WHNP-BC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

PALM-COEIN classification

System for classifying abnormal uterine bleeding into structural causes (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia) and nonstructural causes (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified).

Postmenopausal bleeding evaluation

Any bleeding after 12 months of amenorrhea requires endometrial assessment with transvaginal ultrasound and/or endometrial biopsy to exclude endometrial carcinoma or hyperplasia, regardless of how light the bleeding is.

Cervical screening stop age

Average-risk patients may stop cervical cancer screening at age 65 only after adequate prior negative screening, generally three consecutive negative cytology results or two negative HPV tests in the prior 10 years.

Serial hCG interpretation

In a normal early intrauterine pregnancy, serum hCG rises at least 50-66% every 48 hours; a slower rise suggests ectopic or nonviable pregnancy and warrants ultrasound and continued monitoring.

Preconception folic acid dosing

Patients planning pregnancy take 400 mcg folic acid daily; 4 mg daily is indicated after a prior neural tube defect-affected pregnancy, started at least one month before conception and continued through the first trimester.

Osteoporosis DXA screening

DXA screening is recommended for all women aged 65 and older, and for postmenopausal women younger than 65 whose 10-year FRAX risk of major osteoporotic fracture is 9.3% or greater.

HPV vaccine dosing schedule

Two doses are given when the series begins before age 15, separated by 6-12 months; three doses are required when starting at 15 or older, or in immunocompromised patients.

Colorectal cancer screening initiation

Average-risk adults begin colorectal cancer screening at age 45 and continue through age 75, using colonoscopy every 10 years or annual stool-based testing with colonoscopy for abnormal results.

Amsel criteria

Bacterial vaginosis is diagnosed when three of four are present: homogeneous thin discharge, vaginal pH above 4.5, clue cells on wet mount, and a positive whiff (amine) test.

Rotterdam PCOS criteria

Polycystic ovary syndrome is diagnosed by two of three findings: ovulatory dysfunction, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology, after excluding thyroid, prolactin, and adrenal disorders.

Lichen sclerosus first-line therapy

Ultrapotent topical corticosteroid such as clobetasol propionate 0.05% is first-line treatment; biopsy is indicated when the lesion fails to respond or develops atypical features.

Outpatient PID regimen

Ceftriaxone 500 mg intramuscularly once, plus doxycycline 100 mg orally twice daily for 14 days, plus metronidazole 500 mg orally twice daily for 14 days.

Copper IUD emergency contraception

The copper intrauterine device is the most effective emergency contraceptive when inserted within 5 days of unprotected intercourse, with a failure rate below 0.1%.

Ulipristal versus levonorgestrel

Ulipristal acetate 30 mg works up to 120 hours after intercourse and is more effective than levonorgestrel, particularly with higher body weight; it may temporarily reduce hormonal contraceptive effectiveness.

Gonorrhea treatment dosing

Ceftriaxone 500 mg intramuscularly as a single dose, increased to 1 g for patients weighing 150 kg or more, with retesting for reinfection at three months.

Chlamydia treatment in pregnancy

Azithromycin 1 g orally as a single dose is recommended during pregnancy with a test of cure three to four weeks later; doxycycline 100 mg twice daily for 7 days is used in nonpregnant patients.

Naegele's rule

Estimated due date equals the first day of the last menstrual period plus 280 days, or subtract 3 months, add 7 days, and add 1 year.

Rh immune globulin timing

Unsensitized Rh-negative patients receive RhD immune globulin at 28 weeks and within 72 hours of delivery of an Rh-positive infant, and after abortion, ectopic pregnancy, or invasive procedures.

Preeclampsia severe features

Blood pressure 160/110 mm Hg or higher, platelets below 100,000, transaminases over twice normal, creatinine above 1.1 mg/dL, pulmonary edema, or new cerebral or visual symptoms.

Group B strep prophylaxis

All pregnant patients are screened at 36 0/7 to 37 6/7 weeks; colonized patients receive intrapartum penicillin G, with cefazolin or clindamycin (susceptibility-confirmed) for penicillin allergy.

Menopause clinical diagnosis

Menopause is diagnosed after 12 consecutive months of amenorrhea in a patient over 45; follicle-stimulating hormone testing is unnecessary when symptoms and history are typical.

Progestogen with systemic estrogen

Any patient with a uterus receiving systemic estrogen must also receive a progestogen to prevent endometrial hyperplasia and carcinoma; estrogen alone is appropriate only after hysterectomy.

Hormone therapy contraindications

Unexplained vaginal bleeding, known or suspected breast cancer, active venous thromboembolism, coronary heart disease, stroke, and active liver disease contraindicate systemic hormone therapy.

Nonhormonal hot flash therapy

SSRIs and SNRIs, gabapentin, the neurokinin-3 antagonist fezolinetant, cognitive behavioral therapy, and clinical hypnosis all reduce vasomotor symptoms in patients who cannot use hormone therapy.

Sertraline in pregnancy

Sertraline is often preferred for depression during pregnancy and lactation because of extensive safety data and low milk transfer; untreated maternal depression carries substantial independent risk.

Asymptomatic bacteriuria in pregnancy

All pregnant patients are screened early in pregnancy and positive cultures are treated with a short susceptibility-guided course, because untreated bacteriuria increases pyelonephritis and preterm birth risk.

Migraine with aura contraception

Combined hormonal contraceptives are contraindicated in migraine with aura because of elevated ischemic stroke risk; progestin-only or nonhormonal methods are the preferred alternatives.

Preconception hemoglobin A1c goal

A hemoglobin A1c below 6.5% before conception lowers the risk of congenital anomalies; the preconception visit should also address folic acid and a medication review.

Informed consent elements

Valid consent requires discussion of the diagnosis, nature of the proposed intervention, material risks and benefits, reasonable alternatives including no treatment, and consequences of declining.

Teach-back method

The clinician asks the patient to restate the information in her own words to confirm understanding; this reveals gaps more reliably than asking whether she has questions.

Title X confidentiality

Title X-funded family planning services must be provided confidentially, including to adolescents; clinicians should explain relevant state consent and reporting rules before care is delivered.

Mandatory reporting duties

Clinicians must report suspected child abuse, elder or dependent adult abuse, and specified communicable diseases to designated agencies, following state statutes that define thresholds and timelines.