Reproductive Flashcards
What changes in the reproductive system of the aging adult?
- pubic hair gradually decreases;
- skin is thinner and fat deposits decrease, leaving mons pubis smaller and labia flatter;
- clitoris size also decreases after age 60;
- uterus reduces in size
What are the cervical cancer screening guidelines?
- Women < 21yo = No screening, even if you are a teenage prostitute
- Women 21-29: Pap smear every 3 years
- Women 30-65: Pap plus HPV testing every five years.
- Women >65 = No screening (as long as you’re not at high risk)
- Hysterectomy w/ removal of cervix, no hx of high-grade precancerous lesions = no screening.
What does G P A stand for?
Hint: not grade point average
●Gravida: total number of pregnancies
●Para: total number of deliveries after 20 weeks gestational age (viable or potentially viable)
●Abortus: Number of pregnancy losses (elective, spontaneous before 20 weeks gest. age, induced)
●Pregnancy complications
What occurs during perimenopause (transition to menopause)?
irregular cycles, vaginal dryness, hot flashes, mood swings
Which day is the most important day of your last menstrual pd?
1st day
What interventions can you do to help relax your ptn?
●Empty bladder
●Position table so that she is not exposed to an inadvertent open door
●Ask if she would like someone present; position by woman’s head
●Elevate her head and shoulders to semi sitting position to maintain eye contact
●Place stirrups so that legs are not abducted too far
●Offer a mirror so client can see exam
●Explain each step of exam
In what stage is the hair distribution adult in type but decreased in total quantity? PS. There is no spread to the medial surface of the thighs
Stage IV
In what stage is the hair sparse, long, pigmented, downy, straight or only slightly curled? These hairs are seen mainly along the labia. This stage is difficult to quantitate on black and white photographs, particularly when pictures are of fair-haired subjects.
Stage II
In what stage is there breast budding?
Sorry, Michelle. I know you hate that word.
Stage II
In what stage does breast development generally occur?
breast stage 3 or 4 → by then, she has passed her peak growth spurt.
Lymphatics of penis and scrotal surface drain into …
inguinal lymph nodes
Lymphatics of testes drain into
Abdominal lymph nodes (not accessible)
Testicular Cancer Guidelines
●ACS
○Recommends a testicular exam as part of a routine cancer-related checkup.
○Does not have a recommendation on regular testicular self-exams for all men
●USPSTF
○Recommends against screening for testicular cancer in adolescent or adult men - does more harm than good
What are the risk factors for testicular cancer?
What are the signs and symptoms?
What ages are males most likely to be diagnosed for testicular cancer?
●Males age 15-35 (Average age of diagnosis is 34 yrs old)
●Affects 5 in 100,000 men
●Risk factors: hx of Ca in other testicle, mumps, inguinal hernia, or hydrocele in childhood, undistended testes
●No early symptoms
●Sign: unilateral, hard, painless mass
●High cure rate if identified early; more likely if men know their normal anatomy & report changes
What are the guidelines for prostate canceR?
●USPSTF: Recommends against PSA testing
●ACS:
○Recommends men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. (so, you don’t have to do it)
○Starting at age 50, men should talk to a doctor about the pros and cons of testing so they can decide if testing is the right choice for them. (Should you do it? the choice is up to you)
○If they are African American or have a father or brother who had prostate cancer before age 65, men should have this talk with a doctor starting at age 45. If men decide to be tested, they should have the PSA blood test with or without a rectal exam. How often they are tested will depend on their PSA level.
What issues might someone with prostate cancer have?
●urinary issues, emptying bladder, weak stream, prostate enlargement pushing on urinary tract
●abnormal > 2.5 cm, irregular, “boggy”/very mushy, nodule, very hard, tender
What are the signs of colorectal cancer?
What positions can you put your ptn in to do a rectal exam?
●Look out for poop issues
●pain, bleeding, lesions, discharge, itching
●Exam is in L lateral recumbent, lithotomy, or standing position
What are the colorectal cancer screening guidelines?
●USPSTF:
○Men and women 50-75: in order of least invasive to most invasive
■FOBT or fecal immunochemical test (FIT): every year
●poop on a stick
■FlexSig: every 5 years
●scope in rectum - only up to lower 1/3rd of colon
■Colonoscopy: every 10 years
●very invasive; must be anesthetized, checks entire colon
●laxative at night & enema in the morning
○Men and women >75:
■Make individual decision on testing w/ HCP
ACS adds:
●Double-contrast barium enema every 5 years
○drink barium which outlines your colon in an x-ray (no computers)
○if anything is found in this test, you need a colonoscopy
●CT colonography (virtual colonoscopy) every 5 years (most insurance plans don’t cover)
○uses x-rays and computers to produce images of the entire colon
○if anything is found, you need a colonoscopy
●Stool DNA test (sDNA) every 3 years (expensive, most insurance don’t cover) (poop cancer)
○collect ENTIRE bowel movement & send it to lab to be checked for cancer cells.
dome-shaped white or yellow papules or nodules fomred by occluded follicles filled w/ keratin debris → common, frequently multiple, benign
Epidermoid cysts
Penile vesicles; may look like erosions if vesicular membrane breaks.
Herpes
Penile papules or plaques, may be flat, raised, or cauliflower like.
genital warts caused by HPV
red papule that becomes a chancre (painless erosion)
- treponema pallidum (spirochete)
- may develop lymphadenopathy → rubbery, nontender, mobile.
syphillus
painless moveable mass above testis. may or may not contain sperm
Spermatocele & cyst of epididymis
varicose veins of the spermatic cord - feels like a soft bag of worms. May be associated w/ infertility
varicocele
inflamed epididymis, difficult to distinguish from testis. Coexisting UTI or prostatitis supports diagnosis
Acute epididymitis
twisting of testicle on spermatic cord, acutely painful and tender. Most common in adolescents and is a surgical emergency due to obstructed circulation. >24 hrs = dead testicle
torsion
