Female GU Flashcards
Bartholin glad
secretes mucous into introitus during sexual excitement
What if Bartholin or skene gland inflammed?
think gonorrhea
Cervial OS nulliparous or multiparous
nulliparous- dot or slit
multiparous- smiles
Cervical ectopy
- appear reddish-pink, raw looking area
2. benign
Dyspareunia
- pain with sex
Menstrual cycle days 1-4
- Ovary- estrogen levels rise
- Uterus- progesterone stimulates endometrial prostaglandins that cause vasoconstriction and shedding of endometrium
- CNS hormones- FSH and LH down
- Symptoms- menstrual bleeding
Postmenstrual preovulatory days 5-7
- Ovary- egg development within follicle
- Uterus- proliferative phase where uterine lining thickens
- CNS hormoes- FSH stimulates follicular growth
Ovulation
- occurs day 13 or 14
- ovary- egg drawn into fallopian tube and fertilization may occur
- Uterus- end proliferative phase and progesterone causes uterine wall to thicken
- CNS hormones- LH and estrogen increase and surge in LH causes release of egg
- symptoms- cervical mucous increases and is stringy and elastic
Menstrual cycle days 15-20
- secretory phase
- ovary- egg moved into uterus
- uters- progesterone increases
- CNS hormones- LH and FSH decrease
Menstrual cycle days 21-28
- luteal phase
- ovary- if no implantation, progesterone decrease and estrogen decreases and then rises as new follicle develops
- uterus- menstruation starts around day 28 and menstruation begins 1st fday of next cycle
- CNS hormones- GnRH increases and causes FSH secretion
When does ovulation stop?
1-2 years before menopause
When do periods stop?
40-55 yrs
What is menopause?
1 year without menses
Post-menopausal bleed
- worrisome
2. think CA
Cervical CA risk factors
- Age- increases late teens to 30,
- average age 50-55, s/p 55 less likely
- hx cervical dysplasia
- early age at first intercourse
- multiple partners or partner with multiple partners
- HIV
- smoking
Ovarian CA risk factors
- age 40-60
- fertility drugs
- early menarche (before 12)
- late menopause (s/p 50)
- infertility or first child s/p 30
- hx breast CA
- family hx
- HRT
Endometrial CA risk factors
- post-menopausal
- early menarche
- late menopause
- tamoxifen
What does cervical motion tenderness suggest?
Pelvic inflammatory disease
What do you do if you can palpate an ovary?
get US for cervical CA
Red flags for sexual abuse
- evidence of general abuse or neglect
- genital, anal, or perianal trauma/scarring
- unusual genital/anal pigmentation
- STD
- genitourinary rashes, sores, pain, bleeding, dysuria, hematuria, UTI
- behavorial manifestation
What are behavorial manifestations of sexual abuse?
- sexually provocative mannerisms
- problems with school
- dramatic weight change
- depression
- sleep problems or nightmares
When do pelvic exams begin?
- age 21 or 2 yrs s/p 1st sex
How often do women 21-30 need to have pelvic exam?
- every 2 yrs
How often do women 30 and older need pelvic exam?
- those with 3 negative cervical cytology results every 3 yrs
