EMT-Chapter 24 -Gynecologic Emergencies

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include: A. bacterial vaginosis and chlamydia. B. ovarian abscess and ectopic pregnancy. C. ovarian cysts and gonorrhea. D. uterine rupture with severe bleeding.

B. ovarian abscess and ectopic pregnancy. (See Pathophysiology)

In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. becomes engorged with blood. B. diverts blood flow to the vagina. C. sheds and is expelled externally. D. thins and begins to separate.

A. becomes engorged with blood. (See Anatomy and Physiology)

It is common for young females who experience their first menstrual period to: A. experience abdominal cramping, which may be misinterpreted. B. have a false positive home pregnancy test result. C. become so emotionally distraught that they contemplate suicide. D. lose up to 500 mL of blood within the first 24 hours.

A. experience abdominal cramping, which may be misinterpreted. (See Anatomy and Physiology)

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. may be relatively painless. B. is typically not as severe. C. often presents with acute pain. D. can be controlled in the field.

A. may be relatively painless. (See Pathophysiology)

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: A. provide emotional support and visually assess her for obvious trauma. B. ask her if there is anyone you can contact, such as a friend or relative. C. defer any physical assessment so that you do not destroy potential evidence. D. advise her that she cannot clean herself up because this will destroy evidence.

A. provide emotional support and visually assess her for obvious trauma. (See Assessment and Management of Specific Conditions)

When a female has reached menarche: A. she is capable of becoming pregnant. B. she can no longer produce an ovum. C. menstrual periods become less frequent. D. she usually requires hormone therapy.

A. she is capable of becoming pregnant. (See Anatomy and Physiology)

Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. The most common presenting symptom of PID is generalized upper abdominal pain. B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. C. PID most commonly affects women who have had an ectopic pregnancy in the past. D. The most severe cases of PID occur in women who are not sexually active.

B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. (See Pathophysiology)

When documenting a call in which a female was sexually assaulted, you should: A. record your opinion only if you have reasonable proof to justify the statement. B. keep the report concise and record only what the patient stated in her own words. C. only use quotation marks when recording any statements made by witnesses. D. translate the patient's words or statements using proper medical terminology.

B. keep the report concise and record only what the patient stated in her own words. (See Assessment and Management of Specific Conditions)

The physical examination of a sexual assault victim should be: A. deferred until the patient can be evaluated by a physician. B. limited to a brief survey for life-threatening injuries. C. as detailed as possible so all injuries can be documented. D. performed in the presence of at least two police officers.

B. limited to a brief survey for life-threatening injuries (See Assessment and Management of Specific Conditions)

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. Vaginal passage of blood clots B. Bright red blood in the urine C. A shuffling gait when walking D. A history of ectopic pregnancy

C. A shuffling gait when walking (See Assessment and Management of Specific Conditions)

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? A. Ectopic pregnancy B. Ovarian cysts C. Chlamydia D. Genital herpes

C. Chlamydia (See Pathophysiology)

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? A. Left lower quadrant pain, referred pain to the left shoulder, and fever B. Upper abdominal cramping, severe headache, and heavy vaginal bleeding C. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge D. Pain around the umbilicus, low-grade fever, and generalized weakness

C. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge (See Pathophysiology)

Which of the following statements regarding gonorrhea is correct? A. Most men who are infected with gonorrhea do not experience symptoms. B. Symptoms of gonorrhea usually appear within 3 months after being infected. C. Painful urination is a common symptom of gonorrhea in men and women. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

C. Painful urination is a common symptom of gonorrhea in men and women. (See Pathophysiology)

Each ovary produces an ovum in alternating months and releases it into the: A. vagina. B. cervical os. C. fallopian tube. D. uterus.

C. fallopian tube. (See Assessment and Management of Specific Conditions)

Whenever possible, a female sexual assault victim should be: A. asked to provide a brief description of the perpetrator. B. thoroughly assessed, even if no signs of injury exist. C. given the option of being treated by a female EMT. D. encouraged to take a shower and change her clothes.

C. given the option of being treated by a female EMT. (See Patient Assessment)

When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: Select one: A. keep assessment and treatment to a minimum. B. determine the underlying cause of her problem. C. maintain her ABCs and transport without delay. D. ask questions related to her gynecologic history.

C. maintain her ABCs and transport without delay. (See Patient Assessment)

Pelvic inflammatory disease (PID) typically does NOT affect the: A. ovaries. B. uterus. C. urinary bladder. D. fallopian tubes.

C. urinary bladder. (See Pathophysiology)

Which of the following statements regarding rape is correct? A. Rape causes more physical than emotional harm. B. Only a licensed physician can make a diagnosis of rape. C. The EMT should try to determine if rape occurred. D. Rape is a legal term, not a medical diagnosis.

D. Rape is a legal term, not a medical diagnosis. (See Assessment and Management of Specific Conditions)

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: A. assess her blood pressure and elevate her legs. B. perform a visual assessment of her vaginal area. C. perform a rapid secondary assessment. D. assist her ventilations with a bag-mask device.

D. assist her ventilations with a bag-mask device. (See Patient Assessment)

The onset of menstruation usually occurs in females who are: A. between 18 and 23 years of age. B. between 8 and 10 years of age. C. between 25 and 28 years of age. D. between 11 and 16 years of age.

D. between 11 and 16 years of age (See Anatomy and Physiology)

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: A. refraining from placing any dressings into the vagina. B. treating external lacerations with sterile compresses. C. supplemental oxygen and keeping the patient supine. D. carefully removing any foreign bodies from the vagina.

D. carefully removing any foreign bodies from the vagina. (See Emergency Medical Care)

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: A. has formed a general impression of the patient. B. ascertains if the patient was ever pregnant. C. has obtained a complete set of vital signs. D. has gathered patient history information.

D. has gathered patient history information. (See Patient Assessment)

When caring for a female patient who has been sexually assaulted, you should: A. ask the patient for a concise, detailed report of what happened to her. B. allow law enforcement to take her statement before you begin treatment. C. advise her that she will not be allowed to shower or change her clothes. D. place any bloodstained clothing or other articles in separate paper bags.

D. place any bloodstained clothing or other articles in separate paper bags. (See Assessment and Management of Specific Conditions)

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 can't remember anything, but I know I was raped." The EMTs should suspect that: A. an underlying head injury is causing her amnesia. B. the patient knew her attacker, but is afraid to say. C. the traumatic experience has created a mental block. D. the patient was given a drug prior to the incident.

D. the patient was given a drug prior to the incident. (See Assessment and Management of Specific Conditions)

As a woman approaches menopause: a) she usually experiences abdominal cramping without vaginal bleeding. b) her menstrual periods may become irregular and vary in severity. c) her risk of developing PID lowers significantly. d) she cannot become pregnant because of fluctuating hormone levels.

b) her menstrual periods may become irregular and vary in severity. (See Anatomy and Physiology)