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CS1 Female GYN

Adenexa Fillopian tubes and ovaries
Potential GYN skin lesions 1.Human Papillomavirus (HPV or genital warts). 2.Herpes Simplex Virus (HSV). 3.Syphilis. 4.Lymphogranuloma venereum.
General Vaginal inspection 1.Symmetry. 2.Equal hair distribution. 3.Labia Majora (moisture, swelling, color, rash, lesions, *Increased varicosities during pregnancy*). 4.Labia Minora (glands, clitoris, urethral orifice, perineum).
Insertion of the speculum 1.warmed, lubricated with water. 2.Spread vagina with opposite hand. 3.insert speculum at 45 degree angle. 4.Capture and inspect the cervix
Is it normal for pregnant women to have increased vericosities during pregnancy? YES
Metrorrhagia irregular, non-cyclic menstrual intervals
Oligomenorrhea Prolonged periods, intervals >37 days long. (not as many per year)
Poly/Hypermenorrhea Short menstratual cycles, intervals < 21 days long. (more than 12 periods per year)
Menorrhagia Excessive bleeding and/or prolonged bleeding
Menometrorrhagia Heavier periods as well as increased bleeding between periods
Inspection of the cervix 1.Color (Should be PINK. pale: menapause, ectropion: red tissue around the OS). 2.Lesions. 3.Discharge
Shapes of Cervical OS 1.Horizontal slit: parous women (given birth). 2.Small/round: nulliparous women (no child birth).
Cervix-Uterus position They are inversly related: 1.Anterior OS: Retroverted uterus. 2.Posterior OS: Anteverted uterus. **Normal uterine position: Anteverted and Anteflexed.
What is the Primary screening test for cervical cancer? PAP smear. **MUST VISUALIZE THE CERVICAL OS to conduct the test.
How do you obtain Ectocervical cells? Using a spatula, rotate 360 degrees
How do you obtain Endocervical cells? Insert brush 1/2 way into cervical OS, rotate 1/2 turn.
Advantage of a Cervical Broom? it combines the spatula and brush to collect both endo and ecto cervical cells.
Can you still obtain a PAP smear if an IUD/ Nuvaring are in place? YES
Bimanual exam: Cervix palpation secure the cervix between two fingers. Test mobility insuring that it moves anterior, posterior, and laterally. Also feel for size and shape.
Pelvic Inflammatory Disease (PID) Often discovered when moving the uterus to test its mobility. Patients will experience pain/tenderness.
Bimanual exam: Fundus palpation Size, shape, and consistancy. If Anteverted & Anteflexed: Dr should be able to palpate from the stomach during bimanual exam.
Normal Fundus Pear shaped, 5-8cm in length. **Usually located at level of Pubis
Post-menapausal Fundus May not be palpable due to uterine degredation (dimishes in size).
Bimanaul Exam: Adenexa palpation Often times they are not palpable unless there is a pathology or patient is very thin. **Normal: smooth, 3X2X1 cm
Rectal Exam CHANGE GLOVES. Want to perform hemocult and evaluate tone of anal sphincter/rectal walls. **Better assesment of RETROVERTED Uterus.
Post Hysterectomy PAP Do a PAP of vaginal cuff (one slide only)
How often should a women recieve her pelvic exam? Yearly beginning at age 21
Gardasil Vaccine for cervical cancer. Need to get to as an adolescent.
3 common symmptoms of Cervical Cancer (if any are seen at all) 1.Post Coital Bleeding. 2.Abnormal Uterine Bleeding. 3.Biopsy of ALL visible lesions
Positions for women with disabilities 1.Knee-chest. 2.Diamond-shaped. 3.Obstetric stirrups. 4.M-shaped. 5.V-shaped.
Cervical cancer risk factors 1.STD. 2.Early 1st Coitus (<15yrs). 3.Smoking. 4.Sexual Partners. 5.History of cervical Dysplasia. 6.Obesity (BMI>30) 2X the risk.
Ovarian Cancer risk factors 1.Nulliparity. 2.Endometriosis. 3.Ovarian dysfunction. 4.Spont abortion. 5.Exposure to talc/asbestos. 6.Irradiation of pelvic organs. 7.Anovulation. 8.Breast/endometrial cancer. 9.Family Hx of ovarian/breast cancer with BRCA1/BRCA2 genetic markers
FDLMP First Day of Last Menstrual Period
EDC Estimated Date of Confinement
Pregnancy History: GP(FPAL) 1.G: Gravida (# X Pregnant). 2.P: Para (# of live births). 3.F: Full term preg. 4.P: Preterm preg. 5.A: Abortions/Miscarriages. 6.L: Living children.
G3P2 She had 3 pregnancies with 2 live births
G1P(0202) She had 1 pregnancy, 2 pre-term deliveries, and 2 living children [twins]
G2P(1011) She had 2 pregnancies, 1 full term delivery, 1 abortion/miscarriage, and 1 child living
Created by: WeeG
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