PEDIATRIC AND ADOLESCENT GYNE (AB) Flashcards
(106 cards)
What are the key components of a complete and age-appropriate gynecologic examination in a pediatric patient?
“History taking. general pediatric assessment. external genital examination. Tanner staging and sometimes pelvic examination.”
What are the normal gynecologic findings in pediatric patients?
“Thin. non-elastic hymen. neutral to slightly alkaline vaginal secretions and a narrower. thinner vaginal canal.”
Why are prepubertal children more vulnerable to vulvovaginitis?
“They have a thinner vaginal epithelium. a neutral pH and lack protective estrogenized secretions.”
What are the common causes of vaginal bleeding in children?
“Foreign bodies. trauma. vulvovaginitis. precocious puberty and sexual abuse.”
How should adhesive vulvitis be managed?
“Topical estrogen cream. petroleum jelly and good hygiene practices.”
What are the common causes of genital trauma in pediatric patients?
“Accidental injuries. straddle injuries. sexual abuse and self-inserted foreign bodies.”
What are the characteristics of pediatric ovarian masses?
“Most are benign. commonly functional cysts or benign tumors but some may be malignant and require surgical intervention.”
What anatomical differences exist between a prepubertal female and an adult female?
“Prepubertal females have a thinner. less elastic vaginal canal. non-estrogenized hymen and a neutral vaginal pH.”
What are some key considerations when evaluating gynecologic problems in children?
“Gaining trust. establishing rapport. ensuring a gentle exam pace and avoiding unnecessary instrumentation.”
What are the common gynecologic conditions seen in pediatric patients?
“Vulvovaginitis. labial adhesions. vulvar lesions. genital trauma and suspicion of sexual abuse.”
What should be done before conducting a gynecologic examination on a child?
“Explain the procedure. ensure a comfortable environment and have a female assistant present if the examiner is male.”
What is the recommended approach for history-taking in pediatric gynecology?
“Begin with non-threatening questions. obtain most information from caregivers and use child-friendly language.”
Why is establishing rapport with a pediatric patient important during a gynecologic exam?
“Poor interaction during the first visit may lead to anxiety and reluctance in future medical encounters.”
What is the significance of Tanner staging in pediatric gynecology?
“It helps assess pubertal development by evaluating breast and pubic hair growth.”
What is the purpose of inspecting the external genitalia in a pediatric patient?
“To diagnose common pediatric gynecologic conditions such as vulvovaginitis. labial adhesions and foreign bodies.”
What technique can be used to visualize the introitus in a pediatric patient?
“Downward and outward pressure on the labia majora or asking the child to blow to increase abdominal pressure.”
What is the preferred position for a pediatric gynecologic examination?
“Sitting on the mother’s lap is the most comfortable and acceptable position.”
What are the normal hymenal variations in prepubertal girls?
“Fimbriated. circumferential/annular and posterior rim hymens.”
Why should speculums be avoided in prepubertal girls?
“Even the smallest speculum size can be painful and frightening.”
What are the characteristics of vaginal secretions in prepubertal girls compared to adult women?
“Neutral to slightly alkaline pH whereas adult vaginal secretions are more acidic.”
What is vaginoscopy and when is it indicated?
“It is the insertion of an instrument to visualize the vaginal canal and cervix. usually requiring sedation in prepubertal girls.”
What should never be done during a vaginal examination in a pediatric patient?
“Forcing an examination or using restraints. as it is traumatic and inappropriate.”
How does puberty affect the vaginal canal?
“It becomes wider. more elongated and more distensible due to estrogen influence.”
What approach should be taken when performing a speculum exam on an adolescent female?
“Use the appropriate size speculum and allow the patient to see and touch the instruments to demystify the procedure.”
