Clinical Flashcards
(43 cards)
TQ # of times pt's been preg (twins only counts as 1)
Gravidity
TQ # of pregs that led to birth at or beyond 20 wks OR weighing >500g
Parity
TQ
Baby born at term? (wks)
37-42 wks
TQ
Baby born preterm? (wks)
20-36 wks and 6 days
TQ
All pregnancy losses before 20 wks is defined as?
Abortion
- Spontaneous Abortion (aka miscarriage)
- Elected Abortion
How many living kids mom has is defined as?
Living
TQ
GPTPAL stands for…
Gravidity; Parity; Term; Preterm; Abortion; Living.
TQ
G and Ps?
1) Preg w/ triplets; all delivered pre-term
2) Delivered 39wk male; 2 spont abortions; one living child
3) 1 living child; birth to twins @ 30wks (1 stillborn); had 2 abortions
4) 3 deliveries @ 37, 39, 32 wks; 1 ectopic
1) G1P0103
2) G3P1021
3) G3P0121
4) G4P2113
TQ
What is Naegeles Rule?
Apply it…
ex: if LMP- 7/20/2012
EDC?
EDC of 4/27/2013
Due date!
Pt knows when LMP was… to get due date:
Subtract 3 mo, add 7 days
Abnormal vaginal bleeding:
- post-coital?
- post-meno?
- Clots?
Dx..
Post-coital=cervical ca
Post-meno=endometrial/uterine ca
Heavy bleeding/clots=structural abnormality (fibroids)
Pt reports pain w/ sex…think endometriosis
TQ
When do we give breast exams?
Every 1-3 yrs for women 20-39 yo.
Every yr w/ annual mammograms for F >40yo.
Inverted nipples concerning for ca
Menstrual info:
- Menarche usually b/t what ages?
- Cycles: 28days +/- 7 (21-35). -Days of Menses: 5-7.
12-13 yo
When does the ACOG recommend having your first visit to OB/GYN for screening?
13-15 yo
13-18 yo F presents in clinic.
Key info needed during hx?
PE: : 2ndary sex charc, pelvic exam for vag d/c, menstrual disorder, pelvic pain, STIs, abd exam, periodic STI check, HIV
Key eval and counseling for this age group?
Immunizations?
Hx: Menarche? FMH? Tobacco, alcohol, Drugs? Sexual abuse/practices?
Eval & Counseling: STI prevention-barrier protection; sex abuse; bullying, tobacco, alcohol, drugs
Immunizations:
- HPV Vaccine-(b/t ages 9-26) quadrivalent for HPV 6,11,16,18.
- Diptheria & dTAP vaccine (once b/t 11-18 yo)
- Also: Hep B. Flu. MMR. Varicella.
19-39 yo F presents in clinic.
Key info needed during hx?
When do you start giving breast exams? Paps?
Labs/tests?
Key eval and counseling?
Immunizations?
Hx: FMH? smoke, drink drugs? Sex practices- vag, anal, oral?
Breast exam every 1-3yrs @20 yo.. (first pap @21 yo)
Labs/tests:
Cervical Cytology (test)-
21-39yo: every 3 yrs w/ cytology alone;
@ >30yo screen every 3 yrs w/ cytology alone + co-test w/ cytology & HPV testing every 5 yrs.
HIV!
G&C (25 yo and under).
Eval & Counseling:
- Repro health plan
- preconception & genetic counseling
- STD prevention
- partner violence
- rape prevention
- breast self-awareness
- smoke, drink, drugs.
Immunizations:
- Diptheria & dTAP.
- HPV.
TQ
40-64 yo F presents in clinic.
Key info needed during hx?
Breast exam frequency?
TQ
Labs/tests? (hint colon, mammo)
Key eval and counseling?
Immunizations? (what additional vaccine)
Hx: Menopausal sx, pelvic prolapse, FMH, tobacco, alcohol, drugs
PE: Begin annual breast exam.
Labs/tests:
-Cervical Cytology: every 3 yrs cytology alone + co-test w/ cytology & HPV testing every 5yrs.
-Colorectal cancer screening every 10 yrs:
African Americans @45yo, everyone else starts @50yo.
-HIV
-Lipid profile every 5 yrs @45yo
-Mammography yearly after 40yo.
-Diabetes: every 3yrs @45yo
Eval/Counsel:
- genetic counseling
- sexually transmitted dz prevention
- partner violence, advanced directives
- Tobacco, alcohol drugs
- +Breast self-awareness.
Immunizations:
- Tdap boosters every 10 yrs
- **Varicella Zoster for >60yo.
TQ
>65 yo F presents in clinic.
Key info needed during hx?
Breast exam frequency?
TQ
Labs/tests? (hint discontinue….)
Key eval and counseling?
Immunizations? (what additional vaccine)
Hx: Menopausal symp?Pelvic prolapse? FMH? Tobacco, drink, drugs?
PE: annual breast exam
Labs/tests:
- Can stop cervical cytology if no hx (neg. 3 yrs or 2yrs + co-test)…otherwise 20 yrs
- Colorectal screening every 10 years if>50yo unless African American (45yo)
- **-Bone Mineral Density Screening: no risk factors then every 2yrs.
- Lipid profile: every 5 yrs @45yo.
- Yearly mammography
Eval: Sexual fxn., STI, partner violence, advanced directives, brest-awareness, etc
Immuno:
+ Pneumococcal Vaccine for >65yo.
TQ
High risk factors for ALL ages require what earlier screening…
<127lbs, history of fractures, smoker, alcoholic, RA.
Bone Mineral Density
TQ
High risk factors for ALL ages require what earlier screening…
<40 yo if history of breast ca, family history of ca, + BRCA mut, hi-risk biopsy results.
Mammography
TQ
High risk factors for ALL ages require what earlier screening…
<45yo if history or family history of CAD, AAA, PAD, Obesity, DM, PVD, Hyperlipidemia, premature CV dz.
Lipid Profile
TQ
High risk factors for ALL ages require what earlier screening…
History or family history of colorectal ca, polyps, IBD.
Colorectal
TQ
High risk factors for ALL ages require what earlier screening…
25, 1st degree relative w/ DM, hi-risk race (Native American, Latino), gestational DM, PCOS.
Diabetes
TQ
High risk factors for ALL ages require what earlier screening…
<50yo if family history of thyroid dz
Thyroid
TQ
High risk factors for ALL ages require what earlier screening…
History of multiple sex partners/infxs, sexual contact with STI partner, sexually active adolescents
STI
