pregnancy
Prostatitis
What is the TX for cystitis?
Cipro 250 BID x3d
What are the most common infectious agents in sexually active pt.'s with epididymitis
Neisseria Gonorrhea
Chlamydia trachomatis
What are physical findings of epididymitis?
Hematospermia
Fever
Painful enlargement of epididymis
Urinary frequency and urgency
Dysuria
What is inflammation of the prostate?
Prostatitis
What causes prostatitis
Gram neg rods, E. coli
What is the 2nd most common cause of vaginal infections?
Vaginal candidiasis
What are the physical findings of vaginal candidiasis?
Vulvar pruritus
Erythema and excoriation
Intense burning
D/c, curdish white "cottage cheese"
What is the tx for vaginal candidiasis?
Diflucan 150mg PO single dose (avoid in pregnant chicks)
Cyst commonly formed in chronic inflammation of a mucous gland on each side of the lateral wall of the vaginal opening is defined as?
Bartholin's cyst
What is the operational tx of a Bartholin's cyst?
Typical regimen is Ceftriaxone 250 mg IM, Doxycycline 100 mg 1Tab PO BID x 10 days
What is an inflammation of the breast, in the 42 days following childbirth, where generative organs return to normal?
Puerperal mastitis
What is the tx for puerperal mastitis?
Diclox 500 mg PO Q6 x 7days
If abscess forms, I&D required
Regular emptying of breast (nursing and manual expression)
Consult with a M.O. prior to I&D
An inflammation of the vagina, secondary to bacterial infection is defined as?
Bacterial vaginitis (BV)
What is the most common vaginal infection?
Bacterial vaginitis (BV)
What is present in 50% of all BV cases?
Gardnerella vaginalis
What is the principal method of transmission in BV?
Sexual contact (BV not considered an STD)
What is an expected finding in the wet mount of a pt. w/ BV?
Expect clue cells
What is the tx for BV?
Metronidazole 500 mg PO BID x 7 days
Clindamycin cream x 7days (in cases of pregnancy)
All cases of BV in pregnancy, must be treated to prevent delivery complications
What is known as pediculosis, a parasite infestation of the ksin, scalp, trunk, or pubic areas?
Lice
What is the most contagious STD known?
Lice
What is an extremely common inflammation of the renal pelvis secondary to an infectious agent?
Pyelonephritis
What are complications of pyelonephritis?
Sepsis with shock
Scarring of parenchyma
Abscess
What is a post-streptococcal infection, which is a result of hemopathic transmission?
Glomerulonephritis
What is the most common causative agent in glomerulonephritis?
Group A Beta Hemolytic Streptococci (GABHS)
What is expected result in a UA of a pt. with glomerulonephritis?
Urine will be cola colored
contain proteinuria and red blood cell cast.
What labs are ordered in the operational setting in a pt. with suspected glomerulonephritis?
UA
24h UA
CBC
STD work up
What is an inflammation of testis due to trauma or infection?
Orchitis
What is the most contagious STD known, that has > 90% chance of infection from one sexual exposure w/ an infected partner?
Lice
What is an infection of the uterus, fallopian tubes, and adjacent pelvic structures that is not associated w/ pregnancy or surgery?
Pelvic Inflammatory Dz (PID)
What is the most common cause of infertility and ectopic pregnancy?
Pelvic Inflammatory Dz (PID)
What is the % of tubal infertility in the first case of PID?
8%
What is the % of tubal infertility in the second case of PID?
20%
What is the % of tubal infertility in the third case of PID?
40%
What is an inflammation of vulva and vagina caused by trichomonas?
Trichomonas
What disease is present in up to 75% of prostitues?
Trichomonas
Trichomonas is present in up to what % of women in Gyn clinics?
15%
The etiology of this disease is a single-cell parasite acquired through sexual contact?
Trichomonas
A cervical petchia "strawberry cervix" is a physical finding of what Dz?
Trichomonas
What is the tx of Trichomonas?
Metronidazole 2g PO single dose (treat partner also)
A urethritis, cervicitis, or salpingitis bacterial infection transmitted by sexual contact is defined as?
Neisseria Gonorrhea
A common worldwide dz, that affects an estimated 3 milion new cases annually is known as?
Neisseria Gonorrhea
What is the tx for Neisseria Gonorrhea?
Ceftriaxone 250 mg IM single dose
Doxy 100 mg PO BID x 10 days
What is caused by Calymmatobacterium granulomatis?
Granuloma inguinale
How is Granuloma inguinale spread?
Sexual contact

Chronic nonsexual contact (beating your monkey)
What are the physical findings of granuloma inguinale?
Indurated painless node that erodes becomes an ulcer with a beefy red appearence
What is the incubation period for granuloma inguinale?
8 days to 12 weeks
What is the term for urethritis inflammation caused by organisms other than N. gonorrhea?
Non-gonococcal urethritis
What affects men in high socioeconomic groups, heterosexual males more than homos, and occurs in 50% of pt.'s seen in STD clinics?
Non-gonococcal urethritis
What is a viral disease, creating wart like growths?
Condyloma acuminata
Condyloma acuminata is prevalent among what age range?
16-25 (young adults)
What is the most common STD in the US?
Lymphogranuloma venereum
What percent of gonococcal infections have a concomitant chamydial infection?
45%
What are the complications of Neisseria Gonorrhea?
PID
Disseminated gonococcal infection
What is the causative agent of syphilis?
Treponema Pallidum
What is a complex spirochet infection dz?
Syphilis
What is the predominant age of treponema pallidum (syphillis)?
20 to 35
What is the annual estimated new cases of syphillis in the U.S.?
90,000 new cases
What are the physical findings in the primary phase of syphilis?
Single painless lesion to genitals appearing 3 weeks after exposure.
What are the four different categories of syphillis?
Primary syphilis
Secondary syphilis
Early latent syphilis
Late latent syphilis
What is a viral infection caused by two double strained DNA viruses (HSV 1&2)?
Herpes Simplex
What % of adults are sero-positive for HSV-1?
More than 85%
What % of adults are positive for HSV-2?
25%
A highly infectious non-syphilitic venereal ulcer is defined as?
Chancroid
What dz has a higher incident rate in men than women, w/ higher rate in uncircumcised men in tropical/subtropical regions?
Chancroid (incident rate unknown)
The causative agent of this dz is Haemophilus ducreyi, a gram negative bacillus?
Chancroid
What are the physical findings of chancroid?
1-3 extremely painful ulcers
Accompanied by tender unilateral inguinal LAD
May develop inguinal bubo
What is a physical finding of chancroid that can be seen in women?
Lesion is an inflammatory pustule or papule which ruptures leaving a shallow non indurated ulcer
What is a contraindication in the tx of penile trauma (what must you not use)?
Lido w/ epi
In the tx of scrotal trauma/testicular px, what is indicated if torsion is found?
Perform manual reduction "open book" method
What is a complication of scrotal trauma/testicular px?
Sterility
When you are treating a pt. for shock in bladder trauma, what must you not attempt to do?
Attempt to catheterize (foley)
In a pt. w/ a UTI, women are 50% more likely to develop a UTI by what age?
20
What are physical findings of a UTI?
Urinary frequency and urgency
Dysuria
Suprapubic px
Gross or microscopic hematuria
This disease is predominantly seen in women and is most commonly caused by E. Coli. It is usually the result of an ascending urinary infection?
Cystitis
Hematospermia, Dysuria, Fever, and Painful enlargement of epididymis are physical findings of what disease?
Epididymitis
What are the physical findings of Prostatitis?
Termination trickling
Perineal or suprapubic px
Straining to void
Decreased force of stream
This is an extremely common dz in which women have an incident of infection and the predominant age of infection is during sexually active yrs?
Pyelonephritis
This disease is caused by a gram negative bacilli such as E. Coli in 95% of the cases?
Pyelonephritis
What is the tx for Pyelonephritis?
Ciprofloxacin 750mg BID x 21 days
Orchitis can be the result of which diseases?
Gonorrhea
Metastatic infection (mumps)
Syphilis
TB
At the present rate, what ratio of women will develop breast cancer?
1 of 9 women
Abnormal hyperplasia of ductal epithelium and dilation of mammary ducts, is the etiology of what dz?
Fibrocystic change
What is the causative factor of Fybrocystic change? (rare in postmenopausal women)
Estrogen hormone
A round, firm, discrete movable, non-tender mass that is typically 1 to 5 cm in diameter are physical findings of which dz?
Breast Fibroadenoma
In vaginal candidiasis, what percentage of women will have one episode during child bearing yrs?
75%
In vaginal candidiasis, what percentage of women will have two episodes/attacks during child bearing yrs?
50%
What is usually the causative agent of Puerperal Mastitis?
Staphylococcus aureus
What is a complication of Lice?
Secondary bacterial infection
What is the tx of lice?
Permethrin 1% cream
Abnormal vaginal d/c, Dyspareunia, Dysuria, and Lower abd px are physical findings of what dz?
PID
What is the clinical tx of PID?
Ofloxacin 400 mg PO BID x 14 days, plus Metronidazole 500 mg PO BID x 14 days
What is a complication of PID?
Ectopic pregnancy
Cervical petechiae "strawberry cervix" and a profuse, yellow malodorous vaginal d/c are physical findings of what?
Trichomonas
A single painless lesion to the genitals that appears 3 weeks after exposure is seen in what dz? In what category?
Syphilis: Primary
What symptoms will you see in the "Early latent syphilis" stage of syphilis?
No physical sx's
Nodular ulcerative lesions (gummas), to the skin, mucous membranes, skeleton, and viscera are seen in which category of syphilis?
Late latent syphilis
What is the incubation period of Herpes Simplex?
3 to 7 days
Consitutional sx's, px, burning, itching and tingling prior to onset of initial lesions will be seen in which dz and which episode?
Herpes Simplex, 1st Episode
What is the tx for chancroid?
Azithromycin 1 g PO single dose, or Ceftriaxone 250 mg IM single dose
What is the clinical tx of condyloma acuminata?
Cryotherapy
Mucopurulent d/c, edema and erythema, dysuria, and bilateral inguinal LAD, leading to bubo formation are physical findings of which dz?
Lymphogranuloma Venereum (LGV)
What is the tx for Granuloma Inguinale?
Tetracycline 500 mg PO QID for 3-5 weeks
What are the physical findings of the acute phase of a pt. w/ HIV?
Flu like sx's
Fever
Sore throat
Minority of pt's. present w/ meningitis, Bell's palsy, and peripheral neuropathy