Reproduction

Question 1

Puberty for men and women?

Answer 1

females = 10 to 14, menarche 2-3 years after puberty starts

males = 11 - 16

Question 2

other changes to consider for puberty other than sexual?

Answer 2

increase in height and weight

growth spurt and bone development.

facial hair, axillary hair, thyroid, changes in skin, voice.

Question 3

Tanner stages for breast?

Answer 3

Stage 1 = only nipple elevation

2 = breast bud (breast and nipple as small mound)

3 = enlargement and elevation of breast and areola, no separation of contours

4 = projection of areola and nipple to form secondary mound above the level of breast

5 = mature stage

Question 4

Tanner stage for pubic hair for girls or boys

Answer 4

1 = no hair

2 = some hair

3= coarser, curlier hair

4 = more hair

5 = mature

Question 5

what tanner stage does menarche happen at? what age?

Answer 5

3 or 4, or 8-13 years old

Question 6

what menstrual/gynecologic history is good to know?

Answer 6

LMP

breast history – any disease

last mammogram

last Pap smear

Question 7

gravida and para?

G3P3?

what does G3P2 mean?

Answer 7

Gravida –> # of pregnancies

Para –> live offspring

given birth 3 times, 3 live offspring

3 pregnancies, still pregnant

Question 8

TPAL?

Answer 8

T = term deliveries >37 weeks
P - preterm 20 to 37
A = abortion <20 weeks or less
L - live delivery regardless of gestational age

Question 9

G5P3114

Answer 9

5 total births, 3 term deliveries, 1 live delivery at 35 weeks, 1 abortion, 4 live regardless of gestational age

Question 10

Well Woman Exam?

Answer 10

Pap smear

Mammogram

Question 11

When do you get a Pap smear?

Answer 11

between 21 and 65

yearly for women with abnormal pap smear

every 3 years wit normal consecutively normal pap smears

every 5 years with consecutively normal with negative HPV testing

Question 12

when are mammograms done?

Answer 12

50 years or earlier for women at are at high risk

Question 13

What is a Pap smear?

Answer 13

tissue from the cervix for transformation. looking for cervical cancer.

most is to HPV regions.

Question 14

Where are you doing the Pap smear?

Answer 14

transitional zone of the cervix between endocervix and ectocervix

Question 15

Pelvic exam?

Answer 15

you’re looking at the external and internal genitalia.

you can do a Pap smear during this.

you’re feeling for the uterus and the ovaries through a bimanual exam (inserting index and middle into vagina and lifting upward and using other hand to push downward to examine vagina, uterus, ovary

speculum exam

Question 16

small amount of discharge.. positive for nausea and small amount of vomiting.

nothing aggravates it or alleviates it.. inconsistently uses condoms

pelvic pain

Answer 16

Ectopic Pregnancy

Question 17

Abdominal pelvic pain and vaginal bleeding… what is it?

how do you know it’s what it is?

Answer 17

Ectopic pregnancy

pregnancy test just in case!!

Question 18

3 day history of pelvic pain and foul smelling vaginal discharge

new partner for last 1 month and uses OCP but no condoms really.

LMP 2 weeks ago.

pain on palpation of left pelvic region

what is it?

what do you do?

Answer 18

STI

pelvic exam with bimanual exam and swabs

Question 19

pelvic discomfort, burning with urination and more frequent urination.

no bleeding or vomiting, no constipation or diarrhea

what is it?

what do you do that could work for it?

most common thing that causes it?

Answer 19

UTI

Lloyd’s punch and abdominal exam

E. coli

Question 20

Well Male Exam?

Answer 20

prostate specific Antigen (PSA) is not recommended routinely (prostate cancer)

prostate exam or testicular exam is not recommended routinely

Question 21

Testicular cancer is common in what age?

Answer 21

younger males

Question 22

left sided groin pain, worsens when lifting heavy or basketball

uses condoms

bulge with valsalva maneuver

Answer 22

inguinal hernia

Question 23

inguinal hernia is associated with what? (2)

Indirect?

direct?

Answer 23

pain with physical exertion

bulge

goes into the inguinal ring

goes near pubic tubercles

Question 24

3 day lesion on penile shaft

burning and pan before the lesion presented on his penis

does not use condoms

no discharge

Answer 24

STI

herpes simplex virus –> vesicles on the penis

Question 25

important P’s of sexual history?

Answer 25

Partners
Practices
Prevention of Pregnancy
Protection from STIs and HIV
Past history of STI

Question 26

Untreated STIs can cause what?

Answer 26

infertility, cervical cancer, pelvic inflammatory disease

Question 27

Key to treatment of STIs

Answer 27

antibiotics and antivirals

***behavioral counseling is KEY

***treat the partner too!

Question 28

Gonorrhea

what happens in men and women

if untreated what happens

what are they also at risk for?

Answer 28

men = penile discharge nad dysuria

females = pelvic pain, discharge, or both.

can lead to infertility or pelvic inflammatory disease

at risk for chlamidia as well!

Question 29

Chlamydia?

Answer 29

men = penile discharge, itching, dysuria

females = vaginal discharge, vaginal bleeding, pain during intercourse, dysuria

can lead to infertility or pelvic inflammatory disease

Question 30

Syphilis

what are the stages

how do you dx it?

what do you give?

Answer 30

treponema pallidum

primary stage –> chancre (lesion)

secondary –> joint pains, fatigue, LAD, rash

Latent stage –> asymptomatic

Tertiary –> neurosyphilis (cognitive issues)

serologic testing + antibody detecting

penicillin

Question 31

Genital Herpes

what does it present with

how long does this persist

treatment

Answer 31

Herpes Simplex Virus 2

single or clusters of vesicles on the genitalia

burning, tingling, pain prior to vesicle appearance

this is there for life.

treatment = antiviral

Question 32

Trichomonasis

men and female presentation

what is the organism look like

what do you give them

Answer 32

men = most are symptomatic but some have penile discharge

female = foul smelling thin or purulent discharge, itching, dysuria

organism has flagella

antiprotozoal medication

Question 33

HPV

Answer 33

classical presentation = genital warts

high risk strains lead to cancer

routine Pap smear needed with HPV screens

Gardasil vaccine between 11 and 26