Reproductive Topics

Question 1

When does puberty usually start for females and males?

Answer 1

Females 10 - 14

Males 11 - 16

Question 2

At what Tanner stage of breast development does menarch typically start for females?

Answer 2

Tanner stage 3 or 4

Question 3

Define:

Gonadarche

Adrenarche

Thelarche

Menarch

Spermarche

Pubarche

Answer 3

Gonadarche - activation of gonads by FSH and LH secreted from anterior pituitary

Adrenarche - The increase of androgen hormone production by adrenal cortex

Thelarche - development of breast tissue due to estrogen from ovaries

Menarche - 1st menstrual cycle

Spermarche - 1st sperm production

Pubarche - pubic hair development

Question 4

What does G6P4115 mean?

Answer 4

Pregnant 6 times

4 full term births

1 pre term birth

1 abortion at <20 weeks

5 live births.

P = TPAL

Question 5

What is considered “term” for deliveries?

Answer 5

> 37 weeks gestation.

< is considered “preterm”

Question 6

When should women get pap smears?

Answer 6

From ages 21 to 65

Question 7

What is the presentation for an ectopic pregnancy?

Answer 7

Abdominal/pelvic pain with vaginal bleeding, other pregnancy sx

Question 8

What is the treatment for an inguinal hernia?

Answer 8

Mild - watchful waiting

Moderate/severe - surgery to repair

Question 9

What are the 5 P’s of sexual history?

Answer 9

Partners

Practices

Prevention of pregnancy

Protection

Past history of STI

Question 10

What is the presentation, complications, work up, and treatment for:

Gonorrhea?

Answer 10

Presentation

Men: Penile discharge, dysuria, may be asymptomatic

Women: Pelvic pain, mucopurulent vaginal discharge

urogenital, anorectal, pharyngeal infections

Complication: PID if untreated, scarring of fallopian tube => infertility

W/u: Nucleic acid amplification tests on endocervical, urethral, vaginal, pharyngeal, rectal, urine samples

Tx: Abx, also tx for co-infection with chlamydia, counseling for treatment of partner and safe sex practice

Question 11

What is the presentation, complications, work up, and treatment for:

Herpes Simplex?

Answer 11

Presentation:

Single or clusters of vesicles on genitalia

Burning, tingling, pain prior to vesicle appearance

Complications: meningitis, PID, hepatitis, increased risk of HIV infection

Workup: Serologic test, PCR assay from lesion

Tx: Antiviral (Acyclovir)

Question 12

What is the presentation, complications, work up, and treatment for:

Human papillomavirus?

Answer 12

Presentation: genital warts

Complication: high risk strains can lead to cancer in oropharyngeal region or lower genital tract

Workup

Routine pap smear, test for HPV

Tx

Prevention w/ Gardasil vaccine during adolescence (11-26)

Contains most common high risk strains

Routine pap smear

Genital wart removal (surgery, cream, cryotherapy)

Question 13

What is the presentation, complications, work up, and treatment for:

Syphilis?

Answer 13

Presentation

Primary - chancre

Secondary - Joint pain, fatigue, lymphadenopathy, mucopapular rash

Latent - may be asymptomatic

Tertiary - Neurosyphilis (complication)

Workup: Serologic tests, Ab detection tests, microscopy(nontrepomenal test and treponemal test)

Tx: Penicillin

Question 14

What is the presentation, complications, work up, and treatment for:

Trichomoniasis?

Answer 14

Presentation

Men: may be asymptomatic, may have penile discharge

Women: Foul smelling, thin, purulent vaginal discharge, vaginal pruritis, dysuria

Workup: wet mount (sample on slide under microscope), nucleic acid amplification tests on vaginal or penile fluid

Tx: Antiprotozoal medication like metronidazole