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Flashcards in Female GU Deck (26):
1

Bartholin glad

secretes mucous into introitus during sexual excitement

2

What if Bartholin or skene gland inflammed?

think gonorrhea

3

Cervial OS nulliparous or multiparous

nulliparous- dot or slit
multiparous- smiles

4

Cervical ectopy

1. appear reddish-pink, raw looking area
2. benign

5

Dyspareunia

1. pain with sex

6

Menstrual cycle days 1-4

1. Ovary- estrogen levels rise
2. Uterus- progesterone stimulates endometrial prostaglandins that cause vasoconstriction and shedding of endometrium
3. CNS hormones- FSH and LH down
4. Symptoms- menstrual bleeding

7

Postmenstrual preovulatory days 5-7

1. Ovary- egg development within follicle
2. Uterus- proliferative phase where uterine lining thickens
3. CNS hormoes- FSH stimulates follicular growth

8

Ovulation

1. occurs day 13 or 14
2. ovary- egg drawn into fallopian tube and fertilization may occur
3. Uterus- end proliferative phase and progesterone causes uterine wall to thicken
4. CNS hormones- LH and estrogen increase and surge in LH causes release of egg
5. symptoms- cervical mucous increases and is stringy and elastic

9

Menstrual cycle days 15-20

1. secretory phase
2. ovary- egg moved into uterus
3. uters- progesterone increases
4. CNS hormones- LH and FSH decrease

10

Menstrual cycle days 21-28

1. luteal phase
2. ovary- if no implantation, progesterone decrease and estrogen decreases and then rises as new follicle develops
3. uterus- menstruation starts around day 28 and menstruation begins 1st fday of next cycle
4. CNS hormones- GnRH increases and causes FSH secretion

11

When does ovulation stop?

1-2 years before menopause

12

When do periods stop?

40-55 yrs

13

What is menopause?

1 year without menses

14

Post-menopausal bleed

1.worrisome
2. think CA

15

Cervical CA risk factors

1. Age- increases late teens to 30,
2. average age 50-55, s/p 55 less likely
3. hx cervical dysplasia
4. early age at first intercourse
5. multiple partners or partner with multiple partners
6. HIV
7. smoking

16

Ovarian CA risk factors

1. age 40-60
2. fertility drugs
3. early menarche (before 12)
4. late menopause (s/p 50)
5. infertility or first child s/p 30
6. hx breast CA
7. family hx
8. HRT

17

Endometrial CA risk factors

1. post-menopausal
2. early menarche
3. late menopause
4. tamoxifen

18

What does cervical motion tenderness suggest?

Pelvic inflammatory disease

19

What do you do if you can palpate an ovary?

get US for cervical CA

20

Red flags for sexual abuse

1. evidence of general abuse or neglect
2. genital, anal, or perianal trauma/scarring
3. unusual genital/anal pigmentation
4. STD
5. genitourinary rashes, sores, pain, bleeding, dysuria, hematuria, UTI
6. behavorial manifestation

21

What are behavorial manifestations of sexual abuse?

1. sexually provocative mannerisms
2. problems with school
3. dramatic weight change
4. depression
5. sleep problems or nightmares

22

When do pelvic exams begin?

1. age 21 or 2 yrs s/p 1st sex

23

How often do women 21-30 need to have pelvic exam?

1. every 2 yrs

24

How often do women 30 and older need pelvic exam?

1. those with 3 negative cervical cytology results every 3 yrs

25

What are early signs of pregnancy?

Goodell- softening of cervix
Hegar- softening of uterine isthmus
Chadwick- bluish color of cervix, vagina, vulva

26

Know ACOG recommendations

see paper