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.