H and P HY Flashcards
reduced BC risk
first birth before 30
breast feeding
avoidance or limited HRT
avoidance of radiation
healthy lifestyle
mastalgia
pain in breast
is it temporal sequence (gradual, sudden, duration, constant/intermittent), related to menses
medications that might cause nipple discharge
decrease dopamine/dopaminergic effects
antipsychotics, TCAs, SSRIs, verapamil, methadone
cause of milky nipple edischarge
pregnancy/lactation
HoThyroid
renal disease
cirrhosis
pituitary prolactinoma
endocrine d/o
cause of spontaneous bloody nipple discharge
intraductal papilloma
ductal carcinoma
Paget’s dz of Brest
uni-ductal nipple discharge
clear, serous, green, black and non bloody discharge
can be CA
menopause
cessation of menses ?1 yr
perimenopause
transition from menstrual to non menstrual life
gravid
total number of PREGNANCIES (twins count as 1)
parity
number births given (twins count as 1)
4 digits of P
T (number of pregnancies)
P (preterm deliveries)
A (abortions)
L (living children)
nulligravida
never been pregnant, not now pregnant
primigravida
first pregnancy
multigravida
pregnant more than once
nullipara
never given birth, never had pregnancy past 20 weeks
woman who has given brith 3+ times
grandmultipara
complications included in OB hx
pregnancy
childbirth
postpartum period
increased risk of cervical CA
CIN 2, CIN 3 or cervical cancer hx of HPV smoking immunosuppresion HIV DES exposure
cervical CA screening starts at what age?
regardless of sexual activity
who gets screening for cervical CA
21-65 y.o
cervical CA screening q 3 yrs for
21-29
avg risk women
no co testin
30-65 year cervical ca
- Pap smear every 3 years
2. pap smear and HPV test q 5 years
65+ w. prior screening
no need to further test
65+w.o prior screening
screen until 70=75
HIV + and cervical CA screen
screening starts when diagnosed
<30 = cytology annually
> 30 = co testing or cytology
if nml = q3 yrs (5 if dual)
consensus for annual mammogram is strong for:
50-69
consensus for annual mammogram is NOT strong for:
40-49 , >70
clinical breast exam
breast self exam
risk increased for breast ca
- previous breast CA
- increased age
- estrogen exposure
- race (Caucasian)
- increased BMI
- breast bx/radiation
- absence of Brestfeeding
- nulliparity or older age of first pregnancy
recommendations of breast screening
clinical breast exam annually
mammogram 1-2 yrs for 40-49, annually 50+
self exam = “breast awareness”
MRI and U/s
good for evaluation of palpable masses
not good for average risk
chlamydia and gonorrhea screening
annually <25
all pregnant women <25 and increased risk >25
HIV screen
annually for all sexually active
gardasil
6, 11, 16, 18
males and female
cervarix
16, 18
female only
gardasil 9
9 different strains
6, 11, 16, 18 + others
male and female
what strains of cervical CA increased risk
16 and 18
CI of HPV vax
yeast allergy
3 breast palpitation techniques
radial
spiral
vertical strip
+ attempt to elicit nipple discharge
common breast masses tumors
fibroadenoma
cysts
cancer
fibroadenoma breast
benign brest tumor
common in puberty/young adults
cysts breast
30-50
round, soft firm, mobile
cancer breast
after 50
fixed to underlying tissue
not clearly deliniated
abnormal lymph findings
nodes >1 cm, firm, fixed or matted to underlying tissue
malignancy
Skenes glands location
surround urethral meatus
bartholin gland location
surrounds vaginal oriface
fourchette
small skin fold at base of vluva
pouch of Douglas
rectouterine pouch
space between uterus and rectum
prepubescent child anatomy
narrow vagina
cervix compromises most of uterus
menopause
decreased size of genitalia
loss of elasticity/tone
narrowing of vagina, decreased lubrication
decresed libido
possible etiologies of bludge
cystocele
rectocele
uterine prolapse
purpose of rectovaginal exam
palpate retroverted uterus, uteroscaral ligaments, ouch of Douglas ,adnexa
screen for colon CA (50+)
pelvic pathology
