10: Reproductive Topics

Question 1

Gonadarche

Answer 1

Activation of gonads by FSH and LH

Question 2

Thelarche

Answer 2

Development of breast tissue due to estrogen

Question 3

Spermarche

Answer 3

First sperm production

Question 4

Pubarche

Answer 4

First pubic hair development

Question 5

Age of puberty for females and males

Answer 5

Females: 10-14
Males: 11-16

Question 6

When is menarche compared to puberty?

Answer 6

Menarche comes 2-3 years after puberty

Question 7

What stage of breasts on the Tanner scale are females when menarche occurs?

Answer 7

3 or 4

Question 8

When does pubarche and increased male genitalia occur in males?

Answer 8

From 9-13.5 years old

Question 9

What is the GP (expanded) for a woman with 5 pregnancies, 3 term deliveries, 1 spontaneous abortion, and 1 live delivery at 34 weeks?

Answer 9

G5P3114

Question 10

Ages of females to get a Pap smear

Answer 10

21-65 years old

Question 11

How often to get a Pap smear for different groups of women

Answer 11

1. Abnormal paps: every year
2. Consecutively normal paps: every 3 years
3. Consecutively normal paps + negative HPV testing: every 5 years

Question 12

When to start getting mammograms

Answer 12

50 years

Question 13

What causes 99% of cervical cancer?

Answer 13

High risk HPV strains

Question 14

Where are samples taken during a Pap smear? (4 locations)

Answer 14

Ectocervix, endocervix, transitional zone, squamocolumnar junction

Question 15

Most common area of precancerous lesions and cancers in the cervix

Answer 15

Transformation zone of the cervix

Question 16

Pelvic exam vs Pap smear

Answer 16

Pelvic exam: visual inspection, bimanual exam, and using speculum to swab for STIs
Pap smear: sample the cervix

Question 17

Bimanual exam

Answer 17

Insert index and middle finger in the vagina and lift upward, using other hand push downward to examine the vagina, uterus, and ovaries

Question 18

Some GYN broad DDx

Answer 18

UTI, STI, PID, hernia, ectopic pregnancy, ovarian torsion, ruptured ovarian cyst, spontaneous abortion, tubo-ovarian abscess, uterine fibroid

Question 19

How often is a prostate and testicular exam recommended to be done?

Answer 19

Not recommended routinely, based on symptoms or history

Question 20

What test is indicated for pt with FHx prostate cancer

Answer 20

PSA: prostate specific antigen

Question 21

In which population is testicular cancer most common?

Answer 21

Younger males

Question 22

Broad DDx for groin pain in males

Answer 22

Groin lesion, scrotal mass, hydrocele, epididymitis, testicular cancer, testicular torsion, UTI, inguinal hernia, kidney stones, STI

Question 23

Risk factors for STIs

Answer 23

1. New sex partner in last 60 days
2. Multiple sex partner or sex partner with multiple partners
3. Sex with sex partners recently tx for STI
4. No/inconsistent condom use outside monogamous relationship
5. Trading sex for money/drugs
6. Sexual contact with sex workers
7. Meeting anonymous partners on the internet

Question 24

How are STI’s “reportable diagnoses”?

Answer 24

They must be reported to the local health department for tracking

Question 25

Four ways to detect STIs

Answer 25

Microscopy, wet mount, NAAT, serologic testing

Question 26

NAAT

Answer 26

Nucleic acid amplification testing: methods such as PCR to confirm presence of a bacteria or virus

Question 27

Complications of untreated STIs

Answer 27

PID, upper genital tract infections, infertility, chronic pelvic pain, HPV, chronic infection with herpes/hepatitis/HIV

Question 28

Biggest part of treating STIs

Answer 28

Counseling on sexual behavior

Question 29

How does genital herpes persist for life?

Answer 29

Viral DNA travels by axon to the spinal cord sensory ganglion and stays there forever