Female Genitalia Flashcards
what are important hx questions to ask with female exam?
LMP
frequency/pain a/w periods
heavy or light (# of pads per day)
age at menarche
previous delivery information
OCP hx/past STI
what puts a woman more at risk for endometriosis?
abdominal surgery
smoking increases risk for which virus?
HPV
what is a sign of endometrial cancer?
bleeding in between periods
what classifies stage 1 sexual development?
no pubic hair
what classifies stage 2 sexual development?
few straight hair along labia
what classifies stage 3 sexual development?
curly pigmented hair along labia
what classifies stage 4 sexual development?
curly pigmented hair that has not spread to thighs
what classifies stage 5 sexual development?
adult hair configuration
what is the introitus?
vaginal opening
what are skene’s glands?
paraurethral glands function as lubricator during sex
where are bartholin’s glands located?
on posterior aspect of vaginal opening
- prone to blockage
- function as lubricator during sex
what is the perineum?
area of skin between anus and vulva
what is the transformation zone?
combination of squamous cells (on exocervix) and columnar cells (on endocervix)
what might cause blockage of a bartholin’s cyst?
STD
what is a nabothian cyst?
cyst present on the surface of cervix
painless, sometimes indurated
normal and don’t require treatment
what is a contraindication during pregnancy?
pap smear
what type of lubricant should be used during a pap smear/
saline (preservatives may influence test results)
which direction should you present the speculum at?
obliquely (not transverse)
- angle it downward
- once presented start opening speculum
- may need bigger speculum in obese patients
what are the Pap screening recommendations?
- 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
what does ASC-US mean?
atypical squamous cells of undetermined significance
-when combined with risky sexual behaviors you should perform and HPV exam
what does LGSIL or LSIL mean?
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
what does HGSIL or HSIL mean?
high grade squamous intraepithelial lesion (moderate dysplasia = CIN 2)
(severe dysplasia = CIN 3)
(carcinoma in situ = CIN 3)
what does AGC mean?
atypical glandular cells of undetermined significance
- adenocarcinoma test
- indicates something going on higher up
- would get an endometrial biopsy
which are the more virulent strains of HPV?
6 + 11 (a/w genital warts), 16, 18 (most commonly leads to CA)
what should you note when mobilizing the cervix?
tenderness
what should you note when palpating the ovaries?
tenderness
size, shape
position
-normal fallopian tube will not be palpable
what is bacterial vaginosis?
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
what is trichomonal vaginitis?
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
what is candidiasis?
caused by yeast overgrowth
- will show hyphea on KOH wetmount
- will have lower pH
- previous abx use
what is a “punch”?
cervical biopsy
