Chapter 26 Female Genitourinary

Question 1

At birth DC:

Answer 1

external genitalia engorged because of presence of maternal estrogen
Size recedes in a few weeks.

Question 2

childhood DC:

Answer 2

ovaries are in the abdomen rather than the elvis; move into the pelvis at time of menarche

Question 3

Pregnant woman DC

Answer 3

cervical and vaginal secretions increase during pregnancy.
20-24 weeks—uterus almost to the liver, displacing intestines superiorly and laterally.
During pregnancy—risk of yeast infection—increase glycogen and pH

Question 4

Aging woman DC

Answer 4

Clit size decreases after age 60; menopause at 48-51 years—cessation of menses
Ovaries stop producing progesterone and estrogen.
Decreased size of the uterus; ovaries atrophy; uterus droops;
Vagina less elastic; atrophies; decreased secretions
Decreased sexual response; decreased vaginal secretions; decreased duration of orgasm and rapid resolution.

Question 5

Acute pelvic pain

Answer 5

last less than 3 months consider urgent condition, pelvic inflammatory disease, appendicitis, ruptured ovarian cyst, ovarian torsion, which needs transvaginal ultrasound

Question 6

Consider delayed puberty if

Answer 6

no pubic hair or breast development has occurred by age 13

Question 7

Newborn DC

Answer 7

sanguineous or mucus discharge from vagina normal during first few weeks because of maternal estrogen effect.
Ask about pain with urinating, crying holding genitals

Question 8

Aging Adult and screening

Answer 8

women ages 65 years should stop cervical cancer screening if they have more than 3 consecutive negative pap test or less than 2 consecutive neg hpv and pap test within the last 10 years. Also, women with a total hysterectomy should stop cervical cancer screening.

Question 9

puberty reaches is peaks

Answer 9

during first menstrual cycle.

Question 10

Is irregularity of menstrual cycle common during adolescent?

Answer 10

Yes,

Question 11

menopause symptoms ask about

Answer 11

hot flashes, night sweats, numbness and tingling, headaches, palpitations, mood swings.
Assess reaction to loss.

Question 12

HRT can cause

Answer 12

fluid retention, breast pain, vaginal bleeding, CVD and breast cancer.

Question 13

HPV and pap cotesting every ____ years for women at what age

Answer 13

5 between ages 30-65

Question 14

Acute pelvic pain

Answer 14

last less than 3 months consider urgent condition, pelvic inflammatory disease, appendicitis, ruptured ovarian cyst, ovarian torsion, which needs transvaginal ultrasound

Question 15

Consider delayed puberty if no pubic hair or breast development has occurred

Answer 15

by age 13

Question 16

External genitalia—Inspect—skin color even;

Answer 16

labia minora should be a darker pink

Question 17

perimenopausal period from 40-55 years has hormone shifts, resulting in

Answer 17

vasomotor instability

Question 18

menrrhagia

Answer 18

heavy menses

Question 19

UI can result in what three things

Answer 19

decrease quality of life, limited activities increase falls and fracture risk

Question 20

infertility is considereed

Answer 20

after 1 year of unprotected sexual intercourse without conceiving.

Question 21

pressure in genital area, loss of urine with cough/sneeze, back pain and constipation occurs with

Answer 21

weekend pelvic musculature and uterine prolapse

Question 22

vaginal itching, discharge, pain with intercourse

Answer 22

atrophic vaginitis

Question 23

postmenopausal bleeding warrants

Answer 23

pelvic exam, transvaginal ultrasonography, and referral

Question 24

in the aging adult the cervix

Answer 24

shrinks and looks pale and glistening. It may retract appearing to be flush with the vaginal wall.