Absolute Contraindications To Oral Contraceptives
Category: generalpediatrics-Obgyn
Findings: pregnancy, liver disease, hyperlipidemia, breast cancer, breastfeeding for infant younger than 6 weeks
Notes: A relative contraindication is hypertension.
Question: What are these?
Bacterial Vaginosis
Category: generalpediatrics-Obgyn
Findings: fishy odor, gray vaginal discharge, pH more than 4.5, clue cells
Notes: Treat with metronidazole 500 mg twice daily for 7 days.
Chlamydia Trachomatis
Category: generalpediatrics-Obgyn
Findings: staccato cough in neonate
Question: Which organism causes this finding?
Chorionic Villus Sampling
Category: generalpediatrics-Obgyn
Findings: most helpful test in pregnant women for early detection of genetic or chromosomal abnormality in fetus
Notes: Sample of fetal karyotype from placental biopsy. May be done around 12 weeks. Poses more risk to fetus than amniocentesis.
Question: Which disease is associated with these findings?
Down Syndrome
Category: generalpediatrics-Obgyn
Findings: Common chromosomal abnormality with low AFP, high hCG and inhibin
Notes: Will see low estriol, high hCG, and high inhibin A as part of quad screen.
Question: Which disease is associated with these findings?
Fitz-Hugh-Curtis Syndrome
Category: generalpediatrics-Obgyn
Findings: right upper quadrant pain that may refer to right shoulder, normal LFTs, positive gonorrhea or chlamydia test
Notes: Occurs after pelvic inflammatory disease occurs. Do a pelvic exam. Do not obtain LFTs as they will be normal.
Question: Which disease is associated with these findings?
Herpes Simplex
Category: generalpediatrics-Obgyn
Findings: lymphadenopathy, ulcerative vesicles on labia or penis
Notes: Diagnose with HSV PCR or culture. Treat with acyclovir x 7 days.
Question: Which organism causes these findings?
HSV Encephalitis
Category: generalpediatrics-Obgyn
Findings: fever, seizures, temporal lobe abnormality on head CT, EEG showing periodic lateralizing epileptiform discharges
Notes: Treat with stat IV acyclovir and obtain lumbar puncture for PCR testing.
Lymphogranuloma Venereum
Category: generalpediatrics-Obgyn
Findings: starts as nontender papules or ulcers that resolves, later may present as tender unilateral inguinal lymphadenopathy
Notes: Caused by Chlamydia trochomatis. Treat with doxycycline or erythromycin.
Question: Which disease is associated with these findings?
Neisseria gonorrhoeae
Category: generalpediatrics-Obgyn
Findings: foul smelling green vaginal discharge, arthritis
Notes: Treat with IM ceftriaxone 500 mg x 1 and also doxycycline 100 mg BID for 7 days for potential Chlamydia.
Question: Which organism causes these findings?
Phosphatidylglycerol
Category: generalpediatrics-Obgyn
Findings: Molecule that is best predictor of fetal lung maturity - made after 35th week of gestation.
Notes: A lecithin-sphingomyelin ratio greater than 2 also indicates fetal lung maturity.
Question: Which is the following?
Syphilis
Category: generalpediatrics-Obgyn
Findings: peeling skin in neonate, hepatosplenomegaly, generalized lymphadenopathy
Notes: If untreated, infant may developed perforated palate or nasal septum, hearing loss, hutchinson teeth. Treat with penicillin.
Question: Which organism causes these findings?
Trichomonas Vaginalis
Category: generalpediatrics-Obgyn
Findings: yellow green frothy discharge, pH more than 4.5, pruritic, strawberry cervix
Notes: Treat Women With Metronidazole 500 Mg Twice Daily For 7 Days Men With 2 G Metronidazole Once Or Tinidazle 2 G Once In Either Men Or Women
Question: Which organism is associated with these findings?
Vaginal Candidiasis
Category: generalpediatrics-Obgyn
Findings: vaginal itching, burning with urination, thick white vaginal discharge
Notes: Treat with a single dose of oral fluconazole or a 1 to 3 day regimen of intravaginal antifungal cream.