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OBGYN > Exam 1: Infertility, Breast Disorders, Structural Disorders & Neoplasms > Flashcards

Exam 1: Infertility, Breast Disorders, Structural Disorders & Neoplasms Flashcards

1
Q

inability ot conceive

A

Sterility

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2
Q

prolonged time to conceive

A

Infertility

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3
Q

Infertility affects about ___% of reproductive-age couples; increases with age (especially over ______ years_

A

18%
35 years

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4
Q

Before age 35, couples have _____-_____% chance of conception at each ovulation

A

25-30%

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5
Q

Least invasive way to check couple’s fertility

A

semen analysis

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6
Q

Cause of female infertility: (3)

A

-Ovarian factors
-Uterine, tubal, and peritoneal factors
-pre-existing conditions

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7
Q

Cause of female infertility:
Other factors (pre-existing conditions) (6)

A

-Nutritional deficiencies (anemia)
-Obesity
-Substance abuse
-Thyroid dysfunction
-Genetic Disorder
-Anxiety/Depression

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8
Q

Causes of male infertility (5)

A

-poor sperm quality
-structural and hormonal disorders
-genetic disorders
-decreased libido
-impotence r/t alcohol, antihypertensives, or anti seizure meds

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9
Q

Reproductive alternatives (5)

A

-Ovarian stimulation
-Egg/sperm/embryo donation
-Therapeutic donation insemination (TDI)
-Gestational or surrogate motherhood
-Adoption

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10
Q

Ovarian stimulation is followed by one of the following (4)

A

-IUI
-IVF-ET
-GIFT
-ZIFT

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11
Q

Goals of initial breast evaluation: (2)

A

-distinguish benign from malignant in situ or invasive tumors of the breast
-assess the risk of subsequent breast cancer associated with lesion

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12
Q

breast self-exams are no longer recommended due to

A

lack of efficacy

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13
Q

regular mammograms recommended starting at age

A

45

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14
Q

underdevelopment of breasts

A

micromastia

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15
Q

breast hyperplasia

A

macromastia

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16
Q

Breast development abnormalities include (2)

A

-asymmetric breast development
-Supernumerary nipples or breasts along the milk line

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17
Q

Changes characterized by lumpiness with or without tenderness bilaterally;
Most common benign problem with breasts

A

Fibrocystic breast disease

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18
Q

Fibrocystic breast disease
Etiology:
Manifestations: (4)

A

E: estrogen and progesterone fluctuations

M:
-lumpiness bilateral breasts
-single cyst may occur
-dull heavy pain
-sense of fullness and tenderness (upper outer quadrant) with premenstrual period

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19
Q

Fibrocystic breast disease
diagnosis:
treatment: (6)

A

D: ultrasound to determine fi lump is fluid filled or solid

T: aspiration of fluid filled cysts
-oral contraception
-danazol, bromocriptine, tamoxifen
-evening primrose oil

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20
Q

Mastalgia
Etiology:
Assess:

A

E: hormonal, cystic, trauma, surgery

A: character and pattern of breast pain to determine whether pain is cyclic or noncyclic, diffuse or focal

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21
Q

Mastalgia:
Diagnostics (4)
Treatment (4)

A

D: serological tests for prolactin and hCG
-ultrasound
-mammography
-aspiration and biopsy of cysts

T: dietary changes
-NSAIDS
-hormone treatment
-evening primrose oil

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22
Q

Most common solid mass of breast

A

Fibroadenoma

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23
Q

Fibroadenoma characteristics (3)

A

-discrete
-solitary lumps less than 3 cm in diameter that can be tender during menstruation
-no changes in size or shape over time

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24
Q

Fibroadenoma
Diagnosis: (4)
Treatment: (2)

A

D: mammography
-ultrasound
-MRI
-Core needle biopsy

T: observation and surgical excision

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25
Q

Mammary duct ectasia
Characteristics
Signs (5)

A

C: dilated ducts and nipple inversion during perimenopausal period

S: pain
-redness of skin
-nipple inversion
-green nipple discharge
-may have fever or abscess

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26
Q

Bilateral, spontaneous, milky, sticky discharge r/t increased prolactin levels

A

Galactorrhea

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27
Q

Galactorrhea diagnostic test: (4)

A

prolactin level
thyroid profile
pregnancy test
mammogram

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28
Q

concerns about single breast nipple discharge

A

increase concern of breast cancer

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29
Q

Intraductal papilloma signs

A

serous, serosanguineous, or bloody nipple discharge that is unilateral and spontaneous

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30
Q

Intraductal papilloma
diagnostics:
treatment:

A

D: ductogram
mammography
core biopsy

T: surgical excision recommended

31
Q

most common breast infection:

A

cellulitis with or w/o abscess formation

32
Q

breast infection
-Risk (7)
-Pathogenesis (2)

A

R: obesity
large breasts
surgery
radiation
sebaceous cysts
smoking
diabetes

P: Staph aureus
-MRSA

33
Q

Breast infection
Signs: (5)
Diagnostics: (2)
Treatment: (2)

A

S: pain, red skin, thickening of skin, warm skin, abscess

D: ultrasound
-fluid collection

T: aspiration of abscess
-antibiotic therapy

34
Q

Second leading cause of cancer death in women ages 45-55

A

Breast cancer

35
Q

Nonmodifiable risk factors for breast cancer (8)

A

-gender
-age
-time or menarche
-menopause
-time of first live birth
-personal hx of breast cancer
-fibrocystic changes
-estrogen level

36
Q

Modifiable risk factors for breast cancer (7)

A

-body weight
-diet
-regular exercise
-high saturated fat consumption
-high alcohol consumption
-oral contraception
-HRT use

37
Q

Genetic risk for breast cancer:

A

BRCA1 & BRCA 2 creates 85% chance of developing breast cancer

38
Q

Chemoprevention drugs:

A

tamoxifen
raloxifen

39
Q

Most common form of malignant breast disease; originates in lactiferous ducts

A

Invasive ductal carcinoma

40
Q

S/S or invasive ductal carcinoma: tumor is:(5)

A

-unilateral
-not well delineated
-solid
-nonmotile
-contender

41
Q

malignant breast disease that originates in lobules of breasts

A

lobular carcinoma

42
Q

S/S of lobular carcinoma (2)

A

-nonpalpable
-appears small on imaging studies than actual size

43
Q

Malignant breast disease that originates in the nipple and usually occurs with invasive ductal carcinoma

A

Nipple Carcinoma (Paget disease)

44
Q

S/s of Nipple Carcinoma: (3)

A

-bleeding
-oozing
-crusting of the nipple

45
Q

Clinical manifestation of Breast cancer (2)

A

-palpable lump or ill-defined thickening of breast without pain
-nipple retraction, skin dimpling, or skin changes (redness with edema, pitting of skin)

46
Q

Diagnosis of Breast Cancer

A

-Screening mammogram recommended yearly
-diagnostic mammogram or ultrasound used to f/u on irregularities; MRI can also be used
-Biopsy used for pathology; staging follows

47
Q

Staging of breast cancer goes off

A

-TNM system
-Grading System
-Biomarker testing

48
Q

Treatment of breast cancer (4)

A

-Surgery
-Radiation
-Chemotherapy
-Plastic surgical reconstruction

49
Q

Breast cancer intervention chosen based on: (2)

A

-staging
-characteristics of abnormality

50
Q

removal of the small tumor and a rim of healthy tissue around it to ensure clearance of margins

A

lumpectomy

51
Q

wide excision of a region of the breast to remove tumor

A

segmental (partial) mastectomy

52
Q

complete removal of the breast, including the nipple and areola

A

Mastectomy

53
Q

Types of mastectomys (5)

A

-total simple
-modified radial
-skin-sparing
-nipple sparing
-preventive/ prophylactic

54
Q

Nurse interventions dealing with breast cancer

A

-provide emotional support
-explain treatment and provide pre-operative and post-operative education

55
Q

Variation of normal uterine placement, most commonly posterior displacement, retroversion, retroflexion, and anteflexion

A

Uterine displacement

56
Q

serious type of displacement in which uterus protrudes down into vagina

A

uterine prolapse

57
Q

the protrusion of the bladder downward into the vagina when supporting structures in vesicovaginal septum are injured

A

Cystocele

58
Q

Herniation of the anterior rectal wall through the relaxed or ruptured vaginal fascia and rectovaginal septum

A

Rectocele

59
Q

Perforations between genital tract organs, most commonly between bladder and genital tract, urethra, and vagina, or rectum and vagina

A

Genital fistula

60
Q

sudden increase in intra-abdominal pressure causing involuntary urine loss

A

Stress UI

61
Q

urgency to void without adequate location or time to avoid incontience

A

Urge UI

62
Q

Involves both stress and urge UI with multifactorial causation

A

Mixed UI

63
Q

Benign Neoplasms

A

-Ovarian cysts
-Polycystic ovarian syndrome (PCOS)
-Uterine Polyps
-Leiomyomas

64
Q

types of leiomyomas (4)

A

Fibroid tumors
Fibromas
Myomas
Fibromyomas

65
Q

Functional ovarian cysts are dependent on

A

hormonal influences r/t menstrual cycle

66
Q

Uterine polyps are common in:

A

multiparous women <40 years of age

67
Q

Most common benign tumors of the reproductive system; often occur after ______ yrs old

A

leiomyomas
50 yrs old

68
Q

Most at risk for Leiomyomas (3)

A

-alcoholic women
-women who have never been pregnant
-overweight women

69
Q

Malignant Neoplasms
Incidence:
Greatest risk:
consideration:

A

I: 110,00 women dx with gynecological cancer in 2018

GR: obesity

C: delay of 2 years from end of cancer therapy to conception

70
Q

Most common malignancy of the reproductive system

A

endometrial cancer

71
Q

second most frequently occurring reproductive cancer

A

ovarian cancer

72
Q

third most common reproductive cancer

A

cervical cancer

73
Q

Recognized as the most curable gynecological malignancy

A

Gestational Trophoblastic Neoplasia

OBGYN (6 decks)

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