WGU D117 GIM3 - Gynecological Exam Plan Template|Complete Breast Exam Questions With Answers

WGU D117 GIM3 - Gynecological Exam Plan Template|Complete Breast Exam Questions With Answers .0 station - Answer-Line with plane of maternal ischial spines .1st prenatal visit - Answer-Identify risks OB, medical, surgical, family, social histories Calculate EDD, physical exam, lab tests, patient education .1st stage of labor - Answer-Begins with regular uterine contractions and ends with full cervical dilation Pace depends on parity and use of epidural anesthesia .2nd stage of labor - Answer-Begins with complete dilation and ends with fetal delivery, from 1 contraction to up to 3 hours .2nd trimester testing - Answer-Screening US at 20 weeks (anatomy/gender US) GTT Education on breastfeeding and preterm labor symptoms .3Ps of delivery - Answer-Power (uterine activity), passenger (fetus), passage (maternal pelvis) .3rd stage of labor - Answer-Begins immediately after infant delivery and ends with placenta delivery Lasts 5-15 min .3rd trimester - Answer-CBC and antibody testing (repeat 28-29 weeks if unsensitized), GBS swab at 35-37 weeks, education .3rd trimester considerations - Answer-If patient requires repeat or primary C-section (typically 39 weeks) If >41 weeks will need antenatal testing, biweekly NST and biophysical profile, labor induction (must induce by 42 weeks) .3rd trimester patient education - Answer-Fetal kick counts, pediatrician, OB anesthesia, L and D tour, birth classes, travel (limit after 36 weeks), start stool softners .4th stage of labor - Answer-Immediate post-partum period of about 2 hrs after placenta delivery .Abdominal hysterectomy - Answer-Use when vaginal and laparoscopic options aren't available .Active phase - Answer-Period between increased rapidity of cervical dilation and ends with complete cervical dilation of 10 cm .Acute pelvic pain Dx - Answer-History and physical Pregnancy test, STI cultures, CBC, UA Pelvic/TV sonogram, abdominal series .Acute pelvic pain patho - Answer-Ectopic/miscarriage, ovarian torsion, ruptured cyst, acute PID (with tubo-ovarian abscess), etc. .Acute pelvic pain Tx ectopic/miscarriage - Answer-Surgery or methotrexate if beta-hCG <5000, no fetal HR, stable vitals .Acute pelvic pain Tx nephrolithiasis - Answer-Pain management +/- flomax .Acute pelvic pain Tx PID - Answer-Ceftriaxone, doxycycline, metronidazole Surgery if abscess .Acute pelvic pain Tx ruptured cyst - Answer-Laparoscopy if infection/hemorrhage Conservative management if uncomplicated .Acute pelvic pain Tx torsion - Answer-Surgical emergency .Adenomyosis Dx - Answer-TVUS (initial) MRI Histologic exam (definitive) .Adenomyosis patho - Answer-Endometrial glands and stoma present in deeper layers of muscle that extend into myometrium .Adenomyosis risks - Answer-30-50 y.o., multiparous women Prior uterine surgery .Adenomyosis Sx - Answer-Heavy menstrual bleeding, irregular bleeding, dysmenorrhea or dyspareunia, Chronic pelvic pain, infertility .Adenomyosis Tx - Answer-Hormones for Sx Hysterectomy IR uterine artery ablations .Adequate prenatal care - Answer-Begins early, before 4th month, occurs on regular basis, with mother attending 80+% of expected visits .Adnexal mass Dx - Answer-Incidental finding on pelvic exam, surgery, US, CT CA-125 (<200 = benign, >200 = increased concern for cancer), LDH, AFP, hCG .Adnexal mass hemorrhage Sx - Answer-Right side more common Acute pain and or tachycardia, orthostatic HoTN .Adnexal mass patho - Answer-Include masses in ovary (functional cysts, benign neoplasms), fallopian tube (ectopic pregnancy, hydrosalpinix, cancer), or surrounding connective tissue (paratubal or paraovarian cysts, tubo-ovarian abscess) .Adnexal mass Sx - Answer-Pain and bloating .Adnexal torsion Dx - Answer-Pelvic (or TV) US .Adnexal torsion patho - Answer-Complete or partial twisting of ovarian pedicle Cystic ovary with tumor most common, cysts >4cm .Adnexal torsion Sx - Answer-Sudden onset of severe unilateral lower abdominal pain, +/- started with exercise or sudden movement .Adnexal torsion Tx - Answer-Emergent GYN consult for laparoscopy .After PGE use - Answer-Mom should remain recumbent for at least 30 min Monitor for fetal heart tracing continuously for 30 min - 2 hr .Alloimmunization - Answer-Rh negative mother with Rh positive baby are at risk developing antibodies to Rh antigen and therefore future pregnancy for catastrophic consequences .Amenorrhea - Answer-Abscence of menstruation .Amenorrhea Dx - Answer-PE and pelvic exam looking at stature, Tanner staging, skin findings, Turner syndrome phenotype Beta-hCG, TSH, FT4, FSH, prolactin, LH US, MRI of hypothalamus Genetic testing, karyotype .Amenorrhea risks - Answer-Family history, eating disorders, athletic training, history of gynecologic procedures .Amenorrhea Tx - Answer-Treat cause Diet, manage stress, change exercise routine Meds (HRT), manage infertility +/- surgery .Amniotic fluid embolism Dx - Answer-Sudden CV colapse, severe respiratory difficulty and hypoxia, +/- seizures, followed by DIC .Amniotic fluid embolism patho - Answer-Cytokine storm due to exposure to unknown antigen