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10 Cards in this Set
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Post-menopausal, +TOB, poor screening hx, friable lesion on cervix and firm nodule in posterior cul-de-sac on rectal. Initial Next step?
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Cervical Bx! Pap smear should not be used to exclude cervical cancer, it is a screening test.
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17 yo hx of sexual activity for 3 years w/ negative hCG. Intervention recommended?
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DNA Probes for G&C (pap smear is not an intervention, its a screening tool)
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when is a pap smear not indicated in patient w/ total hysterectomy? What Age is pap smear no longer indicated?
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if TAH was done for non cancerous reasons. If b/w 65-70 and had 3 consecutive negative pap smears.
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49 yo with perimenopausal symptoms (irregular menses) w/ new onset of insominia and anxiety and + blood in vag. +FHx Breast Cancer. + Tob. Next study to be ordered?
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TSH and bHCG. still having menses, anxiety and sleep disturbances. Can't do pap right now cause she active menses (high false negative rate!)
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22 yo G0 w/ recent ASCUS? Immediate next study? If that test is positive?
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HPV Testing. If positive, then she needs a colposcopy w/ bx. alt: repeat pap in 6 mo w/ plans to colpo if >ASCUS. 2 consecultive negative paps are required before she goes back to annual screening.
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Acute salpingitis is another term for...
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PID! cannot be sure of dx of chlaymydia or Gonorrhea w/o specialized media or DNA probes. +CMT, fever, mucoid discharge at os = PID.
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elevated plaques w/ rolled edges on vulva of HIV+ patient w/ brown macular rash on hands and soles of feet. Dx (stage)? Next step management?
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condylmoa lata are classic secondary syphilis lesions. this and rash will be + for spirochetes. Therefore, get dark field microscopy.
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24 yo w/ painful weeping and crusted uclers on vulva. Dx? Further testing?
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Herpes! Micro: MN Giant cells. also do RPR, HIV, Herpes culture, DNA probes for G&C. Give Hep B, if high risk treat for G&C. don't do speculum until after acute episode.
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Yellow frothy discharge + red patches on ectocervix. Under Microscope shows ovoid protozoa w/ flagella. Patient itchy. Dx?
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trichomoniasis. red patches = strawberry cervix.
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Explain negative cultures x 4. In patient w/ painful vulvar lesion w/ hx of similar findings.
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Culture is gold std w/ specificity but low sensitivity (10-20% FNR). Best to culture lesion early in course. Most likely presented late in course.
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