Female GU

Question 1

Bartholin glad

Answer 1

secretes mucous into introitus during sexual excitement

Question 2

What if Bartholin or skene gland inflammed?

Answer 2

think gonorrhea

Question 3

Cervial OS nulliparous or multiparous

Answer 3

nulliparous- dot or slit

multiparous- smiles

Question 4

Cervical ectopy

Answer 4

1. appear reddish-pink, raw looking area

2. benign

Question 5

Dyspareunia

Answer 5

1. pain with sex

Question 6

Menstrual cycle days 1-4

Answer 6

1. Ovary- estrogen levels rise
2. Uterus- progesterone stimulates endometrial prostaglandins that cause vasoconstriction and shedding of endometrium
3. CNS hormones- FSH and LH down
4. Symptoms- menstrual bleeding

Question 7

Postmenstrual preovulatory days 5-7

Answer 7

1. Ovary- egg development within follicle
2. Uterus- proliferative phase where uterine lining thickens
3. CNS hormoes- FSH stimulates follicular growth

Question 8

Ovulation

Answer 8

1. occurs day 13 or 14
2. ovary- egg drawn into fallopian tube and fertilization may occur
3. Uterus- end proliferative phase and progesterone causes uterine wall to thicken
4. CNS hormones- LH and estrogen increase and surge in LH causes release of egg
5. symptoms- cervical mucous increases and is stringy and elastic

Question 9

Menstrual cycle days 15-20

Answer 9

1. secretory phase
2. ovary- egg moved into uterus
3. uters- progesterone increases
4. CNS hormones- LH and FSH decrease

Question 10

Menstrual cycle days 21-28

Answer 10

1. luteal phase
2. ovary- if no implantation, progesterone decrease and estrogen decreases and then rises as new follicle develops
3. uterus- menstruation starts around day 28 and menstruation begins 1st fday of next cycle
4. CNS hormones- GnRH increases and causes FSH secretion

Question 11

When does ovulation stop?

Answer 11

1-2 years before menopause

Question 12

When do periods stop?

Answer 12

40-55 yrs

Question 13

What is menopause?

Answer 13

1 year without menses

Question 14

Post-menopausal bleed

Answer 14

1. worrisome

2. think CA

Question 15

Cervical CA risk factors

Answer 15

1. Age- increases late teens to 30,
2. average age 50-55, s/p 55 less likely
3. hx cervical dysplasia
4. early age at first intercourse
5. multiple partners or partner with multiple partners
6. HIV
7. smoking

Question 16

Ovarian CA risk factors

Answer 16

1. age 40-60
2. fertility drugs
3. early menarche (before 12)
4. late menopause (s/p 50)
5. infertility or first child s/p 30
6. hx breast CA
7. family hx
8. HRT

Question 17

Endometrial CA risk factors

Answer 17

1. post-menopausal
2. early menarche
3. late menopause
4. tamoxifen

Question 18

What does cervical motion tenderness suggest?

Answer 18

Pelvic inflammatory disease

Question 19

What do you do if you can palpate an ovary?

Answer 19

get US for cervical CA

Question 20

Red flags for sexual abuse

Answer 20

1. evidence of general abuse or neglect
2. genital, anal, or perianal trauma/scarring
3. unusual genital/anal pigmentation
4. STD
5. genitourinary rashes, sores, pain, bleeding, dysuria, hematuria, UTI
6. behavorial manifestation

Question 21

What are behavorial manifestations of sexual abuse?

Answer 21

1. sexually provocative mannerisms
2. problems with school
3. dramatic weight change
4. depression
5. sleep problems or nightmares

Question 22

When do pelvic exams begin?

Answer 22

1. age 21 or 2 yrs s/p 1st sex

Question 23

How often do women 21-30 need to have pelvic exam?

Answer 23

1. every 2 yrs

Question 24

How often do women 30 and older need pelvic exam?

Answer 24

1. those with 3 negative cervical cytology results every 3 yrs

Question 25

What are early signs of pregnancy?

Answer 25

Goodell- softening of cervix
Hegar- softening of uterine isthmus
Chadwick- bluish color of cervix, vagina, vulva

Question 26

Know ACOG recommendations

Answer 26

see paper