assisting with reproductive and urinary specialties

gynecology

care of the female reproductive system

obstetrics

the study of pregnancy, labor, delivery, and the period following labor (postpartum)

urology

focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs

menstruation

• the process of discharging blood from the lining of the uterus

• starts in puberty until menopause except during pregnancy

• periods are monthly and last for 3-7 days

menarche

• the first occurrence of menstruation

• onset age approximately 10-15 years old

menopause

• cessation of the menstrual cycle

• naturally occurs between ages 45 and 55

• surgically occurs through a hysterectomy

perimenopause

• transitional period before menopause

• levels of estrogen start to decrease

postmenopause

patient has been without a period for 12 months

what is the purpose of the gynecologic exam?

overview of a woman’s health and cancer-screening exams and tests

why does a female assistant need to be present during the gynecologic exam?

• to assist the doctor

• as a legal chaperone

what is the medical assistant’s role in the gynecologic exam?

• have patient empty bladder and obtain urine specimen if needed

• provide a gown and interview patient

• discuss gynecologic and general health

• review of factors that may indicate cancer or STIs

• ask questions about the patient’s menstrual cycle

  • abnormal discharge

  • discomfort during sexual intercourse

• check vital signs

• determine the 1st day of her last menstrual period (LMP)

• gather supplies and assist physician

what are the supplies needed for a pap smear?

• vaginal speculum

• gauze pads

• cervical specimen collection kit (cervical broom, cervical scrape, endocervical brush, and cotton-tipped applicator)

• exam light

• glass slide and fixative or liquid collection medium for specimen preservation

• water-based lubrication or warm water

breast exam

physician examines breasts and underarm areas to check for abnormal lumps

what is the MA’s role in breast cancer detection?

• ask patient about any concerns or changes in her breasts

• check and document when patient had last mammogram (patients over the age of 40)

• mammograms should be ordered yearly

• educate patient in self-breast exams

pelvic exam

• inspection

  • external genitalia

  • vagina and cervic using a speculum

• palpation

  • vagina

  • rectum

  • abdomen (to assess position of the uterus)

what are the medical assistant’s duties for an obstetrical patient?

• prenatal care - educate on nutrition, exercise, medical monitoring

• during pregnancy - set up childbirth classes, educate on healthy choices

• monitor BP

• urine testing

• pregnancy tests

pregnancy tests

detect presence of hormone HCG (human chorionic gonadotropin)

STI tests

may require bacterial and tissue cultures, examining lesions, blood tests, and patient history

ultrasound

assess organs and structures (uterus, cervix, vagina, fallopian tubes, and ovaries) and produce pictures of a baby

hysterosalpingography

x-ray procedure used to view the inside of the uterus and fallopian tubes

biopsy

tissue from the lining of the uterus is removed and examined under a microscope for cancer and other cell irregularities

coposcopy

• when pap test shows abnormal cells

• doctor can see the surface of the cervix up close

amniocentesis

• needle inserted through the lower abdominal wall

• fetal skin cells obtained and examined for chromosomal abnormalities

D & C

• dilation of the cervix and scraping the uterine lining

• to diagnose and treat uterine conditions and heavy bleeding

• clear the uterine lining after a miscarriage or abortion

hysterectomy

removal of the uterus

hysterosalpingectomy

removal of the uterus and fallopian tubes

hysterosalpingo-oophorectomy

removal of the uterus, fallopian tubes, and ovaries (total hysterectomy)

cryosurgery

• of the cervix

• uses extremely cold chemicals (liquid nitrogen) to destroy suspicious cells or tissue in a woman’s cervix

urologist

• diagnoses and treats urological disorders and diseases

• male and female urinary system

• male reproductive system

assisting in urology

• assists with general exams

• collects and processes urine and blood

• conducts patient education

• patient chief complaint and history: check for any changes in urination

  • dysuria - discomfort or burning with urination

  • incontinence - lack of bladder control

• the physical exam

  • palpation of the kidneys and bladder and visual inspection of the external genitalia

  • inspection and palpation of the penis and scrotum

  • the groin is examined for a hernia

    • in men over 40, the prostate gland is examined by digital insertion into the rectum

• MA is responsible for teaching the patient to perform a regular testicular self-exam (TSE)

pyelography

• x-ray of the kidney area with an iodine-based contrast agent

• used to diagnose renal disorders

urinalysis

most commonly ordered test

blood testing

to monitor for dysfunctions of the prostate gland and certain STIs

semen analysis

determine fertility and evaluate success of vasectomy

smears

to diagnose infections

cystometry

• measures bladder capacity and pressure

• catheter is inserted through the urethra into the bladder

• measurements taken of how much, if any, urine remains in the bladder and bladder pressure

cystoscopy

to examine the lining of the bladder and urethra

testicular biopsy

tissue sampling

alpha-blockers

work by relaxing muscles at the bladder neck to improve urinary flow

5-alpha inhibitors

treat enlarged prostate by blocking the production of the male hormones that are associated with prostate enlargement

anticholinergics

minimize bladder contractions and increase bladder capacity for people with an overactive bladder

ectopic pregnancy

fertilized egg unable to move out of fallopian tube into uterus for implantation

fibrocystic breast disease

benign, fluid-filled cysts or nodules in breast

ovarian cysts

• sacs of fluid or semisolid material

• usually benign

menstrual disturbances

• amenorrhea - absence of menstruation

• dysmenorrhea - painful menstrual periods

• menorrhagia - heavy or prolong menstrual bleeding

• metrorrhagia - abnormal bleeding

impotence

• inability to achieve or to maintain an erection

• cause may be physical, a side effect of medication, or psychological/emotional

sexual dysfunction disorders

• interruption or lack of sexual response cycle

• unhealthy view of one’s feelings about oneself and feelings toward sex

kidney stones

• chemical substances in the urine form crystals in the kidney, ureter, or bladder

• renal calculi, nephrolithiasis, or urolithiasis

what type of organism is chlamydia?

bacteria

what type of organism is gonorrhea?

bacteria

what type of organism is syphilis?

bacteria

what type of organism is trichomoniasis?

protozoa

what type of organism is HSV (herpes simplex virus)?

virus

what type of organism is HPV (human papilloma virus)?

virus

can chlamydia be cured?

yes

can gonorrhea be cured?

yes

can syphilis be cured?

yes

can trichomoniasis be cured?

yes

can HSV (herpes simplex virus) be cured?

no, but can be managed

can HPV (human papilloma virus) be cured?

no, but can be managed

how is chlamydia transmitted?

fluids

how is gonorrhea transmitted?

fluids

how is syphilis transmitted?

skin to skin

how is trichomoniasis transmitted?

fluids

how is HSV (herpes simplex virus) transmitted?

skin to skin

how is HPV (human papilloma virus) transmitted?

skin to skin

what is the average age range for the beginning of menstruation?

• 6 to 10 years old

• 8 to 12 years old

• 10 to 15 years old

• 12 to 18 years old

10 to 15 years old

what does the gynecology speciality focus on?

• pregnancy

• postpartum

• female reproductive system

• male reproductive system

female reproductive system

in addition to assisting in an gynecological exam, what other role might a female medical assistant have during the exam?

• she may prescribe hormonal treatments if needed

• she may perform the actual exam if the physician is male

• her presence provides legal protection for a male physician

• she may operate the microscope to check the specimens obtained

her presence provides legal protection for a male physician

the acronym LMP refers to the:

• first day of a woman’s last menstrual period

• date of a woman’s first menstrual cycle

• last day of a woman’s last menstrual period

• estimated date of a woman’s next menstrual period

first day of a woman’s last menstrual period

pregnancy tests detect the presence of which hormone?

• THC

• TSH

• HBV

• HCG

HCG

which procedure is the removal of the uterus, fallopian tubes, and ovaries?

• hysterectomy

• hysterosalpingectomy

• hysterosalpingo-oophorectomy

• partial hysterectomy

hysterosalpingo-oophorectomy

what is the most commonly ordered test in a urology practice?

• semen analysis

• cystometry

• urinalysis

• cystoscopy

urinalysis

what exam method does the physician use on the kidneys and bladder?

• palpation and auscultation

• palpation and inspection

• inspection

• palpation

palpation