Chapter 23 Gynecologic Emergencies
26.Signs and symptoms of bacterial vaginosis typically include _________.
"fishy," foul-smelling discharge
23.Menstrual flow will typically last approximately _________.
1 week
20.While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age.
11; 50
84.If fertilization has not occurred within about ________ days following ovulation, the lining of the uterus begins to seperate and menstruation occurs
14
52.gonorrhea
A sexually transmitted disease caused by Neisseria gonorrhoeae.
50.chlamydia
A sexually transmitted disease caused by the bacterium Chlamydia trachomatis.
34.You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease?
A shuffling gait when walking
59.In the case of a sexual assault, what is your most important treatment option?
A victim of rape or sexual assault has suffered major trauma. You may be the victim's first contact after the encounter, and how the situation is managed from first contact throughout treatment and transport may have lasting effects for the patient and you. It is very important to always be professional, sensitive, and kind.
3.Causes of vaginal bleeding include which of the following?
A. Ectopic pregnancy B. Vaginal trauma C. Spontaneous abortion =D. All of these answers are correct.=
6.In cases of sexual assault, it is important to ensure that you do which of the following?
A. Immediately write down your observations of the scene before assessing the patient. B. Call for a female EMT or ALS care provider. C. Discuss with law enforcement any suspicions that you may have about the perpetrator. =D. All of these answers are correct.=
4.During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following?
A. The amount of time since of the patent's last menstrual cycle B. The possibility that the patient may be pregnant C. If the patient is sexually active =D. All of these answers are correct.=
89.You should discourage a rape or sexual assault victim from
A. Urinating B. Cleaning herself C. Changing clothes =D. All of the above.=
86.When obtaining a SAMPLE history the following pieces of information is important to obtain?
A. Use of a birth control device or birth control pills B. The date of the patient's last menstrual period C. The possibility of pregnancy =D. All of the above.=
62.What is an EMT's responsibility regarding evidence in the case of a sexual assault?
An EMT's responsibility is to preserve evidence without sacrificing patient care.
53.sexual assault
An attack against a person that is sexual in nature, the most common of which is rape.
51.bacterial vaginosis
An overgrowth of bacteria in the vagina; characterized by itching, burning, or pain, and possibly a "fishy" smelling discharge.
60.In addition to providing medical care to a rape victim, which of the following is the most critical thing you should do?
As the patient's advocate, you need to provide medical assistance and emotional support and ensure the patient's privacy.
77.Left untreated, _____ can lead to premature birth or low birth weight in pregnant women.
Bacterial vaginosis
61.What should you do when a female patient has vaginal bleeding of unknown cause?
Bleeding can lead to shock, so you should be prepared to treat for hypoperfusion by applying oxygen and keeping the patient supine and warm while you transport her.
75.Narrowest portions of the uterus; opens to the vagina
Cervix
82.what is the narrowest portion of the uterus?
Cervix
17.Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?
Chlamydia
39.What is typically the most important intervention that an EMT can provide to the victim of sexual assault?
Comfort and reassurance
27.______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant.
Ectopic pregnancy
64.If PID is not treated, what can occur?
Ectopic pregnancy
85.Which of the following can cause vaginal bleeding?
Ectopic pregnancy, spontaneous abortion, and trauma
73.Connects each ovary with the uterus
Fallopian tubes
19.Which of the following infections, when left untreated, may lead to infection of the blood and brain?
Gonorrhea
43.perineum
In a female, the area between the vagina and the anus.
42.labia minora
Inner fleshy lips devoid of pubic hair that protect the vagina.
63.Why is it important to transport a sexual assault victim to the hospital even if she does not have any obvious injuries?
It is important to transport a sexual assault victim because she may have injuries that were not detected in the field, such as internal bleeding, that have a delayed onset of symptoms.
70.The most common presenting sign of pelvic inflammatory disease is
Lower abdominal pain
41.labia majora
Outer fleshy lips covered with pubic hair that protect the vagina.
21.What is (are) the primary female reproductive organ(s) called?
Ovaries
74.Produces an ovum, or an egg
Ovaries
37.Which of the following statements regarding pelvic inflammatory disease (PID) is correct?
PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.
58.You are assessing a 38-year-old woman who is reporting achy abdominal pain, burning on urination, and a slight fever. As you assist her to the ambulance, you notice that she has a shuffling gait. What condition does this indicate?
PID signs/symptoms include achy abdominal pain, vaginal discharge, fever and chills, and pain or burning on urination. Patients often present with a distinctive gait that appears as a shuffle when they walk.
66.Which of the following statements regarding gonorrhea is correct
Painful urination is a common symptom of gonorrhea in both men and women.
10.Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following?
Pelvic inflammatory disease
69.Which of the following statements regarding rape is correct?
Rape is a legal diagnosis, not a medical diagnosis.
18.Which of the following drugs is commonly referred to as "roofies"?
Rohypnol
88.What drug commonly used to facilitate sexual assault?
Rohypnol
54.rape
Sexual intercourse forcibly inflicted on another person, against that person's will
30.Which of the following signs/symptoms is considered particularly significant in gynecological emergencies?
Syncope
47.cervix
The lower third, or neck, of the uterus; it is the narrowest portion of the uterus and opens into the vagina.
46.uterus
The muscular organ where the fetus grows, also called the womb; responsible for contractions during labor.
55.What is menarche?
The onset of menstruation, which usually occurs between ages 11 and 16 years
48.vagina
The outermost cavity of a woman's reproductive tract that connects the uterus with the vulva (the external female genitalia); the lower part of the birth canal.
56.Which of the following organs or structures controls the process of ovulation and menstruation?
The ovaries are the primary female reproductive organs and control the process of ovulation and menstruation.
44.ovaries
The primary female reproductive organs that produce sex hormones and an ovum, or egg, that, if fertilized, will develop into a fetus
49.ovulation
The process in which an ovum is released from a follicle.
45.fallopian tubes
The tubes that extend from the uterus to the region of the ovary and through which the ovum passes from the ovary to the uterus; the primary location for fertilization of the ovum.
87.What is the EMTs first priority when dealing with a patient experiencing excessive vaginal bleeding?
Treat the patient for shock and transport
76.Muscular organs where the fetus grows
Uterus
72.Outer most cavity of a woman's reproductive system; forms the lower part of the birth canal
Vagina
83.What is the outermost cavity of a womans reproductive system?
Vagina
57.You are assessing a female patient who tells you she feels blood coming from her vaginal area. She gives you permission to look and you observe moderate bleeding from the vagina. What should you do to manage the bleeding?
You should place a sanitary pad over the vaginal opening.
2.A patient with pelvic inflammatory disease will typically complain of _________.
abdominal pain associated with menstruation
1.A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should
administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
35.During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should
assist her ventilations with a BVM.
5.In anticipation of receiving a fertilized ovum, the lining of the uterine wall
becomes engorged with blood.
80.The onset of menstruation usually occurs in women who are
between 11 and 16 years of age.
32.General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT
carefully removing any foreign bodies from the vagina.
40.At the scene of a sexual assault, the EMT should attempt to preserve evidence by _________.
discouraging the patient from removing clothes, using the bathroom, or showering
8.It is common for young females who experience their first menstrual period to
experience abdominal cramping, which may be misinterpreted.
22.The sperm typically fertilizes the egg in the _________.
fallopian tube
79.Each ovary produces an ovum in alternating months and releases it into the
fallopian tube
13.The _____________ connect(s) each ovary with the uterus.
fallopian tubes
71.Which of the following conditions does NOT typically present with vaginal discharge?
genital herpes
67.When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she
has gathered patient history information
36.As a woman approaches menopause
her menstrual periods may become irregular and vary in severity.
68.If a woman with vaginal bleeding reports syncope, the EMT should assume that she
is in shock
12.The __________ and _________ are folds of tissue that surround the urethral and vaginal openings.
labia majora; labia minora
31.When prioritizing care for the victim of a sexual assault, the EMT should focus on _________ first.
life-threatening injuries
15.The physical examination of a sexual assault victim should be
limited to a brief survey for life-threatening injuries.
81.When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to
maintain her ABCs and transport without delay.
7.In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer
may be relatively painless.
28.A patient with vaginal bleeding _________.
may not have obvious signs of shock even if she has experienced significant blood loss
24.If fertilization has not occurred in approximately 14 days postovulation
menstruation will begin.
78.Bacterial vaginosis is a condition that occurs when
normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
16.When caring for a female patient who has been sexually assaulted, you should
place any bloodstained clothing or other articles in separate paper bags.
9.Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should
provide emotional support and visually assess her for obvious trauma.
25.Chlamydia, bacterial vaginosis, and gonorrhea are all examples of _________.
sexually transmitted diseases
38.When a female has reached menarche
she is capable of becoming pregnant.
11.Some women experience ___________ during ovulation.
slight cramping
29.The EMT should perform a "rapid scan" to determine if the patient is __________ during the __________.
stable or unstable; primary assessment
14.The EMT should ensure that vaginal bleeding is _________.
taken seriously and the patient is transported for gynecologic evaluation
33.EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I cannot remember anything, but I know I was raped." The EMTs should suspect that
the patient was given a drug prior to the incident.
65.Pelvic inflammatory disease (PID) typically does NOT affect the
urinary bladder
