Term
| Chlamydia infection is c/b what bacteria? |
|
Definition
|
|
Term
| Transmission of Chlamydia occurs how? |
|
Definition
-Oral, Vaginal, and Anal Intercourse
-From mother to neonate during delivery |
|
|
Term
| Chlamydia infection is greatest among what group of people? |
|
Definition
| Sexually active adolescents and young adults aged 14-24 |
|
|
Term
| What is the CDC recommendation for screening for Chlamydia infections? |
|
Definition
| Annual screening of all sexually active women 25 years of age and younger |
|
|
Term
| Common s/s of chlamydia infection in women |
|
Definition
-yellow or milky white discharge
-pain w/urination
-increased urinary frequency
-pelvic/ab pain
-sore throat
-mouth sores
-dyspareunia |
|
|
Term
| Common s/s of chlamydia infection in men |
|
Definition
-white, cloudy urethral discharge
-red or swollen urethra
-pain w/urination
-incontinence
-testicular pain
-rectal discharge
-mouth sores
-sore throat |
|
|
Term
| PE s/s of chlamydia infection Women |
|
Definition
-Abdomen: guarding, tenderness, masses
-Pelvic: CMT, adnexal tenderness, masses, discharge |
|
|
Term
| Gold standard lab for Chlamydia infection |
|
Definition
| Nucleic Acid Amplification Test (NAAT) |
|
|
Term
| Treatment of Chlamydia infection for nonpregnant patients |
|
Definition
Azithromycin 1g po x 1
OR
Doxycycline 100 mg po bid x 7 days |
|
|
Term
| Treatment for Chlamydia infection in pregnant patients |
|
Definition
Azithromycin 1 g po 1
OR
Amoxicillin 500 mg po tid x 7 days |
|
|
Term
| Treatment education for Chlamydia infection |
|
Definition
-Abstain from intercourse for 7 days from completion of treatment
-all sexual partners in the last 60 days need to be notified, tested and treated |
|
|
Term
| Dual infection with what is common with chlamydia? |
|
Definition
| gonorrhea so make sure you r/o |
|
|
Term
| Complications of chlamydia infection in men |
|
Definition
|
|
Term
| Complications of chlamydia infection for wowmen are: |
|
Definition
-PID
-Tubal infertility
-Chronic pelvic pain
-Ectopic pregnancy |
|
|
Term
| F/U of chlamydia infection for men and nonpregnant women is: |
|
Definition
| ~ 3 months after treatment is finished for re-testing |
|
|
Term
| F/U of chlamydia infection for pregnant women is: |
|
Definition
| ~3-4 weeks after treatment has finished for test of cure |
|
|
Term
| Implications of chlamydia infection to pregnancy include: |
|
Definition
-fetal loss
-increased risk of miscarriage
-premature ROM
-preterm labor
-low birth weight
-postpartum endometritis |
|
|
Term
| Transmission from mom to baby during delivery can cause: |
|
Definition
-conjunctivitis that develops 5-12 days after birth
-pneumonia w/onset at ages 1-3 months |
|
|
Term
| ACOG breast screening guidelines recommend that mammograms begin at what age and are done how often? |
|
Definition
| Begin at age 40 and are done annually |
|
|
Term
| ACOG breast screening guidelines recommend clinical breast exams be done how frequently? |
|
Definition
-Annually for women ages 40 and older
-Every 1-3 years for women ages 20-39 |
|
|
Term
| ACOG breast screening guidelines recommends educating on breast self exams or what is newly termed breast self awareness at what age? |
|
Definition
|
|
Term
| Two estrogenic compounds found in OCs in the United States are: |
|
Definition
-Mestranol (used only in some 50 mcg pills)
-Ethinyl estradiol |
|
|
Term
| Which hormone (estrogen or progestin) in COC provides the majority of the pill's contraceptive activity? |
|
Definition
|
|
Term
|
Definition
-progestin causes thickening of cervical mucus to prevent sperm entry
-progestin suppresses ovulation by providing negative feedback to the hypothalmic-pituitary system (decreased GnRH pulsatility, supresses FSH and LH production, and prevents LH surge) |
|
|
Term
|
Definition
| Higher failure rates than IUDs, implants, and injections but lower failure rates than barrier and behavioral methods |
|
|
Term
| Perfect use failure rate of COC is |
|
Definition
|
|
Term
| Typical use failure rate of COC is |
|
Definition
|
|
Term
| At what point in the pill pack is missing pills more detrimental? |
|
Definition
| Earlier in the pill pack missing pills makes it much more difficult to suppress ovulation |
|
|
Term
| True or False: Fetuses exposed to COC in utero are at increased risk for birth defects |
|
Definition
|
|
Term
| Benefits of COC for perimenopausal women in addition to contraception |
|
Definition
-reduction in hot flashes
-cycle control |
|
|
Term
| On average, how long do women taking COC have to wait for ovulation to return? |
|
Definition
|
|
Term
| True or False: COCs reduce the risk of ectopic pregnancy |
|
Definition
| True: they reduce the risk by 90% |
|
|
Term
| True or False: COCs significantly decrease menstrual cramps and pain |
|
Definition
|
|
Term
| True or False: Women using COCs experience an increase in the number of days of bleeding and the amount of blood lost each cycle |
|
Definition
| False: women taking COCs experience a decrease in the number of days of bleeding and a decrease in the amount of blood lost |
|
|
Term
| True or False: COC and other hormonal methods are first line therapy for the treatment of menorrhagia due to fibroids |
|
Definition
|
|
Term
| True or False: menstrual migraines are increased w/use of COCs? |
|
Definition
| False: menstrual migraines are c/b estrogen w/drawal so COCs decrease them |
|
|
Term
| True or False: Women taking COCs have a decresed risk for getting ovarian cancer |
|
Definition
| True: women w/a family hx experience an even greater benefit from ovarian cancer risk reduction |
|
|
Term
| True or False: Women taking COCs experience an increased risk of endometrial cancer |
|
Definition
|
|
Term
| True or False: COCs users are less likely to develop fibrocystic breast changes, cysts or fibroadenomas |
|
Definition
|
|
Term
| Which two COC have received FDA approval for use in the treatment of mild to moderate acne? |
|
Definition
-Ortho Tri-Cyclen
-Estrostep |
|
|
Term
|
Definition
| By suppressing ovarian production of testosterone, by blocking conversion of testosterone to dihydrotestosterone, and by inducing hepatic production of sex hormone binding globulin SHBG |
|
|
Term
| How long does it take for COCs to have maximum effect on acne? |
|
Definition
|
|
Term
| What is the most appropriate COC for tx of hirsutism? |
|
Definition
| Those w/progestins w/low androgen impact and high dose estrogens |
|
|
Term
| True or False: COCs reduce symptoms of endometriosis |
|
Definition
|
|
Term
| COCs are first line therapy for the following conditions in healthy women: |
|
Definition
-heavy bleeding
-dysfunctional uterine bleeding
-ovarian cysts
-family hx of ovarian cancer
-personal risk factors for endometrial cancer
-acne or hirsutism
-PCOS |
|
|
Term
| True or False: There is an increased risk of MI w/age in women who smoke and use COCs |
|
Definition
|
|
Term
| True or False: ACOG advises caution in the use of estrogen-containing methods of contraception in obese women over age 35 |
|
Definition
| True: there is an increased risk of thrombosis w/obesity |
|
|
Term
| Risk of thrombosis w/COC use is greatest when? |
|
Definition
| during the first year of use |
|
|
Term
| True or False: COCs increase circulating levels of angiotensinogen |
|
Definition
| True: some women are very sensitive to this which can cause an increase in both diastolic and systolic BP |
|
|
Term
| True or False: a pelvic exam is required for woman to receive COC |
|
Definition
|
|
Term
| Medical conditions precluding COC use |
|
Definition
-DVT or thrombophlebitis
-CAD
-Stroke
-Severe HTN
-Headaches w/aura
-major surgery w/prolonged immoblilization
-breast cancer
-carcinoma of endometrium |
|
|
Term
| How long should patient use back up protection w/quick start method for COC? |
|
Definition
|
|
Term
| How long does patient need to use back up protection if she utilizes the first day start method for COC? |
|
Definition
| No back up necessary when pills are started on the first day of menses |
|
|
Term
| Women undergoing a major surgery that will require prolonged immobilization should d/c COCs how long before surgery? |
|
Definition
|
|
Term
| B/c pregnancy is a hypercoagulable state COCs should not be started for how long after delivery? |
|
Definition
|
|
Term
| True or False: Broad spectrum antibiotics decrease the effectiveness of COC |
|
Definition
|
|
Term
| What to instruct patient if she misses 1 or 2 COC pills |
|
Definition
-take 1 pill ASAP and then continue taking pills daily (including pill for today)
-no backup contraception is needed |
|
|
Term
| What to instruct patient if she misses 3 or more COC pills during first 2 weeks of the pack |
|
Definition
-take one active pill ASAP and then continue taking pills daily, 1 each day (including this day)
-Use back up method until she has taken 7 active pills in a row |
|
|
Term
| Estrogen related SE of COC |
|
Definition
-weight gain
-increased BP
-Skin changes
-headaches
-increased HDL and triglycerides
-nausea
-MI and Stroke
-thromboembolism |
|
|
Term
| Progesterone related SE of COC |
|
Definition
-constipation
-bloating
-fatigue
-depressive sx
-increased insulin resistance |
|
|
Term
| Androgen related SE of COC |
|
Definition
-acne
-hirsutism
-elevated LDL
-slow, steady weight gain |
|
|
Term
| What is one of the most common causes of pill associated spotting and bleeding? |
|
Definition
|
|
Term
|
Definition
-ACHES
-Abdominal pain
-Chest Pain
-Headaches
-Eye Problems
-Severe leg pain |
|
|
Term
| Purpose of estrogen in COC is |
|
Definition
| to stabilize the endometrium for a more predictable bleeding pattern |
|
|
Term
| What is the only non androgenic pill |
|
Definition
| Yaz and it contains drospirenone |
|
|
Term
| The more androgenic a progestin in a pill is the more... |
|
Definition
|
|
Term
| What is the biggest problem w/Lybrel the 365 day pack? |
|
Definition
|
|
Term
| How many days of placebo pills do you need to shed endometrium? |
|
Definition
|
|
Term
| True or False: Some placebo pills contain Fe (iron) |
|
Definition
| True: and make sure you educate patient to take placebo pills |
|
|
Term
|
Definition
| Nortestosterone and drospirenone |
|
|
Term
| F/U recommended after how many months of COC use? |
|
Definition
|
|
Term
|
Definition
-older smoker
-moderate or severe HTN
-Diabetes
-Breast, uterine, or cervical cancer
-cardiovascular or cerebrovascular disease
-current liver disease |
|
|
Term
| What steroid should you increase if patient is complaining of bleeding while on COC? |
|
Definition
|
|
Term
| What levels of steroids should be in a COC for a woman who has irregular menses w/excess androgen effects? |
|
Definition
-high progesterone activity
-low androgen activity |
|
|
Term
| What levels of steroids should be in a COC for a woman w/irregular menses w/o excess androgen effects? |
|
Definition
| -low estrogen and progesterone activity |
|
|
