female gu assessment - Sheet1 Flashcards
How many ovaries are there, and what are their functions?
There are two ovaries; they develop ova (eggs) and produce female hormones.
What is the length and orientation of the fallopian tubes?
Each fallopian tube is about 10 cm long and curves posteriorly.
Describe the structure and usual position of the uterus.
The uterus is a thick-walled, muscular organ that typically tilts forward and is positioned superior to the bladder.
Which structure in females is homologous to the male penis?
The clitoris.
Where are Skene’s glands located, and what is their function?
Skene’s glands open posterior to the urethra at the 5 and 7 o’clock positions; ducts are not visible.
What is the function of the Bartholin glands?
Bartholin glands are located on either side and posterior to the vaginal orifice; they secrete lubricating mucus during intercourse.
What is the hymen, and is it always present?
The hymen is a thin fold that may cover part of the vaginal orifice, but it may be absent completely.
What does WSW stand for, and why is it important in assessments?
WSW stands for women who have sex with women; it is important for understanding sexual identity and healthcare needs.
What steps help improve access to care for patients of diverse sexual identities?
Gaining rapport, showing inclusive signs (pamphlets, stickers), and considering needs of transgender women are key.
At what ages and frequency is a cervical cancer screening (Pap test) recommended?
All women with a cervix should have a Pap test every 3 years between ages 21 and 65.
What subjective data is important to collect regarding menstrual history?
Menarche, last menstrual period (LMP), cycle regularity, frequency, duration, and flow.
What are key points in obstetric history to include?
Pregnancy history, any complications, and outcomes.
What are key considerations for menopausal and perimenopausal history?
Age of onset, symptoms like hot flashes, and changes in vaginal elasticity and moisture.
What should be documented for acute pelvic pain?
Onset, duration, severity, location, and associated symptoms.
What objective data should be assessed when inspecting external genitalia?
Skin color, hair distribution, presence of lesions, masses, and discharge.
What is a normal finding for skin color in the genital area?
Even skin color; labia minora are typically a darker pink.
What is the typical hair distribution pattern in the genital area?
Hair should form an inverted triangle shape.
What lesions are commonly considered normal findings?
Occasional sebaceous cysts.
What is an appropriate alternative to a full pelvic exam if the patient is alert and oriented (ANO) x4?
Ask relevant history questions instead of performing a full pelvic exam.
What subjective data should be collected during a breast assessment?
Pain, lump, discharge, rash, swelling, trauma, history of breast disease, surgery or radiation, cosmetic surgeries, medications (e.g., contraceptives).
What are the key elements of a breast inspection?
Symmetry, skin color, presence of bulging/dimpling/puckering, lesions, masses/lumps, texture, appearance of Tail of Spence, and signs of peau d’orange.
What does asymmetry of the breasts indicate?
It could indicate an underlying mass, especially if one breast suddenly becomes larger than the other.
What is peau d’orange, and what might it indicate?
Peau d’orange (orange peel appearance) is often linked to breast cancer, lymphedema, or infection. It usually presents with other symptoms.
How should the location of a breast lump be described?
Use the breast as a clock face (e.g., “2 o’clock position, 3 cm from the nipple”).
What dimensions should be recorded for a lump or mass?
Size should be measured in width, length, and thickness.
What shapes might a breast lump have?
Oval, round, lobulated, or indistinct.
What consistencies can breast lumps have, and what might they indicate?
Soft (possibly a cyst), firm (may indicate a benign tumor), or hard (can indicate malignancy).
What is important to note about the mobility of a lump?
Determine if the lump is freely movable (often benign) or fixed (may suggest malignancy).
What does it mean if a nipple is displaced or retracted?
Nipple displacement or retraction can be a sign of malignancy.
What changes to the skin over a lump should be noted?
Check for erythema (redness), dimpling, or retraction, which could suggest malignancy.
Why is tenderness in a lump significant?
Tenderness may suggest an infection or benign cyst but can also be present in some cancers.
What does lymphadenopathy in a breast exam indicate?
Palpable regional lymph nodes can indicate infection or malignancy.
What is the Tail of Spence, and why is it important in breast self-exams (BSE)?
The Tail of Spence is breast tissue that extends into the axilla, a frequent site for breast tumors, making it crucial to include in BSE.
What characteristics would suggest a normal finding in breast inspection?
Breasts are symmetrical with smooth, even skin tone; no lumps, dimpling, retraction, or lesions are present.
What characteristics would suggest an abnormal finding in breast inspection?
Dimpling, bulging, asymmetry, peau d’orange, or visible lumps could suggest infection, lymphedema, or malignancy.
Are self-breast exams (SBE) still recommended?
No, research hasn’t shown a clear benefit from regular SBEs. Instead, women should know their normal breast look and feel and report changes to a healthcare provider.
What is a mammogram, and what is its purpose?
A mammogram is an X-ray of the breast used to detect breast cancer.
When should women avoid scheduling a mammogram?
Avoid scheduling the week before or during a period, as breasts may be tender or swollen.
What should be avoided on the day of a mammogram?
Do not wear deodorant, perfume, or powder, as these can appear as white spots on the X-ray.
Why might some women prefer to wear a top with pants/skirt rather than a dress for a mammogram?
Because patients must undress from the waist up for the procedure.
What are some breast cancer risk factors that cannot be changed?
Age, genetic mutations (e.g., BRCA1/2), early menstruation (<12 years), late menopause (>55 years), dense breasts, history of breast cancer, family history of breast/ovarian cancer, radiation therapy before age 30, and DES exposure.
What are some breast cancer risk factors that can be changed?
Physical inactivity, postmenopausal obesity, hormone use during menopause, certain contraceptives, reproductive history (e.g., first pregnancy after 30, not breastfeeding), alcohol, and smoking.
What is the significance of BRCA1 and BRCA2 genes?
Abnormal BRCA1 or BRCA2 genes increase the risk of breast, ovarian, and other cancers. Normally, these genes help protect against certain cancers.
What is recommended for women with a family history of breast cancer?
Genetic testing for BRCA1 and BRCA2 mutations may be considered for those at high risk.
What age range is associated with perimenopause, and what symptoms occur?
Perimenopause typically occurs between ages 40-55 and involves hormone shifts leading to vasomotor instability (hot flashes).
At what age range does menopause typically occur?
Menopause usually occurs between ages 35-60.
What vaginal changes are expected with menopause?
The vagina becomes shorter, less elastic, and the vaginal wall more fragile, increasing the risk of vaginitis and irritation.
Why might painful intercourse become more common after menopause?
Due to decreased lubrication and vaginal dryness.
What is the most common STI in the United States?
Human Papillomavirus (HPV).
What is unique about HPV transmission?
HPV can develop symptoms years after transmission and can be spread even when the infected person has no symptoms.
What are possible complications of HPV?
HPV can lead to cervical, anal, penile, vaginal, vulvar, and oropharyngeal cancers.
How is HPV infection typically managed?
Most cases resolve within 2 years without treatment, but vaccination can prevent HPV-related cancers and genital warts.
What is trichomoniasis (trich) and what causes it?
Trichomoniasis is an STI caused by the protozoan parasite Trichomonas vaginalis.
What are common symptoms of trichomoniasis in women?
Itching, burning, soreness in the lower genital tract, and dysuria (painful urination).
How is trichomoniasis treated?
It is curable with antibiotics, usually metronidazole.
What is Pelvic Inflammatory Disease (PID), and what causes it?
PID is an infection often caused by untreated STDs.
How is PID diagnosed?
Through patient history, signs and symptoms, and a pelvic exam.
What is the treatment for PID?
Antibiotics can treat the infection, but they cannot reverse any existing scarring or damage.
What are some complications that can result from PID?
Ectopic pregnancy, infertility, chronic pelvic pain, and tubo-ovarian abscess.
What STI screening does the CDC recommend for sexually active women under 25?
Annual chlamydia and gonorrhea screening, also recommended for older women with risk factors like multiple partners.
How can untreated chlamydia and gonorrhea lead to infertility?
They can cause PID, which may result in scarring and damage to reproductive organs, leading to infertility.
