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PCM Midterm 2020 > Reproduction > Flashcards

Reproduction Flashcards

1
Q

What is Gonadarche

A 
activation of the gonads by the follicle-stimulating hormone (FSH) and
luteinizing hormone (LH) secreted from anterior pituitary
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2
Q

what is Menarche? spermarche?

A

first menstrual cycle

first sperm production

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3
Q

When do girls undergo puberty? Boys?

A

10-14 girls (secondary: breast/areolar development, menarche 2-3 yrs after beginning of puberty)
11-16 boys (penile growth and pubic hair development)

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4
Q

What breast stage does menarche start at?

A

Usually 3 or 4

3: elevation of breast and areola, no separation of contours
4: projection of areola and papilla

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5
Q

Stages of penile development

A

Stages 1 -5

Penis enlarges, testicular size (volume) also increases

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6
Q

Menustral history questions?

A

Age of menarche, duration, flow, cycle length of menses

Last menstrual period

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7
Q

Gynecologic history (more in detail)

A 
Breast history
Last mammogram
Previous GYN surgery
history of infertility
last pap smear (esp if abnormal)
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8
Q

OB History questions.. How do you show number of pregnancies? number of births? what if there are preterm deliveries, abortions, etc.

EX: What does G4P2112 MEAN?

A

TPAL
G4P2112
4 pregnancies, 1 spontaneous abortion, 1 fetal demise at 23 weeks,

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9
Q

What does G5P3114 mean?

A

5 pregnancies, 3 term delivers, 1 spontaneous abortion at 12 weeks, 1 live delivery at 35 week gestations

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10
Q

OB History questions (besides pregnancy, number delivered, etc)

A 
Mode of delivery
gestational age at delivery
maternal complications
fetal complications
delivery complications
contraception method
sexual activity
number of partneres
new partner in last 3 months
condum use
history of sexual abuse
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11
Q

What is considered a ‘well woman exam’ how often should the aspects of this be done?

A 
1) Pap smear: women over 21 - 65
Abnormal: YEARLY
consecutively normal: 3 years
consec. normal + negative HPV test: 5 years
2) Mammogram 50 years or earlier
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12
Q

What is a pap smear for? What areas do you sample? Which is important and why?

A

Screen for cervical cancer C. cancer due to high risk HPV strains.
Ectocerix, endocervix, transitional zone (this has precancerous lesions!!)

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13
Q

What is a pelvic exam?

A

1) Visual exam
2) Bimanual exam
– inserting index and middle finger into the vagina lifting upward and using other hand to push downward to examine the vagina, uterus and the ovary – Performed on both left and right side
3) Swabs for gonorrhea, chlamydia, wet prep for yeast

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14
Q

What is the classical presentation of ectopic pregnancy? What’s the workup? Treatment?

A

PRES: Abdominal or pelvic pain with vaginal bleeding
WORKUP: Urine pregnancy, speculum
TREAT: surgery bc of risk of hemorrhage and death

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15
Q

What is the classical presentation of a UTI? Cause? What’s the workup? Treatment?

A

PRES: Dysuria (pain, burning or discomfort with urination), urinary frequency, urinary urgency, suprapubic pain
CAUSE: E. Coli
WORKUP: Abd exam, Urinalysis
TREAT: Antibiotic

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16
Q

What is considered a ‘well male exam’ how often should the aspects of this be done?

A

1) Prostate exam and testicular exam not routinely

2) Prostate specific antigen (only if family history indicates)

17
Q

What are the aspects of a male genital exam?

A

– Inspection of scrotum, penile shaft, glans, inguinal region – Palpate penile shaft and scrotum (examine for testis, epididymis, spermatic
cord) 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 (DRE)

18
Q

What population do we normally see testicular cancer?

A

Young males (Dr. A said teens to 30s) normally AGGRESSIVE need to catch early

19
Q

How do you palpate the prostate

A

up the butt

actually tho, then press anteriorly, you should feel it

20
Q

What is the classical presentation of inguinal hernia? Exam findings? What’s the workup? Treatment?

A

PRES: Pain with increased intra-abdominal pressure (heavy lifting, straining or prolonged standing – May have palpable bulge on affected side
EXAM: Invaginating scrotal skin with index finger into the inguinal canal and have patient coughor perform Valsalva
WORKUP: Ultrasound
TRT: Mild - watch Severe-surgery

21
Q

What are the 5 P’s of sexual history

A

1) Partners
– Men, Women or both – New partner – Multiple partners (number of partners in last 12 months)
2) Practices
– How often do used condoms – Anatomic site of exposure
3) Prevention of Pregnancy
4) Protection from STIs and HIV
– Condom use
5) Past history of STI
– Have you ever had an STI? – Have any of your partners had an STI?

22
Q

What are the risk factors for STIs & STDs

A

– New sex partner in past 60 days
– Multiple sex partners or sex partner with multiple concurrent sex partners
– Sex with sex partners recently treated for an STI
– No or inconsistent condom use outside a mutually monogamous sexual partnership
– Trading sex for money or drugs
– Sexual contact (oral, anal, penile, or vaginal) with sex workers
– Meeting anonymous partners on the internet

23
Q

What are some examples of an STI?

A
  • Chlamydia (bacterial)
  • Gonorrhea (bacterial)
  • Herpes simplex 2 (viral)
  • Human papilloma vius (HPV) (viral)
  • Syphilis (bacterial)
  • Trichomoniasis (protozoa)
  • Hepatitis B and C (viral)
  • HIV/AIDS (viral)
24
Q

What are some complications of untreated STIs?

A

– Pelvic Inflammatory Disease (more severe infection most commonly due to Gonorrhea or Chlamydia infection)
– Upper genital tract infections
– Infertility
– Chronic pelvic pain
– Cervical cancer (HPV)
– Chronic infection with herpes viruses, hepatitis viruses and HIV

25
Q

What are STI/STD treatments?

A

1) Antibiotics
2) Behavioral counseling
3) treatment of partner

26
Q

What is the classical presentation of gonorrhea? CAUSE? Complications? What’s the workup? Treatment?

A

PRES:
– Men: penile discharge and dysuria or can be asymptomatic,
– Female: cervicitis, pelvic pain or mucopurulent vaginal discharge
Cause: gram negative intracellular diplococci
COMPLICATIONS: Infertility (scarring of fallopian tube), PID
WORKUP: NAATs
TRT: 1) Antibiotics 2) Partner contact 3) Counseling

27
Q

What is the classical presentation of syphillis? CAUSE? Complications? What’s the workup? Treatment?

A 
PRES: 
– Primary – chancre 
– Secondary - joint pains, fatigue, lymphadenopathy, mucopapular rash 
– Latent phase – may be asymptomatic 
– Tertiary – neurosyphilis (confusion, headache, stiff neck, vision loss)
cause: Spirochete, t. pallidum
COMP: Neurosyphilis
WORKUP: Serological testing
TRT: Antibiotic (penicillin)
28
Q

What is the classical presentation of genital herpes? CAUSE? Complications? What’s the workup? Treatment?

A 
PRES: – Single or clusters of vesicles on the genitalia – May have burning, tingling and pain prior to vesicle appearance
CAUSE: Herpes Simplex Virus 2
COMP: meningitis, HIV infection
WORKUP: serologic testing, PCR
MANAGEMENT: antiviral (acyclovir)
29
Q

What is the classical presentation of trichomonasis (protozoa)? CAUSE?? What’s the workup? Treatment?

A

PRES: – Can be asymptomatic – Men: most men are asymptomatic but small percentage may have penile discharge – Female: foul smelling thin or purulent vaginal discharge, vaginal pruritus, dysuria
CAUSE: Protoza with flagella
WORKUP: wet mount (aka put the sample on a slide and see if it moves)
TRT antiprotozal medication

30
Q

What is the classical presentation of HPV (protozoa)? CAUSE?? What’s the workup? Treatment?

A 
PRES: Genital warts
CAUSE: human papillomavirus
COMP: cancer or oropharyngeal region or lower genital tract
WORKUP: routine pap
TRT: prevent with vaccination
genital wart removal
31
Q

What is the classical presentation of chlamydia? CAUSE? Complications? What’s the workup? Treatment?

A 
PRES: discharges, pruritus, disuria, pain during sex
THINK: men itch, women hurt during sex
CAUSE: bacterial
COMP:
WORKUP: NAATS
TRT: Antibiotics (doxy, azith)

PCM Midterm 2020 (6 decks)

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