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Flashcards in Female Exam Deck (18)
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1
Q

Who should get a pelvic exam and how often?

A

First exam - women at age 21 , every 3 years after.

Unless other health concerns.

2
Q

Important issues related to the pelvic exam.

A
Cultural issues
Patient modesty
Anxiety about the exam
History of rape or abuse
Office environment
3
Q

Pelvic exam: Office environment concerns

A

have an additional person in the exam room while assessing reproductive organs, explain what you are doing, ensure comfort and modesty.

4
Q

Pelvic exam: patient comfort/modesty

A

gowns and sterile drapes, foot of table does not face the door, door marked to avoid interuption, allow patient to wear socks, bra or sweater.

5
Q

3 parts of the pelvic exam

A

Speculum exam
Bimanual exam
Recto-vaginal exam

6
Q

3 parts prior to beginning gloved examination

A
History
Inspect
-pubic hair
-lymph nodes
-urethral meatus
-orifices
Palpate
-labia
-milk skene's and bartholin's glands
-perineum
7
Q

Speculum exam

A

1st exam.

performed without lubricant, speculum warmed and closed when inserted at 45 degree angle posteriorly

8
Q

Visual observation of cervix

A
position
color
surface characteristics
discharge
shape/size of os
9
Q

The Papanicolaou [pap] exam

A

minimum 2 samples taken

  • cervical cells
  • vaginalsecretion

-STD tests possible

10
Q

3 most common STDs among women

A

HPV, Herpes, Chlamydia

  • QC (2nd highest in IA
  • in women often no symptoms
11
Q

Goal of pap smear

A

Screen for cervical cancer, assessing the transition zone of cervix

12
Q

Accuracy of pap smear

A
  • Decreased cervical CA death rate by 75%
  • False-positives (10-40%)
  • False-negatives (1-15%)
13
Q

vulvovaginitis

A

due to bacteria, viruses, fungi, protozoans.

symptomatic discharge

itching, burning, color change, texture or odor of discharge

14
Q

Bimanual exam

A

2nd exam

  • evaluate cervix, uterus, adenexal regions
  • PID, endometriosis
  • important for even those who are not sexually active
15
Q

Recto-vaginal exam

A

3rd exam

allows exam of rectal walls, evaluates the posterios aspect of uterus

16
Q

Uterine fibroids

A

risk factors

  • nulliparity
  • african american (2-3x)
  • older age

benign
40% OF WOMEN OVER 40
-MC pelvic tumor
-MC reason for hysterectomy

x-rays - cauliflower-like

17
Q

Symptoms/treatment of Uterine Fibroids (leiomyoma)

A
heavy menstrual bleeding
abdominal distortion
pelvic pressure
low back pain
dyspareunia
infertility
frequent urination
constipation
miscarriage or premature labor

wait and see
hysterectomy
drug therapy

18
Q

Endometriosis

A

“condition of inner layer”

normal endometrium found in abnormal places

risk factors
-25-44 years (10-15%)

Signs and symptoms

  • PAIN, PAIN, PAIN
  • pelvic mass
  • alterations of menses
  • dysmenorrhea
  • infertility
  • dyspareunia
  • pain with defecation,urination

early onset of menses
short cycle (<27days)
severe menstrual cramps
prolonged flow (>1 week)