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Clinical Assess 3 > Female > Flashcards

Female Flashcards

1
Q

Menarche=age of onset is usually

A

9-13

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2
Q

How often does the patient have menses?

A

21 to 35 days is normal

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3
Q

How long are the menses?

A

4 to 7 days is normal

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4
Q

To document menstrual history:

A

Age x Cycle frequency x duration.

Example: age 11, every 28 days, 5 day duration= 11 x 28 x 5

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5
Q

increased frequency of menses

A

polymenhorrhea

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6
Q

excessive amount of menses

A

menorrhagia

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7
Q

decrease frequency of menses

A

oligomenorrhea

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8
Q

interval between menses irregular

A

metrorrhagia

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9
Q

combination: irregular interval, excessive amount of menses

A

menometrorrhagia

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10
Q

absent menses

A

amenhorrhea

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11
Q

failure of menses to be initiated

A

Primary amenhorrhea

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12
Q

cessation of menses have it had previously existed

A

Secondary amenhorrhea

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13
Q

painful periods with cramping or aching in the lower pelvis/lower back

A

dysmenorrhea

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14
Q

Complex of symptoms occuring 4 to 5 days before onset. Psychological and physical (tension, irritability, depression, mood swings, weight gain, bloating, edema, headaches, breast tenderness)

A

Premenstrual syndrome (PMS)

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15
Q

Pregnancy history documentation

A 
G#P(TPAL)
G#=total # pregnancies
P=# deliveries
T=full term deliveries >37 wks
P=premature deliveries  <20-37 weeks
A=abortion/miscarriage
L=living children
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16
Q

Total number of pregnancies

A

gravity

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17
Q

Number of deliveries

A

parity

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18
Q

full term deliveries

A

> 37 wks

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19
Q

premature deliveries

A

<20-37 weeks

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20
Q

Document:

  • 5 living children
  • 4 children delivered full term
  • emergency surgery at 8 months
  • 2 abortions

G_P_ _ _ _

A

G7 P4125

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21
Q

pain with sex

A

dyspareunia

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22
Q

what causes menopause?

A

decline in ovarian production of estrogen

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23
Q

Average age of menopause

A

51 years

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24
Q

Women on contraception. Ask about?

A 
ACHES
Abdominal pain
Chest pain
Headaches
Eye problems
Sudden leg or calf pain
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25
Q

abdominal pain-from IUD

A

dyspareunia

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26
Q

IUD came out

A

expulsion

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27
Q

5 P’s model of sexual history

A 
Partners
Prevention of pregnancy
Protection from STIs
Practices
Past history of STIs
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28
Q

Sequence of female exam

A

1) Inspect
2) Speculum
3) bimanual
4) rectovaginal
5) rectal

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29
Q

Blood supply for female genitalia

A

internal iliac artery

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30
Q

all structures visible externally from pubis to perineum

A

vulva

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31
Q

fat pad located over pubic bone

A

mons pubis

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32
Q

hair-covered folds of tissue that protect inner genitalia

A

labia majora

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33
Q

protects opening of vagina and urethra

A

labia minora

34
Q

erectile tissue to provide sexual pleasure

A

clitoris

35
Q

thin membrane that partially surrounds the opening of the vagina

A

hymen

36
Q

clitoral hood, provides protection

A

prepuce

37
Q

location of bartholin glands

A

4 and 8 o’clock

38
Q

Skene’s glands

A

function debatable; apply pressure on anterior vaginal wall

39
Q

Before speculum exam… instructions for patient

A

NOTHING for 1 to 2 days (48-72 hours)

empty bladder before exam

40
Q

What position is the speculum exam performed in?

A

lithotomy

41
Q

Speculum is a _____ procedure, not a _____ procedure

A

clean, not sterile

42
Q

Speculum insertion steps

A

1) insert index finger
2) locate the cervix
3) insert speculum at slight angle downward, slowly remove finger
4) apply posterior pressure to open/patient should inhale
5) slowly open, catch cervix in between blades and lock in place

43
Q

elastic muscular tube extending upward; connects cervix to vulva

A

vagina

8-10 cm in length

44
Q

consists of fibrous tissue and small amount of smooth muscle; makes up lower 1/3 of uterus

A

cervix

45
Q

ectocervix

A

squamous epithelium

46
Q

endocervical canal

A

columnar epithelium

47
Q

blood supply of cervix

A

uterine artery

3 and 9 oclock

48
Q

Cervical contains and external orifice and internal orifice. what is visible on exam?

A

external os

49
Q

folds lining the vagina; allows expansion during sex and childbirth

A

rugae

50
Q

small, oval cervix

A

nulliparous

51
Q

linear, irregular cervix

A

parous

52
Q

Mucus trapping

A

nabothian cyst

53
Q

soft, friable mass protruding from cervix external os; most common benign cervical lesion

A

polyps

54
Q

Specimen collection of PAP

A

1) obtain from endocervix AND ectocervix
2) place broom in, rotate 360 degrees
3) MUST INCLUDE CELLS FROM ENDOCERVIX (common site for cancer)

If pregnant, use cotton tipped

55
Q

Abnormal secretion

A

wet prep of saline and KOH

56
Q

Removing the speculum

A

make sure blades are closed to avoid lacerations

57
Q

bladder wall weakening

A

cystocele

58
Q

rectal tear or defect cause bulging

A

rectocele

59
Q

pelvic floor muscles and ligaments stretch and weaken causing uterus to descend into vagina

A

uterine prolapse

60
Q

place two fingers inside labia and ask patient to bear down to see if vaginal walls bulge

A

check for prolapse

61
Q

place 2 fingers against walls of vagina and have patient squeeze fingers

A

assess vaginal tone

62
Q

Pain elecited during bimanual exam

A

chandelier sign

63
Q

enlarged uterus causes

A

pregnancy, fibroids

64
Q

adexal mass causes

A

ectopic pregnancy

65
Q

ovarian mass causes

A

cysts

66
Q

tenderness with bimanual exam causes

A

pelvic inflammatory disease (PID)
Endometriosis
Cystitis

67
Q

Cervical cancer is primarily

A

> 80% squamous cell carcinoma

>95% due to HPV

68
Q

HPV types-cancer

A

16 and 18

69
Q

HPV types-genital warts

A

6 and 11

70
Q

Given to mothers to prevent miscarriage

A

diethylstilbestrol hormone (DES)

71
Q

Cervical screening for women ages

A

21-65

72
Q

Cytology guidelines

A

21-30 y

73
Q

Cytology+HPV dna guidelines

A

30-65 y

74
Q

Patient is <21: guideline?

A

do not screen

75
Q

Patient is 21-30: guideline?

A

cytology every 3 years; no HPV

76
Q

patient is 30-65: guideline?

A

cytology every 3 years OR cytology with HPV every 5 years

77
Q

patient is >65 y: guideline?

A

do not screen

78
Q

recommended vaccine for prevention of cervical, vulvar, vaginal, and anal, throat and penile cancers

A

Ages 9-26

Guardasil 9

79
Q

recommended vaccine for prevention of precancerous lesions due to HPV

A

Ages 9-26

Guardasil HPV Quadrivalent

80
Q

Speculum is ____ the bimanual exam

A

before

Clinical Assess 3 (8 decks)

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