Women's Health Well Woman, PE, DX, Imaging Flashcards
WPSI/ACOG screening guidelines SKIN
annual skin exam
WPSI/ACOG screening guidelines BREAST
start mammograms between 40-50, continue 1-2 years (risk dependent), until at least 74
WPSI/ACOG screening guidelines COLORECTAL CANCER
colonoscopy q10yrs at age 50
WPSI/ACOG screening guidelines CERVICAL CA/PAP
cytology (pap) 21-30 q3 yrs
cytology w HPV co-test 30-64 q5 yrs, or cytology alone q3yrs
women’s health immunizations
influenza annually HPV <26 hepatitis (high risk) tetanus (tdap q10yrs) pneumococcal/shingles (>60)
gravida (OB hx)
of pregnancies
para (OB hx)
T= term (>37 weeks)
P = premature (20-36 weeks)
A= abortions (<20 weeks)
L=living
primigravida
first pregnancy
nulligravida
never been pregnant, not now
multigravida
2 or more pregnancies
nullipara
no births
primipara
giving birth for 1st time
multipara
delivered 2 or more pregnancies
uterus positioning “-Version”
position of entire uterus relative to axis of the vagina
uterus positioning “-flexion”
position of the entire fundus relative to the axis of the cervix
Flat films in OB/GYN
KUB, abdominal series
limited utility - stones, IUDs
CT in OB/GYN
cross-sectional 2D pictures, +/- contrast
MRI in OB/GYN
Superior to CT for soft tissue
but $$
ultrasound in OB/GYN
cheap, easy, good for pts with challenging pelvic exam
transabdominal ultrasound
less invasive
transvaginal ultrasound
early pregnancies, assessment of cervix in pregnancy, improved visualization of fetal parts low in pelvis
hysterosalpingogram (HSG) in OB/GYNG
instillation of contrast followed by fluoroscopic images
eval of uterine cavity and fallopian tubes
contrast spill, outline of lumen, shape of uterine cavity, width/length of cervix
indications for hysterosalpingogram
infertility, suspected congenital uterine anomalies, pre-procedure planning for hysterectomy, post-procedure assessment following tubal ligation
contraindications for hysterosalpinogram
pregnancy, active undiagnosed uterine bleeding, acute PID, allergy with severe reaction to contrast
sonohysterography in OB/GYN
instillation of saline followed by transvaginal ultrasound
evaluation of uterine cavity
indications for sonohysterography
dysfunctional uterine bleeding, infertility, suspected uterine cavity abnormalities based on transvag US, recurrent pregnancy loss
contraindications for sonohysterography
same as for HSG - pregnancy, acute PID, acute bleeding
imaging of the cervix, uterus
KUB, abd series, pelvic US, sonohystergram or HSG, MRI, CT
imaging of the endometrium
pelvis US
imaging of the ovaries
KUB, US (transvaginal»), CT, MRI
imaging of fallopian tubes
HSG
pap smear purpose
detection of cytologic abnormalities
colposcopy purpose
identify normal landmarks or changes suggestive of underlying abnormality
colposcope
binocular microscope used for direct visualization of the cervix
indications for colposcopy
follow-up to evaluate cervical lesions (suspected on visualization), abnormal HPV test
acetic acid can detect abnormal/dysplastic cells
endocervical curettage (ECC)
sampling of endocervical canal
usually done with colposcopy
indications for endocervical curettage
women undergoing colposcopy or based on pap smear result - further evaluates concerning findings
contraindications for ECC
pregnancy
cervical conization
method of biopsy - excision of cone-shaped portion of cervix surrounding endocervical canal including transformation zone
indications for cervical conization
advanced epithelial atypia
loop electrosurgical excision procedure (LEEP)
type of cervical conization - cone shaped specimen removed from uterine cervix with wire-loop cautery
hysteroscopy
examine of uterine cavity via hysteroscope
indications for hysteroscopy
dysfunctional uterine bleeding, endometrial ablation, endometrial thickening or polyps, submucosal fibroids and other uterine abnormalities…
Dilation & curettage (D&C)
cervix dilated allowing instrument to pass into uterus, portion of uterine lining or uterine contents removed
cervical Dilation, endometrial Curettage
indications for D&C
abnormal bleeding, management of abortion, diagnosis of uterine cancer
laparoscopy procedure
multiple small incisions in abdominal wall –> passage of camera and instruments
abdomen inflated with CO2
allows for diagnostic and therapeutic procedures
faster recovery than laparotomy
hysterectomy
complete surgical removal of the uterus
indications for hysterectomy
treatment of gynecologic CA, benign gynecologic conditions, obstetric complications
