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Clin Assess > Female GU, MSK, and Cultural > Flashcards

Female GU, MSK, and Cultural Flashcards

1
Q

Purpose of female GU exam

A 
ID pathology
Cervical cancer
STI
Family Planning
Counseling - preconception, menopause
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2
Q

Whats part of Reproductive health visit?

A 
History
General / Vital Signs
Breast
Thyroid
Cardiac
Pulmonary
Abdomen
Pelvic exam
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3
Q

Possible problem visits

A 
Vulvovaginal S/s
AUB  Abnormal Uterine Bleeding
Pelvic pain
Pregnancy management
Contraception complaint
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4
Q

Menarch usually (age)

A

9-13 years old

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5
Q

How often have menses

A

every 21-35 days

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6
Q

how long are menses

A

4-7 days

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7
Q

Menstrual Hx Documentation

A

Age of first x cycle frequency x duration

11 x 28 x 5

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8
Q

Menorrhagia

A

excessive amount
>1 week
>80 mL

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9
Q

Oligomenorrhea

A

Less frequency
>35 days
PCOS, Menopause

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10
Q

Polymenorrhea

A

More frequency

<21 days

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11
Q

Metrorrhagia

A

irregular interval

normal flow

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12
Q

Menometrorrhagia

A

irregular interval
excessive flow
Meno + Metro

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13
Q

Amenorrhea

A

absence of menses

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14
Q

Primary amenorrhea

A

failure to ever start

Chromosomal, malnutrition, hypothalamic/pituitary

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15
Q

Secondary amenorrhea

A

stopped after started

pregnancy, breast feeding, menopause, hypothyroid, pituitary tumor, anorexia

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16
Q

Dysmenorrhea

A

Painful periods w/ back/pelvis cramping

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17
Q

PMS when?

A

4 to 5 days before

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18
Q

Pregnancy history Documentation

A

G# P (TPAL)

abortion = therapeutic, or surgical/abortion pill

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19
Q

ROS focus

A

breast, gyn, GU, GI

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20
Q

Dyspareunia

A

pain w/ sex

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21
Q

Perimenopause

A

3-5 years before cessation (menopause)

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22
Q

Average age of menopause

A

51 y/o

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23
Q

S/S from oral contraception

A 
ACHES
Abdominal pain
Chest Pain
Headaches
Eye problems
Sudden leg/calf pain
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24
Q

STI risk assesment - 5 Ps

A 
Partners
Prevention of pregnancy
Protection from STIs
Practices
Past STI history
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25
Q

Proper sequence of female genital exam

A
  1. Inspect external
  2. Speculum exam
  3. Bimanual exam
  4. Rectovaginal exam
    OPTIONAL 5. Rectal exam
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26
Q

Prepuce

A

clit hood

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27
Q

Skene’s glands

A

around urethra, female orgasm
index finger in vagina, pressure anterior
milk for discharge = infection (gonorrhea)

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28
Q

Bartholin’s glands

A

around vaginal opening - 4 & 8 oclock

non-palpable unless cyst

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29
Q

Introitus

A

vaginal opening

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30
Q

HPV warts

A

condyloma acuminatum

31
Q

Speculum exam requirements

A

Nothing in 1-2 days
empty bladder
lithotomy position
Relaxed patient

32
Q

Spec exam draping

A

ab to knees

33
Q

Ectocervix/ Endocervix cell type

A

Ectocervix - squamous epithelium

Endocervix - columnar epithelium

34
Q

Cervix blood supply

A

uterine artery

35
Q

uterus layers

A

perimetrium, myometrium, endometrium

36
Q

site of most ectopic pregs

A

ampulla - egg hangs out longest

37
Q

Order of fallopian tube from uterus

A

isthmus, uterine tube, ampulla, infundibulum, fimbriae

38
Q

External os - nulliparous/parous

A

Nulliparous - small oval

Parous - linear, irregular

39
Q

bubbly vag discharge

A

trichomonas

40
Q

Where is nabothian cyst?

A

cervix

41
Q

Bleeding after sex, common cause?

A

Cervical polyp

42
Q

Cervical swab - must include cells from

A

transformation zone - endocervix (cancer)

+ ecto = rotate brush 360 degrees

43
Q

when remove speculum, make sure

A

blades are closed

44
Q

cystocele

A

bladder wall weakening (2 fingers in labia and patient pushes)

45
Q

Bimanual exam - which hand in

A

Dom hand, other pressing abdomen

46
Q

Bimanual exam - palpate

A 
Vag walls
Cervix (consistency, position, movement (CMT/chandelier))
Uterus (position?)
Ovaries
Pelvic muscles
47
Q

Uterus positions

A

retro/antiflexed, retro/anteverted

48
Q

Enlarged uterus could be

A

pregnancy, fibroids

49
Q

Adnexal mass could be

A

ectopic preg

50
Q

Ovarian mass could be

A

cyst

51
Q

tenderness could be

A

PID, Endometriosis, Cystitis

52
Q

Cervical cancer cell type

A

80% squamous cell carcinoma (transformation zone)

53
Q

HPV screen - no screen

A

less than 21 y/o, more than 65 y/o

54
Q

HPV screen - just PAP no HPV

A

21-30 y/o, every 3 years

55
Q

HPV screen - PAP w/ HPV (or not)

A

30-65 y/o every 3 years, w/ HPV every 5 years

56
Q

3 components to MSK exam

A

Movement, Neuro, Vascular

57
Q

TMJ range of motion assesment

A

palpate - crepitus, clicking

3 finger insert

58
Q

Bouchard’s nodes

A

osteoarthritis, PIP, painless (never MIP)

59
Q

Heberden’s nodes

A

osteoarthritis, DIP, painless (never MIP)

60
Q

Tophi

A

gout, painful, MIP yes

61
Q

Mallet finger

A

bent DIP on straight finger

jammed then disrupted extensor tendon

62
Q

Trigger finger

A

pops when straighten finger

nodule at base of MIP, flexor tendon

63
Q

Boutonniere deformity

A

Flex PIP, Hyperextend DIP

64
Q

Swan-neck deformity

A

Hyperextend PIP, Flex DIP

65
Q

Chronic rheumatoid arthritis deformity

A

in MIP (so NOT osteoarthritis), squeeze test hurts

66
Q

Olecranon bursitis

A

NO pain, plumbers

67
Q

Silver fork deformity, collee’s fracture

A

distal radius fracture

68
Q

joint effusion

A

fell - blood
longstanding rheumatoid arthritis flair - synovial
Gout - crystals/fluid

69
Q

joint crepitus

A

cartilage loss

70
Q

genu valGUM

A

knock knees

71
Q

genu valRUM

A

bow-legged

72
Q

mongolian spot

A

blue/black discoloration to back

73
Q

FICA

A

F: What is your faith or belief?
Do you consider yourself spiritual or religious?
What things do you believe in that give meaning to your life?
I: Is it important in your life?
What influence does it have on how you take care of yourself?
How have your beliefs influenced your behavior during this illness?
What role do your beliefs play in regaining your health?
C: Are you part of a spiritual or religious community?
Is this of support to you and how?
Is there a person or group of people you really love or who are really important to you?
A: How would you like me, your healthcare provider, to address these issues in your healthcare?

74
Q

Patient Explanatory Model

A

[1] What do you think has caused your problem?
[2] Why do you think it started when it did?
[3] What do you think your sickness does to you? How does it work?
[4] How severe is your sickness? Will it have a short or long course?
[5] What kind of treatment do you think you should receive?
[6] What are the most important results you hope to receive from this treatment?
[7] What are the chief problems your sickness has caused for you?
[8] What do you fear most about your sickness?

Clin Assess (2 decks)

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