Gynecologic Flashcards
What tanner stage for women? Areola and nipple project as secondary mound
stage 4
What tanner stage for women? Preadolescent breasts
stage 1
What tanner stage for women? Breast enlargement without separate nipple contour
stage 3
What tanner stage for women? Breast buds with areolar enlargement
stage 2
What tanner stage for women? Areola recedes, nipple retracts
stage 5
Example of primary amenorrhea
Absence of menarche by age 16
Primary or secondary? Cessation of menstrual flow after the establishment of normal menstrual cycling
secondary
Absence of menarche, absence of secondary sex characteristics, abnormal growth and development
primary amenorrhea
Diagnosis test for amenorrhea
pregnancy test, refer to endocrinologist/obgyn, referral for other studies
Risk factors for cervical cancer
HPC (early, multiple sexual partners), male partner who has had multiple sexual partners, cigarette smoking, NOT HEREDITARY
BETHESDA classification system
- ASCUS
- Low-grade squamous intraepithelial lesion (LSIL or LGSIL)
a. Cervical intraepithelial neoplasia (CIN 1): HPV or mild dysplasia - High-grade squamous intraepithelial lesions (HSILor HGSIL)
a. CIN 2: moderate dysplasia
b. CIN 3: Severe dysplasia - Carcinoma in situ (CIS)
- Squamous cell carcinoma
Management if pap result is: infection
treatment based on causative agent; repeat PAP 3-4 months after treatment
Management of ASCUS
“watch and repeat”
HPV test, repeat PAP smear
Management of LSIL and up
Colposcopy. Refer if CIN 2,3, or CIS
Top Killers of adults in the US
- Heart disease
- Cancer
- Unintentional injury
- low respiratory disease
- CVA
Cancer in women: responsible for the highest mortality?
Lung
Cancer in women: leading GYN-associated cancer “killer”
Ovarian
Cancer in women: highest incidence other than skin cancer?
Breast
Cancer in men: highest mortality?
Lung
2nd most common cancer in men and #2 cancer killer?
Prostate
Men and women leading cancer killer?
Lung
Second leading cancer killer for men and women?
Colorectal
when do we stop screening for cervical cancer?
> 65 years (for patients with adequate negative prior screening and no history of CIN2 or higher within the last 25 years)
How often do we screen cytology for cervical cancer age 21-29?
cytology alone every 3 years. HPV test every 5 years preferred
Patients aged 30-65 years, how often can we do co-testing?
Q5 years is acceptable
Inflammation or infection of the vulva and vagina most commonly caused by bacteria, protozoa, and/or fungi
vulvovaginitis
Symptom of trichomoniasis in men:
often asymptomatic;
malodorous, frothy yellowish-green discharge
what infection? Strawberry patches on cervix and vagina
Trichomoniasis
What infection? watery, gra, “fishy” smelling discharge
Bacterial vaginosis
What infection? Frothy yellowish-green discharge, pruritus
Trichomoniasis