Womens health Flashcards Preview

NP Prep > Womens health > Flashcards

Flashcards in Womens health Deck (192):

What T score reflects a patient who has osteopenia?

Between -1.0 and -2.5


What T-score reflects a patient with osteoporosis?

-2.5 or less


When and what test screens for osteoporosis?

Age 65, DXA scan and if negative, repeat in 2-5 years. If positive, then repeat in 1-2 years.


What tanner stage does breast development (breast buds) start?

Tanner stage II
It ends at stage V


At what age do you start Pap smear?

21 years old and repeat every 3 years


When is Pap smear and HPV co testing started?

Age 30 through 65 and repeat every 5 years.


What is normal vaginal pH?



What medication treats BV?

Metronidazole (Flagyl) BID for 7 days


Strawberry cervix is indicative of?



What medication treats trichomonas?

Metronidazole (Flagyl) 2g POx 1 dose or 500mg BID for 7 days


What is dyspareunia?

Pain during intercourse


A disease of the skin in which white spots appear on the skin and change over time. This is usually found in the vaginal area.

Linchen sclerosis


Sexually active female who has not had a period in 6 to 7 weeks complains of lower abdominal/pelvic pain or cramping. Pain worsens when supine or with jarring. If ruptured, pain worsens and can be referred to the right shoulder. Medical history of pelvic inflammatory disease, tubal ligation, or previous a topic pregnancy. Leading cause of death for women in the US in the first trimester of pregnancy.

Ectopic pregnancy


Middle aged to older female with a dominant mass on one breast that feels hard and is irregular in shape. The mass is attached to the skin, surrounding breast tissue or is immobile. Among the most common locations are the upper outer quadrant of the breast i.e. the tail of Spence. Skin changes maybe seen such as Peau d’orange, dimpling, and retraction. Mass is painless or maybe accompanied by serous or bloody discharge. The nipple may be displaced or become fixed.

Dominant breast mass/breast cancer


Older female reports a history of chronic scaly red colored rash resembling eczema on the nipple that does not heal. Some women complaining of itching. The skin lesion slowly enlarges and evolves to include crusting, alteration, and or bleeding on the nipple.

Paget’s Disease of the breast (ductal carcinoma in situ)


Recent or acute onset of red, swollen, and warm area in the breast of a younger woman. Can mimic mastitis. Often there is no distinct lump on the affected breast. Symptoms develop quickly. The skin maybe pitted or appear bruised. More common and African-Americans. A rare but very aggressive form of breast cancer.

Inflammatory breast cancer


Older woman with complaints of vague symptoms such as abdominal bloating and discomfort, low back pain, pelvic pain, urinary frequency, and constipation. By the time it is diagnosed, the cancer has already metastasized. If metastasis, symptoms depend on area affected. Symptoms maybe bone pain, abdominal pain, headache, blurred vision, others.

Ovarian cancer


In what Tanner are stage does breast development start

Tanner stage two and ends at stage five


Where is the majority of breast cancer located

The upper outer quadrant of the breasts called the tail of Spence


What is the diagnostic test for breast cancer

Tissue biopsy


Is a cervical ectropion benign

Yes. Adolescence have a large ectropion which is an immature cervix


Patients with what condition have high androgen levels and multiple cysts on their ovaries which causes acne, hirsutism, and ogliomenorrhea



What is the diagnostic test for cervical cancer

Biopsy of the cervix


When is the best time to perform a Pap test

Between 10 and 20 days after the last Menses


What should the patient avoid about two days before the pap test

Douching and vaginal foams/medication


When should a baseline Pap smear be done

Age 21 and repeat every three years


If a patient age to 20 or younger had an abnormal Pap smear of undetermined significance when should the pap be repeated

12 months


If the patient has an abnormal Pap of undetermined significance that is 21 years or older what should be done next

Order Pap smear with reflex HPVDNA testing. If Pap is abnormal, HPV strain testing is done automatically by the lab.


What types of HPV are oncogenic

Types 16 and 18. Referral for colposcopy and cervical biopsy


If A patient Pap smear had atypical glandular cells of undetermined significance what should be done next

Refer for endometrial biopsy


If a patient’s Pap results was a low-grade squamous intraepithelial lesion and high grade squamous epithelium lesion what should be done next

HPV Testing and refer for Colposcopy and biopsy


What are the two FDA approved vaccines that are very effective in preventing persistent infection with the oncogenic HPV strain

Gardasil & Cervarix


What is used to help with a diagnosis of fungal infection of the hair skin and nails

Potassium hydroxide slide


A test for BV. A positive result occurs when a strong fishlike owner is released after 1 to 2 drops of KOH are added to the slide

Whiff test


Used as an adjunct for evaluating herpatic infections i.e. oral, genital, skin. A positive smear will show large amounts of abnormal nuclei in the squamous epithelium cells not commonly used

Tzanck smear


What type of birth control pills are used for acne

Triphasic pills such as ortho Tri-Cyclen


What type of birth control pill is safe for breast-feeding women

Progesterone only pills. Use on day one of menstrual cycle.


What are absolute contraindications to birth-control pills

Any condition that increases the risk of blood clotting such as history of thrombophlebitis or thromboembolic disorders such as DVT, genetic coagulation defects such as factor V Leiden disease, major surgery with prolonged immobilization, smoker over the age of 35. Any condition that increases the risk of strokes such as headaches with focal neurological symptoms, history of CVA and TIA, hypertension, migraine headache with aura. Inflammation and or acute infections of the liver with elevated liver function test, and hepatic adenomas or carcinoma, cholestatic jaundice of pregnancy. Known or suspected cardiovascular disease such as coronary artery disease, diabetes with vascular component. Some reproductive condition or cancers, known or suspected pregnancy, undiagnosed genital bleeding, breast, real, or ovarian cancer.


Mnuemonic for absolute contraindications for oral contraceptives

My: migraines with aura
U: undiagnosed genital bleeding
P: pregnant or suspect pregnancy 🤰
L: liver tumor or active liver disease
E: estrogen dependent tumor
T: thrombus or emboli
S: smoker age 35 or older


Advantages of oral contraceptives and after five or more years of use

Decreased incidence of dysmenorrhea and cramps, PID, iron deficiency anemia, acne and hirsutism, ovarian cyst, heavy and or
Irregular period.


Before starting oral contraceptives what must be ruled out



All patients must be instructed to use what during the first two weeks after starting the pill

Back up condoms


Does a patient that takes an oral contraceptive need to follow up

Yes within 2 to 3 months to check blood pressure and for side effects and patients questions


How do you treat menstrual cramps

NSAIDs such as Alleve, naprosyn


What are possible causes of secondary dysmenorrhea

Endometriosis, PID, fibroids


What constitutes primary amenorrhea

Absence of menses by age 15, often secondary to dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina. Refer to reproductive endocrinology.


What are the variables of secondary dysmenorrhea

Onset usually after age 25, abnormal uterine bleeding and, variable symptoms such as nausea, Vomiting, diarrhea, and back pain. Dyspareunia (pain during intercourse), symptoms often worsen over time. Causes are endometriosis, fibroids, PID or infection, adenomyosis


How do you manage dysmenorrhea

Get a good history both medical and menstrual. Physical exam to identify a cause. Pelvic exam may differ if young, not sexually active adolescents with mild symptoms. Consider a pelvic ultrasound to look for adnexal masses, fibroids, other pelvic pathology. If secondary, address underlying cause


Can intrauterine contraception help with dysmenorrhea symptoms



How long does Mirena last

Five years


How long does Skyla last

3 years because skyla=smaller


If a patient comes in with abnormal uterine bleeding and how is this constituted

Any bleeding beyond 12 months since last menstrual period in a post menopausal woman. Even one drop of blood is concerning. Referred to OB/GYN to rule out cancer


How do you define a post menopausal woman

A woman that did not have her period for more than one year


What is the mnuemonic for abnormal uterine bleeding

P: polyps greater than 30 years
A: adenomyosis greater than 30 years
L: leiomyoma/fibroids greater than 30 years
M: malignancy/hyperplasia greater than 40 years, obesity, DM, PCOS greater than 50 years
C: coagulopathy any age
O: ovulatory dysfunction any age
E: endometrial disorders any age
I: iatrogenic medications any age
N: not classified


If a patient misses one day of birth control what must They do next

Take two pills for the next two days to catch up and finish the birth control pill pack. Use condoms for the current pill cycle.


What should a patient do if they miss two consecutive days of birth control

Take two pills the next two days to catch up and finish the birth control pill pack. Use condoms for the current pill cycle.


What drugs interact with oral contraceptives and will cause the patient to use an alternative form of birth control such as condoms when taking these drugs and for one pill cycle afterwards

Anticonvulsants such as phenobarbital and phenytoin, antifungal, certain antibiotics such as ampicillin, tetracycline, and rifampin. Saint Johns wort which may cause a breakthrough bleeding


When should emergency contraception such as the morning after pill be taken

Most effective if taken within the first 24 hours. Rule out pre-existing pregnancy first. Effective up to 72 hours after unprotected sex.


what is the mnuemonic for pill danger signs

A: abdominal pain
C: chest pain
H: headache
E: eye problems change in vision
S: severe leg pain


What type of contraception results in higher levels of estrogen which increases the risk of blood clots and DVT

Contraceptive patch i.e. Ortho Evra


What are contraindications for intrauterine device

Active PID or history of PID within the last year, suspected or with STD or pregnant, uterine or cervical abnormality, undiagnosed vaginal bleeding or uterine/cervical cancer, history of ectopic pregnancy


How long does a dose of Depo-Provera last

Each dose by injection lasts three months. Check for pregnancy before starting dose. Start in first five days of cycle because females are less likely to ovulate at these times. Women on Depo-Provera for at least one year or longer will have amenorrhea because of severe uterine atrophy from lack of estrogen. Do not recommend to women who want to become pregnant within 12 to 18 months. Causes the late return to fertility. It takes up to one year from most women to start ovulating.


What is the black box warning for Depo-Provera

Avoid long term use i.e. more than two years. Increases risk of osteopenia/osteoporosis that may not be fully reversible. Using Depo-Provera for more than two years is discouraged.


What contraceptive should be avoided in anorexia nervosa patients

Avoid using Depo-Provera in this population because it will further increase their risk of osteopenia/osteoporosis. Recommend calcium with vitamin D and weight-bearing exercises for patients on this medication. Consider testing for osteopenia/osteoporosis using a DXA scan


What are the rules for using a diaphragm with contraceptive gel and cervical cap

The diaphragm must be used with spermicidal gel. After intercourse leave diaphragm inside vagina for at least 6 to 8 hours. Can remain inside vagina for up to 24 hours. Need additional spermicide before every act of intercourse.


Patients that use diaphragm are at Increased risk of

UTIs and toxic shock syndrome


Monthly hormonal cycle induces breast tissue to become engorged and painful. Symptoms occur two weeks before the onset of menses and are at their worst right before the menstrual cycle. Resolves after menses start. Commonly starts in women in their 30s.

Fibrocystic breast


Adults to middle aged woman complains of the cyclic onset of bilateral breast tenderness and breast lumps that start from a few days before her period For many years. Once menstruation starts, the tenderness disappears and the size of the breast lumps decrease. During breast examination, the breast lumps are tender and feel rubbery, and are mobile to touch. Denies dominant mass, skin changes, nipple discharge, or enlarged nodes

Fibrocystic breast


What is the treatment plan for fibrocystic breast

Stop caffeine intake. Vitamin E and evening prime rose capsules daily. Wear bras with good support. Must refer if the patient has a dominant mass, skin changes, or fixed mass


What are some risks and complications of PCOS

Endometrial cancer, infertility, diabetes, metabolic syndrome, obesity, cardiovascular disease, and hyperlipidemia.


Signs and symptoms include ogliomenorrhea, amenorrhea, hyperandrogenism i.e. acne, hirsutism, cystic ovaries, infertility, mental health issues. Patient Can skip months of period. It takes two years to have a solid, healthy menstrual period established. These patients need to have babies earlier in life.



Insulin resistance is the pathophysiology of



How do you diagnose polycystic ovarian syndrome

Rotterdam criteria which is two of three:
Cystic ovaries


Complications associated with PCOS include

Uterine/endometrial cancer, diabetes, cardiovascular disease, infertility


Acne, hirsutism, alopecia, acanthosis nigricans, amenorrhea, oligomenorrhea, infertility, hyperinsulinemia and mood disorders in adults are all symptoms of



What is the PCOS diagnostic work up and differential

Bodyweight, BMI greater than 30, waste greater than 35 inches, blood pressure, ultrasound of ovaries/uterus hyperplasia greater than 10 mm, CBC, lipid’s low HDL, high trigs/LDL, LFTs, TSH, oral glucose tolerance hemoglobin A-1 C DM=>6.4 at risk => or equal to 5.6-6.4, total testosterone for PCOS =>60, tumor > 200, free T for PCOS = 2-3, pregnancy 🤰 test hcg, prolactin 3-27ng/ml consider DHEA-S, LH/FSH ratio >3, but may be normal in PCOS


How do you manage a patient with PCOS

Discuss fertility planning, FastTrack fertility, letrozole preferred, not clomid,


What are problems associated with PCOS

Infertility and 40% of females, spontaneous abortion, gestational diabetes, preeclampsia/hypertension


What are lifestyle modifications for PCOS patients

Weight loss greater than 5%, exercise and stress reduction


If a patient with PCOS does not desire pregnancy how are they managed

Combination hormonal contraceptives, low androgen progestins are safer i.e. Levonorgestrel, Norethindrone, Norgestimate which helps androgen symptoms and prevents uterine cancer. Metformin


For most women HPV clears spontaneously within how many months if the patient is less than 24 years old

8 to 24 months


How is cervical cancer develops

Persistent HPV infection over many years


What are high-risk subtypes for cervical cancer

16, 18, 45, 31, 33, 52, 58, 35


When should HPV vaccination be given

Give prior to onset of sexual activity i.e. coitarche. This is the age of first penile vaginal sex. Give routinely at 9 to 12 years for boys and girls in three injections spaced out at the first month, then second month, then six months.If Series is incomplete, finished with new vaccine. May benefit if greater than 26 years old but no recommendations yet


What are the screening guidelines for cervical cancer screening for ages 21 to 29

First Pap at age 21 and repeat every three years up to age 30


What are the screening guidelines for cervical cancer screening age greater than 30

Pap and HPV is the primary screening. Repeat every five years if both negative. Pap only every three years.


What is the cervical cancer screening guidelines for age 65 and over

May stop if negative history times 10 years


What are the cervical cancer screening guidelines after a hysterectomy

For benign disease it can be discontinued. If not benign, three annual negative tests then discontinue ACS. Ongoing screening for 20 years even if older than 65


What are the guidelines for ASC (atypical squamous cells) for ages 21-24

Watch and wait. Repeat pap at 12 mos. if negative, routine screening. If positive then refer for colposcopy.


What are the guidelines of ASC-US age over 24

Reflex HPV and if positive refer for colposcopy


What are the guidelines if a patient is found to have ASC-H

Colposcopy for all


What are risk factors for bacterial vaginosis

New sexual partner, not using condoms, douching, copper are you see which can throw off the vaginal flora


Itching, burning, dysuria, vaginal pH of 4.0 to 4.6, negative with test, and buds and pseudohyphae on KOH

VV Candidiasis


Malodorous discharge, pH of the vagina is greater than 4.6 with a positive whiff test



Malodorous discharge, dysuria, vaginal pH of 5.0 to 6.0, positive or negative with test



If a patient has recurrent used infections what should they be screened for

Diabetes, pregnancy test, HIV


If a patient is on Diflucan or vaginal medication, what must they do for precaution

Delay sexual intercourse until symptoms improve


What treatment for Vulvovaginal candidiasis relieve symptoms most rapidly

Topical antifungal


What is a male yeast infection



If a patient is on an antibiotic and is prone to yeast infections what should be recommended

daily yogurt or lactobacillus pills


Does a sexual partner need to be treated for BV

No because it’s not a sexually transmitted disease


What population with BV are at a higher risk for injury uterine infection and premature labor

Pregnant women


If a what’s near shows clue cells and very few white blood cells what must be considered



What is the normal vaginal pH

4.0 to 4.5


What is considered an alkaline vaginal pH

Greater than 4.5


How do you treat BV

Flagyl or metronidazole b.i.d. for seven days. Do not drink alcohol while on this medication. Abstain from sexual intercourse until treatment is done


Uni cellular protozoan parasite with flagella that infects genitourinary tissue in both males and females. Infection causes inflammation, itching, burning of the vagina/urethra



Adult female complains of very pruitic, reddened Vulvovaginal vaginal area. May complain of dysuria. Copious grayish green and bubbly vaginal discharge. Most males and sex partners may have symptoms urethritis or maybe asymptomatic



When strawberry cervix is found from small points of bleeding on cervical surface with a swollen and vulvar and vaginal area with a vaginal pH of greater than 5.0 what must be considered



Microscopic shows mobile Uni cellular organisms with flagella and large amount of white blood cells



How do you treat trichomonas

Flagyl or metronidazole to grams PO or 500 mg b.i.d. for seven days. Treat sexual partner. Avoid sex until both partners complete treatment.


This occurs in postmenopausal women and they show nonspecific signs and symptoms such as watery, yellow or white, malodorous vaginal discharge

Atrophic vaginitis


Vaginal irritation or burning, dyspareunia or pain with intercourse, urinary tract symptoms, thinning of vaginal epithelium, loss of elasticity, loss of Rugae, vaginal pH greater than or equal to five is consistent with

Atrophic vaginitis


What is the treatment for atrophic vaginitis

Estrogen PV, Osphena as an alternative to estrogen, DHEA PV


A 60-year-old woman has begun to have a small amount of blood escaping from the vagina. What is the most common cause of malignancy when is One found?

Endometrial cancer


Atrophic vaginitis occurs due to

Lack of estrogen and estrogen dependent tissue of the urogenital tract and results in atrophic changes in the vulva and vagina of menopausal women.


Disease of low bone mass with micro architectural disruption



What are risk factors for osteoporosis

Caucasian/Asian, family history, advanced age, previous fracture, long-term glucocorticoid therapy, low bodyweight less than 127 pounds, cigarette smoking, excess alcohol and


What is a T score reflects osteoporosis

-2.5 or less


What is a T score that reflects osteopenia

Between -1.0 & -2.5


How do you screen for osteoporosis and at what age

Screening starts at age 65 and the screening choice is a DEXA scan. Screening that recommended pre-menopause unless risk factors present


How do you manage osteoporosis

Weight bearing exercise, stop cigarette smoking, stop excess alcohol, avoid cortical steroids and anti-convulsant is one possible, take calcium daily at 1200 mg a day plus if vitamin D deficient replace with vitamin D3. The preferred calcium choice is food


What medications can be prescribed for osteoporosis

Oral by phosphonate’s are considered first line for most patients because they inhibit bone resolution and it remains active in the bone for weeks, months and maybe years. It also increases bone mass and reduces risk of fracture.
Alendronate (Fosamax) weekly
Risendronate (Actonel) weekly
Ibandronate (Bonita) monthly. Does not avoid hip fracture risk
These medications need to be taken for 5 years to prevent fracture.


What are the most common breast masses

Fibroadenomas and cysts. Benign complaints can mimic breast cancer. Refer to breast specialist


What are the diagnostic studies for breast masses

Ultrasound for any female/male less than 30 years, with focal mass or symptom. First line in pregnancy or less than 30 years. To assess mass identified on mammogram


What is a diagnostic test for any female or male greater than 30 with a breast complaint



What is the value of a breast ultrasound

Differentiates fluid filled cyst from solid mass


85% of breast cancer occurs in women that are what age

Greater than 50 years


What are risk factors for breast cancer

Gender and age especially greater than 65 years, genetic predisposition BRCA one, to genetic mutation, obesity, family history, reproductive history of low parity, estrogen exposure with early menarche less than 12 years, late menopause greater than 55 years, estrogen medications


What is screening for average risk patients for breast cancer

Mammogram start at age 45. May begin aged 40-44. Then yearly. At age 55+, screen every 2 years. Yearly screening may be offered. Clinical and self breast exam not recommended


What is a great option for contraception for all ages with fewer contra indications

Long acting reversible contraceptives such as ParaGard, Mirena, Skyla


Patients with gastric bypass, celiac disease, hyperthyroidism, ankylosing spondylitis, rheumatoid arthritis and others are at risk for



Low calcium intake, vitamin D deficiency, in adequate physical activity, alcoholic, high caffeine intake, and smoking are lifestyle risk factors for



When should a DEXA scan be repeated

You do a baseline scan and repeat in 1 to 2 years if on a treatment regimen in order to assess the efficacy of the medication. It’s not on treatment, repeat DEXA into 2-five years


What can biphosphonates cause as an adverse reaction

Esophagitis, esophageal perforation, gastric ulcers, reactivation/bleeding peptic ulcer disease. Patients need to report sore throat, dysphasia, or Midsternal pain immediately


When is the best time to take a biphosphonate

Take immediately upon awakening in the morning with a full glass of plain water. Take tablet sitting or standing and wait at least 30 minutes before laying down. Do not crash, split, or two tablets. Swallow the tablets whole. Never take these drugs with other medications such as juice, coffee, antacids, vitamins.


what are contraindications for biphosphonates

Inability to sit upright, esophageal motility disorder’s, history of peptic ulcer disease or history of gastrointestinal bleeding


If I doses of biphosphonate are given what can happen

Osteonecrosis of the jaw more likely if on IM dose. Watch for complaints of Jaw heaviness, pain, swelling, and loose teeth


Estrogen replacement therapy increases the risk of

Heart disease, DVT, breast and endometrial cancer


What type of birth control pill contains iron during the last seven days of the pill cycle instead of a placebo pill

Loestrin FE


Low-dose birth-control pills contain how much of ethinyl estradiol

20-25 mcg


What type of birth control pill is indicated for the treatment of acne

Desogen ortho-tricyclin and Yaz


What type of birth control needs to be avoided in anorexic or bulimic patience because of a very high-risk of osteoporosis



Women taking Seasonale will have how many periods per year



What is considered a relative contraindication of birth control



What is considered an absolute contraindication of birth control

A history of a blood clot that resolved


Squamous epithelium cells that have blurred edges due to the number of bacteria on the cell surface is consistent with what

Clue cells in BV


If an ovary is palpable but must be ordered

Intravaginal ultrasound


If a patient has a hard irregular mass that is not mobile on the breast what must be for what must be ruled out

Breast cancer


Which NSAID is effective for menstrual pain

Mefenamic acid (ponstel)


What type of medication can elevate total T4 levels and triglycerides/lipids

Birth control pills


What is not the best birth control method for a woman who wants to become pregnant in 12 to 18 months



In reproductive aged teens and women who present with acute pelvic pain or Lower abdominal pain what test must always be performed

Pregnancy test


A 28 year-old female presents with a slightly tender 1.5 cm lump in her right breast. She noticed it 2 today’s ago. She has no associated lymphadenopathy and there is no nipple discharge. How should she be managed

Re-examination after her next menses


A patient asks the NPs advice about an herb to help with her hot flashes. The NP knows that these

May be a contraindication in patients with a history of breast cancer


A 22-year-old female has been diagnosed with PCOS. What is a common finding

Elevated insulin levels


A 22-year-old female states that she has multiple sexual partners and in consistently uses barrier protection. Which form of birth control should the nurse practitioner avoid prescribing in this patient

Intrauterine device because when a patient has multiple sexual partners they are at an increased risk for PID


What hormone increases during menopause

Follicle-stimulating hormone


A female should be told to take her oral contraceptive pill at bedtime if she experiences



A patient who takes oral contraceptive pills is at an increased risk of

Gallbladder disease


Hot flashes that occurred during menopause are thought to be related to

Fluctuating estrogen levels


Does ovarian cancer present with postmenopausal bleeding



At what age are Pap smears discontinued in women

After the age of 65


What is the diagnostic test of choice to differentiate a solid from a fluid filled breast mass



To palpate an indirect inguinal hernia in a woman, have her stand and palpate in the labia majora and

Palpate upward to just lateral to the pubic tubercle’s


The most common causes of sexual problems in females are related to

Psychosocial factors


When performing a vaginal exam with a speculum, the use of the upper blade as of a tractor could expose a



Upon examination of the cervix, and an irregular Cauliflower like growth was noted around the cervical os.This finding is most suggestive of

Carcinoma of the cervix


A female patient presents with a profuse, yellowish, green discharge that is malodorous. The vaginal discharge is most consistent with



If urethritis or inflammation of the para urethral glands is expected in a female patient, the index finger should be inserted into the vagina and

Milk the urethra gently from the inside outward


Upon examination of the vagina, a small, red, benign tumor is noted at the posterior part of the urethral meatus. This finding is consistent with a

Urethral caruncle


Upon examination of the vagina, the entire anterior vaginal wall, together with the bladder and urethra create a bulge. This condition is most consistent with a



Chronic pelvic pain refers to pain that does not respond to therapy and lasts more than how many months

Six months


When examining the cervix, a translucent nodule is noted on the cervical surface. This finding is consistent with

A retention cyst


When performing a rectal exam on a female, a hard nodular rectal shelf is palpable at the tip of the examiners finger. This finding is suggestive of

Metastatic tissue in the rectouterine pouch


Examination of a female patients right breast reveals a retraction of the nipple and areola. This finding is consistent with

Breast cancer


If performed correctly and in a timely fashion, what is the most it definitive for the diagnosis of breast cancer. Diagnostic test

Breast tissue sample


The vaginal mucosa lies in transverse folds called the



When performing a vaginal exam with a speculum, the use of the lower blade as a retractor during bearing down could expose an anterior wall defect such as a



Can a female diagnosed with a 2nd° uterine prolapse, the cervix is located

In the introit us


Retraction of the nipple and areola suggest

An underlying breast mass


Postcoital bleeding suggests

Cervical cancer


The deep red area located around the cervical os is known as

The columnnar epithelium


Uterine enlargement may suggest

Pregnancy, uterine myoma’s or fibroids, or malignancy


The most common type of hernia in a woman is the

Indirect inguinal hernia


A 22-year-old patient has a single, nontender, freely movable lump in her right breast. She denies any nipple discharge. Which of the following diagnoses is the clinical presentation most consistent with



In comparing sensitivity to specificity, sensitivity refers to a

True positive


Can a woman taking calcium take it with milk



Does weight loss reduce osteoporosis risk



Why is it important that a post menopausal woman with an intact uterus receive combined estrogen – progestin hormone replacement therapy rather than estrogen alone

Prolonged use of unopposed estrogen’s increases the risk of endometrial cancer


A 50-year-old patient has abnormal vaginal bleeding with heavy periods and intermenstrual watery discharge with a small amount of blood. What is the most likely diagnosis

Endometrial cancer


Hormone replacement therapy is related to an increased risk of