Pap Smear_Pelvic Relaxation Flashcards
HPV that cause cancer
16, 18, 31, 45
What is the gold standard for Dx and Tx of HPV
Colposcopy with directed biopsy
What are acetowhite changes
Large nuclei of abnormal cells (HPV) turn white when washed with acetic acid
What are Tx options for HPV
Ablation
Excisional
Sx’s = watery vaginal discharge, postcoital bleeding, and intermittent spotting in a 47 yo woman
Cervical carcinoma
What population is the HPV vaccine recommended for
Girls/Boys 9-26
Can the HPV vaccine be given during pregnancy and breastfeeding
Pregnancy –> No
Breastfeeding –> Yes
At what age should HPV screening begin
30 yo
At what age should pap smears begin and how often
21
Every 3 years
What population of women don’t need a pap smear
Women > 65 or who have had a hysterectomy
What screening should be done for women between 30-65 yo
Pap with HPV every 5 years OR
Pap alone every 3 years
What is a cystocele
Anterior vaginal prolapse
What is a rectocele
Posterior vaginal prolapse
What is a urethrocele
Urethral prolapse (possible bladder prolapse)
Sx’s = pelvic pressure/bulging, no urinary/bowel issues, normal menses, no dyspareunia
Cystocele
Sx’s = pressure and fullness in vagina, no bladder issues, splints for BM, normal menses
Rectocele
Sx’s = “something falling out,” doesn’t void completely, voids small amounts frequently, no dysuria/hematuria
Uterine prolapse
Sx’s = urinary incontinence with coughing/sneezing/laughing, wears pads, no dysuria/hematuria, no bowel issues
Stress incontinence
What PE test can be performed when stress incontinence is suspected?
Q tip test
Urodynamics test
Postvoid residual test
Sx’s = months of urgency/frequency, rush to bathroom, no dysuria/hematuria, no bowel issues, drinks lots of caffeine, pees 3-4 times/night
Urge incontinence/Overactive bladder
What are the Tx’s for a cystocele
Nothing
Pelvic floor PT
Pessary
Surgery
What is the Tx for a rectocele
Surgery
What are the Tx’s for a uterine prolapse
Pessary
Hysterectomy
Colpocleisis
What are the Tx’s for a stress incontinence
Topical E
Pelvic floor PT
Pessary
Surgery
What are the Tx’s for a urge incontinence/overactive bladder
Decrease caffeine
No fluids after 7pm
Bladder training
Oxybutynin, Tolterodine
