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PCM II > Female GU > Flashcards

Female GU Flashcards

1
Q

Menarche

A

age at onset of menses

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2
Q

menopause

A

absence of menses for 12 consecutive months

(usually 48-55 years old)

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3
Q

post-menopausal bleeding

A

bleeding occuring 6 months or more after cessation of bleeding

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4
Q

amenorrhea

A

absence of menses

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5
Q

dysmenorrhea

A

pain with menses

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6
Q

polymenorrhea

A

menses at abnormally frequent intervals

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7
Q

oligomenorrhea

A

abnormally scant or infrequent menses

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8
Q

menorrhagia

A

excessive bleeding

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9
Q

metrorrhagia

A

bleeding between periods

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10
Q

post-coital bleeding

A

bleeding after sexual intercourse

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11
Q

Questions to ask in a GYN Hx (9)

A
  1. Last mentrual period
  2. regularity of periods
  3. ususal time between periods
  4. number of days of flow
  5. amount of flow (number of pads/tampons per day)
  6. pain with periods
  7. bleeding between periods
  8. age of menarche
  9. Sexual Hx
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12
Q

Questions in Sexual Hx (4)

A
  1. Current sexual status (active and with whom: M/F)
  2. number of partners (increased number = increased risk of infections)
  3. gender of partners
  4. STDs?
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13
Q

OB Hx: Gravida-Para Notation

A

G= number of pregnancies

P= outcome of pregnancies

  • T = term >37 weeks
  • P = Premature
  • A = abortion <20 weeks (induced or spontaneous)
  • L = Living
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14
Q

Urologic Hx (6)

A
  1. frequency
  2. burning
  3. incontinence (stress, urge, overflow)
  4. urency
  5. nocturia
  6. hematuria
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15
Q

Common Chief Complaints (9)

A
  1. amenorrhea
  2. dysmenorrhea
  3. metrorrhagia
  4. vaginal discharge/itching
  5. abdominal/pelvic pain
  6. dysparunia
  7. infertility
  8. pre-menstrual syndrome (premenstrual dysphoric disorder)
  9. changes in urinary patterns
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16
Q

dyspareunia

A

painful intercourse

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17
Q

Skene’s (Paraurethral) glands

A
  1. Position: 10 and 2 o’clock
  2. Function: Lubrication
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18
Q

Bartholin’s Glands

A
  1. Position: 4 and 8 o’clock
  2. Function: Lubrication
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19
Q

Inspection of Cervix (6)

A
  1. color
  2. position
  3. surface characteristics
  4. discharge
  5. os
  6. transformation zone
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20
Q

Palpation of Genitalia

A
  1. glands
  2. run finger along urethra on anterior wall of vagina
21
Q

Cystocele

A

bladder falls onto anterior vaginal wall

can be seen externally

22
Q

Rectocele

A

rectum pushes on posterior wall of vagina

can be seen

may have problems with bowel movements because distorts path of sigmoid colon

23
Q

Inspection of External Genitalia

A
  1. warn patient first
  2. spread labia
  3. look at vaginal introitus
  4. Glands
24
Q

Insertion of Speculum (6 Steps)

A
  1. select appropriate size speculum
  2. warm and lubricate with warm water
  3. hold at 45 degree anglean d point downward or posterior
  4. gentle downward pressure on posterior introitus
  5. once in vagina, straighten the speculum and gently advance maintaining posterior pressure
  6. slowly open the speculum to visualize the cervix
25
Q

Procedures done during Internal genitalia exam (3)

A
  1. PAP smear
  2. Sample of vaginal secretions for wet mount
  3. GEN probe (nucleic acid amplification-espescially used for chlamydia)
26
Q

Inspection of cervical os (7)

A
  1. shape
  2. size
  3. polyps
  4. pus
  5. cancer
  6. cysts
  7. transformation zone
27
Q

Cervical Os shapes

A
  1. nulliparous-oval
  2. multiparous-slit-like
  3. Lacerations from birth (bilateral transverse, stellate, unilateral transverse)
28
Q

Squamocolumnar Junction

A
  1. junction of columnar and squamous epithelium
  2. varies with age and hormonal status
29
Q

true squamocolumnar junction

A
  • proximal limit of squamous metaplasia
  • usually not visualized (within endocervical canal)
30
Q

transformation zone

A
  • where premalignant changes and neoplasia occur
  • encompasses immature and mature squamous metaplasia
31
Q

Nabothian cysts

A

glandular duct blocked and produces a small cyst

[normally: cervix full of glandular tissue that secretes mucus]

32
Q

Characteristics of cervix in fertile phase

A
  1. os open
  2. soft
  3. fertile mucus
33
Q

characteristics of cervix in infertile phase

A
  1. os closed
  2. hard
  3. no mucus
34
Q

PAP smear technique

A

option 1:

  • -spatula (long end in os)-rotate 360
  • -place brush in os and swirl 360

option 2: use “broom”-rotate 360

35
Q

Bimanual Exam (instructions)

A
  1. middle and index finger of nondominate hand placed in vagina with fingertips on cervix (to lift up uterus)
  2. press dominate/abdominal hand in and down trying to grasp the uterus between your two hands
  3. slide abdominal hand on RLQ/LLQ to palpate uterine tubes and try for ovaries (most not palpable-if you can, might be abnormal)
36
Q

Bimanual Exam (what you feel for) (4)

A
  1. cervix: tenderness, size, position, mobility
  2. uterus: size, shape, consistency, mobility, position, fibroids/nodules
  3. ovaries: size, shape, mobility, tenderness; remember to do bilaterally
  4. strength of pelvic floor
37
Q

Version

A

relationship between fundus of uterus and the vagina

38
Q

Flexion

A

relationship between the fundus of the uterus and the cervix

39
Q

Anteverted

A

fundus pointed forward toward anterior body wall

40
Q

Anteflexion

A

fundus of uterus flexed anteriorly and inferiorly toward cervix

41
Q

Retroverted

A

fundus of uterus >90-100 degrees from anterior wall of vagina

42
Q

Retroflexed

A

Fundus of uterus flexed posteriorly and inferiorly toward cervix

43
Q

Rectovaginal Exam (3 purposes)

A
  1. palpate a retroverted and retroflexed uterus and the utersacral ligaments
  2. screen for colorectal cancer in women 50+ years
  3. assess pelvic pathology in posterior recvaginal pouch (Pouch of Douglas)
44
Q

Anatomy mature female breast

A
  1. 2nd to 6th ribs
  2. lateral border of sternum to MAL
  3. axillary tail of Spence extends laterally across the anterior axillary fold
  4. 15-20 lobes composed of several lobules each
  5. suspensory ligaments of Cooper inserted perpendicularly into dermis to provide structural support
45
Q

Lymph drainage of breast

A
  1. axillary tail: subscapular group of axillary l.n.
  2. upper: infraclavicular l.n.
  3. medial: submammary plexus of opposite breast, l.n. along internal thoracic artery –> mediastinal l.n.
  4. inferior: lymphatics of abdominal wall and to extraperitoneal lymphatic plexus
  5. subareolar and submammary: anterior or pectoral group of axillary l.n.
46
Q

Optimal time to do breast exam

A

5-7 days after LMP

47
Q

Breast Inspection (6)

A
  1. development
  2. size and symmetry
  3. contour-look for tumors
  4. retraction/dimpling of skin/tissue
  5. skin color and texture
  6. venous engorgement
48
Q

Breast Inspection Positions (5)

A
  1. Seated, arms down
  2. armsm over head
  3. hands on hips
  4. palms pressed together in front of abdomen
  5. arms extended and ebnt forward at waist
49
Q

Breast Palpation

A
  1. Patient supine, ipsilateral arm above the head
  2. use fingerpads
  3. pattern: vertical strips or concentrically
  4. motion continuous-do not lift hands
  5. palpate by quadrant, then tail of Spence
  6. 3 levels of pressure-light, medium, firm (superficial to deep-each level before moving to new area)
  7. extend palpation upward until feel only clavicle and downward until feel only ribs
  8. Patient sitting, palpate axilla

PCM II (4 decks)

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