OB: Test 1 Flashcards
Who should receive a Pap
Over age 21 (21-65 with cytology every 3 years)
Who should not receive a Pap
Over age 65 and under 21 years old regardless of sexual history
When do you add HPV co-testing?
Over 30/ under 64 years old.
If doing co-testing, PAP is only a 5 years.
If no co-testing PAP is every 3 years.
What is the management for ASCUS (Atypical squamous cells of undetermined significance; abnormal Pap smear) in a 21-year-old?
Repeat cytology in 1 year.
How would you treat an unsatisfactory pap?
Repeat cytology after 2-4 months.
If HPV co-testing is negative, but a 32-year-old has an ASCUS pap, how would you treat this?
Repeat co-testing at 3 years.
HPV HR positive in a 32-year-old patient with a normal pap?
Repeat co-testing at 1 year OR HPV DNA testing.
If HPV 16/18 positive?
perform colposcopy
If 16/18 negative?
repeat co-testing at 1 year
Why should a woman under 21-years get a pap?
If she has a hx of an immunosuppressed condition (like HIV)
How many doses are required with Gardasil UNDER 15 yo?
<15 yo (preferably 11 or 12 y/o), 2 doses 6-12 mo. apart and finishing before 16th bday.
How many doses are required with Gardasil OVER 15 yo?
> 15 3 doses; give second dose 1-2 months after first dose and the 3rd dose 6 months after the first dose
Understand primary dysmenorrhea
Primary dysmenorrhea occurs in the absence of other disease.
Understand secondary dysmenorrhea
Secondary dysmenorrhea is caused by a disorder such as endometriosis or leiomyomata.
Primary dysmenorrhea symptoms
Primary is typically recurrent, crampy, and may radiate to the back or thighs; can be accompanied by nausea, fatigue, general malaise; generally starts just before the onset of menses and lasts 2-3 days; usually begins in adolescence after ovulatory cycles are established.
Primary dysmenorrhea treatment
goal is to relieve pain (local heat, NSAIDS-2-3 days beginning on first day of symptoms and on fixed schedule to maximize, hormonal contraceptives (Progestin only)
Secondary dysmenorrhea Symptoms
Secondary dysmenorrhea can be 2/2 pregnancy, IUD in place, PID, adenomyosis, ovarian cysts, pelvic adhesions, or cervical stenosis.
Primary Amenorrhea definition
Primary amenorrhea is prior to menarche (by age 15 with secondary sex characteristics)
Primary Amenorrhea Etiology
etiologies include anomalies of outflow tract, genetic disorders (turner’s), central anomalies of HPO axis
-r/o HPO by testing FSH, TSH, prolactin levels
Secondary Amenorrhea definition
Secondary amenorrhea is the absence of menses x 3 months after previously menstruating woman or for 9 months in a woman who had irregular menses (i.e. pregnancy, anorexia, female athlete triad).
Consider these 5 when evaluating amenorrhea:
- Hypothalamus disorder
- Outflow tract abnormalities
- Ovarian disorder
- Pituitary disorder
- Endocrine disorder that interferes with HPO axis
Which IUD is approved for heavy menses?
Mirena or skyla
Make sure you watch the wet mount video in the practicum course. Visually, know the difference in a picture with trich, BV, normal epithelial cells, and hyphae
What are lactobacilli?
A healthy vaginal flora.
Why are lactobacilli important?
They serve as a first line of defense against vaginal infections by competitive exclusion or direct killing; produce agents such as lactic acid that creates a pH level that is inhospitable for some pathologic organisms.
Understand the phases of the menstrual cycle.
Table 10-4 pg. 353
What hormones are released in response to ovulation?
luteinizing hormone and follicle-stimulating hormone
LH peaks 10-12 hours after ovulation; estrogen surges 24-36 hours after ovulation, FSH peaks during ovulation as well
