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NURS 414: OB > Chapter 27Common GynecologicalConditions > Flashcards

Chapter 27Common GynecologicalConditions Flashcards

Exam 4 (Final)

1
Q

Expected Uterine Bleeding:

When does normal uterine bleeding begin?

A

Normal uterine bleeding begins every 24 to 38 days.

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2
Q

Expected Uterine Bleeding: When is a female’s period considered regular?

A

A female’s period is considered regular if the difference between her shortest and longest cycle is no more than 7-9 days.

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3
Q

Expected Uterine Bleeding:

What length of bleeding is considered normal

A

Bleeding duration of 8 days or less for a single menstrual period is considered normal.

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4
Q

Expected Uterine Bleeding:

How is the volume of blood loss in females? When is it considered normal?

A

The volume of blood loss varies between females and is considered normal when it does not interfere with physical or emotional health or quality of life.

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5
Q

Abnormal Uterine Bleeding (AUB):

What classification system is used?

A

AUB that consists of heavy menstrual bleeding or bleeding between periods is summarized in the PALM-COEIN classification system.

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6
Q

Abnormal Uterine Bleeding:

What are the different types?

A

Heavy menstrual bleeding (AUB/HMB)

Intermenstrual bleeding (AUB/IMB)

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7
Q

Abnormal Uterine Bleeding:

PALM- structural causes

A

Polyp (AUB-P)

Adenomyosis (AUB-A)

Leiomyoma (AUB-L)

Malignany and hyperplasia (AUB-M)

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8
Q

Abnormal Uterine Bleeding

COEIN- nonstructural causes:

A

Coagulopathy (AUB-C)

Ovulatory dysfunction (AUB-C)

Endometrial (AUB-E)

Iatrogenic (AUB-I)

Not yet classified (AUB-N)

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9
Q

Abnormal Uterine Bleeding: Causes

Adenomyosis or endometrial-type tissue within the myometrium (muscle tissue of the uterus)

What does it cause?

A

Causes heavy menstrual bleeding and dysmenorrhea

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10
Q

Abnormal Uterine Bleeding: Causes

Adenomyosis or endometrial-type tissue within the myometrium (muscle tissue of the uterus)

How may it be treated?

A

May be treated with hormonal contraceptives,

a levonorgestrel intrauterine device or

uterine artery embolization

or hysterectomy

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11
Q

Abnormal Uterine Bleeding: Causes

Leiomyomas are benign tumors of the uterus.

What may they cause?

A

May cause abnormal, often heavy uterine bleeding and pelvic pain.

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12
Q

Abnormal Uterine Bleeding: Causes

Leiomyomas are benign tumors of the uterus.

What kind of problems can it cause?

A

Leiomyomas can cause problems with infertility and pregnancy.

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13
Q

Abnormal Uterine Bleeding: Causes

Leiomyomas are benign tumors of the uterus.

What does treatment include

A

Treatment may include hormonal contraception, myomectomy, endometrial ablation, or hysterectomy.

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14
Q

Abnormal Uterine Bleeding: Causes

What are Hyperplasia and malignancy of the endometrium are evidenced by?

A

Hyperplasia and malignancy of the endometrium are evidenced by postmenstrual bleeding, intermenstrual, or heavy menstrual bleeding that are otherwise unexplained.

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15
Q

Abnormal Uterine Bleeding: Causes

What is a cardinal sign of endometrial cancer?

A

Vaginal bleeding after menopause is a cardinal sign of endometrial cancer.

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16
Q

Abnormal Uterine Bleeding: Causes

What may be a cause for heavy menstrual bleeding?

A

Coagulopathy issues may be a cause for heavy menstrual bleeding.

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17
Q

Abnormal Uterine Bleeding: Causes

What is von willebrand disease?

A

von Willebrand disease is a common clotting disorder that may be hereditary or acquired.

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18
Q

Abnormal Uterine Bleeding: Causes

von willebrand disease: How is diagnosis made?

A

Diagnoses made after careful history taking and laboratory assessment.

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19
Q

Abnormal Uterine Bleeding: Causes

When would ovulatory dysfunction be suspected?

A

Ovulatory dysfunction may be suspected if females experience varying cycles for more than one year with blood volumes that vary from light to heavy.

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20
Q

Abnormal Uterine Bleeding: Causes

What is the cause of ovulatory dysfunction?

A

Cause of ovulatory dysfunction often cannot be identified.

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21
Q

Abnormal Uterine Bleeding: Causes

What medications may cause ovulatory disorders?

A

Medications that may cause ovulatory disorders include antidepressants, antipsychotics, corticosteroids, chemotherapy, and hormonal contraceptives

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22
Q

Abnormal Uterine Bleeding: Causes

What may be a cause of AUB?

A

Endometrial issues may be cause for AUB.

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23
Q

Abnormal Uterine Bleeding: Causes

What are diagnostic tests for endometrial related AUB?

A

There are no diagnostic tests for endometrial related AUB.

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24
Q

Abnormal Uterine Bleeding: Causes

Endometrial issues may be cause for AUB.

When is endometrial issues diagnosed?

A

Diagnosed when other disorders are excluded.

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25
Q

Abnormal Uterine Bleeding: Causes

Endometrial issues may be cause for AUB.

What MAY be the cause of endometrial issues that may cause of AUB?

A

May be caused by inflammation related to STIs (such as chlamydia and gonorrhea).

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26
Q

Abnormal Uterine Bleeding: Causes

Iatrogenic causes of AUB mean what?

A

Iatrogenic causes of AUB mean the AUB is caused by medical examinations or treatment.

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27
Q

Abnormal Uterine Bleeding: Causes

What are examples of Iatrogenic causes of AUB?

A

Examples of iatrogenic causes are anticoagulation therapy or intrauterine devices.

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28
Q

Abnormal Uterine Bleeding: Causes

How about not otherwise classified causes of AUB?

A

Not otherwise classified causes for AUB are very rare and poorly defined (e.g., malformation of the vasculature).

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29
Q

Dysmenorrhea: What is it?

A

Dysmenorrhea is pain with menstruation that limits daily activities and responsibilities.

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30
Q

Dysmenorrhea: What are the two types?

A

Primary dysmenorrhea

Secondary dysmenorrhea

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31
Q

Dysmenorrhea:

Primary dysmenorrhea: How does it occur?

A

Primary dysmenorrhea occurs in the absence of another cause.

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32
Q

Dysmenorrhea:

Primary dysmenorrhea: When does it begin?

A

Usually begins 2 to 5 years after menarche.

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33
Q

Dysmenorrhea:

Primary dysmenorrhea: What are symptoms?

A

Symptoms include cramps to lower abdomen that may also be felt in the back or thighs, fatigue, headache, diarrhea, nausea, and malaise.

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34
Q

Dysmenorrhea:

Secondary dysmenorrhea: What are symptoms? What is an underlying cause?

A

Secondary dysmenorrhea has similar symptoms (to primary) but also an underlying cause such as endometriosis or adenomyosis.

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35
Q

Dysmenorrhea: What is first line cause?

A

First-line treatment for dysmenorrhea includes nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives.

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36
Q

Dysmenorrhea: What are self care measures?

A

Self-care measures include warm packs to the lower abdomen, exercise, and a low-fat or vegetarian diet.

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37
Q

Endometriosis: What is it?

A

Endometriosis is the presence of endometrial tissue outside the uterus.

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38
Q

Endometriosis: What are symptoms?

A

Symptoms include dysmenorrhea, dyspareunia, infertility, pelvic mass, heavy menstrual bleeding, bowel and/or bladder dysfunction, low back pain, and chronic fatigue.

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39
Q

Endometriosis: How is the cause explained?

A

The cause of endometriosis is not well understood but often explained as retrograde menstruation.

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40
Q

Endometriosis: What is first line treatment?

A

First-line treatment generally includes NSAIDs and hormonal contraception.

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41
Q

Endometriosis: What is first line treatment?

A

First-line treatment generally includes NSAIDs and hormonal contraception.

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42
Q

Endometriosis: What happens if a woman does not respond to first line treatment?

A

If the female does not respond to first-line measures, she may receive a GnRH agonist, which produces a hypoestrogenic effect or a laparoscopy for definitive diagnosis and removal of endometrial lesions.

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43
Q

Pelvic Prolapse:

How are pelvic organs usually held in place?

A

Pelvic organs are held in place by a combination of connective tissue and the muscles of the pelvic floor.

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44
Q

Pelvic Prolapse:

What does pelvic organ prolapse involve?

A

Pelvic organ prolapse may involve prolapse of the bladder (cystocele), rectum (rectocele), bowel (enterocele), or uterus.

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45
Q

Pelvic Prolapse:

What is prolapse of the bladder?

A

prolapse of the bladder (cystocele),

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46
Q

Pelvic Prolapse:

What is prolapse of the rectum?

A

rectum (rectocele)

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47
Q

Pelvic Prolapse:

What is prolapse of the bowel?

A

bowel (enterocele)

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48
Q

Pelvic Prolapse:

Risk for pelvic floor prolapse include:

A

Giving birth (risk increases with the number of births)

Vaginal births are associated with higher risk than cesarean births

Obesity

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49
Q

Pelvic Prolapse: Classifications by Stage

Slide 12

A

Slide 12

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50
Q

Pelvic Prolapse: Symptoms and Treatment

Signs and symptoms may include:

A

Vaginal pressure

Pelvic pain

Bulge at the opening of the vagina

Problems with defecation or urination

Sexual dysfunction

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51
Q

Pelvic Prolapse: Symptoms and Treatment

When is treatment indicated?

A

Treatment is indicated when the females experience distressing symptoms.

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52
Q

Pelvic Prolapse: Symptoms and Treatment

What is included in treatment?

A

Treatment may include vaginal pessaries to assist with pelvic organ support, pelvic floor physical therapy, or surgery.

53
Q

Urinary Incontinence

What are risks for developing urinary incontinence?

A

Risks for developing incontinence include aging, past pregnancy, vaginal birth, obesity, or family history.

54
Q

Urinary Incontinence:

There are three main types of incontinence:

A

Stress incontinence

Urge or urgency incontinence

Overflow incontinence

55
Q

Urinary Incontinence:

There are three main types of incontinence: Stress incontinence

What is it caused by and what are examples?

A

Stress incontinence due to increased intrabdominal pressure (e.g., sneezing, coughing, laughing, exercise)

56
Q

Urinary Incontinence:

There are three main types of incontinence: Urge or urgency incontinence

What is it caused by?

A

Urge or urgency incontinence, which is often referred to as an overactive bladder is caused by overactivity of the muscles of the bladder.

57
Q

Urinary Incontinence:

There are three main types of incontinence: Overflow incontinence

What is it caused by?

A

Overflow incontinence, which is caused detrusor underactivity.

58
Q

Urinary Incontinence:

There are three main types of incontinence:

What does treatment depend on?

A

Treatment depends on the type of incontinence and contributing factors and

59
Q

Urinary Incontinence:

What may treatment include:

A

may include pelvic floor exercises, weight loss, limiting alcoholic and caffeinated beverages, and avoiding dehydration.

60
Q

Normal Transition to Menopause

When is natural menopause achieved?

A

Natural menopause is achieved when a female has not menstruated for a full 12 months in the absence of any other reason.

61
Q

Normal Transition to Menopause

When does menopause typically occur?

A

Menopause typically occurs around age 51 or 52.

62
Q

Normal Transition to Menopause

What is the time prior to menopause referred to as? How long does that last?

A

The time prior to menopause is referred to as perimenopause and typically lasts around 4 years.

63
Q

Normal Transition to Menopause:

What are perimenopause symptoms include?

A

Perimenopause symptoms include menstrual irregularities, vaginal dryness (decreased estrogen), disturbed sleep, depression, sleep apnea, insomnia, and mood symptoms.

64
Q

Normal Transition to Menopause:

What are long term consequences of menopause?

A

Long-term consequences of lower estrogen include bone loss and cardiovascular disease.

65
Q

Normal Transition to Menopause:

What is no longer recommended for symptoms of menopause? Why?

A

Estrogen replacement therapy is no longer recommended for symptoms due to the risk for cardiovascular disease and breast cancer.

66
Q

Ovarian Cysts:

What are the two broad groups?

A

Functional ovarian cysts

Nonfunctional ovarian cysts

67
Q

Ovarian Cysts

Functional ovarian cysts include:

A
  1. Follicular cysts
  2. Corpus luteum cysts
68
Q

Ovarian Cysts

When do follicular cysts occur?

A

Follicular cysts occur when the follicle does not rupture during ovulation.

69
Q

Ovarian Cysts

What does follicular cysts commonly occur with?

A

Commonly occurs with polycystic ovarian syndrome.

70
Q

Ovarian Cysts

How are symptoms of follicular cysts?

A

Generally asymptomatic unless rupture or torsion occurs.

71
Q

Ovarian Cysts

When does Corpus luteum cysts occur?

A

Corpus luteum cysts occur when the corpus luteum fails to involute.

72
Q

Ovarian Cysts

When does Corpus luteum cysts resolve?

A

Typically resolves within a few weeks or months.

73
Q

Ovarian Cysts

Nonfunctional ovarian cysts include what?

A

Dermoid cysts

74
Q

Ovarian Cysts

Dermoid cysts are what?
What do they contain?

A

Dermoid cysts, or mature cystic teratomas, are benign ovarian tumors containing ectodermal, mesodermal, and endodermal tissues.

They often contain teeth, hair, or nails.

75
Q

Ovarian Cysts

Nonfunctional ovarian cysts: How are symptoms?

A

Generally asymptomatic unless torsion or rupture occurs.

75
Q

Ovarian Cysts

Nonfunctional ovarian cysts: How is a definitive diagnosis made?

A

Definitive diagnosis made surgically.

76
Q

What is the most common cause of infertility and subfertility in women?

A

PCOS is the most common cause of infertility and subfertility in women.

77
Q

Polycystic Ovarian Syndrome (PCOS):

What is it?

A

PCOS is an endocrine disorder

78
Q

Polycystic Ovarian Syndrome (PCOS):

What is it characterized by?

A

characterized by ovulatory dysfunction (causes irregular menstrual cycle) and hyperandrogenism (causes excess face and body hair and acne).

79
Q

Polycystic Ovarian Syndrome (PCOS):

Who does it commonly appear in?

A

Most commonly appears in adolescence and persists throughout the reproductive life span.

80
Q

Polycystic Ovarian Syndrome (PCOS):

What could be a cause of PCOS?

A

Obesity and insulin resistance may be causative, a result of the syndrome, or both

81
Q

Polycystic Ovarian Syndrome (PCOS):

What are treatment goals for PCOS based on?

A

Treatment goals for PCOS are based on the specific clinical manifestation of the patient.

82
Q

Polycystic Ovarian Syndrome (PCOS):

How is ovulation and pregnancy in patients with PCOS?

A

Patients with PCOS may ovulate intermittently and should use contraception if they do not want to get pregnant.

83
Q

PCOS Diagnostic Criteria for Adolescents:

What does diagnosis require?

A

Diagnosis requires at least one indication from the category of abnormal uterine bleeding and one indication from the category of evidence of hyperandrogenism

84
Q

PCOS Diagnostic Criteria for Adolescents:

How is abnormal uterine bleeding pattern?

A

Abnormal for age or for first time since first menses

Symptoms persist for 1 or 2 years

85
Q

PCOS Diagnostic Criteria for Adolescents:

How is evidence of hyperandrogenism?

A

Moderate to severe hirsutism

Persistent lab elevation of testosterone

86
Q

Gynecological Cancers:

What do they include

A

Gynecological cancers include uterine, cervical, ovarian, vaginal, and vulvar.

87
Q

Gynecological Cancers:

How are cancers staged?

A

Cancers are staged based on the TNM staging system:

88
Q

Gynecological Cancers:

Cancers are staged based on the TNM staging system:

A

T refers to the size and extent of the primary tumor.

N refers to the number of lymph nodes to which the cancer has spread.

M refers to metastasis.

89
Q

Gynecological Cancers: Uterine

What is the fourth most common diagnosed cancer in the US?

A

Cancer of the uterus is the fourth most common diagnosed cancer in the United States.

90
Q

Gynecological Cancers: Uterine

What are the two main types of uterine cancer?

A

The two main types are uterine sarcoma and endometrial adenocarcinoma.

91
Q

Gynecological Cancers: Uterine

The two main types of uterine sarcoma are endometrial adenocarcinoma.

What does treatment include?

A

Treatment often includes hysterectomy with or without bilateral salpingo-oophorectomy, followed by staging of the cancer to determine further treatment.

92
Q

Gynecological Cancers: Uterine

How common are endometrial adenocarcinomas? How are they diagnosed?

A

Endometrial adenocarcinomas are more common and are diagnosed with a pathology examination of the tissue.

93
Q

Gynecological Cancers: Uterine

What is treatment for endometrial adenocarcinomas?

A

Treatment may include surgical removal of the cancerous tissue followed by chemotherapy and radiation as needed.

94
Q

Gynecological Cancers: Cervical

How does cervical cancer develop?

A

Cervical cancer develops from abnormal changes in cervix cells often as a result of human papillomavirus (HPV) infection.

95
Q

Gynecological Cancers: Cervical

What happens to abnormal changes in cervix cells?

A

Abnormal changes are biopsied and assessed by a pathologist.

96
Q

Gynecological Cancers: Cervical

When abnormal changes in cervix cells are biopsied and assessed by a pathologist what may the results be?

A

Results may be negative, cervical intraepithelial neoplasia (CIN), or adenocarcinoma in situ (AIS).

97
Q

Gynecological Cancers: Cervical

Cervical intraepithelial neoplasia (CIN): What is it?

A

CIN refers to abnormal squamous cells of the cervix that can develop into squamous cell carcinoma of the cervix.

98
Q

Gynecological Cancers: Cervical

Adenocarcinoma in situ (AIS): What is it?

A

AIS refers to glandular cell abnormalities that can develop into adenocarcinoma of the cervix.

99
Q

Gynecological Cancers: Cervical

How does cervical cancer spread?

A

Cervical cancer can spread by extension to the uterus, vagina, or abdominal cavity.

It can also spread by the lymph system to other organs.

100
Q

Gynecological Cancers: Cervical

What is treatment for cervical cancer?

A

Treatment may include cone biopsy, hysterectomy, chemotherapy, or radiation.

101
Q

Gynecological Cancers: Ovarian

What is the leading cause of death from gynecological cancer in the US? Why?

A

Ovarian cancer is the leading cause of death from gynecological cancer in the United States because of vague symptoms and late diagnosis.

102
Q

Gynecological Cancers: Ovarian

When are most ovarian cancer identified?

A

Most ovarian cancers are identified at stage III or IV.

103
Q

Gynecological Cancers: Ovarian

What are symptoms of ovarian cancer?

A

Symptoms include abdominal pain, bloating, and increased abdominal girth.

104
Q

Gynecological Cancers: Ovarian

How may ovarian cancer be identified?

When is diagnosis made?

A

May be identified with ultrasound or CT scan, followed by diagnosis after surgery by pathology.

105
Q

Gynecological Cancers: Ovarian

What is treatment for ovarian cancer usually?

A

Treatment is often chemotherapy.

106
Q

Gynecological Cancers: Ovarian

What happens to survivors of ovarian cancer?

A

Survivors of ovarian cancer often have lifetime issues associating with treatment (e.g., hearing loss, neuropathy of the feet, and ambulation difficulties).

107
Q

Gynecological Cancers: Vaginal

How common is it?

A

Rare cancer diagnosed in about 1 in 100,000 females.

108
Q

Gynecological Cancers: Vaginal

What is vaginal cancer associated with?

A

Vagina cancer is associated with HPV.

109
Q

Gynecological Cancers: Vaginal

How are the majority of females with vaginal cancer symptom-wise?

A

The majority of females are asymptomatic and their cancer is discovered incidentally during examination.

110
Q

Gynecological Cancers: Vaginal

What are symptoms of vaginal cancer?

A

Symptoms may include postcoital bleeding or postmenopausal bleeding or a vaginal mass.

111
Q

Gynecological Cancers: Vaginal

What is treatment for vaginal cancer?

A

Treatment is similar to cervical cancer.

112
Q

Gynecological Cancers: Vaginal

What are complications of vaginal cancer?

A

Complications include fistulas and strictures.

113
Q

What is the fourth most common gynecological cancer?

A

Gynecological Cancers: Vulvar

114
Q

Gynecological Cancers: Vulvar

What is diagnosis based on?

A

Diagnosis is based on vulvar biopsy.

114
Q

Gynecological Cancers: Vulvar

How may vulvar cancer appear?

A

Vulvar cancer may appear as a plaque, ulcer, or mass, often on the labia majora.

115
Q

Gynecological Cancers: Vulvar

What is a common complaint/symptoms?

A

Pruritus is a common complaint.

Some females may experience vulvar or rectal bleeding, dysuria, dyschezia (pain with defecation), or edema of the lower extremities.

116
Q

Breast Cancer:

Approximately, how many people will be diagnosed with breast cancer?

A

Approximately 1 in 8 females will be diagnosed with breast cancer during their lifetime.

117
Q

Breast Cancer:

How are the majority of breast cancers discovered?

A

A majority of breast cancers are discovered by mammogram and diagnosed by needle biopsy of the core lesion.

118
Q

Breast cancer:

What are prognostic factors?

A

Prognostic factors include the age and race of the patient, smoking status, tumor stage, tissue markers, gene expression, proliferation markers, tumor assays, and circulating tumor cells.

119
Q

Breast Cancer:

Treatment may include:

A

Surgery (breast-conserving surgery, mastectomy [radical], modified radical, simple mastectomy, skin-sparing, and nipple- and areola-sparing)

Chemotherapy

Radiation therapy

Hormone therapy

120
Q

Slide 27

A
121
Q

Benign Breast Variations:

What is micromastia?

A

Micromastia refers to the underdevelopment of breast tissue and is not considered to be pathological.

122
Q

Benign Breast Variations:

What are conditions that may contribute to micromastia?

A

Conditions that may contribute to macromastia include ovarian failure, androgen excess, hypothyroidism, mitral valve prolapse, chest radiation, and connective tissue disorders.

123
Q

Benign Breast Variations:

What is Accessory breast tissue?

A

Accessory breast tissue refers to any breast tissue beyond the two breasts typical for humans.

124
Q

Benign Breast Variations:

What are Breast cysts?

A

are palpable masses or masses identified by ultrasound that are common in females 35 to 50 years old.

125
Q

Benign Breast Variations:

What can be done to Breast cysts if they are painful?

A

Breast cysts can be aspirated if painful.

125
Q

Benign Breast Variations:

What should be done with Breast cysts?

What are simple breast cysts?

A

Simple breast cysts do not increase cancer risks, but complex cysts should be biopsied.

126
Q

Benign Breast Variations:

How are fibrocystic breasts?

A

Many females of reproductive age have fibrocystic breasts that have a ropey, lumpy texture but are not at risk for breast cancer.

NURS 414: OB (15 decks)

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