18 - Female Genetalia

Question 1

Menarche

Answer 1

first menstruation and initiation of cyclic menstrual function***

Question 2

Menopause

Answer 2

absence of menses for 12 consecutive months, usually occurring between 48 and 55 years***

Question 3

Postmenopausal bleeding

Answer 3

bleeding occurring 6 months or more after cessation of menses***

Question 4

Amenorrhea

Answer 4

absence of menses

***

Question 5

Dysmenorrhea:

Answer 5

painful or difficult menstruation
Primary = no actual pathology
Secondary = endometriosis, other
***

Question 6

Premenstrual syndrome

Answer 6

a cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for 3 consecutive cycles
***

Question 7

Abnormal uterine bleeding

Answer 7

bleeding between menses; includes infrequent, excessive, prolonged, or postmenopausal bleeding

Question 8

Pap smear begins at _____

Answer 8

Age 21

Regardless of behavior, risk factors, and age of first sex
***

Question 9

21-29 year olds

Answer 9

Cytology only every three years, no HPV testing

Question 10

30-65 year olds

Answer 10

• Co-testing: cytology and HPV testing
• Cytology and HPV testing every 5 years (preferred)
  Cytology alone every 3 years (acceptable)

HPV alone NOT RECOMMENDED
***

Question 11

After 65

Answer 11

Depends on previous results

Question 12

65+ and past 5 years were negative

Answer 12

No further testing

This means 3 consecutive negatives or two consecutive co-tests

Question 13

Continue screening 65+ if…

Answer 13

CIN2, CIN3 or adenocarcinoma

Question 14

65+ and hysterectomy

Answer 14

No further testing if cervix removed & no history of CIN2 or higher

Screening continues every 3 years, next 20 years if high-grade lesion prior to hysterectomy or cuff recurrence

Question 15

Guidelines do NOT apply to…

Answer 15

HIV infection
Immunosuppression
Exposure to diethylstilbestrol (DES) in utero
History of cervical cancer

Question 16

Cervix points posteriorly

Answer 16

Anteverted uterus

Question 17

Cervix points anteriorly

Answer 17

Retroverted uterus

Question 18

Cervix in horizontal positon

Answer 18

Midposition uterus

Question 19

Cervix should be…

Answer 19

Midline

Normally, if you go straight in, you will see the cervix

Question 20

Cervix usually protrudes…

Answer 20

Cervix usually protrudes 1-3 cm into vagina

Question 21

HPV vaccine

Answer 21

Gardasil

Targets HPV-16 and HPV-18, 2 most common cancer causing HPV types

Question 22

HPV vaccine limitations

Answer 22

Vaccine does not protect against 30% of cervical cancer caused by HPV types other than 16 and 18

Question 23

Level of protection

Answer 23

• Nearly 100% protection if women are not exposed to the virus and get the vaccine
• Less level of protection if a woman was already exposed to HPV 16 or 18
• May not see impact of vaccine for 15-20 years, thus still need to screen regularly
• Now given to both males/females