Well Woman Exam Flashcards
What is Gravidity and Parity
G = # of times a woman has been pregnant P = # of pregnancies that led to a birth ≥ 20 wks or infant > 5 grams
What is TPAL in terms of Parity
T = term births (37-42 wks) P = preterm births (20-36+6 wks) A = abortions (< 20 wks) L = living (live births)
Def: Gravid
Woman who is or has been pregnant
Def: Primigravida
Woman who is in or has experienced her first pregnancy
Def: Multigravida
Woman who has been pregnant more than once
Def: Nulligravida
Never been pregnant
Def: Primipara
Has given birth to one child
Def: Multipara
Has given birth to > 1 child
Def: Nullipara
Has never given birth or never had a pregnancy > 20 wks
What is the avg age of menarche
12-13 yo
Def: Primary amenorrhea
No menarche by age 16 yo
What is the avg # of days of a cycle
21-35 days
If a pt has post-coital bleeding, what should the concern be
Cervical cancer
If a pt has post-menopausal bleeding, what should the concern be
Endometiral/Uterine cancer
If a pt has heavy bleeding or passes clots, what should the concern be
Structural abnormality
Def: Naegeles Rule
Establishes an estimated date of confinement (EDC) (LMP - 3 months) + 7 days = EDC (LMP + 9 months + 7 days = EDC
How often should women b/w 20-39 have a clinical breast exam
Every 1-3 years
What are the breast exam guidelines for a women > 40 yo
Annual clinical exam and mammogram
When should pts begin annual pelvic exams
21 yo
What are the risk factors for bone mineral density exam earlier than required
Hx of Fx BW < 127 lbs Medical cause of bone loss
What are the risk factors for mammography earlier than required
Hx of BC or FH of premenopausal BC or OC Positive for BRCA1/2 Hx of high risk breast biopsy
What are risk factors for lipid profiles earlier than required
Hx of CAD BMI > 30
What are risk factors for CRC screening earlier than required
FH of CRC FH of FAP or HNPCC Hx of CRC, adenomatous polyps, IBD, UC, CD
What are risk factors for DM screening earlier than requried
BMI > 25 Native America, Latina Hx of GDM
What are risk factors for TSH screening earlier than required
FH of thyroid disease
What are risk factors for STI screening earlier than required
Hx of multiple sex partners Hx of STIs Sexually active adolescents
Wha are the risk factors for meningococcal vaccination
Adults w/ asplenia 1st year college student living in dorm/military recruits Pts traveling to endemic/epidemic areas
When/how often should pts be screened for BMD
65 yo q 2 years (if no risk factors)
When/how often should pts be screened w/ mammography
40 yo q 1 year
When/how often should pts be screened w/ a lipid profile
45 yo q 5 years
When/how often should pts be screened for CRC
45 yo for AA q 10 years
50 yo for everyone else q 10 years
When/how often should pts be screened for DM
45 yo q 3 years
When/how often should pts be screened for TSH levels
50 yo q 5 years
When/how often should pts be screened for STI’s
≤ 25 yo = if sexually active
≥ 26 yo = if at high risk
When should the MMR vaccine be given if the pt is not previously immunized
B/w 40-54 yo
When should a pt receive the Varicella Zoster vaccine
> 60 yo
When should a pt receive the Pneumococcal vaccine
≥ 65 yo
How often should the Tdap booster be given
q 10 years
What are the recommendations for cervical cytology and HPV screening
21-29 yo = cytology alone q 3 years (unless risk factors)
> 30 yo = cytology alone q 3 years OR cytology + HPV q 5 years
When should pts be given the HPV vaccine
B/w 9-26 yo
Def: Chloasma
Pigmentation over bridge of the nose and under eyes that may be a sign of pregnancy
What is a sign on linea nigra that could indicate pregnancy
Pigmentation of the linea nigra
What is the difference b/w a spatula and a cytobrush
Spatula = scrapes ectocervic during PAP
Cytobrush = obtains specimen that is scrapped off during PAP
What pathogen is a “strawberry cervix” associated w/
Trichomonas
Which pathogen is the most common cause of vaginal infection
Bacterial Vaginosis
How do you test a pt for gonorrhea/chlamydia if there is cervical discharge present
Swab inserted into cervical os for 45 seconds
