Questions and Correct Answers|
Updated
Describe the pharmacological treatment for gonorrhea
Ceftriaxone 500 mg IM as a single dose, for persons weighing < 150 kg
For persons weighing > 150 kg, ceftriaxone 1gm IM as a single dose
Describe the pharmacological treatment for chlamydia
Doxycycline 100 mg PO BID for 7 days
During pregnancy, azithromycin 1 gm as a single dose to treat chlamydia
Alternative regimens:
Gentamicin 240 mg IM as a single dose + azithromycin 2 gm PO as a single dose
Cefixime 800 mg orally as a single dose + doxycycline 100 mg PO BID for 7 days (if
chlamydia CANNOT be excluded)
When assessing a patient, what is done first?
- Observe
- Inspect
- Listen
,- Palpate, respectively
Describe assessment findings for appendicitis
Abdominal pain, usually severe; localized to the right lower quadrant (RLQ)
Most common symptoms: anorexia, abdominal pain, nausea and vomiting
(typically present in this order)
Constipation and diarrhea occur after the pain
Describe acute abdominal pain
- severe, persistent pain
- sudden onset
- nausea, vomiting
- abdominal distention
- fever, signs of shock
What is obturator sign?
- The patient lies on the back with hip and knee flexed at 90 degrees while the
knee is stabilized and the ankle rotated away from the body
How is sepsis handled in the primary care setting?
refer patient to the ED
Describe treatment for an abscess
I&D
,Describe assessment findings for cellulitis
Erythema
Warmth
Edema
Pain
Fever
Lymphadenopathy
Fissuring, scaling or maceration in toe webs may be source of colonization (treat
with antifungal agents such as econazole, Naftifine)
History of recurrent abscesses
How is a puncture wound from an animal bite treated?
- typically not sutured closed
- treat with Augmentin
Describe assessment findings for bacterial vaginosis
Most women with BV are asymptomatic
Fishy or musty vaginal odor, more prominent after sexual intercourse and menses
Thin, homogenous discharge
No redness or edema
Normal bimanual exam
, Describe the diagnostic study for bacterial vaginosis
Amsel's criteria specify that diagnosis of BV requires three or more of the
following clinical signs and symptoms:
- Homogenous, thin, gray-white discharge coating the vaginal wall
- Vaginal pH >4.5
- Positive whiff test: amine (fishy) odor after application of 10% KOH on vaginal
discharge sample
- Presence of more than 20% epithelial cells (clue cells) on saline microscopy:
microscopic evaluation of vaginal discharge on glass slide with normal saline
shows few WBCs, and epithelial cells are obscured with coccobacilli.
What is the most reliable predictor of bacterial vaginosis?
Presence of clue cells identified by an experienced microscopist is the single most
reliable predictor of BV
For hematuria caused by an STI, when should follow up scheduled?
one week
Describe assessment findings for acute bronchitis
Cough: dry and nonproductive, then productive; may be purulent
URI symptoms
Fatigue
Fever due to bacterial infection; more common in smokers and patients with
COPD
Fever due to viral cause (unusual after first few days)