WOMENS HEALTH A PRIMARY CARE CLINICAL
GUIDE 5TH EDITION |Q&A LATEST| APPROVED
ANSWERS | YOUNGKIN SCHADEWALD PRITHAM
TEST BANK
Follicle Stimulating Hormone (FSH) - ANSWERS - Follicular phase: 2-15 Midcycle peak:22-57
Luteal phase: 1 - 16
Leutenizing Hormone (LH) - ANSWERS - Follicular phase:1-10 Midcycle peak: 6-17 Luteal phase: 1-9
Pelvic Exam Steps - ANSWERS - 1. Inspect vulva, labia, urethra for erythema, lesions, discharge
2. Insert speculum. Inspect vaginal mucosa for color, edema, lesions
3. Inspect cervix for erythema, lesions, discharge from os (q-tip test)
4. Perform bimanual exam for masses, tenderness
5. Laboratory work-up
Pelvic Exam Lab Work-Up - ANSWERS - - Test discharge for pH (yeast pH <4.5)
- Perform KOH " +Whiff Test" ( BV)
- Wet Mount (+clue cells BV)
- Vaginal, cervical cultures (Gen Probe) PAP
Family Planning: Patient Education - ANSWERS - - Goal = prevent unwanted pregnancy by providing safe,
effective contraception with few side effects & high level of convenience that the patient will use consistently.
- At annual visit should re-evaluate each woman's contraceptive choice, sex practices (include partner if possible) at least once each year.
- Education about sexual health, fertility, menses, menopause - use flip charts, models, diagrams and handouts to increase patient's understanding of anatomy
Family Planning Options: Barrier Methods - ANSWERS - Condoms
Spermicidal
Diaphragm
Family Planning Options: Hormonal Methods - ANSWERS - IUD
Oral Contraceptive Pills
Patch Vaginal Ring
Emergency Contraception
Family Planning Options: Permanent - ANSWERS - Tubal ligation
Vasectomy
Barrier Methods: Condoms - ANSWERS - ** STD Protective benefits**
Male condom = most common barrier method- most effective when combined with a spermicide such as nonoxynol-9. 82 - 98% effective in preventing pregnancy
Female condom = fits loosely inside the vagina and covers the perineum. Flexible rims on both ends. 79 -
95 % effective preventing pregnancy
Barrier Methods: Diaphragm - ANSWERS - Latex hemisphere with flexible rim. Must be fitted. Size can change with weight gain or loss of 10 lbs. Use with spermicide. Leave in place for 8 hrs post-coitus
Barrier Methods: Cervical Cap - ANSWERS - Cup shaped fits around cervix- must be fitted. Can be left in place for 48 hrs. Use with spermicide
Hormonal Methods: Implant - ANSWERS - Progestin infused silicone rod inserted medial aspect inner arm (Nexplanon/Implanon)
- 99% effective for up to 3 years
- Clinicians must be specially trained to insert/remove
- Irregular menses most frequent reason for discontinuation: either amenorrhea or prolonged bleeding
- Fertility may be somewhat delayed after removal
Hormonal Methods: Injection - ANSWERS - Depo-Provera or Depo-Sub Q Provera (150 mg Depo-Provera deep IM q12 weeks or Depo-Sub Q Provera 104 mg SQ q 12 weeks)
- Initial injection given on day 5 of menses
- Discontinue after 2 years of use due to decrease bone density
- Side effects = increase lipids, weight gain, depression, unpredictable uterine bleeding
- Contraindications = osteoporosis, abnormal vaginal bleeding
- Thinning of uterine lining makes it more difficult to conceive for 1 year post treatment
Hormonal Methods: Oral Contraceptives - ANSWERS - - Most common are 4 week pill packs w/4th week placebo pills. Packs are a combination of estrogen and progestin or progestin only pills (mini pills)
- Continuous OC with withdrawal bleeds every 3 months.
- Continuous OC taken 365 days/year with no placebo or pill free interval
Oral Contraceptives: Types - ANSWERS - Monophasic
Biphasic (least common)
Triphasic
GUIDE 5TH EDITION |Q&A LATEST| APPROVED
ANSWERS | YOUNGKIN SCHADEWALD PRITHAM
TEST BANK
Follicle Stimulating Hormone (FSH) - ANSWERS - Follicular phase: 2-15 Midcycle peak:22-57
Luteal phase: 1 - 16
Leutenizing Hormone (LH) - ANSWERS - Follicular phase:1-10 Midcycle peak: 6-17 Luteal phase: 1-9
Pelvic Exam Steps - ANSWERS - 1. Inspect vulva, labia, urethra for erythema, lesions, discharge
2. Insert speculum. Inspect vaginal mucosa for color, edema, lesions
3. Inspect cervix for erythema, lesions, discharge from os (q-tip test)
4. Perform bimanual exam for masses, tenderness
5. Laboratory work-up
Pelvic Exam Lab Work-Up - ANSWERS - - Test discharge for pH (yeast pH <4.5)
- Perform KOH " +Whiff Test" ( BV)
- Wet Mount (+clue cells BV)
- Vaginal, cervical cultures (Gen Probe) PAP
Family Planning: Patient Education - ANSWERS - - Goal = prevent unwanted pregnancy by providing safe,
effective contraception with few side effects & high level of convenience that the patient will use consistently.
- At annual visit should re-evaluate each woman's contraceptive choice, sex practices (include partner if possible) at least once each year.
- Education about sexual health, fertility, menses, menopause - use flip charts, models, diagrams and handouts to increase patient's understanding of anatomy
Family Planning Options: Barrier Methods - ANSWERS - Condoms
Spermicidal
Diaphragm
Family Planning Options: Hormonal Methods - ANSWERS - IUD
Oral Contraceptive Pills
Patch Vaginal Ring
Emergency Contraception
Family Planning Options: Permanent - ANSWERS - Tubal ligation
Vasectomy
Barrier Methods: Condoms - ANSWERS - ** STD Protective benefits**
Male condom = most common barrier method- most effective when combined with a spermicide such as nonoxynol-9. 82 - 98% effective in preventing pregnancy
Female condom = fits loosely inside the vagina and covers the perineum. Flexible rims on both ends. 79 -
95 % effective preventing pregnancy
Barrier Methods: Diaphragm - ANSWERS - Latex hemisphere with flexible rim. Must be fitted. Size can change with weight gain or loss of 10 lbs. Use with spermicide. Leave in place for 8 hrs post-coitus
Barrier Methods: Cervical Cap - ANSWERS - Cup shaped fits around cervix- must be fitted. Can be left in place for 48 hrs. Use with spermicide
Hormonal Methods: Implant - ANSWERS - Progestin infused silicone rod inserted medial aspect inner arm (Nexplanon/Implanon)
- 99% effective for up to 3 years
- Clinicians must be specially trained to insert/remove
- Irregular menses most frequent reason for discontinuation: either amenorrhea or prolonged bleeding
- Fertility may be somewhat delayed after removal
Hormonal Methods: Injection - ANSWERS - Depo-Provera or Depo-Sub Q Provera (150 mg Depo-Provera deep IM q12 weeks or Depo-Sub Q Provera 104 mg SQ q 12 weeks)
- Initial injection given on day 5 of menses
- Discontinue after 2 years of use due to decrease bone density
- Side effects = increase lipids, weight gain, depression, unpredictable uterine bleeding
- Contraindications = osteoporosis, abnormal vaginal bleeding
- Thinning of uterine lining makes it more difficult to conceive for 1 year post treatment
Hormonal Methods: Oral Contraceptives - ANSWERS - - Most common are 4 week pill packs w/4th week placebo pills. Packs are a combination of estrogen and progestin or progestin only pills (mini pills)
- Continuous OC with withdrawal bleeds every 3 months.
- Continuous OC taken 365 days/year with no placebo or pill free interval
Oral Contraceptives: Types - ANSWERS - Monophasic
Biphasic (least common)
Triphasic
