GU & Reproductive - Week 12 Flashcards
Your 61-year-old female patient presents with chief complaint spontaneous, unilateral bloody nipple discharge. As her FNP, you know this warrants further evaluation for: (Bates, p. 439)
a. Breast Ca
b. Intraductal papilloma
c. Trauma
d. Hormonal levels
B
spontaneous unilateral blood discharge from one or two ducts warrants further evaluation for intraductal papilloma, ductal carcinoma in situ, or paget disease of the breast
Your female patient presents today with chief complaint of painful swelling “in my vagina”. On PE on the vaginal vestibule (posterior introitus), you observe an erythematous, painful, abscess with exudate (pus) expressed. You suspect: (Bates, pp. 566 & 597)
a. Condyloma acuminatum
b. Urethral carbuncle
c. Bartholin gland infection
d. Carcinoma of the vulva
C
PSA stands for: (Bates, p. 610)
a. Prostate sensitivity antigen
b. Prostate sensitivity antibody
c. Prostate specific antibody
d. Prostate specific antigen
D
A testis that does not reside in & can’t be manipulated into the scrotum is: (Bates, p. 841)
a. Ectopic testis
b. Cryptorchidism
c. Gliding testis
d. Ascended testis
B
Your 19-year-old, sexually active female presents today for contraception counseling and concerns that she might have a “STD”. She is also asking if she should start cervical cancer screening by having a Pap smear while she is here today. You counsel her regarding USPSTF recommendations: (Bates, 576)
a. It is ideal to have Pap testing coincide with counseling & STI screening.
b. Testing should have started after coitarche (sexual debut).
c. Co-infection with an STI can give a false positive for HPV.
d. Should begin at the age of 21.
D
The FNP should apply a small amount of lubricant to the speculum prior to Pap testing to decrease patient discomfort. (Bates, p. 587; Pits & Pearls lecture)
a. True b. False
B
Your 55 y.o. patient is s/p TAH BSO for uterine fibroids. She should continue with cervical CA screening per guidelines. (Bates, p 576)
a. True b. False
B
Your patient has a PSA level of 6. You counsel your patient: (Bates, p. 612)
a. This is a normal value (range 3-6 ng/mL)
b. This is a normal value (range 4-7 ng/mL)
c. This is an abnormal value (range 1-4 ng/mL)
d. This is a “borderline” value (range 3.5 – 5.0 ng/mL)
C
On a male, newborn assessment, you observe swelling in the right scrotum that overlies the testis & spermatic cord that can be transilluminated. You discuss with this parents that this is likely (Bates, p. 841)
a. A hydrocele
b. Cryptorchidism
c. Inguinal hernia
d. Hypospadias
*Extra: describe each disorder
A
hydrocele overlies the testes and the spermatic cord, are not reducible and can be transilluminated
cryptorchidism undescended testicle
inguinal hernia -hernias are separate from testes, are usually reducible, and often do not transilluminate. they do not resolve. sometimes a thickened spermatic cord (silk sign) is noted
hypospadias abnormal location of the urethral orifice to some point along the ventral surface of the glans or shaft of the penis
The correct order for initiating a female pelvic exam is: (Bates, p. 584)
a. Choose appropriate size speculum, lubricate with water & use a gentle technique
b. Avoid unexpected movements, explain the process, drape the patient
c. Drape the pt., choose appropriate speculum size, monitor the pt. for discomfort
d. Obtain permission, explain the process before starting, drape the patient
D
In this type of urinary incontinence, there is increased abdominal pressure causing bladder pressure to exceed urethral resistance with poor urethral sphincter tone or poor support of the bladder neck. This type of incontinence is known as: (Bates, p. 463)
a. Urge incontinence
b. Stress incontinence
c. Overflow incontinence
d. Functional incontinence
*Extra: Describe each type of incontinence
B
urge incontinence - urgency is followed by involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance
stress incontinence - increased abdominal pressure causes bladder pressure to exceed urethral resistance, there is poor urethral sphincter tone or poor support of bladder neck
overflow incontinence - neurologic disorders or anatomic obstruction from pelvic organs or the prostate limit bladder emptying until the bladder becomes over distended
functional incontinence - arises from impaired cognition, musculoskeletal problems, or immobility
The most common cause of acute pelvic pain in the female patient is: (Bates, p. 574)
a. Ectopic pregnancy
b. Mittelshmerz
c. PID
d. Uterine fibroids
C
Part of the sexual health history should include all except: (Bates, p. 572 – 574)
a. Do you engage in oral & anal sex?
b. Do you prefer to have sex with males, females or both?
c. How many sexual contacts have you had over the last 3-6 months?
d. Is there any family history of chlamydia or gonorrhea?
D
