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Self Care > 1- Women's Health > Flashcards

1- Women's Health Flashcards

1
Q

What are the signs and symptoms of vulvovaginal candidiasis (VVC)?

A

-discharge: thick, white
-odor: no odor
-normal vaginal pH
-not sexually transmitted
-caused by candida

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2
Q

What other common vaginal infection must be referred and are not suitable for self-care?

A

bacterial vaginosis(BV) and trichomoniasis

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3
Q

What are the risk factors of VVC?

A

-pregnancy
-diabetes
-antibiotic use
-immunosuppressive agent
-HIV infection
-receptive oral sex
-vaginal sponge use
-use of combined oral contraceptives (COCs) and estrogen effect vaginal pH

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4
Q

What are the exclusions for self-care for VVC?

A

-age <12 years old
-pregnancy
-fever or pain in pelvic area/lower abdomen/back/shoulders
-use of corticosteroids, antineoplastics
-uncontrolled diabetes or HIV infection
-recurrent VVC (> 3 infections per year or 1 infection in the past 2 months
-first VVC episode

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5
Q

What are the goals of treatment?

A

-relief of symptoms
-eradication of infection
-reestablishment of normal vaginal flora

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6
Q

What are non-pharmacological treatment for VVC?

A

eating yogurt-containing live cultures and if possible, discontinue medication that may increase risk

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7
Q

What is the preferred pharmacological treatment for VVC?

A

intravaginal imidazole

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8
Q

What is the MOA of imidazole?

A

alter fungal cell membrane permeability

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9
Q

What are the strengths and duration of therapy of clotrimazole?

A

-1% cream: 1 applicatorful intravaginally at bedtime x7 days
-2% cream: 1 applicatorful intravaginally at bedtime x3 days

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10
Q

What products can be found in 1 day preperations?

A

-miconazole 1200 mg vaginal suppository
-tioconazole 6.5% ointment

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11
Q

What is the preferred duration of therapy recommended by the CDC?

A

for most patients short course therapy is preferred (1 or 3 days)

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12
Q

What are the side effects of imidazoles?

A

BURNING

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13
Q

When should patients seek medical attention for VVC?

A

if symptoms:
-continue beyond 1 week after treatment
-reoccur within 2 months
-symptoms occur more than 3x in 12 months

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14
Q

What should patients avoid while using imidazole treatment?

A

-douching
-tampons
-intercourse (may weaken integrity of latex condoms)
-other vaginal preparations

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15
Q

What can be used to treat vaginal itching?

A

-imidazole creams externally
-vagisil cream(benzocaine and resorcinol or hydrocortisone)

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16
Q

What are complementary treatment options for VVC?

A

-lactobacillus (probiotics, yogurt)
-sodium bicarbonate sitz bath
-tree tea oil (for resistant infections)
-gentian violet (for resistant candida infection)
-boric acid (for non-candida)

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17
Q

What is dysmenorrhea?

A

painful menstrations

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18
Q

What is the difference between primary and secondary dysmenorrhea?

A

-primary = pain at the time of menstruation
-secondary = typically associated with pelvic pathology

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19
Q

What are the exclusions for self-care for dysmenorrhea?

A

-severe dysmenorrhea and/or heavy bleeding
-symptoms inconsistent with primary dysmenorrhea (pain at other times than menses)
-history of pelvic inflammatory disease, infertility, irregular menstrual cycles, endometriosis, ovarian cysts
-use of IUD
-use of warfarin, heparin, lithium
-active GI disease
-bleeding disorder

20
Q

What are the goals of treatment for dysmenorrhea?

A

-resolve/improve symptoms
-minimize disruption of usual activities

21
Q

What are the non-pharmacological treatment options for dysmenorrhea?

A

-heat therapy
-sleep
-exercise
-smoking cessation

22
Q

What is the preferred pharmacological treatment for dysmenorrhea?

A

NSAIDs (ibuprofen or naproxen)

23
Q

What is the recommended dosage of NSAIDs for dysmenorrhea?

A

start at onset of menses or 1-2 days prior- SCHEDULED doses for first 48-72 hours of menses
-ibuprofen= 200-400 mg q4-6h (max= 1200mg/day)
-naproxen= 220-440 mg initially, then 220mg q8-12h

24
Q
A
25
Q

What are some dietary supplements and complementary therapy that can treat dysmenorrhea?

A

fish oil (diet or supplements) and vitamin D (600 IU/day) have the most robust evidence
Transcutaneous electrical nerve stimulation (TENS)

26
Q

What are counseling points for dysmenorrhea?

A
  • avoid aspirin in children/ adolescents
  • avoid high dose aspirin in breast feeding women
  • educated on dysmenorrhea
  • not all patients respond to INITIAL treatment
  • excessive blood loss needs evaluated
27
Q

Define: Premenstrual Syndrome (PMS)

A

One physical or mood symptom during 5 days prior to menses, resolves around day 5 of cycle

28
Q

What are “typical” premenstrual symptoms?

A

Mild physical or mood changes before menses that do not interfere with normal life functions
-breast tenderness
-bloating
-backache
-irritability

29
Q

Define: Premenstrual Dysphoric Disorder (PMDD)

A

Five or more symptoms (physical/mood) during last week of cycle. One symptom will be depression, anxiety, affective lability, or anger. Interferes with work, school, social activities, relationships.

30
Q

What are the exclusions for self-care for PMS or PMDD?

A

-severe symptoms
-uncertain pattern of symptoms
-onset of symptoms coincident with use of oral contraception or MHT
-contraindications to dietary supplements

31
Q

What are the treatment goals for PMS?

A

-increase understanding premenstrual disorders
-improve or resolve symptoms (50%+ improvement)

32
Q

What are the non-pharmacological treatment options for PMS?

A

-aerobic exercise
-complex carbohydrates
-cognitive behavioral therapy
-limit sodium
-avoid caffeine
-avoid alcohol

33
Q

What are pharmacological treatment options for PMS?

A

-pyridoxine
-calcium and vitamin D
-magnesium
-vitamin E
-NSAIDs
-diuretics

34
Q

What are patient counseling points for PMS?

A

-PMS does not occur after menopause
-avoid herbal products in breast feeding patients
-encourage tracking of symptoms and cycle
- begin management 7-14 days before menses
-it may take several cycles to see improvement
-monitor impact on daily life

35
Q

What contraceptive barrier methods prevent pregnancy AND STI

A

Male/Female condom

36
Q

What contraceptive barriers methods only prevent pregnancy?

A

Spermicide, sponge

37
Q

Review Male Condoms

A
38
Q

What are patient counseling points for female condom?

A

-breakage rate is lower than male condom but slippage may be higherDO NOT USE WITH MALE CONDOM
-may be inserted 2 hours before intercourse
-works immediately

39
Q

What are patient counseling points for spermicide?

A

-nonoxynol-9, found in foams, gels, suppositories, film, sponge
-immediate onset of action (except suppositories and film= 10-15 mins)
-duration of action= 1 hour
-must be reapplied after every episode of sexual intercourse
-low effectiveness when used alone

40
Q

What are patient counseling points for vaginal sponge?

A

-sponge with nonoxynol-9 (spermicide)
-may fit poorly in women with previous vaginal births
- may insert 24 hours before intercourse
-must remain in place for SIX HOURS AFTER intercourse
-do not use during menses

41
Q

What are patient counseling point for a diaphragm?

A

-prescription only
-use spermicide
-most require a fitting by a clinician
-reusable
-insert up to 2 hours before intercourse
-MUST LEAVE INSERTED FOR AT LEAST 6 HOURS AFTER INTERCOURSE

42
Q

What are patient counseling points of Cervical Caps?

A

-prescription only
-reusable for 1 year
-may be used up to 48 hours
-use with spermicide
-may be inserted 6 hours prior to intercourse
-must keep in place for 6 HOURS after intercourse

43
Q

Describe the Calendar Method

A

uses the menstrual cycle length to calculate fertile window, takes 6-12 cycles to predict range, best for cycles 26-32 days

44
Q

Describe the cervical mucus methods

A

detect changes in cervical mucus, cervical mucus becomes more prevalent, clear, “stretchy” and disappears with ovulation and thick or absent mucus will appear when ovulation is over

45
Q

Describe Basal Body Temperature (BBT) monitoring

A

-charting body temperature upon waking, before getting out of bed
-BBT drops 12-24 hours before ovulation, then rises by at least 0.4F at time of ovulation
-app= Natural Cycles

Self Care (23 decks)

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