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OB > Common menstrual disorders > Flashcards

Common menstrual disorders Flashcards

1
Q

When is menarche usually? menstrual period

A

around 13 years old in the United States.

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2
Q

What happens during mensration in all the hormones?

A

↓ Estrogen(E2) & Progesterone (P4)- stimulates hypothalamus (GnRh)

↑ GnRH stimulates follicle-stimulating hormone (FSH)

↑ FSH stimulates development of the ovarian follicles= ↑ovarian production of E2

Slight midcycle ↓ E2 triggers GnRH to stimulate the anterior pit to secrete luteinizing hormone (LH)

A Surge of LH and small ↑ E2 stimulates ovulation. If fertilization doesn’t occur- E2 & P4 decrease and the corpus luteum regresses

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3
Q

What happens in the follicular phase of the ovarian cycle?

A
  • Follicular phase
  • Before ovulation FSH & E2 cause development of 1-30 follicles
  • LH causes 1 oocyte to mature and is released (usually around day 14)
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4
Q

What happens in the follicular phase of the ovarian cycle?

A

Luteal Phase

  • Begins after ovulation- ends with menstruation
  • Corpus luteum secretes E2/P4= peak day 8
  • Corpus luteum regresses without conception
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5
Q

What’s the MENSTRUAL PHASE of the endometrial cycle?

A

The shedding of the functional endometrium

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6
Q

Whats the PROLIFERATIVE PHASE of the endometrial cycle?

A

E2 causes- Rapid endometrial growth

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7
Q

What’s the SECRETORY PHASE of the endometrial cycle?

A

P4 causes endometrium to thicken- ↑ blood

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8
Q

What’s the ISCHEMIC PHASE of the endometrial cycle?

A

Spasm and necrosis of the functional layer of the endometriuum

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9
Q

The surge of which hormone causes Which hormone is responsible for the maturation and release of an oocyte at midcycle?

A

LH

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10
Q

What is Amenorrhea?

A

Absence of menstrual flow

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11
Q

Primary and Secondary cause for Amenorrhea?

A

primary: anatomical, disease
process

secondary: pregnancy

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12
Q

s/s of amenorrhea? what’s the assessment?

A

s/s: absence of menstruation

assessment: history and exam

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13
Q

What is hypogonadotropic?

and what is the cause?

A

Absence of menstrual flow due to hypothalamic suppression

Etiology: stress, low weight range, excessive exercise.

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14
Q

S/S of hypogonadoptropic amenorrhea?

A

S/S: absence of menstruation

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15
Q

assessment and management for hypogonadotropic amenorrhea?

A

Assessment: history & physical examination; Hcg, FSH, TSH, prolactin
Management: Counseling & education regarding stress, exercise, and weight loss. ** OCA’s, Ca supplements

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16
Q

What is dysmenorrhea?

A

Pain during or shortly before menstruation

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17
Q

What is primary dysmenorrhea and what is the cause?

A

Abnormally increased uterine activity

Etiology: Physiologic alteration; prostaglandin excess

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18
Q

S/S of primary dysmenorrhea?

A

S& S: severe cramps, back pain, GI sx

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19
Q

Management of primary dysmenorrhea?

A 
Management:
Alleviating discomfort
Nonsteroidal anti-inflammatory drugs
OCA’s
Education
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20
Q

What is secondary dysmenorrhea? and whats the cause?

A

Acquired menstrual pain associated with possible pelvic pathology
Etiology: Adenomyosis, Endometriosis, PID, fibroids

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21
Q

What are the S/S of secondary dysmenorrhea and what is the assessment?

A

S&S: heavy mentrual flow, dull lower abd ache
Assessment:
Pelvic exam/ USG exam

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22
Q

What is the management of secondary dysmenorrhea?

A

Management:
Treatment directed to removal of underlying pathology.
Comfort: NSAIDS, OCA’s, diet, exercise, heating pads

23
Q

When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended?

A

D. Using a heating pad on the abdomen to relieve cramping

***double check for the answer.

24
Q

What is PMS premenstrual syndrome?

A

cyclic symptoms occurring in luteal phase of menstrual cycle.

when you’re cray cray

25
Q

What is the cause of PMS?

A

Etiology: Poorly understood

26
Q

S/S of PMS?

A

S&S: Cluster of physical, psychologic, and behavioral symptoms

27
Q

Management of PMS?

A

Management: diet, exercise, and herbal therapies ** education, avoid caffeine, limit ETOH

28
Q

In helping a client manage premenstrual syndrome (PMS), the nurse should:

A

a. Recommend a diet with more body-building and energy food such as red meat and sugar.
b. Suggest herbal therapies, yoga, and massage.
c. Tell the client to push for medications from the physician as soon as symptoms occur to lessen their severity.
d. Discourage the use of diuretics.

29
Q

What is Endometriosis?

A

Presence and growth of endometrial tissue outside of uterus

30
Q

What is the cause of endometriosis?

A

possible retrograde menstruation

31
Q

What are the s/s of endometriosis?

A

Dysmenorrhea & dyspareunia

32
Q

what is the management of endometriosis?

A

Drug therapy- Danazol; Lupron; OCA’s, NSAIDS
Surgical intervention – Lap 40%
Education/ Support

33
Q

What are Fibroids?

A

Benign tumor that originates from the myometrium of the uterus

34
Q

what causes Fibroids?

A

genetic, hormones- association with CHTN

35
Q

what are the S/S of fibroids?

A

menorrhagia, dysmenorrhea

36
Q

What is the management of Fibroids?

A

Medication

Surgically- myomectomy

37
Q

What are the 3 alterations in cyclic bleeding?

A
  • oligomenorrhea
  • hypomenorrhea
  • metrorrhagia
38
Q

What is the Oligomenorrhea?

A

Infrequent menses Q 40-45d

Etiology- pituitary tumor, excessive exercise, low BMI, PCOS, perimeno

39
Q

What is hypomenorrhea?

A

Scant bleed, normal interval

Etiology- similar as Oligo

40
Q

What is Metorrhagia?

A

Intermenstrual bleed

Etiology- pregnancy, onset of OCA, endom, fibroids, & cancer

41
Q

What is Menorrhagia? etiology?

A

Excessive menstrual bleed (duration or amount)

Etiology- fibroids, malignancy, polyps

42
Q

What is Menometrorrhagia?etiology?

A

excessive menstrual bleed which is irregular & frequent

Etiology- adenomyosis, fibroids

43
Q

What is abnormal uterine bleeding? etiology?

A

Irregular in amount, duration or timing
Etiology- Obesity, hyperthyroidism, hypothyroidism, PCOS. DUC- dx after rulle out other casues
Management- hospitalize prn, transfusion, D&C, endometrial bx, ablation (Novasure)

44
Q

What is Fibrocystic breasts?

A

benign breast changes characterized by small cysts

45
Q

What is the cause of Fibrocystic breasts?

A

imbalance of estrogen/ progesterone

46
Q

What are the S/S of Fibrocystic breasts?

A

timing, characteristics

47
Q

How do you detect Fibrocystic breasts?

A

Detection: Exam, USG, aspiration, FNA

48
Q

Management for Fibrocystic breasts?

A

Management: conservative, Vit E, OCA’s, surgical removal, NSAIDs, decrease caffeine, smoking & ETOH

49
Q

Can you name a few other menstrual disorders?

A

Lipomas

Nipple Discharge

Galactorrhea

Mammary Duct Ectasia

Intraductal Papilloma

*** EDUCATION- BSE, CBE, intervals, dietary changes, comfort measures

50
Q

Malignancy screening?

A

ACOG–BSE has the potential to detect palpable breast cancer and can be recommended.
Newer concept called “breast self-awareness“
EDUCATION

51
Q

What are S/S of breast cancer?

A

Hard, fixed lump, irregular borders, nipple discharge, discoloration, unilateral

52
Q

Breast cancer management?

A 
Surgical
	Radiation
	Adjunct
	Hormone
	Chemotherapy
53
Q

Do menstrual disorders diminish the quality of life?

A

yes!

OB (6 decks)

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