Test 3 Flashcards by Austin sides

menstrual cycle days 1 to 4

progesterone stimulates endometrium shedding, estrogen levels rise

How well did you know this?

Not at all

Perfectly

menstrual cycle days 5 to 12

uterine lining thickens, egg develops within follicle

How well did you know this?

Not at all

Perfectly

menstrual cycle days 13 to 14

egg is launched, brought into the fallopian tube

How well did you know this?

Not at all

Perfectly

what is spinnbarkeit mucus

stringy and elastic during menstration

How well did you know this?

Not at all

Perfectly

menstrual cycle days 15 to 20

egg is dropped into the uterus

How well did you know this?

Not at all

Perfectly

menstrual cycle days 21 to 28

day one of next cycle starts, progesterone drops and a new follicle develops

How well did you know this?

Not at all

Perfectly

cyclic pelvic pain is an indication of what disorder

endometriosis

How well did you know this?

Not at all

Perfectly

a bright red polypoid growth that protrudes from the urethral meatus

urethral caruncle

How well did you know this?

Not at all

Perfectly

a thin vertical slit or a large orifice with irregular edges

vaginal introitus

How well did you know this?

Not at all

Perfectly

were is the skenne gland how do you check it

around the urethra, put a finger in the vagina and press up and toward you on both sides of the urethra and directly on it, any discharge is an infection and normally gonococcal

How well did you know this?

Not at all

Perfectly

how do you check the bartholian gland

squeeze the labia with one finger in the vagina, down both sides

How well did you know this?

Not at all

Perfectly

what are small, white or yellow, raised, round areas on the cervix

nabothian cysts

How well did you know this?

Not at all

Perfectly

what is a cystocele

protrusion of the urinary bladder in to the vagina

How well did you know this?

Not at all

Perfectly

what is a rectocele

protrusion of the rectum into the vagina

How well did you know this?

Not at all

Perfectly

how do you check for an imperforate hymen

have them cough, it it bulges during it it is imperforate

How well did you know this?

Not at all

Perfectly

how big should a fundal height measure

1cm per week gestation

How well did you know this?

Not at all

Perfectly

when do you hear fetal heart beat

10-12 weeks with doppler

How well did you know this?

Not at all

Perfectly

what is goodell sign

softening of the cervix about week 5

How well did you know this?

Not at all

Perfectly

what is hegar sign

softening of the uterine isthmus about week 7

How well did you know this?

Not at all

Perfectly

what is mcdonald sign

fundus flexes easily on the cervix about week 7

How well did you know this?

Not at all

Perfectly

what is braun von fernwald sign

fullness and softening of the fundus near the site of implantation week 7

How well did you know this?

Not at all

Perfectly

what is piskacek sign

palpable lateral bulge or soft prominence of one uterine cornu about week 7

How well did you know this?

Not at all

Perfectly

what is chadwick sign

bluish color of the cervix vagina and vulva about week 9

How well did you know this?

Not at all

Perfectly

what is effacement

thinning of the cervix before labor

How well did you know this?

Not at all

Perfectly

what is a concerning count for fetal movement

less than 10 in 12 hours after 17 weeks

what are lepold maneuvers

locating the fetal position by four steps and ending with feeling the fetal head in line with the pelvis

how is station measured

centimeters from the ischial spine, inside is up to -5 and coming out it up to +5

what denotes infertility

no baby after 1 year of trying

what is endometriosis

growth of endometrial tissue outside the uterusfinding with laparoscopy, painful

what is condyloma acuminatum associated with

hpv infection it looks like genital warts

Viral infection of the skin and mucous membranes; considered a sexually transmitted infection in adults, in contrast to the common non–sexually transmitted infection occurring in young children Caused by a poxvirus, the virus enters the skin through small breaks of hair follicles ♦ Spreads through direct person-to-person contact and through contact with contaminated object ♦ Genital lesions are sexually transmitted ♦ Incubation period is from 2 to 7 weeks ♦ Painless lesions in genital area ♦ Sexually active ♦ White or flesh-colored, dome-shaped papules that are round or oval ♦ Surface has a characteristic central umbilication from which a thick creamy core can be expressed ♦ Lesions may last from several months to several years ♦ Diagnosis usually based on the clinical appearance of the lesions

MOLLUSCUM CONTAGIOSUM

Sexually transmitted infection caused by the bacterium Treponema pallidum ♦ Transmitted through direct contact with a syphilis sore ♦ Lesion of primary syphilis generally occur 2 weeks after exposure ♦ Chancre lasts 3 to 6 weeks, heals without treatment ♦ Often no lesion noted, as may be internal (Fig. 18-49) ♦ Painless genital ulcer ♦ Sexually active ♦ Solitary lesion; firm, round, small, painless ulcer ♦ Lesion has indurated borders with a clear base ♦ Scrapings from the ulcer, examined microscopically, show spirochetes

SYPHILITIC CHANCRE

Sexually transmitted infection caused by the bacterium T. pallidum ♦ Appear about 6 to 12 weeks after infection ♦ Healed solitary genital lesion ♦ Sexually active ♦ Flat, round, or oval papules covered by a gray exudate

CONDYLOMA LATUM Lesions of secondary syphilis

Most commonly caused by the herpes simplex virus 2 virus (HSV-2) ♦ Most transmission of HSV occurs when individuals shed virus in the absence of symptoms ♦ Painful lesions in genital area ♦ History of sexual contact ♦ May report burning or pain with urination ♦ Superficial vesicles in the genital area; internal or external (Figs. 18-51 and 18-52); may be eroded ♦ Initial infection is often extensive, whereas recurrent infection is usually confined to a small localized patch on the vulva, perineum, vagina, or cervix

GENITAL HERPES

Commonly, but not always, caused by Neisseria gonorrhea ♦ May be acute or chronic ♦ Pain and swelling in the groin ♦ Hot, red, tender, fluctuant swelling of the Bartholin gland that may drain pus (Fig. 18-53) ♦ Chronic inflammation results in a nontender cyst on the labium

INFLAMMATION OF BARTHOLIN GLAND

Squamous cell carcinoma begins in the epithelial lining of the vagina; may be caused by HPV; develops over a period of many years from precancerous changes called vaginal intraepithelial neoplasia (VAIN) ♦ Adenocarcinoma begins in the glandular tissue ♦ Malignant melanoma develops from pigment-producing cells called melanocytes ♦ Sarcomas form deep in the wall of the vagina, not on its surface epithelium ♦ Abnormal vaginal bleeding ♦ Difficult or painful urination ♦ Pain during sexual intercourse ♦ Pain in the pelvic area back or legs ♦ Edema in the legs ♦ Risk factor includes patient's mother having taken DES during pregnancy ♦ Vaginal discharge, lesions, and masses ♦ Melanoma tends to affect the lower or outer portion of the vagina ♦ Tumors vary greatly in size, color, and growth pattern ♦ Diagnosis is based on tissue biopsy

VAGINAL CARCINOMA Classified according to the type of tissue from which the cancer arises: squamous cell, adenocarcinoma, melanoma, and sarcoma

Increase in discharge Clear or mucoid discharge; pH < 4.5 Wet mount: up to 3 to 5 WBCs; epithelial cells

Physiologic vaginitis

No foul odor, itching or edema Foul-smelling discharge; complains of “fishy odor” Homogenous thin, white or gray discharge; pH

Bacterial vaginosis (Gardnerella vaginalis)

Pruritic discharge; itching of labia; itching may extend to thighs White, curdy discharge; pH 4.0 to 5.0; cervix may be red; may have erythema of perineum and thighs KOH prep: mycelia, budding, branching yeast, pseudohyphae

Candida vulvovaginitis (Candida albicans)

Watery discharge; foul odor; dysuria and dyspareunia with severe infection Profuse, frothy, greenish discharge; pH 5.0 to 6.6; red friable cervix with petechiae (“strawberry” cervix) (see Fig. 18-60) Wet mount: round or pear-shaped protozoa; motile “gyrating” flagella

Trichomoniasis (Trichomonas vaginalis)

Partner with STI; often asymptomatic or may have symptoms of PID Purulent discharge from cervix; Skene/Bartholin gland inflammation; cervix and vulva may be inflamed Gram stain Culture DNA probe

Gonorrhea (Neisseria gonorrhoeae)

Partner with nongonococcal urethritis; often asymptomatic; may complain of spotting after intercourse or urethritis ± Purulent discharge; cervix may or may not be red or friable DNA probe

Chlamydia (Chlamydia trachomatis)

Dyspareunia; vaginal dryness; perimenopausal or postmenopausal Pale, thin vaginal mucosa; pH < 4.5 Wet mount: folded, clumped epithelial cells

Atrophic vaginitis

New bubble bath, soap, douche, or other hygiene products Foul smell; erythema; pH < 4.5 Wet mount: WBCs

Allergic vaginitis

Red and swollen vulva; vaginal discharge; history of use of tampon, condom, or diaphragm Bloody or foul-smelling discharge Wet mount: WBCs

Foreign body

Result of weakening of the supporting structures of the pelvic floor, often occurring concurrently with a cystocele and rectocele ♦ Uterus becomes progressively retroverted and descends into the vaginal canal (Fig. 18-58) ♦ Sensation of pelvic heaviness and/or uterus falling out ♦ Tissue protruding from vagina ♦ May report urine leakage or urge incontinence, difficulty having a bowel, movement, or low back pain ♦ First-degree prolapse: the cervix remains within the vagina ♦ Second-degree prolapse: the cervix is at the introitus ♦ Third-degree prolapse: the cervix and vagina drop outside the introitus

UTERINE PROLAPSE Descent or herniation of the uterus into or beyond the vagina

Arise from the overgrowth of smooth muscle and connective tissue in the uterus ♦ May occur singly or in multiples and vary greatly in size ♦ Fibroid symptoms are related to the number of tumors, as well as to their size and location; symptoms may include the following: ♦Heavy menses ♦Abdominal cramping usually felt during menstruation ♦Urinary frequency, urgency, and/or incontinence from pressure on the bladder ♦Constipation, difficult defecation, or rectal pain from pressure on the colon ♦Abdominal cramping from pressure on the small bowel ♦Generalized pelvic and/or lower abdominal discomfort ♦ Firm, irregular nodules in the contour of the uterus on bimanual examination ♦ Uterus may be enlarged

MYOMAS (LEIOMYOMAS, FIBROIDS) Common, benign, uterine tumors

Occurs most often in postmenopausal women ♦ Nearly all endometrial cancers are cancers of the glandular cells found in the lining of the uterus; most known risk factors for endometrial cancer are linked to the balance between estrogen and progesterone in the body ♦ Women taking tamoxifen are at increased risk ♦ Postmenopausal vaginal bleeding—red flag for endometrial cancer ♦ None; diagnosed by endometrial biopsy

ENDOMETRIAL CARCINOMA

Follicle undergoes varying rates of maturation and cysts can occur as the result of hypothalamic-pituitary dysfunction or because of native anatomic defects in the reproductive system ♦ Can occur unilaterally or bilaterally ♦ Can be present from the neonatal period to postmenopause ♦ Most ovarian cysts occur during infancy and adolescence, which are hormonally active periods of development ♦ Most are functional in nature and resolve with minimal treatment ♦ Usually asymptomatic. ♦ May report lower abdominal pain: sharp, intermittent, sudden, and severe ♦ Sudden onset of abdominal pain may suggest cyst rupture ♦ Pelvic mass may be palpated ♦ Cervical motion tenderness may be elicited ♦ Often an incidental finding during ultrasonography performed for other reasons

OVARIAN CYSTS

Most common site is in one of the fallopian tubes but can occur in other areas ♦ Ectopic pregnancy usually caused by a condition that blocks or slows the movement of a fertilized egg through the fallopian tube to the uterus ♦ May be caused by a physical blockage in the tube; most cases from scarring caused by past ectopic pregnancy, past infection in the fallopian tubes, pelvic inflammatory disease, or surgery of the fallopian tubes ♦ Abnormal vaginal bleeding ♦ Low back pain ♦ Mild cramping on one side of the pelvis ♦ Pain in the lower abdomen or pelvic area ♦ If the area of the abnormal pregnancy ruptures and bleeds, symptoms may worsen ♦ Feeling lightheaded or syncope ♦ Pain that is felt in the shoulder area ♦ Severe, sharp, and sudden pain in the lower abdomen ♦ Marked pelvic tenderness, with tenderness and rigidity of the lower abdomen ♦ Cervical motion tenderness; a tender, unilateral adnexal mass may indicate the site of the pregnancy (Fig. 18-62) ♦ Tachycardia and hypotension reflect hemorrhage of a ruptured tubal pregnancy into the peritoneal cavity and impending cardiovascular collapse ♦ A ruptured tubal pregnancy is a surgical emergency

TUBAL (ECTOPIC) PREGNANCY Ectopic pregnancy occurs outside the uterus

Often caused by Neisseria gonorrhoeae and Chlamydia trachomatis ♦ May be acute or chronic ♦ Symptoms may be mild or absent ♦ Unusual vaginal discharge that may have a foul odor ♦ Symptoms include painful intercourse, painful urination, irregular menstrual bleeding, and pain in the right upper abdomen ♦ Acute PID produces very tender, bilateral adnexal areas; the patient guards and usually cannot tolerate bimanual examination ♦ Symptoms of chronic PID are bilateral, tender, irregular, and fairly fixed adnexal areas

PELVIC INFLAMMATORY DISEASE (PID) Infection of the uterus, fallopian tubes, and other reproductive organs; a common and serious complication of some sexually transmitted infections

Most cases of acute salpingitis occur in two stages: the first involves acquisition of a vaginal or cervical infection; the second involves ascent of the infection to the upper genital tract ♦ Organisms most commonly associated with acute salpingitis are Neisseria gonorrhoeae and C. trachomatis ♦ Lower quadrant pain; constant and dull or cramping; pain may be accentuated by motion or sexual activity; coexisting purulent vaginal discharge; abnormal vaginal bleeding, nausea, vomiting, fever ♦ Cervical motion tenderness and/or adnexal tenderness on bimanual examination ♦ Mucopurulent cervical discharge

SALPINGITIS Inflammation or infection of the fallopian tubes, often associated with PID; can be acute or chronic

♦ Obstruction usually caused by an imperforate hymen or, less commonly, a transverse vaginal septum ♦ None ♦ Small midline lower abdominal mass or a small cystic mass between the labia ♦ Condition may resolve spontaneously or may require surgical intervention ♦ Abdominal sonography is helpful in making the correct diagnosis, showing a large midline translucent mass displacing the bladder forward

HYDROCOLPOS Distention of the vagina caused by accumulation of fluid due to congenital vaginal obstruction

Inflammation of the vulvar and vaginal tissues

VULVOVAGINITIS

♦ Caused by lack of estrogen during perimenopause and menopause ♦ Vaginal soreness or itching ♦ Discomfort or bleeding with sexual intercourse ♦ Vaginal mucosa is dry and pale, although it may become reddened and develop petechiae and superficial erosions ♦ Accompanying vaginal discharge may be white, gray, yellow, green, or blood-tinged ♦ Can be thick or watery and, although it varies in amount, rarely profuse

ATROPHIC VAGINITIS Inflammation of the vagina due to the thinning and shrinking of the tissues, as well as decreased lubrication

what makes an erection

the corpora cavernosa become engorged

what is it called if the forskin is to tight and you can not retraact it

phimosis

what is infection of the glans?

balanitis

what does a downward bowed penis at birth suggest

chordee

If a bright penlight transilluminates the mass, and there is no change in size when reduction is attempted, it most likely contains what

fluid, hydrocele

A mass that neither changes in size nor transilluminates may represent

incarcerated hernia

A mass that does not transilluminate but does change in size when reduction is attempted is

hernia

what is cryptorchidism

undescended testes

hard, enlarged, painless testicle may indicate

tumor

Acute swelling in the scrotum with discoloration can result from

torsion of the spermatic cord or orchitis

Acute, painful swelling without discoloration and a thickened or nodular epididymis suggests

epididymitis

The inability to replace the foreskin to its usual position after it has been retracted behind the glans

paraphimosos

Congenital defect in which the urethral meatus is located on the ventral surface of the glans penile shaft, or the base of the penis

HYPOSPADIAS

Solitary lesion; firm, round, small, commonly located on the glans but can be located on the foreskin (Fig. 19-20) ♦ Lesion has indurated borders with a clear base ♦ Scrapings from the ulcer, when examined microscopically, show spirochetes ♦ lasts 3 to 6 weeks and heals without treatment

SYPHILITIC CHANCRE

Superficial vesicles on the glans, penile shaft, or at the base of the penis (Fig. 19-21) ♦ Often associated with inguinal lymphadenopathy and systemic symptoms, including fever ♦ Men who have sex with men may also get blisters in or around the anus

GENITAL HERPES

Single or multiple papular lesions ♦ May be pearly, filiform, fungating (ulcerating and necrotic) cauliflower, or plaquelike (Figs. 19-22 and 19-23) ♦ Can be smooth, verrucous, or lobulated ♦ May be the same color as the skin, or they may be reddish or hyperpigmented ♦ Lesions are commonly present on the prepuce, glans penis, and penile shaft, but they may be present within the urethra as well

CONDYLOMA ACUMINATA

Sexually transmitted infection that of the lymphatics

LYMPHOGRANULOMA VENEREUM

Painless lesions on penis ♦ Contact with an infected person ♦ Lesions are pearly gray, often umbilicated, smooth, dome shaped, and with discrete margins (Fig. 19-25) ♦ Lesions most common on the glans penis

MOLLUSCUM CONTAGIOSUM

Dense, fibrous scar tissue (plaque) forms in the tunica albuginea (wall of the corpus cavernosum) ♦ Plaque focally interferes with expansion of the corpus cavernosum during erection ♦ Etiology unclear; may occur as the result of trauma, inflammation, or inherited disorder ♦ It is generally unilateral ♦ The mid-top of the penis is the area most commonly involved ♦ Bending and/or indentation of the erection (Fig. 19-26) ♦ Loss of penile length ♦ May have pain with erection ♦ Family history of the condition ♦ History of Dupuytren contracture (fourth and fifth fingers of the hand)

PEYRONIE DISEASE

Fluid accumulation in the scrotum

HYDROCELE

Benign cystic accumulation of sperm occurring on the epididymis

SPERMATOCELE

Abnormal tortuosity and dilation of veins of the pampiniform plexus within the spermatic cord

VARICOCELE

how is a varicocele graded

Small: palpated only during Valsalva maneuver ♦Moderate: easily palpated without Valsalva maneuver ♦Large: causing visible bulging of the scrotum

Acute inflammation of the testis secondary to infection

ORCHITIS

Inflammation of the epididymis (a major consideration in the differential diagnosis is testicular torsion, a surgical emergency Often seen in association with a urinary tract infection ♦ May also occur as a result of an STI ♦ Occasionally, chronic epididymitis may occur as a consequence of tuberculosis ``` ♦ Painful scrotum ♦ Urethral discharge ♦ Fever ♦ Pyuria ♦ Recent sexual activity ``` ♦ Epididymis feels firm and lumpy; is tender (Fig. 19-32) ♦ Vasa deferentia may be beaded ♦ Overlying scrotum may be markedly erythematous

EPIDIDYMITIS

Twisting of testis on spermatic cord ♦ A congenital anatomic anomaly (bell-clapper deformity) results in incomplete testicular attachment ♦ Twisting of the spermatic cord cuts off the blood supply to the testicle ♦ Occurs in newborns to adolescents; most common in adolescents ♦ Acute onset of scrotal pain, often accompanied by nausea and vomiting ♦ Absence of systemic symptoms such as fever and myalgia ♦ Risk factors: trauma and strenuous physical activity ♦ The testicle is exquisitely tender ♦ Scrotal discoloration is often present ♦ Absence of cremasteric reflex on side of acute swelling

TESTICULAR TORSION

what is the formula for BMI

pounds divided by inches squared all times 703 or in kg dived by meters squared

how much weight should a women gain when preg

25-35 if normal 40 if underweight 15-25 for overweight less than 15 for obese

A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses Face and skull—frontal skull bossing, cranial ridges, mandibular overgrowth, maxillary widening, teeth separation, malocclusion, overbite ♦ Skin thickening on the face (tongue, lips and nose), hands and feet leading to enlargement ♦ Joint enlargement, swelling, pain; vertebral enlargement, kyphoscoliosis ♦ Cardiac ventricular enlargement bilaterally with decreased exercise tolerance

ACROMEGALY

A disorder associated with a prolonged and excessively high exposure to glucocorticoids Obesity, “buffalo hump” fat pad, supraclavicular and pendulous abdominal fat distribution ♦ Facial plethora or moon facies ♦ Thin skin, reddish-purple striae, poor skin healing ♦ Proximal muscle weakness ♦ Hirsutism or female balding ♦ Peripheral edema ♦ In children—short stature, abnormal genital virilization, delayed puberty, or pseudo-precocious puberty

CUSHING SYNDROME

A genetic disorder in which there is partial or complete absence of a second X chromosome Short stature ♦ Webbed neck ♦ Broad chest with widely spaced nipples ♦ Wide carrying angle of elbow (cubitus valgus) ♦ Low posterior hairline, misshapen or rotated ears, narrow palate with crowded teeth ♦ Coarctation of aorta, bicuspid aortic valve ♦ Sensorineural hearing loss ♦ Infertility ♦ Karyotype or chromosome analysis is performed

TURNER SYNDROME

what does PPE stand for

preparticipation physical evaluation

what is atlantoaxial instability and why is it important in who

common in children with downs, could cause spinal cord compresion and neuro problems. Exsessive neck instability

how long does a simple conccusion last

7 to 10 days

what is a complex concussion

multiple form decreasing amounts of force, or LOC more than 1 min, or extended length of symtpms

what is postconcussive syndrome

returning to sports too soon and a minor impact can cause a loss of blood supply to the brain and rapid mental deteriroation and even death

what is the SCAT card

sports concussion assessment tool

Sensitivity

the ability of an observation to identify correctly those who have a disease

Specificity

the ability of an observation to identify correctly those who do not have the disease

True positive

an expected observation that is found when the disease characterized by that observation is present

True negative

an expected observation that is not found when the disease characterized by that observation is not present

False positive:

an observation made that suggests a disease when that disease is not present

False negative

a disease is present, the observation is there to be made, and it is not appreciated

Positive predictive value:

the proportion of persons with an observation characteristic of a disease who have it (e.g., when an observation is made 100 times, and on 95 of those occasions that observation proves to be consistent with the ultimate diagnosis, the positive predictive value of the observation is 95%)

Negative predictive value:

the proportion of persons with an expected observation who ultimately prove not to have the expected condition (e.g., if 100 observations are made expecting a disease, and 95 times that observation is not found and the condition proves not to have been the diagnosis, the negative predictive value of the observation is 95%)

the likelihood of your diagnosis being related to your findings depends on the probability of those findings being associated with that diagnosis, and the prevalence of both that particular diagnosis and that combination of findings in the community in which you are serving.

Bayes Theorem

Test 3 Flashcards

(101 cards)