Well Woman Exam LECT [Slides 1-50] Flashcards
When recording a pt’s obstetric hx, what information must be recorded?
Date of delivery/termination
Hospital
Gestational age, sex, birth weight (gravity and parity)
Type of delivery
Duration of labor
Type of anesthesia
Maternal complications
Fetal complications
What weeks are considered full term?
37-42
What weeks are considered preterm?
20-36 weeks+6 days
What is the difference between primapara and primagravida?
Primapara - has given birth to one child
Primagravida - woman who is in or has experienced her 1st pregnancy
What is the difference between nullipara and nulligravida?
Nullipara - has never given birth or has never had a pregnancy progress beyond the gestational age of an abortion
Nulligravida - never been pregnant
Most common causes of amenorrhea (2)
Pregnancy
Menopause
Averate age of menarche
12-13
When would a pt be considered to have primary amenorrhea?
If pt has not cycled at 16 yo
What should you be concerned about if a pt has post-coital bleeding?
Cervical CA
What should you be concerned about if a pt has post-menopausal bleeding?
Endometrial/uterine CA
What should you be concerned about if a pt has heavy vaginal bleeding, passing clots?
Structural abnormality
Pt complaining of midcycle ovulatory pain/cramps most likely has what syndrome?
Mittelschmerz syndrome
What does Naegel’s rule calculate?
Estimated date of confinement (delifery)
Subtract 3 months and add 7 days to LMP
What kind of gynecologic hx do you want to obtain in preconception planning/counseling?
PNV, folic acid
Have they had chicken pox?
Do they have cats?
Will tehre be risk with their job? (daycare workers CMV)
When does ACOG recommend getting a clinical breast exam?
Every 1-3 years for women age 20-39
Every year w/ annual mammogram for women >40
When does ACOG recommend beginning annual pelvic exams?
Age 21
What STD screening should be periodically obtained in female pts aged 13-18 yo?
Chlamydia/Gonorrhea (if sexually active)
HIV
In female pts aged 13-18 yo, what counseling must you do to address sexuality?
Address high risk sexual behaviors (# of partners)
Contraception options
STD prevention (barrier protection)
In female pts aged 13-18, what psychosocial evaluation/counseling must be done?
Suicide, depressive sx, bullying, school experiences
sexual abuse by family or partner
When should pts receive the Tdap vaccine booster?
Once b/w 11-18 yo
When should pts receive the HPV vaccine?
One series for those who are not previously immunized b/w 9 and 45
- Cervarix - 16 and 18*
- Gardasil HPV - 6, 11, 16, 18*
- Gardasil 9 - everything basically*
How often should pts get cervical cytology?
21-29: q3 years with cytology alone
>30: q3 years with cytology alone, cotest with HPV q5 years
When should pts get GC screening?
25 yo or younger and sexually active
26 and older who are at high risk
What kind of psychosocial evaluation must be done for female pts aged 19-39?
Intimate partner violence
Acquaintance rape prevention
