Ch. 37 OB/GYN(Correctly solved)
Gynecological Exam correct answers In assisting with the complete physical exam (CPE,
discussed in Chapter 35), the examination of the vagina and genitalia was described as part of the
total exam; however, a Pap test is not necessarily done at that time. Women may schedule
appointments with their general or family practitioners for a Pap test or might prefer to see a
gynecologist for this type of examination. The OB/GYN (obstetrics/gynecology) practice focuses
on the female reproductive system.
Obstetrics focuses on pregnancy and childbirth, whereas the gynecology practice addresses
diseases and disorders of the female reproductive system correct answers When a patient calls a
general or family practice for an appointment, be sure to make a distinction between a physical
exam and a gynecological exam with a Pap test so that the appropriate amount of time is allotted,
and proper instructions are given. Remember that the CPE is a review of systems (ROS) of the
total body, and the gynecologic exam is of the female reproductive organs only.
The Pap Test correct answers The Papanicolaou (Pap) technique is a cytological screening test to
detect cancer of the cervix. This method of detection was developed by an American physician,
George N. Papanicolaou, in 1883. This simple smear technique used samples taken from the
vagina, the cervix, and the endocervix to look for atypical cytology. The samples were smeared
onto slides and then sprayed with a fixative or placed in an alcohol solution and sent to a lab.
Studies have shown that the technique produced many inadequate specimens, sometimes
requiring repeating the procedure. Up to two-thirds of the false negative reports were caused by
the limitations of the sampling technique and the slide preparation. Often, cells on the slide were
piled up so those underneath could not be seen. Additionally, cervical cells were hidden by pus
cells from infection, yeast cells, bacteria, and increased mucus. Therefore, precancerous cells
were not visible, and the results were incorrectly reported negative. Furthermore, if the slide was
not treated immediately after the smear was done, the cells dried out and became distorted,
leading to possible reading errors.
More Info: Pap Test correct answers In May 1996, after 50 years of conventional Pap testing, the
U.S. Food and Drug Administration (FDA) approved a new, liquid-based method known by the
brand names of ThinPrep and AutoCyte. This improved technique involves collecting the sample
with a plastic endocervical "broom" and immediately placing it into a bottle of preservative
solution (Figure 37-1). The broom is swished 10 times in the solution to remove the collected
cells. The solution prevents the cells from drying out and significantly reduces the presence of
mucus, bacteria, yeast, and pus cells on the slide prepared from the diluted cell samples in the
solution. This technique slightly improves the detection of cancers but greatly improves the
detection of precancers. This method also provides the ability to do additional studies from the
same sample, such as tests for the presence of the human papillomavirus (HPV), trichomonas,
chlamydia, and gonorrhea.
The American Cancer Society recommends the following guidelines for early detection of
cervical cancer: correct answers Age 21 - 29
Pap test every 3 years
HPV testing should not be used for screening in this age group unless abnormal
, Age 30-65
Pap test combined with an HPV test every five years
65+ who have had regular screening in the previous 10 years should stop cervical cancer
screening as long
Women who are at high risk of cervical cancer because of a suppressed immune system - should
be screened more often
Women who have had a total hysterectomy should stop screening unless removal was for
cancer...
- who have had a hysterectomy
- without removal of the cervix continue cervical cancer screening according to the guidelines
above
Women of any age should NOT be screened every year by any screening method.
Women who have been vaccinated against HPV still get screened
Pap Patient Education correct answers When the patient is scheduled for a Pap test, she must be
given clear instructions to follow in preparation for the test. The following are recommended by
the American Cancer Society for accurate results:
- Do not use tampons, birth control foams, jellies, or other vaginal creams for 48 hours before the
test. (They alter the cervical and vaginal environment.)
- Do not douche for 48 hours prior to the test. (Douching could wash away exfoliated cancer
cells and cause the test to be falsely reported as negative.)
- Do not have sexual intercourse for 48 hours before the test. (This adds extra cells and fluid to
the environment, making reading more difficult.)
- Try to schedule the Pap test at least five days after the menstrual period. Avoid scheduling
during the period. (Red blood cells make the test more difficult to read.)
The MA´s Role is Gynecological Exams correct answers 1. Prior to bringing the patient into the
examination room for the pelvic exam and Pap, the medical assistant should make the necessary
preparations. As with any procedure or patient contact, wash your hands before you begin. The
exam table should have a clean, protective covering. Place a gown and drape sheet on the end of
the table for the patient (either cloth or disposable paper).
2. Prepare the Mayo tray with the instruments and supplies the provider will need to perform the
pelvic exam and obtain the Pap test (Figure 37-2). Specula can be reusable or disposable. Place
the tray in a convenient location near the end of the exam table. Cover the equipment with a
towel to help allay the patient's anxiety from seeing the equipment. To aid in the inspection part
of the pelvic exam, an exam lamp should also be placed within reach of the examiner's stool at
the end of the table. (Most lamps are expandable and attached to the wall.)
The MA´s Role is Gynecological Exams (2) correct answers 3. Call the patient from the
reception room to prepare her for the exam. Instruct her to go to the bathroom to empty her
bladder before the test. If a specimen is to be obtained, instruct her in the method of collection. A
Gynecological Exam correct answers In assisting with the complete physical exam (CPE,
discussed in Chapter 35), the examination of the vagina and genitalia was described as part of the
total exam; however, a Pap test is not necessarily done at that time. Women may schedule
appointments with their general or family practitioners for a Pap test or might prefer to see a
gynecologist for this type of examination. The OB/GYN (obstetrics/gynecology) practice focuses
on the female reproductive system.
Obstetrics focuses on pregnancy and childbirth, whereas the gynecology practice addresses
diseases and disorders of the female reproductive system correct answers When a patient calls a
general or family practice for an appointment, be sure to make a distinction between a physical
exam and a gynecological exam with a Pap test so that the appropriate amount of time is allotted,
and proper instructions are given. Remember that the CPE is a review of systems (ROS) of the
total body, and the gynecologic exam is of the female reproductive organs only.
The Pap Test correct answers The Papanicolaou (Pap) technique is a cytological screening test to
detect cancer of the cervix. This method of detection was developed by an American physician,
George N. Papanicolaou, in 1883. This simple smear technique used samples taken from the
vagina, the cervix, and the endocervix to look for atypical cytology. The samples were smeared
onto slides and then sprayed with a fixative or placed in an alcohol solution and sent to a lab.
Studies have shown that the technique produced many inadequate specimens, sometimes
requiring repeating the procedure. Up to two-thirds of the false negative reports were caused by
the limitations of the sampling technique and the slide preparation. Often, cells on the slide were
piled up so those underneath could not be seen. Additionally, cervical cells were hidden by pus
cells from infection, yeast cells, bacteria, and increased mucus. Therefore, precancerous cells
were not visible, and the results were incorrectly reported negative. Furthermore, if the slide was
not treated immediately after the smear was done, the cells dried out and became distorted,
leading to possible reading errors.
More Info: Pap Test correct answers In May 1996, after 50 years of conventional Pap testing, the
U.S. Food and Drug Administration (FDA) approved a new, liquid-based method known by the
brand names of ThinPrep and AutoCyte. This improved technique involves collecting the sample
with a plastic endocervical "broom" and immediately placing it into a bottle of preservative
solution (Figure 37-1). The broom is swished 10 times in the solution to remove the collected
cells. The solution prevents the cells from drying out and significantly reduces the presence of
mucus, bacteria, yeast, and pus cells on the slide prepared from the diluted cell samples in the
solution. This technique slightly improves the detection of cancers but greatly improves the
detection of precancers. This method also provides the ability to do additional studies from the
same sample, such as tests for the presence of the human papillomavirus (HPV), trichomonas,
chlamydia, and gonorrhea.
The American Cancer Society recommends the following guidelines for early detection of
cervical cancer: correct answers Age 21 - 29
Pap test every 3 years
HPV testing should not be used for screening in this age group unless abnormal
, Age 30-65
Pap test combined with an HPV test every five years
65+ who have had regular screening in the previous 10 years should stop cervical cancer
screening as long
Women who are at high risk of cervical cancer because of a suppressed immune system - should
be screened more often
Women who have had a total hysterectomy should stop screening unless removal was for
cancer...
- who have had a hysterectomy
- without removal of the cervix continue cervical cancer screening according to the guidelines
above
Women of any age should NOT be screened every year by any screening method.
Women who have been vaccinated against HPV still get screened
Pap Patient Education correct answers When the patient is scheduled for a Pap test, she must be
given clear instructions to follow in preparation for the test. The following are recommended by
the American Cancer Society for accurate results:
- Do not use tampons, birth control foams, jellies, or other vaginal creams for 48 hours before the
test. (They alter the cervical and vaginal environment.)
- Do not douche for 48 hours prior to the test. (Douching could wash away exfoliated cancer
cells and cause the test to be falsely reported as negative.)
- Do not have sexual intercourse for 48 hours before the test. (This adds extra cells and fluid to
the environment, making reading more difficult.)
- Try to schedule the Pap test at least five days after the menstrual period. Avoid scheduling
during the period. (Red blood cells make the test more difficult to read.)
The MA´s Role is Gynecological Exams correct answers 1. Prior to bringing the patient into the
examination room for the pelvic exam and Pap, the medical assistant should make the necessary
preparations. As with any procedure or patient contact, wash your hands before you begin. The
exam table should have a clean, protective covering. Place a gown and drape sheet on the end of
the table for the patient (either cloth or disposable paper).
2. Prepare the Mayo tray with the instruments and supplies the provider will need to perform the
pelvic exam and obtain the Pap test (Figure 37-2). Specula can be reusable or disposable. Place
the tray in a convenient location near the end of the exam table. Cover the equipment with a
towel to help allay the patient's anxiety from seeing the equipment. To aid in the inspection part
of the pelvic exam, an exam lamp should also be placed within reach of the examiner's stool at
the end of the table. (Most lamps are expandable and attached to the wall.)
The MA´s Role is Gynecological Exams (2) correct answers 3. Call the patient from the
reception room to prepare her for the exam. Instruct her to go to the bathroom to empty her
bladder before the test. If a specimen is to be obtained, instruct her in the method of collection. A
