Gynecologic Examination and Prenatal Care

Questions and Answers

A complete gynecologic examination consists of a breast examination and a pelvic examination.

True

The American College of Obstetricians and Gynecologists recommends that a woman perform a breast self-examination weekly.

False

The purpose of the Pap test is for early detection of cervical cancer.

True

The patient should be instructed to douche before having a Pap test.

False Signup and view all the answers

Trichomoniasis produces a profuse, frothy vaginal discharge.

True Signup and view all the answers

Another name for candidiasis is a yeast infection.

True Signup and view all the answers

Prenatal refers to the care of the pregnant woman before delivery of the infant.

True Signup and view all the answers

During each return prenatal visit, the mother's urine is tested for glucose and protein.

True Signup and view all the answers

The normal range for the fetal pulse rate is between 120 and 160 beats per minute.

True Signup and view all the answers

Amniocentesis can be used to diagnose certain genetically transmitted conditions.

False Signup and view all the answers

The patient position for a breast examination is the lithotomy position.

False Signup and view all the answers

Most breast lumps are discovered by the physician.

False Signup and view all the answers

Trichomoniasis is caused by a virus.

False Signup and view all the answers

Chlamydia often occurs in association with syphilis.

False Signup and view all the answers

In the absence of complications, the first prenatal visit should be scheduled after a woman misses her first period.

False Signup and view all the answers

True labor pains are referred to as Braxton Hicks contractions.

False Signup and view all the answers

The purpose of measuring fundal height is to determine the degree of cervical dilation and effacement.

False Signup and view all the answers

The fetal heart tones can first be detected between 4 and 6 weeks of gestation using a Doppler fetal pulse detector.

False Signup and view all the answers

Obstetric ultrasound scanning is used to assess fetal lung maturity.

False Signup and view all the answers

The perineum is the period of time in which the body systems are returning to their prepregnant state.

False Signup and view all the answers

What is the purpose of the gynecologic examination?

Assess the health of the female reproductive organs to detect early signs of disease, leading to early diagnosis and treatment. Signup and view all the answers

What is the purpose of performing a breast examination?

To check for any abnormalities and signs of breast cancer and to notice any changes in the breasts. Signup and view all the answers

How often should a woman perform a breast self-examination at home? When should it be performed in relation to the menstrual cycle and why?

Once monthly; 2-3 days after your period because your breasts won't be as tender/swollen. Signup and view all the answers

What are the components of the pelvic examination?

Inspection of external genitalia, vagina, and cervix; collection of specimen for a Pap test; bimanual pelvic examination; rectal-vaginal examination. Signup and view all the answers

What position is generally used for the pelvic examination?

Lithotomy position. Signup and view all the answers

How can the medical assistant help the patient to relax during the pelvic examination?

Telling her to breathe deeply, slowly, and evenly through the mouth. Signup and view all the answers

What is the function of a vaginal speculum?

Hold the walls of the vagina apart to allow visual inspection of the vagina and cervix. Signup and view all the answers

What is the purpose of performing a visual examination of the vagina and the cervix?

To observe for color, lacerations, ulcerations, redness, nodules, and discharge. Signup and view all the answers

What are three examples of vaginal infections that cause a discharge?

Trichomoniasis, candidiasis, chlamydia. Signup and view all the answers

What is the purpose of performing a Pap test?

Used for the early detection of cervical cancer, detect abnormal cells of the cervix. Signup and view all the answers

What causes most cervical cancers?

Human papillomavirus (HPV). Signup and view all the answers

Describe the schedule for having a Pap test as recommended by the American Cancer Society.

Begin at age 21 performed every 3 years until age 29; at age 30 Pap test combined with HPV every 5 years until age 65. Signup and view all the answers

Why should the medical assistant instruct the patient not to douche or insert vaginal medications for 2 days before coming to the medical office to have a Pap test?

To reduce the number of cells available for analysis; spermicides change the pH of the vagina. Signup and view all the answers

What are the three types of specimens that may be obtained for a Pap test? Where is each collected?

Vaginal, cervical, and endocervical. Signup and view all the answers

Why must the slides be fixed immediately after collection of a specimen for the direct-smear Pap test method?

They must be fixed before they dry to avoid inaccurate results, maintain normal appearance of the cells. Signup and view all the answers

What are the advantages of using the liquid-based Pap test method?

Improves the quality of the specimen, resulting in fewer slides that are unsatisfactory for evaluation. Signup and view all the answers

List three conditions that the maturation index can help to evaluate.

The cause of infertility, menopausal or post-menopausal bleeding or amenorrhea. Signup and view all the answers

Why is the Bethesda System recommended for reporting the results of the Pap test?

It provides a detailed cytologic description rather than a numerical result. Signup and view all the answers

What is the purpose of performing the bimanual pelvic examination?

Palpate the size, shape, and position of the uterus and ovaries; detect tenderness or lumps. Signup and view all the answers

What is the purpose of the rectal-vaginal examination?

Obtain information about the tone and alignment of the pelvic organs; detect the presence of hemorrhoids, fistulas, and fissures. Signup and view all the answers

Describe the laboratory procedure that can be used to identify Trichomonas vaginalis in the medical office.

Wet preparation, using a sterile swab to place a small amount of discharge on a slide, adding isotonic saline, and placing a coverslip. Signup and view all the answers

Describe the laboratory procedure that can be used to identify Candida albicans in the medical office.

Microscopically by placing a specimen of vaginal discharge on a slide and adding a drop of a 10% solution of potassium hydroxide (KOH). Signup and view all the answers

What are the symptoms of PID? What complications can occur from PID?

Symptoms include lower abdominal pain, fever, nausea, vomiting, dyspareunia, vaginal discharge, and bleeding between periods. Complications include chronic pelvic pain, scarring, ectopic pregnancy, and infertility. Signup and view all the answers

How are chlamydial and gonorrheal infections usually diagnosed?

Using a nucleic acid amplification test or a nucleic acid hybridization test known as the DNA-probe test. Signup and view all the answers

What is the purpose of prenatal care?

Prenatal education, prevent disease, promote health of the mom, and detect early detection of problems. Signup and view all the answers

List the three categories of medical office visits for provision of prenatal and postnatal care to the pregnant woman.

First prenatal visits; return prenatal visits; 6 weeks postpartum visits. Signup and view all the answers

List the four components of the first prenatal visit.

Completion of a prenatal record form; initial prenatal examination; prenatal patient education; laboratory tests. Signup and view all the answers

What is the purpose of the prenatal record?

Provides information regarding the past and present health of the patient. Signup and view all the answers

List two types of information included in the past medical history (of the prenatal record).

Focuses on conditions that could affect the health of the mother and fetus and immunizations and childhood diseases. Signup and view all the answers

List three types of information included in the present pregnancy history.

Establishes a baseline for the present health status of the prenatal patient; warning signs that may place the mother or fetus in jeopardy; early signs of pregnancy. Signup and view all the answers

What are the warning signs of a spontaneous abortion?

Abdominal cramps and vaginal bleeding, sometimes with clots or bits of tissue. Signup and view all the answers

What are the warning signs of preeclampsia?

Increasing hypertension, albuminuria, and edema. Signup and view all the answers

What is the purpose of the interval prenatal history?

To update the record. Signup and view all the answers

Explain the importance of performing a physical examination on the prenatal patient.

To establish a baseline for women's general state of health. Signup and view all the answers

What is the importance of making sure that a pregnant woman does not have gonorrhea before delivery of the infant?

The N. gonorrhoeae organism could infect the infant's eyes during passage through the birth canal. Signup and view all the answers

Why is a pregnant woman tested for group B streptococcus (GBS)? When is the woman tested for GBS?

It can cause life-threatening infection in a newborn. Testing is done at 35-37 weeks of gestation. Signup and view all the answers

What is the purpose of performing a hemoglobin and hematocrit evaluation on a prenatal patient?

For precautions against anemia. Signup and view all the answers

What is the importance of assessing the Rh factor and ABO blood type of a pregnant woman?

To anticipate blood type and Rh factor incompatibilities that could affect the fetus. Signup and view all the answers

What is the purpose of performing a glucose challenge test on a pregnant woman?

To screen for gestational diabetes mellitus (GDM). Signup and view all the answers

What is the purpose of performing a rubella titer test on a pregnant woman?

To determine whether the woman is immune to rubella. Signup and view all the answers

Why does the Centers for Disease Control and Prevention recommend that pregnant women have a blood test to screen for exposure to the hepatitis B virus?

To screen for the hepatitis B virus which can increase the risk of complications. Signup and view all the answers

What is the purpose of the return prenatal visit? List the usual schedule for return prenatal visits.

To provide continuous assessment of the health of the mother and fetus; 0-28 weeks: every 4 weeks; 29-35 weeks: every 2 weeks; 36 weeks until delivery: every week. Signup and view all the answers

What tests are performed on the patient's urine specimen at each return visit and why is each performed?

Tests include glucose and protein checks to monitor for potential complications. Signup and view all the answers

List two purposes of measuring the fundal height.

To guide further measurements and assess fetal growth. Signup and view all the answers

What is the normal range for the fetal heart rate?

120-160 beats per minute. Signup and view all the answers

What is the purpose of performing a vaginal examination as the patient nears term?

To confirm presenting part and determine degree of cervical dilation and effacement. Signup and view all the answers

What is the purpose for performing each of the following special tests and procedures?

To screen for fetal abnormalities and evaluate fetal health. Signup and view all the answers

What is the purpose of the multiple marker test?

To screen for the presence of certain fetal abnormalities, including neural tube defects. Signup and view all the answers

What is the purpose of the obstetric ultrasound scan?

To evaluate the health of the fetus and determine gestational age. Signup and view all the answers

Study Notes

Gynecologic Examination

A complete gynecologic examination includes breast and pelvic examinations.
The Pap test is crucial for early detection of cervical cancer.
Douching before a Pap test should be avoided as it reduces the number of cells for analysis.
Common vaginal infections causing discharge include trichomoniasis, candidiasis, chlamydia, and gonorrhea.
Trichomoniasis leads to a profuse, frothy vaginal discharge, while candidiasis presents as a thick, cottage cheese-like discharge.

Prenatal Care

Prenatal care focuses on the health of the pregnant woman before delivery.
Regular urine tests for glucose and protein are performed during prenatal visits.
A normal fetal heart rate ranges from 120 to 160 beats per minute.
The first prenatal visit should occur after the woman misses her period.

Pelvic Examination Details

Components of a pelvic examination include inspection of external genitalia, collection of specimens for Pap tests, and bimanual pelvic examination.
The lithotomy position is typically used for pelvic examinations.
A vaginal speculum aids in visual inspection of the vagina and cervix.

Pap Test Protocol

Women should not douche or use vaginal medications two days prior to a Pap test to ensure accurate results.
The Bethesda System enhances communication of Pap test results through detailed descriptions instead of numerical results.
There are three specimen types collected for Pap tests: vaginal, cervical, and endocervical.

Symptoms of STDs

Trichomoniasis symptoms in females include a yellowish green discharge with an unpleasant odor and potential “strawberry cervix” appearance.
Candidiasis symptoms involve intense itching and a thick, odorless discharge.
In females, chlamydia may present with dysuria and yellow, odorless discharge, but often has no symptoms.
Gonorrhea can lead to dysuria and yellow discharge in females, with males experiencing more noticeable symptoms.

Importance of Prenatal Visits

Prenatal visits aim to educate the patient, prevent disease, and identify health issues early.
The first prenatal visit encompasses health history documentation, physical examination, and lab tests.
Key warning signs during pregnancy include symptoms of spontaneous abortion (abdominal cramps and vaginal bleeding) and preeclampsia (hypertension and edema).

Diagnostic Tests & Procedures

A glucose challenge test screens for gestational diabetes mellitus.
Assessing Rh factor and ABO blood type is essential to avoid potential incompatibilities that may harm the fetus.
Routine evaluations include hemoglobin and hematocrit tests to monitor for anemia.

Follow-up and Monitoring

Return prenatal visits allow for ongoing health assessments of the mother and fetus, scheduled based on gestational age.
Measuring fundal height provides insights into fetal growth and position.
A vaginal examination near term is performed to assess cervical dilation and effacement.

Diagnostic Imaging

Obstetric ultrasounds are used to assess fetal health and establish gestational age.
The multiple marker test screens for specific fetal abnormalities like neural tube defects.

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Description

This quiz covers essential elements of gynecologic examinations and prenatal care. It includes details on breast and pelvic exams, the importance of Pap tests, and key aspects of prenatal health monitoring. Test your knowledge on common vaginal infections and fetal assessment.