Reproductive Health

Question 1

Breast Exam

Answer 1

Q 3yrs for women ages 20-39
Yearly women ages 40yrs and older

Question 2

Fibrocystic Breast

Answer 2

Mobile
Tender
Don’t cause skin retractions
Regular margins
‘Common bengin breast’

Question 3

Cancerous Tissue

Answer 3

Fixed
Painless
Tissue retraction
Abnormal breast shape
Skin dimpling
Nipple retractons
Unlitateral mass

Question 4

Risk Factors

Answer 4

AA under 35 yrs
White over 35 yrs
Early Menarche ( < 12)
Late Menopause ( > 55)
Nulliparity or first pregnancy after 35 yrs
Previous h/o breast cancer
Long term hormone replacement
**Mutation in BRCA1 and BRCA 2 **
CHEK-2 gene mutation (responsible for breast cancer in men & women)

Question 5

Breast Testing

Answer 5

**Mammogram **
10 min
* screening age 40
* Every 1-2 yr after that
* age 50 and older yearly
* Detect lesions as small as 0.5 cm
* Uncomfortable

Ultrasound: Cystic areas
MRI: questionable areas/common w/ implants
Fine needles aspirations: Tissues/fluids diagnosis

Question 6

Teaching Points

Answer 6

Schedule after menses to reduce breast tenderness
No deodorant or powder day of the procedure (shadows)
Tylenol for pain
Leave neck jewelry at home
Facility accredited by American college of Radiology

Question 7

SBE

Self Breast Examination

Answer 7

q monthly, 2-3 days after period
Exam breast and armpit with raised arm
Use fingerpads w/ massage oil
Up and down
Wedges
Circle
Examine breasts in the mirror lumps or skin dimpling
Changes in color
Nip deformation color changes

Question 8

Pelvis Exam

Answer 8

External organs
Speclum exam
Pap smear
Cervical cultures/STI testing
Bimanual exam (internal)
Rectal Exam

Question 9

Speculum Exam

Answer 9

Bivalve speclum to inspect the vag and cervix (metal/plastic), first when sexually active
Size, shape, color of cervix
Lesions, discharge, lacerations
Pap test: age 21

Question 10

Pap Test

Answer 10

Detect changes in the cervix before cervical cancer develops ( precancerous condition)
Human Papiloma Virus ( HPV) testing
Cervical cell sampling done via speculum exam
Cervical slide w/ fixative/liquid pap test

Question 11

Cervical Cancer STATs

Answer 11

Third most common repro cancer
Highest in Hispanic women
Avg Age: 40-50

Question 12

Risk Factors for Cervical Cancer

Answer 12

Early age of first coitus (sexual intercourse)
Multiple sexual parnters ( more than 2)
High parity
Low socioeconomic status
Long term oc use
Smoking
Highest mortiality rate in AA/Hispanic population

Question 13

Screening for Cerivcal Cancer

Answer 13

Pap: Detect 90 % of cervical changes
Begins 21 yrs
Women age 21-29: q 3 yrs
Women 65 or older: w/ 3 neg HPV can stop
Management of cervical cancer: depends on stages
* Colposcopy
* Radiation
* Surgery

Question 14

Uterus (Cancer)

Answer 14

Most common form of cancer of reproductive
Age: 50-65 yrs
Risk factors:
* Obesity
* Nulliparity
* Late onset menopause
* Family hx of breast, ovarian cancer, coloeractive
* Slow growing: usually good prognosis

white, pear shaped uterine cancer increased

Question 15

Treatment

Answer 15

Surgical:
* TAH (total abdominal hysterectomy)
* BSO (bilateral SO)
* Radiation
* Radical hysterectomy
* Chemo
* Depo
* Tamoxifen

Question 16

Ovarian Cancer

Answer 16

Second most freq occuring cancer of reproductive system
Whisper cancer: symptoms are vague
Most likley originates in the fallopian tubes
Dg late stages
Risk Factors:
* Nulliparity
* Family history of breast and ovarian ca
* BRCA1 and BRAC2
* HRT use
* Talc powder, high fat diet, fertility drugs

Question 17

Testicular Cancer

Answer 17

Treatable Cancer: 90% cure rate
Most common between ages 15-40
Biggest risk:
* undescended testicle
* Born w/ penis abnormalities
* Male w/ HIV

Question 18

**Exam (Testicular) **

Answer 18

Examine one at a time
When: once a month
Where: in the shower