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Intravenous Drug Abuse

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8021. Hemorrhagic Ovarian Cyst

Hemorrhagic Ovarian Cyst Hemorrhagic Ovarian Cyst Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hemorrhagic Ovarian Cyst Hemorrhagic (...) Ovarian Cyst Aka: Hemorrhagic Ovarian Cyst From Related Chapters II. Background Suggests benign Occurs with bleeding into simple cyst Follicular cyst III. Symptoms IV. Findings on Ultrasound Homogenous low level echoes in simple cyst Reticular or fishnet pattern of linear echoes Differentiate from septations in complex cyst No detectable flow on color doppler Decrease in size or resolve within 6-8 weeks Especially during or immediately after V. References Images: Related links to external sites (from

2018 FP Notebook

8022. Ovarian Follicular Cyst

Ovarian Follicular Cyst Ovarian Follicular Cyst Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ovarian Follicular Cyst Ovarian (...) Follicular Cyst Aka: Ovarian Follicular Cyst , Follicular Cyst of Ovary From Related Chapters II. Background Seen early in pregnancy and resolves by mid-pregnancy Result from failed III. Symptoms Asymptomatic in many cases occurs in IV. Radiology: Ultrasound findings Size: 3-8 cm in diameter Thin-walled, anechoic cyst Round or oval V. Course Immature follicle contains unresorbed fluid With , cyst-lining granulosa cells luteinize Follicular cyst transitions to corpus luteum Corpus luteum grows >2.5 cm

2018 FP Notebook

8023. Corpus Luteal Cyst

Corpus Luteal Cyst Corpus Luteal Cyst Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Corpus Luteal Cyst Corpus Luteal Cyst Aka (...) : Corpus Luteal Cyst , Luteal Cyst , Cyst of Corpus luteum From Related Chapters II. Background Often seen in pregnancy Corpus luteum develops from follicular cyst Corpus luteum considered cyst when >2.5 cm III. Symptoms Asymptomatic in many cases occurs in IV. Radiology: Ultrasound Size: 3 to 11 cm Variable appearance on Commonly thin-walled unilocular cyst Color doppler shows circumferential vascularity V. References Images: Related links to external sites (from Bing) These images are a random

2018 FP Notebook

8024. Secondary Dysmenorrhea

Secondary Dysmenorrhea Secondary Dysmenorrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Secondary Dysmenorrhea Secondary (...) Dysmenorrhea Aka: Secondary Dysmenorrhea From Related Chapters II. Definition secondary to underlying pelvic organix disorder III. Symptoms See IV. Evaluation See V. Causes: Secondary Dysmenorrhea (pelvic pathology) See VI. Management See for evaluation and management Evaluate and treat the underlying cause Symptomatic treatment as with Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Secondary Dysmenorrhea." Click on the image (or right

2018 FP Notebook

8025. Primary Dysmenorrhea

Primary Dysmenorrhea Primary Dysmenorrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Primary Dysmenorrhea Primary Dysmenorrhea (...) mmHg Increased frequency of uterine contractions Dysrhythmia of uterine contractions Increase in enzyme Prostaglandin Synthetase Increased prostaglandins result in striction Uterine (uterine ) IV. Symptoms See V. Examination See Normal pelvic examination VI. Differential Diagnosis See VII. Labs See PCR PCR VIII. Precautions Primary Dysmenorrhea is a diagnosis of exclusion Exclude causes (at minimum: pregnancy, and Older women without prior history of should be assumed to have until thorough

2018 FP Notebook

8026. Postmenopausal Bleeding

Postmenopausal Bleeding Postmenopausal Bleeding Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Postmenopausal Bleeding Postmenopausal (...) without on >6 months IV. Evaluation See Careful exam of external genitalia as well as speculum exam Catheterized Rectal exam V. Imaging Determine endometrial thickness (5 mm) Evaluate for other uterine and l anomalies VI. Management See VII. References Apgar (2003) AAFP Board Review, Seattle Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Postmenopausal Bleeding." Click on the image (or right click) to open the source website

2018 FP Notebook

8027. Menorrhagia Management

to temporize until definitive therapy VII. References Mace (2013) Crit Dec Emerg Med 27(2): 13-21 Nelson (1997), Fam Prac Recert 19(8):14 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Menorrhagia Management." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Menstrual Disorders About FPnotebook.com is a rapid access, point-of-care medical (...) Menorrhagia Management Menorrhagia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Menorrhagia Management Menorrhagia

2018 FP Notebook

8028. Ovulatory Bleeding

Ovulatory Bleeding Ovulatory Bleeding Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ovulatory Bleeding Ovulatory Bleeding Aka (...) : Ovulatory Bleeding , Menorrhagia From Related Chapters II. Pathophysiology Shortened or prolonged corpus luteum life span Abnormal relative ratio of to Usually due to low levels III. Risk Factors Increases with age IV. Causes See s (before ) Endometrial polyps s (present in 13% of women with Menorrhagia) Advanced liver disease V. Symptoms Premenstrual Symptoms are present intervals are normal (every 24 to 35 days) Change in Amount of bleeding Menorrhagia Patient describes very heavy periods Change pad

2018 FP Notebook

8029. Metrorrhagia Management

Metrorrhagia Management Metrorrhagia Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Metrorrhagia Management Metrorrhagia (...) Management Aka: Metrorrhagia Management , Anovulatory Bleeding Management From Related Chapters II. Indication ( ) III. Goal: Correct Unopposed Estrogen Prevent Prevent Uncoordinated Sloughing IV. Management Switch to containing pill Avoid when is contraindicated (e.g. users over age 35 years) Limit to no more than 35 mcg Lower is not associated with bleeding acetate ( ) 10 mg oral daily for 10-14 days per month (Aygestin) Dose: 5 mg PO tid cycle days 15 to 25 Micronized (Prometrium) Dose: 200 mg PO qd

2018 FP Notebook

8030. Abnormal Uterine Bleeding Causes

See V. Causes: Endocrine-related uterine bleeding complications Increased Increased Testosterone Increased Adrenal Excessive Androgen Production Miscellaneous VI. Causes: Medication-related Uterine Bleeding Disorders See VII. Causes: Structural-related uterine Bleeding Disorders Local infection Salpingitis Endometrial and Endocervical Polyps Functional ovarian tumors (produce sex hormones) Submucosal or intramural leiomyoma s of the endometrium Vaginal (foreign body, sexual abuse, ) VIII (...) Abnormal Uterine Bleeding Causes Abnormal Uterine Bleeding Causes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Abnormal Uterine

2018 FP Notebook

8031. Anovulatory Bleeding

Anovulatory Bleeding Anovulatory Bleeding Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anovulatory Bleeding Anovulatory Bleeding (...) Aka: Anovulatory Bleeding , Metrorrhagia From Related Chapters II. Epidemiology causes 90% Age breakdown of Anovulatory Bleeding Women over age 40 years represent 50% of this group Adolescent women represent 20% of anovulatory group Common at the extremes between and : First 2-3 years with irregular cycles (immature hypothalamic-pituitary-ovarian axis) : Up to 8 years prior to III. Associated Conditions : 3 fold See for evaluation indications IV. Pathophysiology Anovolution results in no LH surge

2018 FP Notebook

8032. Secondary Amenorrhea

Secondary Amenorrhea Secondary Amenorrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Secondary Amenorrhea Secondary Amenorrhea (...) % of secondary causes) (10% of secondary causes) Oophoritis (rare) or Radiation Infection (e.g. , ) Axis 4: Asherman's Syndrome (5%) Cervical stenosis IV. Causes: Miscellaneous Other endocrine causes See Adrenal hyperplasia (adult onset) Androgen-secreting tumor Severe Physiologic causes Pregnancy! Exogenous androgens V. Pathophysiology: Mechanisms dysfunction Insufficient leads to long cycles Hypoestrogenemia (Most common) Able to conceive VI. History Menstrual history Age at characteristics Premenstrual

2018 FP Notebook

8033. Primary Amenorrhea

Primary Amenorrhea Primary Amenorrhea Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Primary Amenorrhea Primary Amenorrhea Aka (...) ) Pituitary Null Cell Tumor (No hormone produced) Empty Sella Syndrome Pituitary Pituitary Axis 3: Ovarian (10% of primary causes) Findings: , , and Turner Syndrome and Mosaics (30% of primary causes) Findings: , Web neck, and Shield May present as and alone tic Male (10% of primary causes) Gonadal dysgenesis Axis 4: Mullerian Agenesis (20% of primary causes) Mayer-Rokitansky-Kuster-Hauser Syndrome Transverse vaginal septum Complete androgen resistance IV. Labs (UPT) Serum (LH) Serum (FSH) (TSH) V

2018 FP Notebook

8034. Vaginal pH

Bing) These images are a random sampling from a Bing search on the term "Vaginal pH." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Pathology and Laboratory Medicine About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 (...) Vaginal pH Vaginal pH Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vaginal pH Vaginal pH Aka: Vaginal pH II. Indications Evaluation

2018 FP Notebook

8035. Estrogen-Progesterone Challenge Test

-Progesterone Challenge Test Estrogen-Progesterone Challenge Test Aka: Estrogen-Progesterone Challenge Test II. Indications evaluation No withdrawal bleeding with III. Procedure Administer - (options below) Premarin 1.25 mg orally daily for 21 days or for 2 Cycles or Estradiol 2 mg orally daily for 21 days and Follow with 7-10 days of See for options Assess for after stopping medication Anticipate within 7 days of medication completion IV. Interpretation No withdrawal bleeding occurs Suggests uterine (...) Estrogen-Progesterone Challenge Test Estrogen-Progesterone Challenge Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Estrogen

2018 FP Notebook

8036. Progesterone Challenge Test

Progesterone Challenge Test Progesterone Challenge Test Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Progesterone Challenge Test (...) Progesterone Challenge Test Aka: Progesterone Challenge Test II. Indications evaluation III. Procedure: Progesterone Challenge Administer (options below) 10 mg PO once daily 7-10 days or 5 mg PO once daily for 7-10 days or 200 mg IM for one dose or Micronized 400 mg oral qd x7-10 days or micronized gel (4 to 8%) or Apply intravaginally every other day for 6 doses Assess for after Anticipate within 7 days of completion IV. Interpretation Withdrawal bleeding within 7 days Suggests with deficiency See

2018 FP Notebook

8037. Mid-Luteal Serum Progesterone

Medicine About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns (...) Mid-Luteal Serum Progesterone Mid-Luteal Serum Progesterone Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Mid-Luteal Serum

2018 FP Notebook

8038. Inadequate Pap Smear

) Related Topics in Pathology and Laboratory Medicine About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should (...) Inadequate Pap Smear Inadequate Pap Smear Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Inadequate Pap Smear Inadequate Pap Smear

2018 FP Notebook

8039. AGUS Pap Smear

Hungarian AGUS , Meghatározatlan jellegű atypusos glandularis sejtek Derived from the NIH UMLS ( ) Related Topics in Pathology and Laboratory Medicine About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website (...) AGUS Pap Smear AGUS Pap Smear Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 AGUS Pap Smear AGUS Pap Smear Aka: AGUS Pap Smear

2018 FP Notebook

8040. High Grade Squamous Intraepithelial Lesion

squamous intraepithelial lesion Hungarian Súlyos fokú intraepithelialis squamosus laesio , HSIL Derived from the NIH UMLS ( ) Related Topics in Pathology and Laboratory Medicine About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access (...) High Grade Squamous Intraepithelial Lesion High Grade Squamous Intraepithelial Lesion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4

2018 FP Notebook

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