NURS 546 MIDTERM STUDY SET QUESTIONS AND SOLUTIONS

NURS 546 MIDTERM STUDY SET
QUESTIONS AND SOLUTIONS

BV treatment - ANSWER: Metronidazole 500mg BID x 7 days
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Metronidazole gel 0.75% 1 application (5g) daily QD x 5 days bb bb bb bb bb bb bb bb bb bb



Clindamycin cream 2% 1 application (5g) QD at bedtime x 7 days bb bb bb bb bb bb bb bb bb bb bb




BV treatment for recurrence - ANSWER: May consider Metronidazole 2x weekly 2-4
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mo
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OR
Nitroimidazole PO, f/b Boric Acid (NOT in pregnancy) and metronidazole bb bb bb bb bb bb bb bb bb




BV risk factors - ANSWER: multiple sex partners
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douching
lack of barrier use
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hygiene bb



absence or dec in lactobacilli, or few H2O2 producing lactobacilli
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BV treatment metronidazole education - ANSWER: caution against drinking alcohol
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with use, during and 24 hours post use
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stomach upset common bb bb



metallic taste bb




BV treatment clindamycin education - ANSWER: cream is oil based, may degrade
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latex condoms
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inc risk of breakage within 72 hours of use
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BV Amsel Criteria - ANSWER: Diagnose if 3 or 4 are present:
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1. >pH (>4.5)
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2. Positive whiff test
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3. Clue cells on microscopy
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4. Discharge
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BV symptomology - ANSWER: odor (amine), discharge (milky white, thin, "fishy")
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usually vulva and cervix are not involved, may be asymptomatic
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pH >4.5 bb



positive whiff test bb bb



wet mount: clue cells >20% on sample
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no or few WBC, few lactobacilli on slide
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BV treatment in pregnancy - ANSWER: Metronidazole 500 mg twice a day for 7 days
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, treat as early as possible, re-exam for recolonization in 1 month
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Candidiasis (VVC) s/s - ANSWER: thickened, curd-like "cottage cheese" white
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discharge
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*pruritus*
vulva and labial swelling and erythema,
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erythematic vaginal walls bb bb



no odor
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no common effect on cervix
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pH usually <4.5
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Dx of Candidiasis (VVC) - ANSWER: wet mount KOH will see pseudohyphae or
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spores
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Tx of VVC - ANSWER: OTC intravaginal meds:
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Butoconazole (Gynazole), Clotrimazole (Gyne-Lotrimin), Miconazole (Monistat),
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Tioconazole (Vagistat) creams
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Prescription intravaginal agents: bb bb



Nystatin (Mycostatin) vaginal tablet 100,000 unit for 14 days
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Prescription oral agent: bb bb



Fluconazole (Diflucan) 150mg tablet PO once bb bb bb bb bb




Complicated VVC - ANSWER: Recurrent (RVVC) 4 or more episodes in one year
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Severe - edema, excoriation, fissure formation
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Non-albicans strain bb



Compromised host bb




Tx for RVVC - ANSWER: 7-14 days topical therapy
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PLUS bb



Fluconazole 100, 150 or 200mg given every 3rd day (1, 4, 7)bb bb bb bb bb bb bb bb bb bb bb




Treatment for VVC in pregnancy - ANSWER: 7 days topical therapy
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*Fluconazole is contraindicated* bb bb




KOH prep kills off all _____ _______ cells - ANSWER: non-fungal
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Trichomoniasis symptomology - ANSWER: itching, discharge, 70% may be bb bb bb bb bb bb bb bb



asymptomatic
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frothy, gray, yellow/green discharge
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cervical petechiae (strawberry cervix)
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dysuria, dyspareunia bb bb



pH >4.5
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may have positive whiff test
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wet mount: motile protozoa, many WBC
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