Female GU Flashcards
PMS
-A collection of physical, psychological, and mood symptoms related to a woman’s menstrual cycle
Patho:
Subjective: Symptoms may include breast swelling and tenderness, acne, bloating and waking, headache or joint pain, food cravings, irritability, difficulty concentrating, mood swings, crying spells, and depression. Symptoms of her 5 to 7 days before.
Objective: None. Diagnosis based on symptoms in relationship to menstrual cycle
Infertility
-Inability to conceive over a period of one year of unprotected sexual intercourse
Patho: Many causes, including both male and female conditions. Abnormalities of the vagina, cervix, uterus, fallopian tube’s, and ovaries. Many influencing factors.
Subjective: Unsuccessful attempts to become
Objective: Varies with underlying cause. Often no findings on physical examination
Endometriosis
-Presents and growth of endometrial tissue outside of the uterus
Patho: Not definitive
Subjective: Pelvic pain, dysmenorrhea, and heavy or prolonged menstrual flow
Objective: No findings. On bimanual exam, tender nodules maybe palpable along the ligaments. Diagnosis confirmed by laproscopy
Genital warts (condyloma acuminatum)
-Warty lesions to do to sexually transmitted infection with HPV
Patho: HPV invades the basal layer of the epidermis and virus penetrates through skin and causes me coastal micro abrasion’s. Latent viral phase begins with no signs or symptoms and can last for a month to several years.
Subjective: Soft painless wart like lesions. History of sexual contact.
Objective: Flash – colored, whitish pink to reddish brown, discrete, soft growths on labia, vestibule, Orr. Anal area. Lesions me a Kerr singly or in clusters in May and large the form cauliflower like masses
Molluscum contagiosum
-Viral infection of the skin and mucous membranes. Considered an ST I in adults, in contrast to the common non-– sexually transmitted infection occurring in young children.
Patho: Caused by a pox virus. Spreads through direct contact and through contact with contaminated object.
Subjective: Painless lesions in genital area. Sexually active.
Objective: White or flash – colored, dome – shaped papules that are round or oval. Surface has a characteristic central umbilication from which a thick creamy core can be expressed. lesions may last from several months to several years. Diagnosis usually based on clinical appearance. Direct microscopic exam of stained material from the core will reveal typical molluscum bodies with in the epithelial cell
Syphilitic canker
-Skin lesion associated with primary syphilis
Patho: STI. Transmitted through direct contact with the syphilis sore. Lesions of primary syphilis generally occur two weeks after exposure. Kinker last 3 to 6 weeks, heels without treatment.
Subjective: Often no lesion noted, as may be internal. Painless and genital ulcer. Sexually active.
Objective: Solitary lesion. Firm, round, small, painless ulcer. Lesion has indurated borders with a clear base. Scrapings from the ulcer, examined microscopically, show spirochetes
Condyloma latum
-Lesions of secondary syphilis
Patho: Up here about 6 to 12 weeks after infection
Subjective: Heald solitary genital lesion. Sexually active
Objective: Flat, round, or oval papules covered by a gray exit 8
Genital herpes
-Sexually transmitted viral infection of the skin and mucosa
Patho: Caused by HSV.
Subjective: Painful lesions and genital area, history of sexual contact, may report burning or pain with urination.
Objective: Superficial vesicles in the genital area, internal or external, maybe eroded. Initial infection is often extensive, whereas recurrent infections usually confined to a small localize patch on the vulva, perineum, vaginal or cervix
Inflammation of Bartholin’s gland
Patho: Commonly caused by gonorrhea. Maybe acute or chronic
Subjective: Pain and swelling in the groin
Objective: Hot, red, tender, fluctuant swelling of the Bartholin’s gland that may drain pass. Chronic inflammation result in a nontender cyst on the labium.
Vaginal carcinomas
-Classified according to the type of tissue from which the cancer arises. Squamous cell, adenocarcinoma, melanoma, and sarcoma.
Patho: Squamous cell carcinoma begins in epithelial lining up the vagina, maybe caused by HPV. I don’t know carcinoma begins in the glandular tissue. Malignant melanoma develops back from pigment – producing cells. Sarcomas form deep in the wall of the vagina.
Subjective: Abnormal vaginal bleeding, difficult or painful urination. Pain during sexual intercourse, pain in the pelvic area, back, or legs. Edema in the legs. Risk factor includes patient’s mother having taken DES during pregnancy
Objective: Vaginal discharge, lesions, and masses. Melanoma tends to affect the lower or outer portion of the vagina. TimerZ very greatly in size, color, and growth pattern. Diagnosis is based on tissue biopsy.
Vulvar carcinoma
-Classified according to the type of tissue from which the cancer arises: squamous cell, adenocarcinoma, Melanoma, and basal cell
Patho:
Subjective: Lump or growth in or on the vulvar area or a patch of skin that is differently textured or colored. Ulcer that process for longer than one month. Bleeding from vulvar area. Change in the appearance of an existing mold. Persistent itching, pain, soreness, or burning in the vulvar area. Aim for urination.
Objective: squamous cell carcinoma, also rated or raised lesion on the vulva. Usually found on the labia.
Adenocarcinoma: also rated or leave raised lesion usually found on the side of the vaginal opening.
Melanoma: dark – color lesion most often on the clitoris or the labia minora.
Basal cell: ulcerated lesion.
Physiologic vaginitis
Hx: Increase in discharge
Physical findings: Clear or mucoid discharge
Diagnostic tests: Wet mount: up to 3 to 5 WBCs epithelial cells
BV
Hx: No foul odor, itching, or edema. Foul smelling discharge. Complains of fishy odor.
Physical findings: Homogenous then, white or gray discharge
Diagnostic tests: With test. Wet mount shows a clue cells
Candida vulvovaginitis
Hx: Paretic discharge, itching of labia, itching may extend it to thighs
Physical findings: White, Curti discharge. Cervix may be read. May have erythema of perineum and thighs
Diagnostic tests: Budding branching yeast
Trichomoniasis
Hx: Watery discharge, foul odor, dysuria
Physical findings: Profuse, frothy, greenish discharge. Read friable cervix with petechiae, strawberry cervix
Diagnostic tests: Wet mount shows around or pear shaped protozoa. Motile gyrating Flagella
Gonorrhea
Hx: Partner with STI. Often asymptomatic or may have symptoms of PID
Physical findings: Purulent discharge from cervix. Northland gland inflammation. Cervix and Volvo maybe inflamed
Diagnostic tests: Gram stain, culture, DNA probe
Chlamydia
Hx: partner with nongonococcal urethritis, often asymptomatic. Making plan of spotting after intercourse or urethritis.
Physical findings: Cereal and discharge, cervix may or may not be read or friable
Diagnostic tests: DNA probe
Atrophic vaginitis
Hx: dyspareunia, Vaginal dryness, perimenopausal or post menopausal
Physical findings: Pale, then vaginal mucosa
Diagnostic tests: Wet mount: folder, clumped epithelial cells
Allergic vaginitis
Hx: New bubble bath, soap, dish, or other hygiene product
Physical findings: Foul smell, erythema, pH may be altered
Diagnostic tests: wet mount: WBC
Cervical cancer
-Classified according to the type of tissue from which the cancer arises.
Patho:
Subjective: Usually asymptomatic. Mary port unexpected vaginal bleeding or spotting
Objective: After no findings on physical exam. A hard granular service at or near the cervical us. Lesion can evolve to form an extensive irregular cauliflower growth that bleeds easily. Early lesions are indistinguishable from ectropion. Ulcerated area. Pre-cancerous in early cancer changes are detected by Pap smear
Uterine prolapse
-Dissent or herniation of the uterus into our beyond the vagina
Patho: We can of the supporting structures of the pelvic floor. Occurs concurrently with cystocele and rectocele
Subjective: Sensation of pelvic heaviness and uterus falling out. Tissue protruding from vagina. Mary port urine leakage or urgent continents. Difficulty having bowel movement or blow back pain.
Objective: 1st° prolapse: cervix remains within the vagina. 2nd° prolapse: the cervix is at the introit us. 3rd° prolapse: the cervix and vagina drop out side introit us
Myomas (leiomas, fibroids)
-Common, benign, uterine tumors
Patho:
Subjective: Fibroid symptoms are related to the number of tumors, as well as their size and location. Symptoms may include heavy bleeding, abdominal cramping felt during menstruation, urinary frequency and urgency, constipation, difficult defecation, abdominal cramping, generalized pelvic and lower abdominal discomfort
Objective: Firm, irregular nodules in the count tour of the uterus on bimanual examination. Uterus maybe enlarged
Endometrial cancer
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Patho: Most often in postmenopausal women. Most known risk factors related to in balance between estrogen and progesterone
Subjective: Postmenopausal vaginal bleeding is a red flag
Objective: None. Diagnosed by endometrial biopsy
Ovarian cyst
-Fluid – filled sac in an ovary
Patho:
Subjective: Usually asymptomatic. May report Laura domino pain. Set an onset of abdominal pain may suggest cyst
Objective: Pelvic mass maybe palpated. Cervical motion tenderness may be elicited. Often and incidental finding during ultrasound performed for other reasons
Ovarian cancer
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Patho:
Subjective: Asymptomatic it first. Suspect ovarian cancer in a woman older than 40 years with persistent and unexplained vague gastrointestinal symptoms such as generalized abdominal discomfort pain, gas, indigestion, pressure, swelling, bloating, cramps, or feeling of fullness even after a light meal
Objective: May have no physical findings. On bimanual exam, and ovary that is a marched in pre-menopausal woman or a palpable ovary and post them in a possible woman should be considered suspicious for cancer.
At topic pregnancy
-Occurring outside the uterus
Patho:
Subjective: Abnormal vaginal bleeding. Low back pain. Mild cramping on one side of the pelvis. Pain in the lower abdomen and pelvic area. If the area of abnormal pregnancy ruptures and please symptoms we were sitting. Feeling lightheaded, syncope. Pain in the shoulder area. Severe, sharp, and a sudden pain in the lower abdomen
Objective: Pelvic tenderness with tenderness in the charity at the lower abdomen. Cervical motion tenderness, a tender, unilateral adnexal mass may indicate the side of the pregnancy. Tachycardia and hypertension like hemorrhage. A ruptured table pregnancy is a surgical emergency.
Pelvic inflammatory disease
-Infection of the uterus, fallopian tube’s, and other reproductive organs. A common and serious complication of son of sexually transmitted infections
Patho: Often caused by gonorrhea or chlamydia. Acute or chronic.
Subjective: Maybe mild or absent. I need your vaginal discharge that may have a foul odor. Symptoms include painful intercourse, painful urination, irregular menstrual bleeding, and pain in the right upper abdomen.
Objective: Acute PID produces very tender, bilateral adnexal areas. The patient guards and usually cannot tolerate by manual exam. Symptoms of chronic PID Our bilateral, tender, irregular, and fairly fixed adnexal areas.
Salpingitis
-Inflammation or infection of the fallopian tube’s, often associated with PID
Patho: most cases Occur in two stages: first is vaginal or cervical infection and the second is ascent of the infection to the upper genital tract.
Subjective: Lower quadrant pain. Constant and dollar cramping. Pain may be accentuated by motion or sexual activity. Call existing Pieriel and vaginal discharge. Abnormal vaginal bleeding. Nausea, vomiting, fever.
Objective: Cervical motion tenderness or adnexal 10 of us on bimanual exam. Mucopurulent cervical discharge
Atrophic badger nidus
-Inflammation of the vagina due to the thinning and shrinking of the tissues, as well as decreased lubrication. In elderly.
Patho: Lack of estrogen during perimenopause and menopause.
Subjective: Vaginal soreness or itching. Discomfort or bleeding with sexual intercourse
Objective: Casual mucosa is dry and pale, although it maybe come right in the novella petechia and superficial emotions. Accompanying vaginal discharge maybe white, gray, yellow, green or blood tinged. Can be thick or a watery and although it varies in amount rarely profuse
Screening for cervical cancer
21–65: screen with cytology Pap smear every three years.
30-65: a screen with cytology every three years or Co. testing every five years.
<21: do not screen.
>65 who have had adequate pirate screening and are not high risk: do not screen.
Women after hysterectomy with removal of the cervix and with no history of high grade pre-cancer or cervical cancer: do not screen.
<30: do not screen with HPV testing alone or with cytology.
Risk assessment: HPV infection associated with nearly all cases of cervical cancer.
Screening for ovarian cancer
Do not screen for ovarian cancer.
Women with BRCA1 and BRCA2 genetic mutations, the Lynch syndrome, or family history of ovarian cancer are at increased risk for ovarian cancer. They should be considered for genetic counseling to further evaluate potential risks. Increased risk family history generally means having two or more first or 2nd° relatives with a history of ovarian cancer or a combination of breast and ovarian cancer.
