Women's Health EOR Exam 2023/ 510
Questions and Answers/100% Correct.
Causes and risk factors for post partum depression - -cause is not totally known,
hypothryoidism is a cause is in some cases so screen if appropriate, women who had
depression before or who have poor support systems are more likely to develop severe
depression, psychotic features are possible
-treatement for postpartum depression - --consult psych for psychotherapy
-antidepressant medication
-support groups
-involvement of services to relieve child care burden
-presentation of postpartum depression - --does not devote usual amount of attention
to newborn
-postpartum blues features and presentation - --within 2 weeks of delivery, at height of
hormonal change
-common (50-85%), typical depressive emotions (plus elation?)
-unrelated to the health of mother or baby, social situation,
-more common in cultures where emotions are expressed and with family support
-postpartum blues course and tx - --usually self-limiting
-lasts a few days to 2-3 weeks
-20% will go on to develop depression in first postpartum year
-tx consists of support from family, provider, and other mothers
-when does postpartum Depression develop - -weeks to months after delivery
-how is postpartum depression diagnosed - -standardized self report or physician
screen
,-when is the most likely time in a women's life to develop new onset psychosis? - -
postpartum
-most women with gonorrhea are (symptomatic / asymptomatic) - -asymptomatic
carriers
-microbilogy of gonorrhea - -gram negative diplococcus
oxidase positive colonies
ferments glucose
-grows in Thayer-Martin or Martin-Lester medium
-gonorrhea sx - -purulent vaginal discharge
urinary frequency and dysuria
rectal discomfort
-sx of disseminated gonorrhea - -triad of polyarthralgia, tenosynovitis, and dermatitis,
or purulent arthritis without dermatitis
may be septic
-the major complication of gonorrhea in females - -salpingitis
-prevention and tx of gonorrhea - --abstain from sexual activity for 7 days after tx is
started
-re-examine after 3 weeks to rule out tx failure or reinfection
-use condoms
tx with 250mg ceftriaxone and (1g azithromycin or 100mg doxycycline bid x 7 days)
-tx for disseminated gonorrhea - --admit
-ceftriaxone 1g IM or IV q24h or cefotaxime or ceftizoxime 1g IV q8h
-penicillin allergic spectinomycin 2g IM q12h
,-tx for infant born to untreated mother with gonorrhea - -ceftriaxone 25-50mg/kg IV
or IM NTE 125mg once
-the most commonly reported notifiable disease in the US - -chlamydia
-microbiology of chlamydia - -obligate intracellular microorganisms
cell wall similar to gram negative
contain both DNA and RNA
divide by binary fission but grow intracellularly like viruses
can only be grown by tissue culture
-risk factors for chlamydia - -obvious stuff - younger age, sexually active without
barrier protection, lower status
OCP use INCREASES risk?
-sx of chlamydia infection - -may be asymptomatic
-mucopurulent cervical discharge
-hypertrophic cervical inflammation
-appearance of PID on US - -ACUTE - "cogwheel sign" - incomplete septation of the
tubal wall
CHRONIC - "beaded string" - thin tubal wall
-microbiology of syphilis - -treponema pallidum
spirochete
-primary syphilis presentation - -treponemes enter mucous membrane or broken skin
10-90 days after, painless chancre develoeps
indurated, firm, painless papule or ulcer with raised borders
persists for 1-5 weeks and heals spontaensously
, -secondary syphilis presentation - -2 weeks to 6 months (average 6 weeks) after
chancre appears
generalized cutaneous eruption heals spontaneously after 2-6 weeks
may involve palms and soles, macular, maculopapular, papular, or pustular
patchy alopecia
Condyloma Lata - moist papules in perineal area
-tertiarty syphilis presetnation - -4-20 years after primary
-testing for syphilis - -darkfield microscopy of lesion or immunoflurescence
serologic tests (VRDL) (RPR) every week for 6 weeks or until positive (usually 3-6 weeks
after infection or 2-3 weeks after chancre)
Treponemal antibody tests - FTA-ABS or MHA-TP are more sensitive and specific, but
remain positive despite therapy
-presentation of latent syphilis - -infectious in first 1-2 years of latency
early latent < 1 year, late latent > 1 yr
possible asymptomatic neurosyphilis (CSF examination recommended)
-neurosyphilis prestnation - -most common during latent syphilis
opthalmic and auditiory
CN palsy, meningeal signs
CSF for cell count, protein, VDARL and FTA-ABS
-syphilis during pregnancy - -the earlier in pregnancy the fetus is exposed, the more
severe to fetal infection, greater the risk of premature delivery or stillbirth
tx the same except no doxy, use penicillin despite allergy, consider inpatient
-syphilis treatment - -tx any pt who had been exposed or is symptomatic despite
serological tests
Primary, secondary, and early latent all tx the same
-Benzathine penicillin G 2.4 million units IM once
Questions and Answers/100% Correct.
Causes and risk factors for post partum depression - -cause is not totally known,
hypothryoidism is a cause is in some cases so screen if appropriate, women who had
depression before or who have poor support systems are more likely to develop severe
depression, psychotic features are possible
-treatement for postpartum depression - --consult psych for psychotherapy
-antidepressant medication
-support groups
-involvement of services to relieve child care burden
-presentation of postpartum depression - --does not devote usual amount of attention
to newborn
-postpartum blues features and presentation - --within 2 weeks of delivery, at height of
hormonal change
-common (50-85%), typical depressive emotions (plus elation?)
-unrelated to the health of mother or baby, social situation,
-more common in cultures where emotions are expressed and with family support
-postpartum blues course and tx - --usually self-limiting
-lasts a few days to 2-3 weeks
-20% will go on to develop depression in first postpartum year
-tx consists of support from family, provider, and other mothers
-when does postpartum Depression develop - -weeks to months after delivery
-how is postpartum depression diagnosed - -standardized self report or physician
screen
,-when is the most likely time in a women's life to develop new onset psychosis? - -
postpartum
-most women with gonorrhea are (symptomatic / asymptomatic) - -asymptomatic
carriers
-microbilogy of gonorrhea - -gram negative diplococcus
oxidase positive colonies
ferments glucose
-grows in Thayer-Martin or Martin-Lester medium
-gonorrhea sx - -purulent vaginal discharge
urinary frequency and dysuria
rectal discomfort
-sx of disseminated gonorrhea - -triad of polyarthralgia, tenosynovitis, and dermatitis,
or purulent arthritis without dermatitis
may be septic
-the major complication of gonorrhea in females - -salpingitis
-prevention and tx of gonorrhea - --abstain from sexual activity for 7 days after tx is
started
-re-examine after 3 weeks to rule out tx failure or reinfection
-use condoms
tx with 250mg ceftriaxone and (1g azithromycin or 100mg doxycycline bid x 7 days)
-tx for disseminated gonorrhea - --admit
-ceftriaxone 1g IM or IV q24h or cefotaxime or ceftizoxime 1g IV q8h
-penicillin allergic spectinomycin 2g IM q12h
,-tx for infant born to untreated mother with gonorrhea - -ceftriaxone 25-50mg/kg IV
or IM NTE 125mg once
-the most commonly reported notifiable disease in the US - -chlamydia
-microbiology of chlamydia - -obligate intracellular microorganisms
cell wall similar to gram negative
contain both DNA and RNA
divide by binary fission but grow intracellularly like viruses
can only be grown by tissue culture
-risk factors for chlamydia - -obvious stuff - younger age, sexually active without
barrier protection, lower status
OCP use INCREASES risk?
-sx of chlamydia infection - -may be asymptomatic
-mucopurulent cervical discharge
-hypertrophic cervical inflammation
-appearance of PID on US - -ACUTE - "cogwheel sign" - incomplete septation of the
tubal wall
CHRONIC - "beaded string" - thin tubal wall
-microbiology of syphilis - -treponema pallidum
spirochete
-primary syphilis presentation - -treponemes enter mucous membrane or broken skin
10-90 days after, painless chancre develoeps
indurated, firm, painless papule or ulcer with raised borders
persists for 1-5 weeks and heals spontaensously
, -secondary syphilis presentation - -2 weeks to 6 months (average 6 weeks) after
chancre appears
generalized cutaneous eruption heals spontaneously after 2-6 weeks
may involve palms and soles, macular, maculopapular, papular, or pustular
patchy alopecia
Condyloma Lata - moist papules in perineal area
-tertiarty syphilis presetnation - -4-20 years after primary
-testing for syphilis - -darkfield microscopy of lesion or immunoflurescence
serologic tests (VRDL) (RPR) every week for 6 weeks or until positive (usually 3-6 weeks
after infection or 2-3 weeks after chancre)
Treponemal antibody tests - FTA-ABS or MHA-TP are more sensitive and specific, but
remain positive despite therapy
-presentation of latent syphilis - -infectious in first 1-2 years of latency
early latent < 1 year, late latent > 1 yr
possible asymptomatic neurosyphilis (CSF examination recommended)
-neurosyphilis prestnation - -most common during latent syphilis
opthalmic and auditiory
CN palsy, meningeal signs
CSF for cell count, protein, VDARL and FTA-ABS
-syphilis during pregnancy - -the earlier in pregnancy the fetus is exposed, the more
severe to fetal infection, greater the risk of premature delivery or stillbirth
tx the same except no doxy, use penicillin despite allergy, consider inpatient
-syphilis treatment - -tx any pt who had been exposed or is symptomatic despite
serological tests
Primary, secondary, and early latent all tx the same
-Benzathine penicillin G 2.4 million units IM once
