PEM Source

Your source for all things Pediatric Emergency Medicine

All posts with tag: "gyn"

Tips and Tricks

You've probably heard... AAP Subcommittee on Febrile Infants came out with new guidelines. The algorithms have been posted on PEMsource algorithms page, and the fever table updated to reflect them.

Also, the CDC came out with new guidelines regarding STI treatment. The summary wall poster can be found on the PEMsource On Shift tab. Some highlights: higher dose of ceftriaxone recommended for uncomplicated gonococcal infections, doxycycline only is 1st line for chlamydial infection (azithromycin no longer 1st line), and sex-specific dosing for trichomoniasis treatment. Also recommended IV regimen to treat PID is ceftriaxone + doxycycline + metronidazole; clindamycin & gentamicin now an alternate regimen.

To remember the difference in antibiotic regimens for chlamydia cervicitis / urethritis vs pelvic inflammatory disease, rap this in your head: Ceph 10 x 50 for GC is nifty; give Zith 1 gram for the chlam, but doxy 14 days BID is needed for PID

PEM Questions

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[yop_poll id="195"]
(Click the link to comment and to vote - voting not working through email, sorry!) You are seeing a 13 year old girl with heavy prolonged menses x 10 days who appears pale to her parents. She had menarche at age 11, and has had heavy irregular menses since then. She actually feels that her menses is slowing down and she is currently using 1-2 pads per day. She has never had any other bleeding. Her HR is 90, and BP 100/50. Her hemoglobin is 9 and her MCV is 65. [yop_poll id="50"]
(Click the link to comment and to vote - voting not working through email, sorry!) A 13 year old girl presents with sudden onset sharp RLQ pain radiating toward her groin, along with nausea and vomiting once, non-bloody, non-bilious. [yop_poll id="40"]

Controversies

(Click the link to comment and to vote - voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other! [poll id="43"]

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