Female Genital Flashcards
absence of menstruation
amenorrhea
shortened interval between periods—less than 19 to 21 day
oligomenorrhea
lengthened interval between periods—more than 35 days
polymenorrhea
excessive flow during normal duration of regular periods
Hypermenorrhea
d flow during normal duration of regular periods
Hypomenorrhea
regular and normal interval between periods, excessive flow and duration
menorrhagia
irregular interval between periods, excessive flow and duration
metrorrhagia
irregular or excessive bleeding during periods and between periods
menometrorrhagia
What is time btw menstrual cycle?
mittelschmerz
What is GTPAL?
gravidity term preg preterm preg abortions Living
What is the purpose of the genital self exam?
to find STI or malignant changes
What are symptoms of female genitalia that are related to aging?
itching, urinary symptoms, dyspareunia
Who can discontinue cervical cancer screening?
those post hysterectomy that have had it removed for non cancerous reasons
What are pap smear and pelvic recommendations for healthy low risk asymptomatic pts?
3-5 yrs
What is pap/pelvic recommendation for high risk disease, symptomatic?
yearly
When should cervical ca screenings start?
age 21
How often should cervical CA be screened in 21-29yo?
every 3 yrs, NO HPV testing
How often should women 30-65 be screen for cervical CA?
pap + HPV every 5 years
OR
pap every 3
What is the screening requirement for women over 65 for cervical canceR?
if had normal results than NONE
hx of cervical precancer - test for 20 years after yearly
What is the recommendation for cervical screening for pt with uterus and cervix removed?
none – if not removed for cancer reasons
What are risk factors for cervical cancer?
HPV infection HPV vaccination is + protect Lack of pap smears high parity young age at parity smoking HIV infection Diet - if shitty/overwt DES exposure OCP use for 5+ years low socioeconomic status
What are risk factors for ovarian cancer?
age - increases BRCA 1 and BRCA 2 Family hx - colon ca, ashkenazi jew obesity Nulliparity use fertility drugs personal hx of ca hormone replacement therapy diet - high fat OCP - + protective
What is a protective factor for cervical CA?
HPV caccination
What is protective factor for ovarian?
OCP use
What are the risk factors for endometrial CA?
early menarch 50 total menstration years infertility or nulliparity obesity tamoxifen ERT ovarian disease diet - high fat DM age - increase >40 yo family hx - endo, breast, ovrain, colorectal personal ca hx pelvic radiation
What position do you do the pelvic in?
lithotomy
What do you palpate the cervix for?
size, shape, position, length, mobility
What do you have pt do before pelvic?
empty bladder
How big is the clitoris?
2 cm long and .5cm wide
What gland do you milk?
skene, move finger up and outward
What is an anterior pointing cervix?
retroverted uterus
What is posterior pointing cervix?
anteverted
What is a horizontal cerix?
midposition
What does the os look like in nulliparitious?
small round or oval
How does the os look like in multiparious women?
horizontal slit or irregualar shape
What can present on cervix?
nab cyst
hold a cotton swab in the cervical os for 10 to 30 seconds. Then spread the specimen in a Z pattern over the culture medium
gonococcal culture specimen
rotate a Dacron swab in the endocervical canal for 30 seconds. Then place the swab in the reagent tube.
DNA probe fro clamydia and gonorrhea
obtain a vaginal discharge specimen with a swab. Smear the specimen on a glass slide and add a drop of normal saline
wet mount
What does a wet mount detect?
trichomonads or clue cells
What does a fishy odor mean?
bacterial vaginosis
obtain a vaginal discharge specimen with a swab. Place the specimen on a glass slide and add a drop of 10% potassium hydroxide.
KOH test
what does KOH test for?
candidiasis
What do you want to check the vaginal walls for?
color, surface, secretion, hernial protrusions
What is protrusion through anterior vagina?
cystocele
What is protrusion through posterior vaginal wall?
rectocele
What part of the pap stick should you use for post hysterectomy?
blunt end around suture
What do you have to label pap for post hysterectomy?
vaginal cells
What do you look for with the uterus?
location, position, size, shape, contour, mobility
How does the vaginal mucosa appear?
transverse rugated, loses rugation after menopause
What is chadwick sign?
blue vagina mucosa
What can cervical motion tenderness mean?
PID
Are nabothian cysts malignant?
no, normal variant
What are clue cells seen in?
bacterial vaginosus
What does a fixed uterus mean?
adhesions
What do cervical polyps look like?
bright red
