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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?
Cervical Bx! Pap smear should not be used to exclude cervical cancer, it is a screening test.
17 yo hx of sexual activity for 3 years w/ negative hCG. Intervention recommended?
DNA Probes for G&C (pap smear is not an intervention, its a screening tool)
when is a pap smear not indicated in patient w/ total hysterectomy? What Age is pap smear no longer indicated?
if TAH was done for non cancerous reasons. If b/w 65-70 and had 3 consecutive negative pap smears.
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?
TSH and bHCG. still having menses, anxiety and sleep disturbances. Can't do pap right now cause she active menses (high false negative rate!)
22 yo G0 w/ recent ASCUS? Immediate next study? If that test is positive?
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.
Acute salpingitis is another term for...
PID! cannot be sure of dx of chlaymydia or Gonorrhea w/o specialized media or DNA probes. +CMT, fever, mucoid discharge at os = PID.
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?
condylmoa lata are classic secondary syphilis lesions. this and rash will be + for spirochetes. Therefore, get dark field microscopy.
24 yo w/ painful weeping and crusted uclers on vulva. Dx? Further testing?
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.
Yellow frothy discharge + red patches on ectocervix. Under Microscope shows ovoid protozoa w/ flagella. Patient itchy. Dx?
trichomoniasis. red patches = strawberry cervix.
Explain negative cultures x 4. In patient w/ painful vulvar lesion w/ hx of similar findings.
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.