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17 Cards in this Set
- Front
- Back
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T/F: Pre-pubertal girl interested in traditionally male interests warrants work up.
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False. If girl has normal physical exam, diagnostic studies unnecessary.
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Mother takes daughter because she fears she is sexually active. Daughter is active and on OCPs. Most appropriate action?
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Tell mom daughter is healthy. do not discuss sexuality with mother.
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57 yo w/ dyspareunia and menopause at 50 has narrowed vagina and atrophic mucosa. appropriate recommendation?
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estrogen cream. long term use may require addition of progestin.
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In post menopausal women, when is oral estrogen contraindicated.
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if she has an intact uterus.
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lesbian wants to perform oral sex but has type I herpes on lip. treated w/ acyclovir. advice?
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use a dental dam
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T/F: Women who are raped are often in denial or shock
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True. They may shower after an attack but destroy evidence.
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10 yo girl drawing sex explicit pictures. behavior showing wide ranges. won't go to bathroom alone. most likely cause?
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child abuse. There is often no evidence of physical injury and a careful history must be taken.
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1st course of action when you suspect sexual abuse.
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call police! keep out of presence of the accused. even slightest suspicious!
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3 yo girl brought in by father for vaginal discharge and swollen volva. exam shows linear abrasion over the area. Next action?
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begin antifungal. yeast infections are common after abx therapy (ask about recent illness). scratching can look like abuse.
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4yo girl is brought in by her father for smelly private parts. underwear shows brown-yellow odorous stain. girl healthy. cause?
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foreign body. Children will place objects in any orifice. toilet paper is most common.
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3 yo w/ earring in vagina. most appropriate course of action?
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removal under anesthesia. almost impossible w/o it. gentle recta exam using smallest finger can milk out object.
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In the case of date rape, besides counseling and screening for STDs, what is the most appropriate course of action?
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emergency contraception.
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T/F: in adult rape victims, prophylactic antibiotics should always be offered (before test results of STDs return).
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true
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Where is the best place to place domestic violence outreach information in your clinic office?
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Areas that allow for most privacy (office rest room).
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most common cause of spiral fractured
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domestic violence. due to twisting of the arm.
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79 yo in ER in comatose state. Daughter has tied her to bed to prevent from wandering. zolidem q4hrs to keep sedated. unresponsive, thin, dehydrated woman w/ bedsores. After proper treatment, next step?
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notify social services. should not be on zolpidem.
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patient c/o of premenstrual syndrome symptoms. on a SSRI w/o change in symptoms. on physical exam bruising on patient's arm and reports of husbands temper. next step
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offer domestic violence resources. individuals present w/ symptoms of PMS and will usually not volunteer infomration. IT IS PATIENTS CHOICE WHETHER TO INVOLVE POLICE (she may be worried about children)
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