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Year 1: 2020 PCM II Midterm > Lecture 8: Approach to Reproductive Topics > Flashcards

Lecture 8: Approach to Reproductive Topics Flashcards

1
Q

What is puberty?

A

Developmental stage characterized by transition from sexual immaturity to sexual maturity

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2
Q

What is gonadarche activation?

A

Stimulation of gonads by FSH and LH from anterior pituitary

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3
Q

What is adrenarche?

A

Increase in androgen production by adrenal cortex

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4
Q

What is thelarche?

A

Development of breast tissue due to estrogen from ovaries

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5
Q

What is menarche?

A

First menstrual cycle

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6
Q

What is spermarche?

A

First sperm production

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7
Q

What is pubarche?

A

Pubic hair development

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8
Q

When do females normally undergo puberty?

What is developing then?

A

Ages 10-14

  • breast/areolar development
  • menarche
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9
Q

When do males normally undergo puberty?

What is developing then?

A

Ages 11-16

  • penile growth
  • pubic hair development
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10
Q

What are the Tanner stages for the development of external genitalia in boys?

A

Stage 1: Prepubertal
Stage 2: Enlargement of testes and scrotum (scrotal skin reddens and changes in texture)
Stage 3: Enlargement of penis lengthwise and growth of testes
Stage 4: Increased size of penis and development of glans; testes and scrotum larger, scrotal skin darker
Stage 5: Adult genitalia

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11
Q

What are the Tanner stages for the development of breast development in girls?

A

Stage 1: Prepubertal
Stage 2: Breast bud stage w/ elevation of breast and papilla, enlargement of areola
Stage 3: Further enlargement of breast and areola - no separation of their contour
Stage 4: Areola and papilla form a secondary mound above level of breast
Stage 5: Mature stage: projection of papilla only

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12
Q

What are the Tanner stages for the development of pubic hair in both boys and girls?

A

Stage 1: Prepubertal (vellus hair)
Stage 2: Sparse growth of long, slightly pigmented hair at base of penis or labia
Stage 3: Darker, coarser, curlier hair sparesley over junction of pubes
Stage 4: Adult hair in smaller area
Stage 5: Adult hair with horizontal upper border

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13
Q

What should be included in a menstrual history?

A

Age of menarche
Duration: how many days each period lasts
Flow: heavy/light
Cycle: length of each menstrual cycle

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14
Q

What should be included in a gynecologic history?

A 
Breast history
Last mammogram
GYN surgeries 
Infertility
Last pap smear
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15
Q

What should be included in an obstetrical history regarding pregnancies?

A 
Gravida: number of pregnancies
Para: number of viable births/offsprings
-T: Term deliveries (>37 weeks)
-P: Preterm deliveries (20-37 weeks)
-A: Abortion (<20 weeks)
-L: Live delivery regardless of gestational age
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16
Q

What would be the obstetrical history of a patient who had 6 pregnancies: 1 spontaneous abortion at 17 weeks, 2 fetal demise at 22 and 23 weeks?

A

G6P3213

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17
Q

What would be the obstetrical history of a patient who had one pregnancy and twins born at 38 weeks?

A

G1P2

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18
Q

What is other information that should be noted in an obstetrical history?

A 
Mode of delivery
Gestational age at delivery
Maternal complications
Fetal complications
Delivery/operative complications
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19
Q

What is information that should be noted in a contraceptive/sexual history?

A 
Contraception methods
Currently sexual active
Number of partners
New partners in last 3 months
Condom use
History of sexual abuse
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20
Q

At what age should women get pap smears?

A

Ages 21-65

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21
Q

How often should women get pap smears?

A

Yearly: abnormal pap smears
Every 3 years: normal pap smears
Every 5 years: normal pap smears with negative HPV testing

22
Q

What is the purpose of a pap smear?

A

Screen for cervical cancers

-mostly caused by HPV

23
Q

Where is a sample taken in a pap smear?

A

Ectocervix
Endocervix
Transitional Zone: between original and new SCJ
Squamocolumnar Junction (SCJ)

24
Q

What is the most important area to take a sample when testing for cervical cancer?

A

Transitional zone

25
Q

What is the difference between a pelvic exam and pap smear?

A

Pap smears: looks at cervix and obtains samples

Pelvic exam: inspects both external and internal genitalia

26
Q

Describe a pelvic exam.

A
  • Visual inspection
  • Bimanual exam: insert index and middle finger into vagina to examine vagina, uterus, and ovary on both left and right side
  • Check cervical motion
  • Obtain swabs to check for STI and vaginosis
27
Q

What is an ectopic pregnancy?

How does it present?

A

Fertilized egg implants and grows outside the main cavity of the uterus

  • abdominal or pelvic pain with vaginal bleeding
  • pregnancy symptoms
28
Q

What is a workup for a woman presenting with ectopic pregnancy?

A

Double check pregnancy
Speculum exam
Surgical removal

29
Q

What are some symptoms of an UTI?

A 
Dysuria
Urinary frequency
Urinary urgency
Suprapubic pain 
Hematuria
30
Q

What physical exam findings can be found in a patient with an UTI?

A

Costovertebral angle tenderness (Lloyd’s punch)

31
Q

What is a workup for a woman presenting with an UTI?

A

Urinalysis

-also pregnancy test

32
Q

True or false?

Males should have regular prostate and testicular exams.

A

False

33
Q

Describe a male genital exam.

A
  • Inspect scrotum, penile shaft, glans, and inguinal region
  • Palpate penile shaft and scrotum with thumb and first two fingers
  • Retract foreskin if present
  • Palpate inguinal region and examine for hernias
  • Examine prostate by palpation on digital rectal exam
34
Q

Which age group is more prone to develop testicular cancer?

A

Younger males

35
Q

Describe an inguinal hernia.

How does it present?

A

Bulge in a weak spot in the abdominal muscles

-pain with increased intra-abdominal pressure

36
Q

What are the 5 P’s of sexual history?

A 
Partners
Practices
Prevention of Pregnancy
Protection from STIs and HIV
Past History of STI
37
Q

What are some risk factors of STIs?

A

New sexual partner
Multiple sex partners
Sex with sex partners recently diagnosed w/ STI
No/Inconsistent use of condoms
Trading sex for money/drugs
Sexual contact with sex workers or anonymous partners from internet

38
Q

What are some bacterial STIs?

A

Chlamydia
Gonorrhea
Syphils

39
Q

What are some viral STIs?

A

Herpes simplex 2
Human papilloma virus (HPV)
Hepatitis B and C
HIV/AIDS

40
Q

What are some protozoa STIs?

A

Trichomoniasis

41
Q

How does gonorrhea present?

A

Men: penile discharge and dysuria (or asymptomatic)
Females: pelvic pain or mucopurulent vaginal discharge

42
Q

When treating gonorrhea, what other STI is also treated with it?

A

Chlamydia

43
Q

How does chlamydia present?

A

Most cases asymptomatic
Males: penile discharge, pruritus (itchiness), dysuria
Females: vaginal discharge, vaginal bleeding, or pain during intercouse

44
Q

If gonorrhea and chlamydia are left untreated, what can be some complications?

A

Pelvic inflammatory disease

Fertility issues due to scarring of fallopian tubes

45
Q

How does syphilis present?

A

Primary: chancre (ulcers)
Secondary: joint pains, fatigue, lymphadenopathy, mucopapular rash
Latent phase: asymptomatic
Tertiary: neurosyphilis

46
Q

What are some complications of syphilis?

A

Neurosyphilis

-infection of the central nervous system

47
Q

How does genital herpes present?

A

Single of clusters of vesicles on genitalia

-Burning, tingling, and pain

48
Q

What are complications of genital herpes?

A

Meningitis
Pelvic inflammatory disease
Hepatitis
Increase risk of HIV infection

49
Q

How does trichomonasis present?

A

Men: mostly asymptomatic but might have penile discharge
Female: foul smelling, thin, or purulent vaginal discharge, vaginal pruritis, dysuria

50
Q

How does HPV present?

A

Genital warts

51
Q

What are complications of HPV?

A

High risk strains can lead to cancer

-cervix, penile, or anorectal

Year 1: 2020 PCM II Midterm (14 decks)

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