Approach the Female Patient - Lecture 1 Flashcards
What do you used to determine the expected date of confinement (EDC)?
Nagele Rule
What is the Nagele Rule?
add 9 months and 7 days to FIRST DAY of last NORMAL menstrual period - assuming normal 28 day cycle
If your patient becomes pregnant while they have IUD what do you do??
leave IUD in place most likely
If your patient is pregnant what type of pet do you ask if they have?
cat → toxoplasmosis
Presumptive signs of pregnancy
skin/mucus membrane changes → chadwick sign, linea nigra
amenorrhea, nausea, breast change, fatigue, back pain
Probable signs of pregnancy
changes in uterus and cervix → softer, larger, globular
elevation of basal body temperature, breast tenderness and swelling, chloasma, linea nigra, Chadwick sign, abdominal enlargement, softening of the cervix, ballotability of the uterus, quickening, and positive pregnancy test results
When do you schedule fetal ultrasound in pregnancy?
10-12 weeks
while fetal movement may vary, it is usually seen at 15 weeks and is called ____
quickening
At what ages is vaginal bleeding abnormal?
before 9 and after 52
1 cause of amenorrhea
pregnancy
What do you want to ask about sexual history (the Ps)?
Partners Prevention of Pregnancy Protection from STDs Practices Past History of STDs
Name of system used to give female obstetric history?
FPAL - full term, premature, abortion, living
If you see vaginal bleeding in a newborn it is often from
maternal estrogen withdrawal
Patient experiences vaginal bleeding before other evidence of maturation
precocious puberty
Vaginal bleeding in geriatric patient → first thought
cancer
two guidelines you can follow up with or reference in terms of immunizations or preventative health screening
USPSTF or ACOG
Patients between the ages 21-29 should receive cervical cytology for cervical cancer screening every ____
every 3 years
three options given to pateints between the ages 30-65 in terms of cervical cancer screening
cervical cytology alone every 3 years
high risk HPV screen alone every 5 years
cervical cytology + HPV screen every 5 years
When can you stop screening a patient for cervical cancer?
age 65
what is the USPSTF recommendation for breast cacner screening?
every 2 years between the ages 50-74
what is the ACOG recommendation for breast cancer screening?
every 1-2 years starting at 40, no later than 50, and stopping at age 70
What is the current USPSTF for colorectal screening? What are the options and how often?
45 - 75
FOBT/FIT every year, Flex sigmoidoscopy every 5 years, colonoscopy every 10 years
what is the american cancer society guidelines for colorectal cancer screening?
start at 45 and stop at 75
Colorectal cancer screening is not recommended in patients over
85
what should you do in regards to colorectal cancer screening in a patient between the ages 76-85?
look at patient preference, life expectancy, overall health, prior screening history
where can you find the most recent vaccination chart and schedule?
CDC
