EMT: Chapter 23 [gynecologic emergencies]

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Signs and symptoms of bacterial vaginosis typically include _________.

"fishy," foul-smelling discharge

Menstrual flow will typically last approximately _________.

1 week

While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age.

11;40

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

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

A patient with pelvic inflammatory disease will typically complain of _________.

abdominal pain associated with menstruation

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 O2, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay

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 when a BVM

left untreated, _____________________ can lead to premature birth or low birth weight in pregnant women

bacterial vaginosis

In anticipation of receiving a fertilized ovum, the lining of the uterine wall:

becomes engorged with blood

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

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated?

chlamydia

in rare cases, _____________________ causes arthritis that may be accompanied with skin lesions and inflammation of the eyes and urethra

chlamydia

What is typically the most important intervention that an EMT can provide to the victim of sexual assault?

comfort and reassurance

______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant.

ectopic pregnancy

Causes of vaginal bleeding include which of the following?

ectopic pregnancy, vaginal trauma, spontaneous abortion

It is common for young females who experience their first menstrual period to:

experience abdominal cramping, which may be misinterpreted

Each ovary produces an ovum in alternating months and releases it into the:

fallopian tube

the sperm usually fertilizes the egg in the:

fallopian tube

The _____________ connect(s) each ovary with the uterus.

fallopian tubes

if a sexual assault patient tells you that she would like to be transported to the hospital but refuses a physical examination, you should:

follow your system's refusal of treatment policy and respect the patient's wishes without judgment

Which of the following conditions does NOT typically present with vaginal discharge?

genital herpes

Whenever possible, a female sexual assault victim should be:

given the option of being treated by a female EMT

Which of the following infections, when left untreated, may lead to infection of the blood and brain?

gonorrhea

painful urination associated with burning and a yellowish discharge is associated with:

gonorrhea

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

As a woman approaches menopause:

her menstrual periods may become irregular and vary in severity

In cases of sexual assault, it is important to ensure that you do which of the following?

immediately write down your observations of the scene before assessing the patient, call for female EMT or ALS care, discuss with law enforcement any suspicions you may have about the perpetrator

If a woman with vaginal bleeding reports syncope, the EMT must assume that she:

is in shock

When documenting a call in which a female was sexually assaulted, you should:

keep the report concise and record only what the patient stated in her own words

The __________ and _________ are folds of tissue that surround the urethral and vaginal openings.

labia majora; labia minora

rape is considered to be a ____________________ diagnosis, not a medical diagnosis

legal

When prioritizing care for the victim of a sexual assault, the EMT should focus on _________ first.

life-threatening injuries

The physical examination of a sexual assault victim should be:

limited to a brief survey for life-threatening injuries

what is the most common presenting sign or symptom of PID?

lower abdominal pain

Which of the following clinical presentations is MOST consistent with PID?

lower abdominal pain, fever, general malaise, foul-smelling vaginal discharge

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

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer:

may be relatively painless

A patient with vaginal bleeding _________.

may not have obvious signs of shock even if she has experienced significant blood loss

If fertilization has not occurred in approximately 14 days postovulation:

menstruation will begin

Bacterial vaginosis is a condition that occurs when:

normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms

Potentially life-threatening consequences of PID include:

ovarian abscess and ectopic pregnancy

what is the primary female reproductive organ?

ovary

Which of the following statements regarding gonorrhea is correct?

painful urination is a common symptom of gonorrhea in men and women

Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following?

pelvic inflammatory disease

When caring for a female patient who has been sexually assaulted, you should:

place any bloodstained clothing or other articles in separate paper bags

when performing a physical exam on a victim of sexual assault, you should:

place the patient's clothes into a paper bag

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

Which of the following statements regarding rape is correct?

rape is a legal diagnosis, not a medical diagnosis

Which of the following drugs is commonly referred to as "roofies"?

rohypnol

Chlamydia, bacterial vaginosis, and gonorrhea are all examples of _________.

sexually transmitted diseases

When a female has reached menarche:

she is capable of becoming pregnant

Some women experience ___________ during ovulation.

slight cramping

The EMT should perform a "rapid scan" to determine if the patient is __________ during the __________.

stable or unstable; primary assessment

Which of the following signs/symptoms is considered particularly significant in gynecological emergencies?

syncope

The EMT should ensure that vaginal bleeding is _________.

taken seriously and the patient is transported for gynecologic evaluation

During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following?

the amount of time since last menstrual cycle, possibility patient may be pregnant, if the patient is sexually active

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

PID typically does NOT affect the:

urinary bladder


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