Pap Smear_Pelvic Relaxation

Question 1

HPV that cause cancer

Answer 1

16, 18, 31, 45

Question 2

What is the gold standard for Dx and Tx of HPV

Answer 2

Colposcopy with directed biopsy

Question 3

What are acetowhite changes

Answer 3

Large nuclei of abnormal cells (HPV) turn white when washed with acetic acid

Question 4

What are Tx options for HPV

Answer 4

Ablation

Excisional

Question 5

Sx’s = watery vaginal discharge, postcoital bleeding, and intermittent spotting in a 47 yo woman

Answer 5

Cervical carcinoma

Question 6

What population is the HPV vaccine recommended for

Answer 6

Girls/Boys 9-26

Question 7

Can the HPV vaccine be given during pregnancy and breastfeeding

Answer 7

Pregnancy –> No

Breastfeeding –> Yes

Question 8

At what age should HPV screening begin

Answer 8

30 yo

Question 9

At what age should pap smears begin and how often

Answer 9

21

Every 3 years

Question 10

What population of women don’t need a pap smear

Answer 10

Women > 65 or who have had a hysterectomy

Question 11

What screening should be done for women between 30-65 yo

Answer 11

Pap with HPV every 5 years OR

Pap alone every 3 years

Question 12

What is a cystocele

Answer 12

Anterior vaginal prolapse

Question 13

What is a rectocele

Answer 13

Posterior vaginal prolapse

Question 14

What is a urethrocele

Answer 14

Urethral prolapse (possible bladder prolapse)

Question 15

Sx’s = pelvic pressure/bulging, no urinary/bowel issues, normal menses, no dyspareunia

Answer 15

Cystocele

Question 16

Sx’s = pressure and fullness in vagina, no bladder issues, splints for BM, normal menses

Answer 16

Rectocele

Question 17

Sx’s = “something falling out,” doesn’t void completely, voids small amounts frequently, no dysuria/hematuria

Answer 17

Uterine prolapse

Question 18

Sx’s = urinary incontinence with coughing/sneezing/laughing, wears pads, no dysuria/hematuria, no bowel issues

Answer 18

Stress incontinence

Question 19

What PE test can be performed when stress incontinence is suspected?

Answer 19

Q tip test
Urodynamics test
Postvoid residual test

Question 20

Sx’s = months of urgency/frequency, rush to bathroom, no dysuria/hematuria, no bowel issues, drinks lots of caffeine, pees 3-4 times/night

Answer 20

Urge incontinence/Overactive bladder

Question 21

What are the Tx’s for a cystocele

Answer 21

Nothing
Pelvic floor PT
Pessary
Surgery

Question 22

What is the Tx for a rectocele

Answer 22

Surgery

Question 23

What are the Tx’s for a uterine prolapse

Answer 23

Pessary
Hysterectomy
Colpocleisis

Question 24

What are the Tx’s for a stress incontinence

Answer 24

Topical E
Pelvic floor PT
Pessary
Surgery

Question 25

What are the Tx’s for a urge incontinence/overactive bladder

Answer 25

Decrease caffeine
No fluids after 7pm
Bladder training
Oxybutynin, Tolterodine