Reproductive Complaint Flashcards
(32 cards)
What is one of the first signs of puberty in females?
Elevation of the nipple
when does menarche start in regards to breast maturation?
Stage 3 or 4
What age do breast development and pubic hair occur?
8-13
Pubic hair and size of male genitalia start growth from ages ____.
9-13.5
What is taken in a thorough OB/GYN history?
- Menstrual history
- Gynecologic history: brest history, mammogram, surgeries,infertility, pap
- Gravida and Para
- TPAL
- Mode of delivery
- Gestational age
- Maternal complications and fetal complications
- Delivery/Operative complications
- Contraceptive/Sexual history
What does this mean: G5P3114
- 5 pregnancies
- 3 term deliveries
- 1 live delivery preterm
- 1 spontaneous abortion at 12 wks
- 4 live delivery at 35 weeks
P is split up into TPAL
- Term delilvery
- Preterm
- Abortion
- Live delivery
What is a well woman exam?
- Pap smear for sexually active women 21-65
- yearly for women with abnormal pap
- Every 3 years with normal pap
- Every 5 with normal pap and negative HPV
- Mammogram at 50 or earlier for women at risk
Where do you get a cervical sample from for a pap?
- Endo and ecto cervix
- Transitional zone
- area btw original SCJ and new SCJ
- Squamocolumnar junction
What is the difference btw a pelvic exam and a pap smear?
Pelvic exam:
- visual inspection
- Bimanual exam: insert index and middle finger into vagina lifting up and using other hand to push down to exam vagina uterus and ovary
- Check for cervical motion and tenderness
- Obtain swabs for infections
Pap smear:
- obtains samples of cervix to look for cervical cell transformation
How does ectopic pregnancy present?
- Abdominal or pelvic pain with vaginal bleeding
- Could have other pregnancy symptoms, nausea breast tenderness etc
How do you workup suspected ectopic pregnancy test?
- pregnancy test
- speculum exam
- transvaginal US
How does UTI present and whats most common cause
- Dysuria, urinary freuency and urgency, suprapubic pain
- Hematuria possible
- E. Coli most common cause
What would be some PE findings for a UTI and the workup and treatement?
- Perform abdominal exam
- Check CVA tenderness Lloyd’s punch
- Urinalysis
- Antibiotics
What is a well male exam?
- Prostate and testicular exam and PSA is NOT recommended routinely
- PSA recommended with Fhx
Male genital exam?
- Inspection of scrotum, shaft, glans, and inguinal region
- Palpate penile shaft and scrotum with thumb and first two fingers
- Retract foreskin
- Palpate inguinal region exam for hernias
- Examine prostate by DRE
- Testicular cancer most common in younger males, important for them to perform self exam
How would inguinal hernia present and what would PE look like? workup?
- Pain with increased intraab pressure
- May have palpable buldge
- Invaginating scrotal skin with index finger into inguinal canal and have patient cough, may help feel hernial
- US
Direct hernia?
- above inguinal ligament close to the pubic tubercle doesn’t go to scrotal area
- Less common than indirect, usually men >40 yrs, rare in women
Indirect hernia?
- Most common, affects all ages and both sexes, often in kids
- above inguinal ligament near midpoint
- Often goes into scrotum
what are the 5 P’s?
- Partners
- Practices
- Prevent pregnancy
- Protection STI and HIV
- Past STI hx
How do you detect STI’s?
- Microscopy
- Wet mount
- Nucleic acid amplification testing
- Serologic testing
What are complications of untreated STI’s?
- PID
- upper Genital tract infections
- Infertility
- Chronic pelvic pain
- Cervical cancer (HPV)
- Chronic infections with herpes, hep, and HIV
How does Gonorrhea present?
Males:
- Penile discharge or asymptomatic
Females:
- Pelvic pain, mucopurulent vaginal discharge
Can cause infection of urogenital, anorectal, or pharyngeal infections
Complications of gonorrhea?
- PID if untreated
- Scarring of fallopian tube
Chlamydia presentation?
gram negative bacteria, chalymdia trachomatis
- Men present with penile discharge,puritus,dysuria
- Women present with vaginal discharge, bleeding, or pain with intercourse, dysuria
- Can cause infection of urogenital, anorectal, conjunctival (neonates), or pharyngeal infections
