Pee Pee with TMB
This is the minimum evaluation for stress urinary incontinence
History, PE, questionnaires, tx goals, UA, PVR
This is the culture result when you should treat a UTI in pregnancy
culture positive for >100,000 cfu of bacteria
A 25 year old wants contraception. She has a history of PID due to chlamydia and gonorrhea infection at 24. She has no signs/symptoms of cervicitis today. She'd like an IUD. What should you do?
Place the IUD
True/False: you need to perform a pelvic exam when prescribing any contraception including IUD
False, only for IUD or to test for STIs
Sacral neuromodulation is an effective treatment of urinary incontinence. What is the MOA and what nerve does it stimulate?
MOA unknown. Stimulates S3
Do not use these two antibiotics in treating UTIs in pregnancy due to increased resistance
Amoxicillin and amoxicillin-clavulanate
A patient who has BV would have this pH
More basic than normal vaginal pH (>4.5-5)
This is the interval women need to see their OB-GYN
once annually or as needed due to symptoms/problems
A 65 year old patient with past medical history of HTN, narrow angle glaucoma treated last year, and DM2 is having stress urinary incontinence. She'd like to start treatment with oxybutinin. Is this an appropriate treatment?
Technically yes. She is being treated for her narrow angle glaucoma, so oxybutinin is no longer contraindicated
Define pyuria
More than 5 WBC/hpf or presence of leukocyte esterase
This has 97% sensitivity for UTIs
This is the most common cancer in pregnancy
Dysgerminoma (germ cell tumor)
This is when you should perform a speculum exam routinely in the office
When history indicated, screening for STI, IUD placement or due to shared decision making
Name the mechanism of action of mirabegron, and 1 side effect. How are the side effects compared to oxybutinin?
B3 agonist
Side effects: dry mouth, dry eyes, constipation
but overall less side effects compared to oxybutinin
You cannot use these two antibiotics when treating pyelonephritis due to issues with the drug reaching therapeutic levels in the kidney
Nitrofurantoin and fosfomycin
This is the counseling you should give a patient you diagnose with chlamydia
Partner needs to be treated, complete the full course of antibiotics, and abstain from intercourse for 7 days following treatment of both partners
2 Potential harmful consequences of routine speculum exams
fear, anxiety, discomfort, pain, embarrassment
False reassurance has not been proven
Describe Botox treatment for urinary incontinence. (MOA, dose, how to administer, and #1 side effect)
Onabotulinum A paralyzes muscular tissue.
100 units divided into 20, 5 unit injections administered in an even pattern throughout the posterior wall of the bladder.
MC side effect is urinary retention. These patients have to be okay with intermittent self cath
These are the two options for suppressive therapy for pyelonephritis in pregnancy and this is how long you continue prophylaxis
Nitrofurintoin 100 mg qD or keflex 250-500 mg qD
Continue 4-6 weeks postpartum
These are the 4 treatment options for symptomatic BV in pregnancy (students only, no doses)
Clindamycin gel (2%)
Oral clindamycin
Metro gel (0.75%)
Oral metro
These are 2 conditions that may warrant routine screening per set protocols