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Clinical Assess 3 > Female > Flashcards

Flashcards in Female Deck (80):
1

Menarche=age of onset is usually

9-13

2

How often does the patient have menses?

21 to 35 days is normal

3

How long are the menses?

4 to 7 days is normal

4

To document menstrual history:

Age x Cycle frequency x duration.
Example: age 11, every 28 days, 5 day duration= 11 x 28 x 5

5

increased frequency of menses

polymenhorrhea

6

excessive amount of menses

menorrhagia

7

decrease frequency of menses

oligomenorrhea

8

interval between menses irregular

metrorrhagia

9

combination: irregular interval, excessive amount of menses

menometrorrhagia

10

absent menses

amenhorrhea

11

failure of menses to be initiated

Primary amenhorrhea

12

cessation of menses have it had previously existed

Secondary amenhorrhea

13

painful periods with cramping or aching in the lower pelvis/lower back

dysmenorrhea

14

Complex of symptoms occuring 4 to 5 days before onset. Psychological and physical (tension, irritability, depression, mood swings, weight gain, bloating, edema, headaches, breast tenderness)

Premenstrual syndrome (PMS)

15

Pregnancy history documentation

G#P(TPAL)
G#=total # pregnancies
P=# deliveries
T=full term deliveries >37 wks
P=premature deliveries <20-37 weeks
A=abortion/miscarriage
L=living children

16

Total number of pregnancies

gravity

17

Number of deliveries

parity

18

full term deliveries

>37 wks

19

premature deliveries

<20-37 weeks

20

Document:
-5 living children
-4 children delivered full term
-emergency surgery at 8 months
-2 abortions

G_P_ _ _ _

G7 P4125

21

pain with sex

dyspareunia

22

what causes menopause?

decline in ovarian production of estrogen

23

Average age of menopause

51 years

24

Women on contraception. Ask about?

ACHES
Abdominal pain
Chest pain
Headaches
Eye problems
Sudden leg or calf pain

25

abdominal pain-from IUD

dyspareunia

26

IUD came out

expulsion

27

5 P's model of sexual history

Partners
Prevention of pregnancy
Protection from STIs
Practices
Past history of STIs

28

Sequence of female exam

1) Inspect
2) Speculum
3) bimanual
4) rectovaginal
5) rectal

29

Blood supply for female genitalia

internal iliac artery

30

all structures visible externally from pubis to perineum

vulva

31

fat pad located over pubic bone

mons pubis

32

hair-covered folds of tissue that protect inner genitalia

labia majora

33

protects opening of vagina and urethra

labia minora

34

erectile tissue to provide sexual pleasure

clitoris

35

thin membrane that partially surrounds the opening of the vagina

hymen

36

clitoral hood, provides protection

prepuce

37

location of bartholin glands

4 and 8 o'clock

38

Skene's glands

function debatable; apply pressure on anterior vaginal wall

39

Before speculum exam... instructions for patient

NOTHING for 1 to 2 days (48-72 hours)
empty bladder before exam

40

What position is the speculum exam performed in?

lithotomy

41

Speculum is a _____ procedure, not a _____ procedure

clean, not sterile

42

Speculum insertion steps

1) insert index finger
2) locate the cervix
3) insert speculum at slight angle downward, slowly remove finger
4) apply posterior pressure to open/patient should inhale
5) slowly open, catch cervix in between blades and lock in place

43

elastic muscular tube extending upward; connects cervix to vulva

vagina
8-10 cm in length

44

consists of fibrous tissue and small amount of smooth muscle; makes up lower 1/3 of uterus

cervix

45

ectocervix

squamous epithelium

46

endocervical canal

columnar epithelium

47

blood supply of cervix

uterine artery
3 and 9 oclock

48

Cervical contains and external orifice and internal orifice. what is visible on exam?

external os

49

folds lining the vagina; allows expansion during sex and childbirth

rugae

50

small, oval cervix

nulliparous

51

linear, irregular cervix

parous

52

Mucus trapping

nabothian cyst

53

soft, friable mass protruding from cervix external os; most common benign cervical lesion

polyps

54

Specimen collection of PAP

1) obtain from endocervix AND ectocervix
2) place broom in, rotate 360 degrees
3) MUST INCLUDE CELLS FROM ENDOCERVIX (common site for cancer)

If pregnant, use cotton tipped

55

Abnormal secretion

wet prep of saline and KOH

56

Removing the speculum

make sure blades are closed to avoid lacerations

57

bladder wall weakening

cystocele

58

rectal tear or defect cause bulging

rectocele

59

pelvic floor muscles and ligaments stretch and weaken causing uterus to descend into vagina

uterine prolapse

60

place two fingers inside labia and ask patient to bear down to see if vaginal walls bulge

check for prolapse

61

place 2 fingers against walls of vagina and have patient squeeze fingers

assess vaginal tone

62

Pain elecited during bimanual exam

chandelier sign

63

enlarged uterus causes

pregnancy, fibroids

64

adexal mass causes

ectopic pregnancy

65

ovarian mass causes

cysts

66

tenderness with bimanual exam causes

pelvic inflammatory disease (PID)
Endometriosis
Cystitis

67

Cervical cancer is primarily

>80% squamous cell carcinoma
>95% due to HPV

68

HPV types-cancer

16 and 18

69

HPV types-genital warts

6 and 11

70

Given to mothers to prevent miscarriage

diethylstilbestrol hormone (DES)

71

Cervical screening for women ages

21-65

72

Cytology guidelines

21-30 y

73

Cytology+HPV dna guidelines

30-65 y

74

Patient is <21: guideline?

do not screen

75

Patient is 21-30: guideline?

cytology every 3 years; no HPV

76

patient is 30-65: guideline?

cytology every 3 years OR cytology with HPV every 5 years

77

patient is >65 y: guideline?

do not screen

78

recommended vaccine for prevention of cervical, vulvar, vaginal, and anal, throat and penile cancers

Ages 9-26
Guardasil 9

79

recommended vaccine for prevention of precancerous lesions due to HPV

Ages 9-26
Guardasil HPV Quadrivalent

80

Speculum is ____ the bimanual exam

before