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Patient Assessment > Female Genitalia > Flashcards

Female Genitalia Flashcards

1
Q

What can dates of previous periods signal?

A

Possible pregnancy or menstrual irregularities

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2
Q

Primary dysmenorrhea

A

Results from increased prostaglandin production during the luteal phase of the menstrual cycle, when estrogen and progesterone levels decline

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3
Q

What are the causes of secondary dysmenorrhea?

A

endometriosis, adenomyiosis (endometriosis in muscular layers of uterus), pelvic inflammatory disease, endometrial polyps, low body weight from any causes including malnutrition, and anorexia nervosa, stress, chronic illness, hypothalamic-pituitary-ovarian dysfunction

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4
Q

What are the causes of abnormal uterine bleeding?

A

Vary by age group; includes pregnancy, cervical or vaginal infection or cancer, cervical or endometrial polyps or hyperplasia, fibroids, bleeding disorders, and hormonal contraception or replacement therapy

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5
Q

What is suggestive of postcoital bleeding?

A

cervical polyps or cancer; atrophic vaginitis in an older women

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6
Q

What are causes of postmenopausal bleeding?

A

endometrial cancer, hormone replacement therapy, uterine polyps, and cervical polyps

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7
Q

What is suggestive of amenorrhea followed by heavy bleeding?

A

Suggests a threatened abortion or dysfunctional uterine bleeding related to lack of ovulation

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8
Q

What are the signs and causes of female sexual dysfunction?

A

A woman may lack desire, fail to become aroused an attain adequate vaginal lubrication, or despite adequate arousal, may be unable to reach orgasm. Causes include lack of estrogen, medical illness and psychiatric conditions

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9
Q

What is suggestive of superficial pain?

A

May suggest local inflammation, atrophic vaginitis, or inadequate lubrication

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10
Q

What is suggestive of deeper pain?

A

May suggest pelvic disorders or pressure on a normal ovary

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11
Q

What is the most common cause of acute pelvic pain?

A

Pelvic inflammatory disease (PID), followd by ruptured ovarian cyst, and appendicitis. STIs and recent IUD insertion are red flags for PID.

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12
Q

What must always be ruled out first when doing a serum or urine test?

A

Ectopic pregnancy

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13
Q

What can you consider if a patient presents with pelvic pain?

A

Mittelschmerz (pain from ovulation at midcycle), ruptured ovarian cyst and a tubo-ovarian abscess

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14
Q

Endometriosis

A

Caused from retrogade menstrual flow and extension of the uterine lining outside the uterus. It affects 50% to 60% of women and gerils with pelvic pain

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15
Q

What are other causes of endometriosis?

A

Adenosis and fibroids, from tumors in the uterine wall or submucosal or subserosal surfaces arising from the smooth muscle cells of myometrium.

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16
Q

Red flag for chronic pelvic pain

A

sexual abuse

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17
Q

Conventional pap smears

A

Have a 30% to 87% sensitivity and 86% to 100% specificity for detecting cervical cancer

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18
Q

Liquid-based cytology

A

Have a 61% to 95% sensitivity and 78% to 82% specificity. Blood cells can be filtered out during this test

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19
Q

Delayed puberty

A

Often familial or related to chronic illness. May also arise from abnormal function of the hypothalamus, anterior pituitary gland or ovaries

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20
Q

What is suggestive of pediculosis pubis (lice or “crabs”)?

A

Excoriations or itchy, small, red maculopapules. Look for nits or lice at the bases of the pubic hairs

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21
Q

What conditions are indicated by enlarged clitoris?

A

masculinized conditions

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22
Q

What should you look for when examining the urethral meatus?

A

Observe for urethral caruncle, prolapse of the urethral mucosa and tenderness in interstitial cystitis

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23
Q

What can occur to Bartholin’s gland?

A

May become acutely or chronically infected and then produce a swelling

24
Q

Imperforate hymen

A

This condition occasionally delays menarche. Be sure to check for this possibility when menarche seems unduly late in relation to the development of a girl’s breasts and pubic hair

25
Q

What should you look for in an endometriosis involving the uterosacral ligament?

A

look for lateral displacement of the cervix

26
Q

What does a yellowish discharge on endocervical swab suggests?

A

Suggests a mucopurulent cervicitis, commonly caused by Chlamydia trachomatis, Neisseria gonorrheae, or herpes simplex

27
Q

What occurs in condylomata or cervical cancer?

A

lesions that are raised, friable, or lobed wartlike

28
Q

What is chlamydial infection linked to?

A

It is linked to urethritis, cervicitis, pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain.

29
Q

What are risk factors for chlamydial infection?

A

Age younger than 26, multiple partners, and prior history of STI’s

30
Q

What can be used to test for Chlamydia and gonorrhea?

A

cervical broom and liquid-based cytology

31
Q

What causes vaginitis with discharge?

A

Candida, Trichomonas vaginalis, and bacterial vaginosis

32
Q

What does the diagnosis of vaginitis depend on?

A

Depends on laboratory tests because sensitivity and specificity of discharge characteristic is low. Vaginal cancer is rare int his condition.

33
Q

What are risk factors for vagintis?

A

diethylstilbestrol (DES) exposure in utero and HPV infection

34
Q

What distinction can a rectovaginal examination make?

A

It can distinct the difference between a rectovaginal mass (simulated by stool in rectum & dented by digital pressure) and malignant mass.

35
Q

What does cervical motion tenderness and/or adnexal tenderness suggest?

A

They can suggest pelvic inflammatory disease, ectopic pregnancy, and appendicitis

36
Q

What can a uterine enlargement suggest?

A

It can suggest pregnancy, uterine myomas (fibroids), or malignancy

37
Q

What does nodules on uterine surfaces suggest?

A

Myomas

38
Q

Palpation of ovaries

A

Ovaries are often non-palpable and atrophic 3 to 5 years after menopause. In postmenopausal women, investigate a palpable ovary for possible ovarian cyst or ovarian cancer

39
Q

What are common some signs of ovarian cancer?

A

pelvic pain, bloating, increased abdominal size, and urinary tract symptoms

40
Q

What are some causes of adnexal masses?

A

Can arise from tubo-ovarian abscess, salpingitis or inflammation of fallopian tubes form PID or ectopic pregnancy. Should distinguish from uterine myoma.

41
Q

What are some causes of pelvic floor muscle weakness?

A

Due to aging, vaginal deliveries, neurological conditions. Associated with stress incontinence

42
Q

What causes overrecruitment with tightening, vaginal wall tenderness, and refered pain found in pelvic pain?

A

Pelvic floor spasm, interstitial cystitis, vulvodynia, and urethral spasms

43
Q

Trigger point tenderness in pelvic floor muscles can be seen in what condition?

A

Pelvic floor spasm

44
Q

What occurs in endometriosis?

A

nodularity and thickening of uterosacral ligaments, and pain with uterine movement

45
Q

What is the most common type of hernia found in women?

A

An indirect inguinal hernia is the most common followed by femoral hernia.

46
Q

What can cause urethritis?

A

Can arise from infection with Chlamydia trachomatis or Neisseria gonnorrhea

47
Q

Syphilitic chancre lesion

A

firm, painless ulcer

48
Q

Variations in cervical surfaces

A

squamous epithelium, columnar and squamous epithelium, retention/nabothian cysts, cervical polyps

49
Q

Retroversion of uterus

A

tilting backward of entire uterus, including both body and cervix; can be due to endometriosis or pelvic inflammatory disease; cervix faces forward and uterine body cannot be felt by abdominal hand

50
Q

Retroflexion uterus

A

backward angulation of uterus in relation to cervix; cervix maintains normal position; body of uterus palpable through rectum or posterior fornix

51
Q

Myomas (fibroids)

A

Common benign uterine tumors that feel like firm, irregular nodules in continuity with uterine surface

52
Q

Prolapse of uterus

A

results from weakness of supporting structures of pelvic floor and is often associated with rectocele and cystocele.

53
Q

1st degree prolapse:

A

cervix is still within vagina

54
Q

2nd degree prolapse:

A

cervix at introitus

55
Q

3rd degree prolapse (procidentia):

A

cervix and vagina are outside introitus

Patient Assessment (18 decks)

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