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PCM II Midterm > Reproductive Topics > Flashcards

Reproductive Topics Flashcards

1
Q

What is puberty?

A

developmental stage characterized by transition from sexual immaturity to sexual maturity

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2
Q

Gonadarche

A

activation of gonads by FSH & LH secreted from anterior pituitary

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3
Q

Adrenarche

A

increase in androgen hormone production by adrenal cortex

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4
Q

Thelarche

A

development of breast tissue due to estrogen from ovaries

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5
Q

Menarche

A

first menstrual cycle

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6
Q

Spermarche

A

first sperm production

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7
Q

Pubarche

A

pubic hair development

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8
Q

When does puberty typically start for females and males?

A

for females, about 10-14 yo (breast development)

for males, about 11-16 yo (penile growth & pubic hair development)

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9
Q

When does menarche occur in regards to onset of puberty?

A

1st menstrual cycle will occur 2-3 years after beginning puberty

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10
Q

What are some physical findings to consider in repro exam?

A

increase in height & weight (varies w/ person)
growth spurt & bone growth
development of facial & axillary hair, voice changes
facial appearance changes
increase size of thyroid
change in skin (acne?)

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11
Q

What is are the first signs of puberty in females?

A

breast & pubic hair development

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12
Q

Describe stages of breast development

A

Stage 1: pre-adolescent
Stage 2: breast bud stage
Stage 3: further enlargement & elevation of breast
Stage 4: secondary mound above level of breast
Stage 5: full mature, only nipple projects

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13
Q

Describes stages of pubic hair (females)

A

Stage 1: no hair
Stage 2: sparse growth of long, slightly pigmented hair (only along labia)
Stage 3: darker & more coarse, curlier hair over pubic symphysis
Stage 4: coarse & curly in adults
Stage 5: hair spreads to medial thighs (not over abdomen)

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14
Q

When does menarche typically occur in relation to breast development?

A

usually starts @ breast stage 3 or 4

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15
Q

When does pubic hair development & growth of genitalia typically start in males?

A

9 to 13.5 yo (increase in volume of testicles)

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16
Q

In what stage is male pubic hair coarse & curly but not extended to thighs?

A

Stage 4

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17
Q

What is stage 2 in male development associated with?

A

sparse growth of long & slightly pigmented pubic hair, no change in penis size

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18
Q

What is important in OB/GYN history?

A

menstrual history (LMP)
gynecologic history
obstetrical history

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19
Q

What does a menstrual history include?

A

age of menarche
duration, flow & cycle length of periods
LMP

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20
Q

What does a gynecologic history include?

A 
breast history
last mammogram
previous GYN surgery
history of infertility
last pap smear
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21
Q

What is gravida para?

A

part of obstetrical history

of pregnancies & # of viable births/offsprings

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22
Q

TPAL

A

part of obstetrical history to determine # of:

Term deliveries
Pre-term deliveries (20-37 weeks)
Abortions
Live delivery

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23
Q

What would GP be for pt with 4 pregnancies, 1 spontaneous abortion at 14 weeks, 1 fetal demise at 28 weeks?

A

Pt is 31 yo G4 P2112

24
Q

What does an obstetrical history include?

A 
mode of delivery
gestational age @ delivery
maternal complications
fetal complications
delivery or operative complications
25
Q

What does a contraceptive/sexual history include?

A 
contraception method
current sexual activity
# of partners (last yr or lifetime)
new partner in last 3 months
condom use
history of sexual abuse
26
Q

What does a well woman exam include?

A

pap smear

mammogram

27
Q

Describe the guidelines for pap smears

A

for women over 21yo to 65yo

yearly for women w/ history of abnormal pap
every 3 yrs for women w/ consecutively normal paps
every 5 yrs for women w/ normal paps & negative HPV

28
Q

Describe the guidelines for mammograms

A

@ 50 yo or earlier for women who are high risk (depends on family history or other concerns)

29
Q

What is a pap smear?

A

test to screen for cervical cancer & checks for abnormal transformation of cervical cells

sample from ectocervix, endocervix, transitional zone & squamocolumnar junction

30
Q

Why is the transformation zone significant?

A

most common area of precancerous lesions & cancers

between original SCJ & new SCJ

31
Q

How is a pelvic exam different from a pap smear?

A

pelvic exam examines internal & external genitalia (visual inspection & bimanual exam to check for tenderness & swab area for STIs)

pap smear takes sample specifically of cervix by scraping of cells

32
Q

What do you palpate for during female pelvic exam?

A

first inspect visually

second bimanual exam to palpate for vagina, uterus & ovaries

33
Q

How do ectopic pregnancies present?

A

abdominal or pelvic pain w/ vaginal bleeding

34
Q

What should you always do with pt who presents w/ pelvic pain (or pelvic complaints)?

A

perform a pregnancy test

35
Q

How do UTIs present?

A

dysuria (pain, burning or discomfort when urinating)
urinary frequency
urinary urgency
suprapubic pain

may have hematuria (pink urine)

36
Q

What is the major cause of UTIs?

A

E coli

37
Q

When is a male exam usually performed?

A

not recommended regularly unless have specific complaint (or history of prostate cancer)

38
Q

Describe well male exam

A

inspect of scrotum, penile shaft, glands, inguinal region
palpate penile shaft & scrotum
retract foreskin if present
palpate inguinal region & examine for hernias
examine prostate w/ digital rectal exam

39
Q

How do you palpate the penile shaft?

A

w/ thumb & first 2 fingers

40
Q

When is testicular cancer a concern?

A

most common in younger males (teens & 20s)

41
Q

How does an inguinal hernia present?

A

pain w/ increased intra-abdominal pressure (as w/ heavy lifting or prolonged standing)

may have palpable bulge on affected side

42
Q

Where will you find an indirect inguinal hernia?

A

@ tip of finger (b/c hernia is near midpoint of inguinal ligament)

43
Q

Where will you find a direct inguinal hernia?

A

side of finger (b/c hernia is above inguinal ligament & close to pubic tubercle)

44
Q

What are the 5 Ps of sexual history?

A 
Partners
Practices
Prevention of pregnancy
Protection from STIs & HIV
Past history of STI
45
Q

What are risk factors for STIs?

A 
new partner in past 60 days
multiple sex partners or partner w/ many partners
sex w/ partners recently treated for STI
inconsistent condom use
trading sex for money
sexual contact w/ sex workers
meeting partners on internet
46
Q

What makes STIs unique?

A

reportable diagnosis

can report positive result to health department

47
Q

What is the key to treatment with STIs?

A

behavioral counseling (treatment of partner, counseling on safe sex, stress use of condoms)

48
Q

Gonorrhea

A

bacterial cause

men have penile discharge & dysuria or no symptoms
female have pelvic pain & vaginal discharge

can lead to pelvic inflammatory disease if not treated or lead to fallopian tube scarring (infertility0

49
Q

Chlamydia

A

most cases are asymptomatic

men have penile discharge & dysuria while females have vaginal discharge/bleeding or pain w/ intercourse

can lead to PID or fertility issues in women

50
Q

What are two STIs that are common tested for together?

A

Gonorrhea & chlamydia

51
Q

Syphilis

A

caused by bacterial

may have initial rash, then joint pain & fatigue w/ latent phase where asymptomatic until develop neurosyphilis

52
Q

What is neurosyphilis?

A

confusion, headache, stiff neck, vision loss

53
Q

Genital Herpes

A

virus

clusters of vesicles on genitalia & may have burning, tingling or pain prior to vesicle/wart appearance

increase risk of HIV infection (if open sores)

54
Q

Trichomonasis

A

caused by protozoa w/ flagella

men usually asymptomatic & females will have foul smelling thin or purulent vaginal discharge & itching & dysuria

55
Q

HPV

A

virus that causes genital warts

most lesions are self limited, high risk strains can lead to cancer of oropharyngeal region or lower genital tract

56
Q

How can best screen for HPV?

A

routine pap smear

PCM II Midterm (15 decks)

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