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PCM II > Reproduction > Flashcards

Reproduction Flashcards

1
Q

At what breast stage does menarche typically begin?

A

3-4

*breast development and pubic hair occur 8-13

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2
Q

At what stages do men develop pubic hair?

A

stage 4 and 5

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3
Q

OB/GYN History includes…

A
  1. first menarche, duration, flow, cycle length, LMP
  2. Breast history
  3. Previous GYN surgery
  4. history of infertility
  5. Last pap smear
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4
Q

What is gravid? para

A
  1. number of pregnancies

2. number of viable births/offspring

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5
Q

What is TPAL?

A
  • T – Term deliveries >37 wks gestation
  • P – Preterm delivery 20 to <37 wks gestation
  • A – Abortion <20wks gestation
  • L – Live delivery regardless of gestational age
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6
Q

What is included in a Well Woman Exam?

A
  1. Pap smear (women 21-65)

2. Mammogram (50+ or earlier with high risk)

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7
Q

How often should a woman get a pap smear?

A
  • Yearly for women with abnormal pap smear
  • Every 3 years for women with consecutively normal pap smears
  • Every 5 years with women with consecutively normal pap smear with negative HPV testing
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8
Q

What is a pap smear?

A
  • Papanicolaou (Pap) test (cytology) to help screen for cervical cancer
  • Sample taken of the cervix (ectocervix) and the cervical canal (endocervix) during a speculum exam
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9
Q

Where should you get a sample during the pap smear?

A

ectocervix, endocervix, the transitional zone and squamocolumnar junction (SCJ)

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10
Q

Is cervical cancer hereditary?

A

Nope - 99% caused by high risk HPV strains

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11
Q

Where do we typically find cancer cells in the cervix?

A

transitional zone

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12
Q

What does a pelvic exam include?

A

Pelvic exam
– Examines the internal and external genitalia
• Visual inspection
• Bimanual exam
– Check for cervical motion tenderness (pain with bimanual exam)
– Obtain swabs for gonorrhea, chlamydia and wet prep for yeast, trichomonas or bacterial
vaginosis

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13
Q

What does an ectopic pregnancy present with?

A
  • abdominal or pelvic pain with vaginal bleeding
  • may have other pregnancy related symptoms

*start with a pregnancy test, speculum exam, and then determine if its ectopic

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14
Q

If a woman comes in with pelvic pain and is under 55, what should you begin with?

A

pregnancy test

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15
Q

How does a UTI present?

A
  • dysuria, urinary frequency, urinary urgency, suprapubic pain
  • may have hematuria

*perform abdominal exam, Lloyd’s punch

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16
Q

What does a well male exam include?

A

•Prostate exam and testicular exam is not recommended routinely.
•Prostate Specific Antigen (PSA) is not recommended routinely.
– PSA may be indicated for patient with family history of prostate cancer
•These exams or lab are performed based on patient signs and symptoms from history

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17
Q

What population is more at risk of testicular cancer?

A

younger men

18
Q

What is the classical presentation of an inguinal hernia?

A

– Pain with increased intra-abdominal pressure (heavy lifting, straining or prolonger standing
– May have palpable bulge affected side

19
Q

What conditions are considered STI?

A
  • Chlamydia (bacterial)
  • Gonorrhea (bacterial)
  • Herpes simplex 2 (viral)
  • Human papilloma vius (HPV) (viral)
  • Syphilis (bacterial)
  • Trichomoniasis (protozoa)
  • Hepatitis B and C (viral)
  • HIV/AIDS (viral)
20
Q

Gonorrhea -

Presentation

A
  1. – Men: penile discharge and dysuria or can be asymptomatic
    – Female: pelvic pain or mucopurulent vaginal discharge
21
Q

What are the 5 Ps?

A

Partners, Practices, Prevention of Pregnancy, Protection from STIs/HIV, Past history of STI

22
Q

Gonorrhea -

Complication

A

– Pelvic inflammatory disease (PID) if untreated

– Scarring of the fallopian tube may occur if the infection is left untreated, which can lead to infertility.

23
Q

Gonorrhea - Work up

A

– Nucleic acid amplification tests (NAATs) on endocervical, urethral, vaginal, pharyngeal, rectal, or urine
samples

24
Q

Gonorrhea - Management/Tx

A

– Antibiotics
– Usually will also treat for Chlamydia infection if patient has Gonorrhea as Chlamydia is often an asymptomatic co-infection
– Counseling patient to make sure to contact partner and have them also get treatment
– Counseling safe sex practices i.e. condom use

25
Q

Chlamydia - classic presentation

A

– Men: penile discharge, pruritus, dysuria

– Female: vaginal discharge, vaginal bleeding or pain during intercourse (dyspareunia), dysuria

26
Q

Chlamydia - complication

A

– Pelvic inflammatory disease (PID) if untreated

– Fertility issues due to scarring of the fallopian tube if left untreated

27
Q

Chlamydia - management/tx

A

– Antibiotics i.e. azithromycin or doxycycline
– Counseling patient to make sure to contact partner and have them also get treatment
– Behavioral counseling safe sex practices i.e. condom use

28
Q

Syphilis - presentation

A

– Primary – chancre
– Secondary - joint pains, fatigue, lymphadenopathy, mucopapular rash
– Latent phase – may be asymptomatic
– Tertiary – neurosyphilis (confusion, headache, stiff neck, vision loss)

29
Q

Syphilis - complication

A

progression to neurosyphilis

30
Q

Syphilis - tx

A

antibiotic (penicillin)

31
Q

Genital Herpes - presentation

A

– Single or clusters of vesicles on the genitalia

– May have burning, tingling and pain prior to vesicle appearance

32
Q

Genital herpes - complication

A

– meningitis, PID, Hepatitis, increase risk of HIV infection (possible due to the open sores)

33
Q

Genital Herpes - management/tx

A

antiviral (acyclovir)

34
Q

Syphilis - work up

A

serologic testing, antibody detection testing, microscopy etc (nontrepomenal test and treponemal test)

35
Q

Trichomonasis (protozoa) - classical presentation

A

– Men: most men are asymptomatic but small percentage may have penile discharge
– Female: foul smelling thin or purulent vaginal discharge, vaginal pruritus, dysuria

36
Q

Trichomonasis (protozoa) - work up

A

– Wet mount (sample on slide seen under microscope) or Nucleic acid amplification tests
(NAATs) on vaginal fluid or penile fluid

37
Q

Trichomonasis (protozoa) - management/tx

A

– Antiprotozoal medication like metronidazole

38
Q

HPV - presentation

A

– Genital warts (papules, cauliflower-like lesions or flat)

39
Q

HPV - complication

A

– Most lesions are self limited
– high risk strains can lead to cancer of the oropharyngeal region or lower genital tract (cervix, penile, or
anorectal)

40
Q

HPV - work up

A

– Routine pap smear, intervene if there are any cervical changes
– May test for HPV during routine pap smear

41
Q

HPV - Management/tx

A

– Prevention by vaccinating
– Routine pap smear for surveillance
– Genital wart removal

PCM II (15 decks)

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