Female Genitalia

Question 1

what are important hx questions to ask with female exam?

Answer 1

LMP
frequency/pain a/w periods
heavy or light (# of pads per day)

age at menarche
previous delivery information
OCP hx/past STI

Question 2

what puts a woman more at risk for endometriosis?

Answer 2

abdominal surgery

Question 3

smoking increases risk for which virus?

Answer 3

HPV

Question 4

what is a sign of endometrial cancer?

Answer 4

bleeding in between periods

Question 5

what classifies stage 1 sexual development?

Answer 5

no pubic hair

Question 6

what classifies stage 2 sexual development?

Answer 6

few straight hair along labia

Question 7

what classifies stage 3 sexual development?

Answer 7

curly pigmented hair along labia

Question 8

what classifies stage 4 sexual development?

Answer 8

curly pigmented hair that has not spread to thighs

Question 9

what classifies stage 5 sexual development?

Answer 9

adult hair configuration

Question 10

what is the introitus?

Answer 10

vaginal opening

Question 11

what are skene’s glands?

Answer 11

paraurethral glands
function as lubricator during sex

Question 12

where are bartholin’s glands located?

Answer 12

on posterior aspect of vaginal opening

• prone to blockage
• function as lubricator during sex

Question 13

what is the perineum?

Answer 13

area of skin between anus and vulva

Question 14

what is the transformation zone?

Answer 14

combination of squamous cells (on exocervix) and columnar cells (on endocervix)

Question 15

what might cause blockage of a bartholin’s cyst?

Answer 15

STD

Question 16

what is a nabothian cyst?

Answer 16

cyst present on the surface of cervix
painless, sometimes indurated
normal and don’t require treatment

Question 17

what is a contraindication during pregnancy?

Answer 17

pap smear

Question 18

what type of lubricant should be used during a pap smear/

Answer 18

saline (preservatives may influence test results)

Question 19

which direction should you present the speculum at?

Answer 19

obliquely (not transverse)

• angle it downward
• once presented start opening speculum
• may need bigger speculum in obese patients

Question 20

what are the Pap screening recommendations?

Answer 20

• w/in 3 yrs of the first sexual intercourse (or by age 21 yo)
• annually up to the age of 30 yo
• > 30yo if 3 consecutive negative paps screen every 2-3 years

Question 21

what does ASC-US mean?

Answer 21

atypical squamous cells of undetermined significance

-when combined with risky sexual behaviors you should perform and HPV exam

Question 22

what does LGSIL or LSIL mean?

Answer 22

low grade squamous intraepithelial lesion (mild dysplasia)
CIN 1 (cervical intraepithelial neoplasia)
-most common cause is HPV
-usually resolves on its own w/in two years

Question 23

what does HGSIL or HSIL mean?

Answer 23

high grade squamous intraepithelial lesion (moderate dysplasia = CIN 2)
(severe dysplasia = CIN 3)
(carcinoma in situ = CIN 3)

Question 24

what does AGC mean?

Answer 24

atypical glandular cells of undetermined significance

• adenocarcinoma test
• indicates something going on higher up
• would get an endometrial biopsy

Question 25

which are the more virulent strains of HPV?

Answer 25

6 + 11 (a/w genital warts), 16, 18 (most commonly leads to CA)

Question 26

what should you note when mobilizing the cervix?

Answer 26

tenderness

Question 27

what should you note when palpating the ovaries?

Answer 27

tenderness
size, shape
position
-normal fallopian tube will not be palpable

Question 28

what is bacterial vaginosis?

Answer 28

imbalance of bacterial flora

• look for clue cells on slide (bacteria stuck to them)
• greyish, thin discharge
• fishy or musty odor (wiff test)
• will have alkaline pH (elevated)- normal is 3.8-4.2

Question 29

what is trichomonal vaginitis?

Answer 29

caused by protozoal parasite
irritation, burning, itching of urethra (dyspurunia)
-will do a saline wetmount which will show the parasite (elevated pH)
-do a STI panal
-strawberry cervix (petechiae)
-greenish/white discharge

Question 30

what is candidiasis?

Answer 30

caused by yeast overgrowth

• will show hyphea on KOH wetmount
• will have lower pH
• previous abx use

Question 31

what is a “punch”?

Answer 31

cervical biopsy