Chapter 11 Structural Disorders And Neoplasms Flashcards
Follicular cysts
Common in young women, dependant on hormones and associated with menstrual cycle, asymptomatic unless ruptur
Treat with NSAIDs or birth control, surgery when large
PCOS
Endocrine imbalance results in high estrogen high testosterone high LH and low FSH. Multiple follicular cysts develop on one or both ovaries and produce excess estrogen, the ovaries often double in size.
PCOS clinical manifestations
Obesity, her suitism, irregular menses or amenorrhea and fertility. Impaired glucose tolerance and hyperinsulinemia in about 40% of women. Increased risk of metabolic syndrome including development of type 2 diabetes, non-alcoholic fatty liver disease possible cardiovascular disease.
PCOS treatments
Losing weight to prevent progression of type 2 diabetes and lowering cardiovascular risk. Oral contraception to treat a regular menses because they inhibit LH and decrease testosterone levels. Spironolactone and antiandrogen with OC. In severe cases GnRH analogs can treat hirsutism. Metformin is used to lower insulin testosterone and glucose levels.
Uterine polyps origin
Endometrial or cervical tissue. Arise from mucosa.
Education after polyp removal
No tampons, no sex for a week. S/sx of infection, notify hcp of heavy bleeding
Most common age group for uterine polyps
Multiparous women older than forty
Leiomyomas
AKA fibroid tumors, fibromas, myomas, fibromyomas
slow growing benign tumors rising from the muscle tissue of the uterus
Most common benign tumors of the reproductive system
Leiomyomas most common in
African-American women, nulliparity, obese
Leiomyomas growth
Influenced by hormones and typically spontaneously shrink after menopause due to decreasing hormones
Leiomyomas clinical manifestations
Usually asymptomatic
Can see abnormal uterine bleeding (risk for anemia), a large tumor can cause a backache, pressure in lower abdomen, constipation, dysmenorrhea
Heavily influenced by estrogen, so can have effect on implantation and maintaining pregnancy.
Can cause miscarriages, preterm labor or a difficult labor.
Leiomyomas medical management
NSAIDs, oral contraceptives, GnRH agonists because they will decrease the size of the fibroid
Uterine artery embolization will block blood supply to fibroid causing it to shrink.
Laser or operative removal, possible hysterectomy necessary.
Nursing interventions with leiomyomas
Fertility, consent form, childbearing concerns, and bleeding
Most common type of reproductive cancer
Endometrial cancer
Risk factors for endometrial cancer
Obesity, Nulliparity, infertility, late on set menopause (after 60), diabetes, hypertension, PCOS, familial history of ovarian or breast cancer, tamoxafen use, most significant risk factor is hormonal imbalance
Endometrial cancer
Slow growing, good prognosis,
Endometrial cancer treatments
Hysterectomy (even when caught early), chemo for advanced stage, anti estrogen agents (tamoxifen) with recurrent cancer
Cardinal sign of endometrial cancer
Abnormal uterine bleeding
Endometrial cancer diagnosis
Pap smear, biopsy of endometrium, pelvic exam (3 most common)
Other S/sx of endometrial cancer
Vaginal discharge (pinkish) mucousy, lower back pain, pelvic pain
Ovarian cancer
Second most common
Ovarian cancer symptoms
Vague (the most undiagnosed cancer), discovered in advanced stage, no definitive screening
Some that are seen: urinary urgency, urinary frequency, abdominal bloating, increase in abdominal girth, pelvic and abdominal pain, feeling full quickly when eating
Ovarian cancer cause
Unknown
Ovarian cancer risk factors
Nulliparity, infertility, previous breast cancer, familial history, ethnicity (northern american women european descent)
Ovarian cancer treatment
Depends on stage: surgical removal (ovary or radical hysterectomy), cytoreductive surgery (debulking a large tumor), antineoplastic surgery, chemotherapy and radiation
Antineoplastic surgery, chemo and radiation used together?
Cancer of the cervix
Third most common malignancy to the repro system
Begins at lesion on the cervix
Can spread to vaginal mucosa, pelvic wall, bowel, bladder
Incidence of cervical cancer is highest in
Hispanic women
HPV causes
90% of cervical cancers
Cervical cancer diagnosis
Pap smear detects 90% of malignancies, colposcopy (scope that magnifies the cervix to be visualized), biopsy
Cervical cancer signs and symptoms
Typically no symptoms, could see:
Abnormal bleeding after intercourse, rectal bleeding, hematuria, back and leg pain, abnormal bleeding puts patient at risk for anemia
Cervical cancer medical and surgical management
Radiation, laser ablation, hysterectomy if invasive, chemotherapy
Cancer of the vulva
Fourth most common gynecological cancer, slow growth metastasize fairly late with a 90% survival rate
Most common sight of vulva cancer
Labia majora
Vulva cancer treatment
Laser surgery, cryosurgery, electrosurgical excision, vulvectomy
Cancer of the vagina
Accounts for one to three percent of gynecological cancers
50% of cases occur between the ages of 70 and 90 years old
Cancer of the vagina potential causes
Vaginal irritation, vaginal trauma, genital viruses
Cancer during pregnancy
Rare during the reproductive years, occurrence one out of 1000 women
Ethical dilemma, save baby or Mom.
Most frequent types of cancer that occur during pregnancy
Breast, cervical, leukemia, Hodgkin disease, melanoma, thyroid, colon
