Chapter 11 Structural Disorders And Neoplasms

Question 1

Follicular cysts

Answer 1

Common in young women, dependant on hormones and associated with menstrual cycle, asymptomatic unless ruptur

Treat with NSAIDs or birth control, surgery when large

Question 2

PCOS

Answer 2

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.

Question 3

PCOS clinical manifestations

Answer 3

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.

Question 4

PCOS treatments

Answer 4

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.

Question 5

Uterine polyps origin

Answer 5

Endometrial or cervical tissue. Arise from mucosa.

Question 6

Education after polyp removal

Answer 6

No tampons, no sex for a week. S/sx of infection, notify hcp of heavy bleeding

Question 7

Most common age group for uterine polyps

Answer 7

Multiparous women older than forty

Question 8

Leiomyomas

Answer 8

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

Question 9

Leiomyomas most common in

Answer 9

African-American women, nulliparity, obese

Question 10

Leiomyomas growth

Answer 10

Influenced by hormones and typically spontaneously shrink after menopause due to decreasing hormones

Question 11

Leiomyomas clinical manifestations

Answer 11

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.

Question 12

Leiomyomas medical management

Answer 12

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.

Question 13

Nursing interventions with leiomyomas

Answer 13

Fertility, consent form, childbearing concerns, and bleeding

Question 14

Most common type of reproductive cancer

Answer 14

Endometrial cancer

Question 15

Risk factors for endometrial cancer

Answer 15

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

Question 16

Endometrial cancer

Answer 16

Slow growing, good prognosis,

Question 17

Endometrial cancer treatments

Answer 17

Hysterectomy (even when caught early), chemo for advanced stage, anti estrogen agents (tamoxifen) with recurrent cancer

Question 18

Cardinal sign of endometrial cancer

Answer 18

Abnormal uterine bleeding

Question 19

Endometrial cancer diagnosis

Answer 19

Pap smear, biopsy of endometrium, pelvic exam (3 most common)

Question 20

Other S/sx of endometrial cancer

Answer 20

Vaginal discharge (pinkish) mucousy, lower back pain, pelvic pain

Question 21

Ovarian cancer

Answer 21

Second most common

Question 22

Ovarian cancer symptoms

Answer 22

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

Question 23

Ovarian cancer cause

Answer 23

Unknown

Question 24

Ovarian cancer risk factors

Answer 24

Nulliparity, infertility, previous breast cancer, familial history, ethnicity (northern american women european descent)

Question 25

Ovarian cancer treatment

Answer 25

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?

Question 26

Cancer of the cervix

Answer 26

Third most common malignancy to the repro system

Begins at lesion on the cervix

Can spread to vaginal mucosa, pelvic wall, bowel, bladder

Question 27

Incidence of cervical cancer is highest in

Answer 27

Hispanic women

Question 28

HPV causes

Answer 28

90% of cervical cancers

Question 29

Cervical cancer diagnosis

Answer 29

Pap smear detects 90% of malignancies, colposcopy (scope that magnifies the cervix to be visualized), biopsy

Question 30

Cervical cancer signs and symptoms

Answer 30

Typically no symptoms, could see:
Abnormal bleeding after intercourse, rectal bleeding, hematuria, back and leg pain, abnormal bleeding puts patient at risk for anemia

Question 31

Cervical cancer medical and surgical management

Answer 31

Radiation, laser ablation, hysterectomy if invasive, chemotherapy

Question 32

Cancer of the vulva

Answer 32

Fourth most common gynecological cancer, slow growth metastasize fairly late with a 90% survival rate

Question 33

Most common sight of vulva cancer

Answer 33

Labia majora

Question 34

Vulva cancer treatment

Answer 34

Laser surgery, cryosurgery, electrosurgical excision, vulvectomy

Question 35

Cancer of the vagina

Answer 35

Accounts for one to three percent of gynecological cancers

50% of cases occur between the ages of 70 and 90 years old

Question 36

Cancer of the vagina potential causes

Answer 36

Vaginal irritation, vaginal trauma, genital viruses

Question 37

Cancer during pregnancy

Answer 37

Rare during the reproductive years, occurrence one out of 1000 women

Ethical dilemma, save baby or Mom.

Question 38

Most frequent types of cancer that occur during pregnancy

Answer 38

Breast, cervical, leukemia, Hodgkin disease, melanoma, thyroid, colon