Health)
Primary amenorrhea
(Ans-
the failure to begin menstruating at puberty. Patient has never had a
any bleeding (menses) Ever. No prior first period. If they are 15 or 16,
need to think about structural problems, missing ovaries,
etc.)chromosomal irregularities leading to primary ovarian insufficiency
(e.g., Turner syndrome) or anatomic abnormalities (e.g., Müllerian
agenesis).
secondary amenorrhea
(Ans-
Menstruation begins normally, then ends before menopause.no
menses for 3-6 months after the regular cycle has been established.
Cannot be classified as Secondary amenorrhea in the first 2years of
starting menarche.
Primary amenorrhea signs and symptoms are:
(Ans-
Milky nipple discharge.
Hair loss.
Headache.
,Vision changes.
Excess facial hair.
Pelvic pain.
Acne.
Secondary amenorrhea symptoms are:
(Ans-
No menses for at least 3-6 months. Part two is that they need to have
had a regular cycle prior to this.
Secondary amenorrhea physical exam. What to look for?
(Ans-
acne.
vaginal dryness.
deepening of the voice.
excessive or unwanted hair growth on the body.
headaches.
changes in vision.
nipple discharge.
,Labs for primary and secondary amenorrhea?
(Ans-
Primary:
Second: Pregnancy test. This will probably be the first test your doctor
suggests, to rule out or confirm a possible pregnancy.
Thyroid function test. ...
Ovary function test. ...
Prolactin test. ...
Male hormone test.
Pap guidelines
(Ans-
Age 21- Initiate screenings
21-29: Pap every 3 yrs, no HPV
30-65: Pap every 3 yrs, or every 5 yrs w/ HPV
65: Stop screenings if 3+ neg in a row, no CIN2+ for 20 yrs
Stop post-hysterectomy if no history of CIN2+
Bethesda classification for Pap's
(Ans-
, Atypical, Low-grade, High-grade, SCC, Glandular cell, Endocervical
adenocarcinoma in situ, Adenocarcinoma
Normal findings : No Atypia, No malignancy in PAP are:
(Ans- report 1 unsatifactory..repeat 2 months
Infection in pap?
(Ans- Could be HPV, bact vag, trich, candida. Give ABX
Reactive or reparative changes
(Ans-
Ascus
(Ans- Atypical Squamous cells of unknown significance. <25 yo age
repeat the pap do colposcopy> 25yoa add HPV and
positive?=colposcopy.
LSIL, HSIL
(Ans- Low grade squamous intraepithelial lesion. report IV. do a
colposcopy. High grade intra epithelial lesion go for: colposcopy and
biopsy