Term
| What is the organism that causes syphilis? |
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Definition
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Term
| What are the signs of primary syphilis? |
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Definition
| PAINLESS chancre (ulceration)in genital region, can often go undetected |
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Term
| What are the signs of secondary syphilis? |
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Definition
-diffuse maculopapular rash (palms & soles)
-mucous patches in the mouth
-hair loss |
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Term
| What are the signs/complications of tertiary syphilis? |
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Definition
-gummas
-neuro changes
-heart problems |
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Term
| What are the implications for syphilis in pregnancy? |
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Definition
-Fetal or congenital syphilis
-Preterm labor
-Stillbirth |
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Term
| What is the lab used to test for syphilis? |
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Definition
RPR or VDRL: nonspecific, measure amount of IgG or IgM
Treponemal: specific to antibodies against treponemal antigens |
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Term
| How is syphilis transmitted? |
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Definition
-mucous membranes contact infected lesions
-oral, vaginal, or anal sex
-vertically from placenta-->fetus |
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Term
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Definition
Early/primary syphilis: Penicillin G 2.4 million units IM x1
(same in pregnancy)
Latent syphilis: Same dose, just weekly for 3 weeks |
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Term
| What are the symptoms of gonorrhea? |
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Definition
-can often be asymptomatic
-abnormal d/c
-dysuria
-abnormal menses
-PID: painful intercourse, pain in R upper abdomen |
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Term
| What is the treatment for gonorrhea? |
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Definition
| Rocephin (ceftriaxone) 250mg IM x1 |
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Term
| If a patient tests positive for syphilis what should you also test for? |
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Definition
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Term
| What do you give to treat syphilis if your pregnant patient is allergic to PCN? |
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Definition
| Desensitize and give penicillin |
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Term
| What are the complications of rubella for a developing fetus? |
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Definition
-sensorineural hearing loss in infant (most common)
-cardiac anomalies
-miscarriage
-mental retardation |
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Term
| What is the most detrimental time period for rubella infection in pregnancy? |
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Definition
| 1st trimester. Defects are rare for fetuses infected after 16 weeks. |
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Term
| True or false: The rubella vaccine should be offered to all pregnant women. |
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Definition
| False. Rubella is a live attenuated vaccine, therefore contraindicated in pregnancy. (Too easy, I know:) |
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Term
| True or false: Women who are inadvertently vaccinated against rubella while pregnant should terminate the pregnancy because of the high likelihood of birth defects. |
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Definition
| False. No cases of congenital rubella syndrome have been reported in women inadvertently vaccinated in pregnancy. |
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Term
| How long should women wait before becoming pregnant after receiving the rubella vaccine? |
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Definition
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Term
| What are the complications of rubella for children and adults? |
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Definition
| Minimal. Fever and a rash. |
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Term
| How does congenital rubella syndrome typically manifest in an unborn fetus? |
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Definition
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Term
| How do you calculate the fertile window for the calendar method of NFP? |
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Definition
Record menstrual cycles for 6-12mos.
Shortest cycle-18=1st fertile day
Longest cycle-11=last fertile day |
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Term
| Explain the mechanism for the basal body temp method of NFP. |
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Definition
-BBT is lowest during 1st half of menstrual cycle
-0.4 degree increase with ovulation and remains high throughout rest of cycle/pregnancy
-abstain/barrier method from end of menstruation thru 3 days after temp. incr. |
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Term
| Megan reports that her menstrual cycles occur every 30-35 days. Is the Standard Days Method an appropriate method for her? |
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Definition
| No. The standard days method is best for women whose menstrual cycles are 26-32 days. |
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Term
| How does woman use the Standard Days method of NFP for contraception? |
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Definition
Day 1=1st day of menstrual cycle
Days 1-7: Unprotected intercourse OK
Days 8-19: Barrier method/abstain
Days 20-end: Unprotected intercourse OK |
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Term
| How does the 2 Day method of NFP work? |
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Definition
| 2 day method: Woman becomes aware of cervical secretions. If she notices any secretions TODAY or YESTERDAY, she can become pregnant TODAY. |
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Term
| What are the characteristics of "fertile" cervical mucus? |
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Definition
-abundant
-clear
-stretchy
-wet
-slippery |
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Term
| What is a major flaw in the Billings or 2 day methods of NFP? |
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Definition
| Semen or vaginal secretions from infections can obscure cervical secretion awareness. 1 day of abstinence is recommended between each day of intercourse to accurately interpret cervical secretions. |
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Term
| When is the "fertile period" of the Billings cervical secretion method of NFP? |
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Definition
| Ovulation occurs 1 day before, during, or after the LAST day of "fertile" secretions (peak day). The fertile period begins when ANY secretions are observed (shortly after menses), and ends 4 days after the peak fertility day (last day of slipper sensation at the vulva) |
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Term
| How does the symptothermal method of NFP work? |
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Definition
utilizes ALL signs of ovulation, including mucus observation, BBT, Mittelschmerz, inc. in libido, mood changes, cervical mucus ferning, cervical changes, and breast tenderness
-Intercourse is avoided during menses, days with secretions, until 3 days after rise in BBT, or 4 days after peak cervical mucus |
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Term
| What are the failure rates for NFP methods? |
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Definition
2-5% perfect use
12-22% typical use |
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Term
| What methods of NFP can be used by women with irregular menses? |
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Definition
| Symptothermal, 2 day, Billings, BBT, Calendar (anything but Standard Days) |
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Term
| When are NFP methods less effective/predictable? |
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Definition
-recent childbirth
-current breastfeeding
-recent menarche
-recent d/c of hormonal contraception
-approaching menopause |
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Term
| Where in the body can gonorrhea infections occur? |
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Definition
-throat
-urinary tracts
-reproductive tracts
-rectum |
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Term
| What are the signs of gonorrhea? |
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Definition
-Inflammation of the Skene's/Bartholin's glands, cervix, or vulva
PID:
-Bilateral adnexal tenderness
-Cervical motion tenderness |
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Term
| What are complications of untreated gonorrhea? |
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Definition
-PID: future fertility implications
-Disseminated Gonococcal Infection: skin lesions, arthralgias, septic joints, hepatitis, endocarditis, meningitis |
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Term
| What can untreated gonorrhea cause in neonates? |
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Definition
-opthalmia neonatorum: can cause blindness
-can also cause a joint/blood infection |
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Term
| How do you know that syphilis is "cured?" |
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Definition
| 4 fold reduction in nontreponemal titer (RPR or VDRL) in 1 year |
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