Reproductive

Question 1

How to evaluate female development stages?

Answer 1

Tanner Stages

Question 2

Tanner stage 1

Answer 2

< 10yrs,
preadolescent,
no hair

Question 3

Tanner stage 2

Answer 3

10-11 yrs,
small amount hair,
breast buds

Question 4

Tanner stage 3

Answer 4

11-13 yrs,

elevation of breast and areola, menses stage III - IV

Question 5

Tanner stage 4

Answer 5

13-14yrs,

adult like but no hair on thigh

Question 6

Tanner stage 5

Answer 6

> 14 yrs,
mature stage,
projection of nipple only,
hair extends to thighs

Question 7

Define menarche, menopause, and postmenopausal bleeding

Answer 7

menarche = 1st period
menopause = 12 months without a period; age 48 - 55yo
postmenopausal bleeding = bleeding after 12 months without a period. need a biopsy

Question 8

Define dysmenorrhea, LARC, PMS, Dyspareunia, and vaginismus

Answer 8

Dysmenorrhea = pain/cramps with period
Contraction LARC - long acting reversible contraception.. Periguard = copper that repels sperm, no hormones
PMS; for 3 consecutive cycles*
Dyspareunia = pain with sex
Vaginismus = vaginal pain in young girls with low estrogen

Question 9

STIs can cause…

Answer 9

Chlamydia can cause infertility

Men present with “UTI” symptoms, UTI is rare, think STI*

Question 10

Bartholin Glands

Answer 10

Located under the vagina above the anus
Job = Lubricate the vagina
Older women with low estrogen get dry
Infection = d/t e. Coli or gram - d/t proximity to rectum OR STI (chlamydia or gonorrhea)

Question 11

Cervix

Answer 11

“Donut” cerivcal epithelia and transformation zone
Opening to the uterus
Papsmears to eval for HPV
16 and 18 –> CANCER
6 and 11 –> WARTS
Vaccinate everyone, including gay men up to 45yrs old

Question 12

Epidermoid cyst

Answer 12

Benign in the epidermis

Question 13

Venereal wart

Answer 13

d/t HPV 6 and 11

Question 14

Syphillitic chancre

Answer 14

Painless

Question 15

Uterine prolapse

Answer 15

Uterus falls through

Question 16

Genital herpes

Answer 16

Painful in clusters, shallow vesicles

Question 17

Bartholin gland infection

Answer 17

d/t STI or e. Coli from rectum

Question 18

Condyloma acuminatum

Answer 18

Genital warts - HPV 6 and 11

Question 19

Clue Cells

Answer 19

= bacterial vaginosis

Saline wash, highly concentrated, STI.
Tx = flagyl
“Sniff test” after saline or potassium –> fishy smell

Question 20

Trichomonas (from wet mound reading)

Answer 20

with TAILS, move quick

not normal, STI that needs to be treated ASAP

Question 21

Yeast

Answer 21

Potassium wash to kill everything else, DOES NOT kill yeast

Question 22

Lactobacilli

Answer 22

normal

Question 23

Papsmear

Answer 23

Begin at 21 years old, does NOT have to be sexually active

Question 24

Breasts

Answer 24

are fibrotic before period, examine 5-7 days after period onset
Dense = estrogen
Palpate with pad of fingertip in circular, vertical strip, or wedge motion
FEEL UP INTO AXILLA FOR TAIL OF SPENCE
Young people need an ultrasound versus mammogram.

Question 25

If you squeeze the breast and milk comes out...

Answer 25

If milk comes out & not pregnant = prolactinoma Brain MRI immediately d/t pituitary tumor that is compressing Can lose lateral vision d/t tumor compression

Question 26

Breast Masses - fibroadenoma, cysts, cancer

Answer 26

Fibroadenoma = fluctuate, come and go Cysts = fluid filled, aspirate Cancer = no well defined, Retraction, Abnormal contours, Skin dimpling, Edema of skin

Question 27

Paget Disease

Answer 27

= nipple cancer

Question 28

Mammograms

Answer 28

@ 40 years old, yearly

Question 29

Male breasts

Answer 29

Male Breast: small nipple and areola, thin tissue 1% of breast CA Gynecomastia = hormonal, will go away mostly

Question 30

Testis

Answer 30

make sperm, nourishment

Question 31

epididymis

Answer 31

top of testicle, stores and matures sperm

Question 32

Vas Deferens

Answer 32

carry sperm up

Question 33

BPH

Answer 33

Benign prostatic hyperplasia - common older men, restricts the urethra --> dysuria, nocturia, dribble

Question 34

PHIMOSIS

Answer 34

“CANT SAY HI” | Cannot RETRACT

Question 35

PARAPHIMOSIS

Answer 35

Remains retracted, cannot pull forward | SURGICAL EMERGENCY

Question 36

Epidermoid cyst

Answer 36

benign

Question 37

Hypospadias

Answer 37

urethral opening on bottom

Question 38

Epispaidias:

Answer 38

urethral opening on TOP

Question 39

Scrotal edema =

Answer 39

d/t fluid or inflammation

Question 40

Hydrocele =

Answer 40

fluid filled mass, nontender

Question 41

Scrotal hernia

Answer 41

= indirect inguinal hernia that comes from external inguinal ring, *finger cannot get above the mass*

Question 42

Cryptorchidism:

Answer 42

testes fail to descend | atrophied testes and lays outside the scrotum

Question 43

Small testes =

Answer 43

<2cm, klinefelter syndrome

Question 44

Acute Orchitis =

Answer 44

inflamed testes | MUMPS

Question 45

Spermatocele:

Answer 45

painless fluid filled cyst in epididymis

Question 46

Varicocele:

Answer 46

“bag of worms” enlargement of veins within scrotum | Can cause infertility

Question 47

Torsion of spermatic cord:

Answer 47

MEDICAL EMERGENCY | Only 6 hours until testes die

Question 48

Prehns Sign:

Answer 48

test for testicular torsion - ++ pain = testicular torsion - no pain = epididymitis

Question 49

Indirect hernia

Answer 49

Indirect: most common Comes down inguinal canal Into scrotum have pt cough

Question 50

Direct hernia

Answer 50

above inguinal ligament next to external inguinal ring | Bulges anteriorly and pushes the side of the finger forward, common in men >40yrs

Question 51

External inguinal ring

Answer 51

- direct | Have them valsalva

Question 52

HPV wart causing strains

Answer 52

6 and 11 --> warts

Question 53

Herpes Simplex

Answer 53

d/t vesicles

Question 54

Chancre =

Answer 54

painless erosion, 2cm | d/t syphilis

Question 55

Chancroid =

Answer 55

red papule then becomes painfully deep ulceration | Caused by haemophilus ducryi, rare STI

Question 56

Testicular self exam:

Answer 56

- in mirror, one at a time, should be smooth | - ages 15- 35 cancer most common

Question 57

Prostate CA screening:

Answer 57

>50years old, digital rectal exam feel ANTERIORLY

Question 58

risk factors for testicular cancer

Answer 58

- cryptorchidism - mumps - inguinal hernia - hydrocele in childhood - family history and history of carcinoma in contralateral testicle

Question 59

cryptorchidism

Answer 59

= one or both testicles fail to descend from abdomen to scrotum