may be caused by an imbalance in progesterone and estrogen resulting in thickening of breast tissue

Findings on physical examination:

mild signs of irregularity and nodularity

possible expressible nipple discharge

Treatment:

Sodium and caffeine restriction may help

Vitamin B6 supplements may help

Typical characteristics:

freely movable solid benign tumor

well defined, rounded with rubbery texture

asymptomatic and non-tender

Intraductal Papilloma

(epithelia neoplasm)

Tumor within ductal system of breast

Prevalent during menopause, have potential to become malignant

Characteristics:

nipple discharge in NONPREGNANT, NONLACTATING females

small, ball-like solitary nodules

Signs and symptoms:

Pelvic pain r/t menstrual cycle, Dyspareunia, Painful bowel mvmt, Occasionally abnormal uterine bleeding

Bimanual examination:

fixed, tender uterus; palpable nodules in cul de sac; Dx confirmed by laparoscopy

Risk factors:

use of super absorbent tampons

use of cervical cap or diaphragm during menses

colonization of staph aureus after surgery, skin or bone infexns, dermatologic lesions, resp tract infexns (sinusitis)

Signs & Symptoms:

Fever > 38.9C or 102F

Rash on trunk

Desquamation of skin, esp in palms/soles occurs 1-2 wks after onset of symptoms

Hypotension with dizziness

vomiting, diarrhea, severe myalgia, and inflammed vaginal mucous membranes

alt in consciousness, disorientation, coma

Signs and Symptoms:

thin, watery, white or gray, fishy vaginal discharge

Dx:

"Clue" Cells are seen on wet mount prep

Metronidazole (flagyl)

Metrogel

Alternate use of Clindamycin (Cleocin) vaginal cream

Oral Clindamycin

Tx for Bacterial Vaginosis

___________________

___________________

___________________

___________________

Signs and symptoms:

THICK, CURDY vaginal discharge

severe itching

dyspareunia

dysuria

Redness, swelling, pruritus

often asymptomatic; can cause ophthalmia neonatorum

Prophylaxis: Erythromycin ointment

may cause PID

treat BOTH partners w/ doxycycline or azirthromycin

signs and symptoms:

thin or purulent discharge

dysuria

lower abd pain, unilateral

signs and symptoms:

purulent, green-yellow discharge

dysuria

urinary frequency

gonorrhea treatments:

antibiotics

Ceftriaxone

treatment for gonorrhea:

treat both partners c _____________

treat pregnant women c __________

Acyclovir

anti-herpes viral drugs

Podophillin

trichloracetic acid

Imiquimod (Aldara)

podofilox (Condylox)

Syphillis

primary

signs and symptoms

chancre at site of entry

signs and symptoms:

6 wks-6mos chancre disappears;

wart-like skin eruptions (condyloma lata)

palmer rash

flu-like systems

signs and symptoms:

CV, neuro, skeletal, and skin symptoms after long, latent period

2.4 million units

bentzathine penicillin G

IM single dose

IM 2.4 million units bezathine penicillin G

once a wk x 3wks

Doxycycline or tetracycline

Desensitize to penicillin then treatmnent

tx syphilis:

CDC recommended: __________________

Syphillis >1yr duration: _______________

Nonpregnant women c penicillin allergy: __________________________________

Pregnant women c penicillin allergy:

_______________________________

s/s:

bilateral sharp cramping pain of lower abd

purulent vaginal discharge

irregular vaginal bleeding

n/v

malaise

sometimes asymptomatic c normal lab values

shuffle

chills

fever

IV fluids

analgesics

IV antibiotics

tx of sexual partner

s/s:

palpable @ pelvic exam

asymptomatic/symptomatic

cramping

dypareunia

irregular bleeding

bloating

irregular bowel mvmts

s/s:

lower abd pain

fullness or pressure

menorrhagia

dymenorrhea