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Women's health > Benign disorders > Flashcards

Benign disorders Flashcards

1
Q

What are benign disorders?

A
  1. Vaginitis
  2. Pelvic inflammatory disorders ( PID )
  3. Uterine prolapse
  4. Infertility
  5. Contraception
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2
Q

What is vaginitis?

A
  • Inflammation of the vaginal mucosa
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3
Q

What are the common types of vaginitis?

A
  1. Bacterial vaginosis
  2. Yeast infections
  3. Trichomoniasis
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4
Q

What is bacterial infection?

A

which results from a change of the normal bacteria found in your vagina to overgrowth of other organisms

Staphylococci, streptococci, E.coli, chlamdiya, gonococci

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5
Q

What is yeast infection?

A

It is usually caused by a naturally occurring fungus called Candida albicans

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6
Q

What is trichomoniasis?

A

Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse

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7
Q

What is the management of vaginitis?

A
  • Diagnosis through vaginal swab – Culture & Sensitivity

* Treatment – oral anti-fungal, + to treat the partner

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8
Q

What is Pelvic Inflammatory Disease ( PID ) ?

A

Pelvic inflammatory disease is an infection of a woman’s reproductive organs

  • Common infection of reproductive tract, often involves several causative bacteria ( e.g. Neisseria gonorrhea, Chlamydia Trachomatis )
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9
Q

What are the other causes of PID?

A

• Includes: Cervicitis, Endometritis, Salphingitis, Oophoritis

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10
Q

What are the types of PID?

A
  • Acute

- Chronic

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11
Q

What are the risk factors for PID?

A 
Risk factors: multiple sexual partners, frequent intercourse, women with
Intrauterine contraceptive device (IUCD), had previous Sexually
Transmitted Infection (STI).
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12
Q

What is the pathophysiology for PID?

A

• Ascending infection from endocervix

UTERUS -> Fallopian tube

• Oedema, fills with purulent exudate
• Obstructs tube and restricts drainage into
uterus, exudate drips out of fimbriae onto
ovaries and surrounding tissue
• Peritoneal membrane attempts to localize
but peritonitis may develop
• Pelvic abscesses may form
• Cause septic shock, life-threatening
• Adhesions affect tubes and ovaries
• Lead to infertility and ectopic pregnancies,
chronic pelvic pain

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13
Q

What are the manifestations of acute PID?

A

• Bilateral lower abdominal pain, radiating to the legs (1st indication) ->
sudden and severe or gradually increasing
• Tenderness during pelvic exams
• Foul smelling vaginal discharge, purulent discharge at cervix
• Dysuria
• Fever (T > 38o Celsius) and leucocytosis can occur

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14
Q

DIfferential diagnosis

A 
Other important conditions associated with abdominal pain in women
to exclude are:
- Ectopic pregnancy
- Acute appendicitis
- Endometriosis
- Irritable Bowel Syndrome
- Complications of Ovarian Cyst
-  Urinary Tract Infection
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15
Q

What is collaborative care?

A

Diagnostic tests and method:
• Pregnancy Test
• Full Blood Count, C-Reactive Protein
• Screening for STIs including HIV
• Culture & Sensitivity Swab, pelvic examination, ultrasound, laparoscopy
Treatment:
• Aggressive broad spectrum antibiotic therapy: Cefoxitin, Doxycycline
• Analgesics
• Sex partners should be treated as well
• Follow-up appointment to ensure eradication since recurrent infections are
common

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16
Q

Nursing care

A

• Attitude: non-judgmental, accepting
• Heat application to abdominal area if ordered: to improve circulation and provide
comfort

Patient education:

• Basic Hygiene
• Perineal hygiene: wipe from front to back
• Recognize whether her sexual partner is infected with gonococcus: discharge from
penis of whitish fluid with painful urination (not all males are symptomatic) .
• Compliance to treatment: Completing the treatment regimen and follow-up visits.
• Safe sex guidelines

17
Q

What is uterine prolapse?

A
  • A downward displacement of the uterus into the vagina
18
Q

What are the risk factors?

A

Multiple pregnancies, third- or fourth- degree lacerations with childbirth, and weakening of pelvic muscles as an aging process

19
Q

What is postoperative care?

A

General post-operative care:
• Observe for vaginal haemorrhage and discharge
• Observe for urine retention, burning, frequency, or urgency to void
• Administer catheter care
• Listen to renewed bowel sounds
• Observe the incision
• Provide patient teaching on discharge
• Heavy lifting, prolonged standing, walking, and sitting are contraindicated
• Sexual intercourse should be avoided until approved by physician

20
Q

What is infertility?

A

the inability to conceive a child or sustain
a pregnancy to childbirth
• Pregnancy not occurred after at least 1 year of engaging
in unprotected sexual intercourse

• Affects 15% of couples desiring children in SIN
Types:
• Primary/ Secondary infertility
• Sterility (e.g. Azoospermia, anovulation) /Sub-fertility (e.g.
the sperm: low number, reduced motility, lower normal
forms and shapes)

21
Q

What are the causes of infertility?

A 
• Male factor (35%)
• Tubal and pelvic pathology e.g. endometriosis (30-35%)
• Ovulatory dysfunction (20-40%)
• Other uncommon problems e.g. coital problems, sexual dysfunction and
uterine factors (5%)
22
Q

what are the causes of female infertility>

A
  • Hormonal Imbalances – altered function of hypothalamus,
    pituitary or ovaries (Anovulation)
  • Obstruction of fallopian tubes – PID or endometriosis
  • Structural abnormalities – small uterus, fibroid
  • Access of viable sperms – pH change, thick cervical mucous,
    presence of antibodies to sperms
  • Smoking – by female and male
23
Q

What is diagnostic test for infertility?

A

• Pelvic examinations, ultrasound, hysteroscopy, CT scans: structural
abnormalities
• Basal body temperature: ovulation?
• Uterine endometrial biopsy: tissue responses during both phases of
menstrual cycle.
• Blood tests throughout cycle: hormone levels.
• Laparoscopy: endometriosis, adhesions, or scar tissue.
• Hysterosalpingogram: tubes

24
Q

What are the treatment modalities assisted reproductive techniques ( ART )

A
  1. Artificial Insemination
  2. In vitro fertilization
  3. Gamete intrafallopian transfer
  4. Zygote intrafallopian transfer
  5. Surrogate embryo transfer
25
Q

What are the contraceptive options - female

A

• Fertility awareness methods: Rhythm and natural methods
• Hormonal contraception: Oral (pills)/ transdermal/ injectable
contraceptives
• Intrauterine Devices
• Barrier Methods
• Surgical Methods

26
Q

What are fertility awareness methods?

A
  • Calendar method
  • Sympto-thermal method:
  • Cervical mucus method
  • Basal body temperature (BBT)
  • Lactation amenorrhea method
27
Q

What are the oral contraceptives?

A

• Estrogen + progesterone
• Estrogen: suppresses FSH and LH, and ovulation
• Progesterone: decreases the permeability of cervical mucus
• Types:
- Monophasic: fixed dose (E, P)
- Biphasic: same (constant) amount of estrogen with increased Progesterone
- Triphasic: 3 different doses of hormones in the 3 weeks of active pills

28
Q

What are the hormonal : Transdermal and injectable contrraceptives

A

• Norplant:

  • Six small progestin-filled pellets inserted under the skin of the upper arm
  • 5 years

• Depo-Provera:
- injected every 12 weeks

29
Q

What are the intrauterine devices?

A 
• Placed within uterus – string protrudes into vagina
• Side effects:
- Spotting or uterine cramping
- Increased risk for PID
- Heavier menstrual flow
- Dysmenorrhea
- Ectopic pregnancy
30
Q

What are the barrier methods?

A
  • Spermicidal products (creams, jellies, foam)
  • Diaphragms
  • Cervical caps
  • Condoms
31
Q

What are the surgical methods?

A

Tubal ligation:

- 28% of all women in the USA

32
Q

What is emergency post-coital complication?

A
  • Initiated within 72 hours after unprotected intercourse.
  • Types:
  • “Morning-after pills” (Emergency contraception)
  • High level of estrogen
33
Q

What are the contraceptive options for male?

A
  • Coitus interruptus/withdrawal
  • Condoms
  • Surgical method: vasectomy
34
Q

What is elective termination of pregnancy?

A

Procedure to deliberately end a pregnancy before fetal viability:

  • Induced abortion
  • Medically induced abortion: Mifepristone + prostaglandin

Women's health (9 decks)

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