10: Reproductive Topics Flashcards
Gonadarche
Activation of gonads by FSH and LH
Thelarche
Development of breast tissue due to estrogen
Spermarche
First sperm production
Pubarche
First pubic hair development
Age of puberty for females and males
Females: 10-14
Males: 11-16
When is menarche compared to puberty?
Menarche comes 2-3 years after puberty
What stage of breasts on the Tanner scale are females when menarche occurs?
3 or 4
When does pubarche and increased male genitalia occur in males?
From 9-13.5 years old
What is the GP (expanded) for a woman with 5 pregnancies, 3 term deliveries, 1 spontaneous abortion, and 1 live delivery at 34 weeks?
G5P3114
Ages of females to get a Pap smear
21-65 years old
How often to get a Pap smear for different groups of women
- Abnormal paps: every year
- Consecutively normal paps: every 3 years
- Consecutively normal paps + negative HPV testing: every 5 years
When to start getting mammograms
50 years
What causes 99% of cervical cancer?
High risk HPV strains
Where are samples taken during a Pap smear? (4 locations)
Ectocervix, endocervix, transitional zone, squamocolumnar junction
Most common area of precancerous lesions and cancers in the cervix
Transformation zone of the cervix
Pelvic exam vs Pap smear
Pelvic exam: visual inspection, bimanual exam, and using speculum to swab for STIs
Pap smear: sample the cervix
Bimanual exam
Insert index and middle finger in the vagina and lift upward, using other hand push downward to examine the vagina, uterus, and ovaries
Some GYN broad DDx
UTI, STI, PID, hernia, ectopic pregnancy, ovarian torsion, ruptured ovarian cyst, spontaneous abortion, tubo-ovarian abscess, uterine fibroid
How often is a prostate and testicular exam recommended to be done?
Not recommended routinely, based on symptoms or history
What test is indicated for pt with FHx prostate cancer
PSA: prostate specific antigen
In which population is testicular cancer most common?
Younger males
Broad DDx for groin pain in males
Groin lesion, scrotal mass, hydrocele, epididymitis, testicular cancer, testicular torsion, UTI, inguinal hernia, kidney stones, STI
Risk factors for STIs
- New sex partner in last 60 days
- Multiple sex partner or sex partner with multiple partners
- Sex with sex partners recently tx for STI
- No/inconsistent condom use outside monogamous relationship
- Trading sex for money/drugs
- Sexual contact with sex workers
- Meeting anonymous partners on the internet
How are STI’s “reportable diagnoses”?
They must be reported to the local health department for tracking
Four ways to detect STIs
Microscopy, wet mount, NAAT, serologic testing
NAAT
Nucleic acid amplification testing: methods such as PCR to confirm presence of a bacteria or virus
Complications of untreated STIs
PID, upper genital tract infections, infertility, chronic pelvic pain, HPV, chronic infection with herpes/hepatitis/HIV
Biggest part of treating STIs
Counseling on sexual behavior
How does genital herpes persist for life?
Viral DNA travels by axon to the spinal cord sensory ganglion and stays there forever
