exam 1 Flashcards
maternal
entire pregnancy plus 7 weeks after
neonatal
a newborn less than 1 month
perinatal
the time around birth, 20th week of gestation to 1-4 weeks after birth
infant
the first year of life
maternal morbidity
illness or injury in a maternal woman
neonatal mortality
death in a neonate per 1,000
perinatal mortality
death in a perinatal per 1,000
infancy mortality
death in a infant per 1,000
common causes of death in a mother
postpartum hemorrhage
sepsis
hypertensive pregnancy/CVD
unsafe abortion
zygote
fertilized ovum
mitosis
produces cells for growth and tissue repair
meiosis
produces reproductive cells
gametes
ovum and sperm
gametogenesis
production of gametes
oogenesis
production of ovum/oocyte
fertiization
ovum and sperm unite
amnion
innermost enclosure of embryo
chorion
outermost enclosure of embryo
two main factors of breast cancer
gender
age
suspicious family hx of breast cancer
2-3 affected bilateral br ca 2 or more generations under 40 any male member
normal menses
2-8 days of bleeding no more often than 21-23 days up to 8 pads per day/less than 1 pad per hour clots smaller than plum no symptoms of hemodynamic instability
irregular menstrual bleeding
vries by 20 days
infrequent menstrual bleeding
1-2 menses in 90 days
frequent mensetrual bleeding
more than 4 per 90 day period
dysmenorrhea
painful periods
amenorrhea
absence of periods
abnormal uterine bleeding
erratic or post coital
myotoma
fibroids
main pH of vagina
4.4
main bacteria of vagina
lactus bacillus
when does PMS HAPPEN
luteal phase
symptoms of PMS
mood changes bloating brest tenderness headache constipation
treatment of PMS
ibuprofen
calcium or b6
exercise
menopause defined
1 year with NO period
vasomotor instability
hot flash and night sweats
symptoms of bacterial vaginosis
odor
discharge esp after intercourse
treatment for BV
metronidazol for 1 wk
yeast infection symptoms
itch
discharge
trichomoniasis symptoms
frothy
yellow discharge
itchy
treatment for trich
metronidazol
diagnosis for vaginitis
history PE pH nucleic acid probe WHIFF culture test
what is PMDD
luteal depressive disorder
symptoms of PMDD
matches PMS but extreme
treatment for PMDD
SSRI
cognitive behavioral therapy
what is endometriosis
endometrium cells outside of the uterus that still responds like every other endometrial cell
diagnosis of endometriosis
surgery or symptoms
endometriosis treatment includes
surgery
OCP
GnRH antagonist
progestin OCP
what is infertility
trying for over 1 yr with no pregnancy
testing for infertility
tubal potency (HSG)
ovulation (LH levels)
sperm count
Huhners (post coital)
what does estrogen do to LH and FSH?
inhibits FSH
stimulates LH
what does estrogen do to follicles?
help mature follicles
what is estrogen associated with?
female characteristics
what is progesterone associated with?
maintaining pregnancy
what does progesterone do to the cervical mucus?
thickens
what are the phases of the uterine cycle
menstruation
proliferative phase
secretory phase
ischemic phase
what happens during the menstrual phase?
menses!
what happens during the proliferative phase?
blood vessel dilation
thicken of endometrium
thinning of cervical mucus
what happens during the secretory phase?
after ovulation
vascularity increases
progesterone grows the endometrium
what happens during the ischemic phase
after the ovum is not fertilized –
estrogen and progesterone diminish
vascularity diminishes
what days are the follicular phase
1-14
what days are the luteal phase
15-28
what happens during the follicular phase
FSH matures the follicle
follicle produces estrogen
what happens during the luteal phase
ovum leaves follicle
corpus luteum develops under LH
corpus luteum produces high levels of progesterone and low levels of estrogen
what days do the menstrual phase happen
1-6
what days do the proliferative phase happen
7-14
what days do the secretory phase happen
15-26
what days do the ischemic phase happen
27-28
what does the hypothalamus secrete
GNRH
what does the anterior pituitary secrete
LH and FSH
what is FSH primarily responsible for
follicle maturation
what happens as the follicle matures?
estrogen is released – helps with proliferation and rebuilding as well
what does LH do
allows estrogen to reduce and progesterone to become dominate before ovulation
autonomy
respecting your patients choice
beneficence
what will benefit my patient?
justice
equal and fair distribution of care
nonmalifecence
do no harm
what age is no consent for mental health and substance abuse?
13 and up
what age is no consent for contraception or abortion
ANY age
what age is no consent for std or stis?
14 and older
if a patient is less than 12, what age is it legal for their partner?
less than 24 months
if a patient is older than 12, but no older than 14, what age is it legal for their partner?
less than 36 months
if a patient is 16 and up – what age is it legal for their partner?
no more than 5 years older, and it cannot be a supervisory relationship
sexual interactions for ages:
12 and under - 14
14-16
and 16-18
follows
under 12 - 14 no more than 36 mos
14-16 no more than 48 mos
16-18 no more than 60 mos
chlamydia and gonorrhea diagnosis
swabs - cervical, vaginal, penile
urine
how do you do a STD urine specimen?
dirty catch only to the line!!
what are symptoms of chlamydia and gonorrhea?
abdominal pain
penile or vaginal discharge
burning with and without urination
scrotal pain
what is pelvic inflammatory disease?
inflammation of fallopian tube
what does pelvic inflammatory disease lead to?
scarring and adhesions
infertility
ectopic pregnancy
what is pelvic inflammatory disease caused by?
uncontrolled STD… many other factors - but pertains to sexual activity and unprotected sex
what can treat pelvic inflammatory disease?
metronidazole
doxycycline
antibiotics
what cures syphillis?
penicillin!!!
what can treat gonorrhea and chlamydia?
antibiotics
doxycycline (not ok for pregnancy)
azithromyocin (orally)
cetrofiaxone (IM injection)
what kind of treatment is good for herpes?
anti retrovirals
diagnosis of HSV
swab of a moist lesion within 72 hours
blood work – IgM or IgG
USUALLY IGG!! IgM occurs very quickly and is sometimes hard to miss
treatment of condyloma accuminta
tricholoronic acid
cryotherapy
excision
laser
iminquoid! aldara
what are the recommendations for pap smears?
every 3 years for 21 to 65
every 5 for women 30-65 for cytology and HPV
epididymitis symptoms
horrible pain
epididymitis leads to
scarring
infertility
what usually leads to epididymitis after age 30
BPH and urinary bacterial exposure
what helps epididymitis?
azithromyocin
when is spontaneous abortion most likely to happen?
conception to 20 weeks
what is the first trimester
last menstrual period to 12 weeks
second trimester
12 weeks to 28 weeks
third trimester
28 to 40 wks
when is it considered term?
37 to 38 weeks
what is considered late preterm
34 to 37 weeks
what is full term
40 wks
when can pregnancy be diagnosed?
wk 4
what is the impact of teratogens?
timing
type
dose and toxicity
what is combined hormonal contraceptives?
estrogen and progesterone
what are the types of combined hormonal contraceptives?
pill
nuva ring
evra patch
what are contraindications for the hormonal pill?
CVD
BRCA
endometrial cancer
warning for hormonal contraceptives?
ACHES abdominal pain due to liver tumor chest pain from PE and MI headaches from stroke eye sight with spots severe leg cramps
how does hormonal contraceptives work?
helps suppress ovulation
what is plan b?
progestin pill!!!!
what is progestin best for?
cvd patients
BF women
in terms of bleeding, what does progestin cause?
irregular bleeding
what are the forms of progestin only contraception?
OCP
IUD
emergency
depo provera
what are the types of IUD?
copper and hormonal
what does the copper IUD do for bleeding?
increases pain
increases bleeding
how does the copper IUD work?
spermicide
how does the progestin IUD work for bleeding?
decreases pain and bleeding
amenorrhea
irregularities!
contraindications for IUD
PID
ectopic pregnancy
uterine anomoly
what needs to be done before IUD insertion?
STD test and pregnancy test
how does a non copper IUD work
atrophies the endometrium
how does the nexplanon implant work?
no ovulation – thickens mucus for no sperm to get through
how does hormonal contraception work?
no ovulation
atrophies the endometrium
thickens the mucus
