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OBGYN > Exam 1: Reproductive Concerns, STIs, & Contraception/Abortion > Flashcards

Exam 1: Reproductive Concerns, STIs, & Contraception/Abortion Flashcards

1
Q

Absence of menstrual flow

A

amenorrhea

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2
Q

most common cause of amenorrhea

A

pregnancy

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3
Q

Signs amenorrhea is caused by a disorder (3)

A

-Absence of menarche and secondary sexual characteristics by age 14
-Absence of menses by age 16
-6 months or more without menses after initial menstruation

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4
Q

pain before or during menstruation

A

dysmenorrhea

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5
Q

cluster of physical, psychological, and behavioral symptoms around the menstrual cycle period

A

Premenstrual syndrome (PMS)

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6
Q

severe variant of PMS with specific criteria fro dx

A

premenstrual dysphoric disorder (PMDD)

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7
Q

decreased menstruation in amount and/or duration (infrequency)

A

Oligomenorrhea (hypomenorrhea)

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8
Q

inter-menstrual bleeding that occurs in between normal menses

A

Metrorrhagia

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9
Q

excessive menstrual bleeding in either duration for amount

A

Menorrhagia (hypermenorrhea)

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10
Q

any form of uterine bleeding that is irregular in amount, duration, or timing that is not related to regular menstrual bleeding

A

Abnormal uterine bleeding

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11
Q

Abnormal uterine bleeding:
Pregnancy related conditions (5)

A

-Threatened or spontaneous miscarriage
-Retained products of conception after elective abortion
-Ectopic pregnancy
-Placenta previa/placental abruption
-Trophoblastic disease

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12
Q

Abnormal uterine bleeding
Lower Reproductive Tract Infections (4)

A

-cervicitis
-endometritis
-myometritis
-salpingitis

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13
Q

Abnormal uterine bleeding
Benign Anatomic Abnormalities (3)

A

-Adrenomyosis
-Leiomyomata
-Polyps of the cervix or endometrium

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14
Q

Abnormal uterine bleeding
Neoplasms (4)

A

-Endometrial hyperplasia
-Cancer of cervix and endometrium
-Hormonally active tumors
-Vaginal tumors

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15
Q

Abnormal uterine bleeding
Malignant Lesions (5)

A

-Cervical squamous cell carcinoma
-Endometrial adenocarcinoma
-Estrogen-producing ovarian tumors
-Testosterone producing ovarian tumors
-Leiomyosarcoma

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16
Q

Abnormal uterine bleeding
Trauma (3)

A

-Genital injury
-Foreign body
-Lacerations

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17
Q

Abnormal uterine bleeding
Systemic Conditions (8)

A

-Adrenal hyperplasia and Cushing disease
-Blood dyscrasia
-Coagulopathies
-Hypothalamic suppression
-Polycystic ovarian syndrome
-Thyroid disease
-Pituitary edema or hyperprolactinemia
-Severe organ disease

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18
Q

Abnormal uterine bleeding
Iatrogenic causes (7)

A

-Medications involving estrogen
-Anticoagulants
-Exogenous hormone use
-SSRIs
-Tamoxifen
-IUDs
-Ginseng (herbal supplement)

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19
Q

presence and growth of endometrial tissue outside of the uterus

A

endometriosis

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20
Q

________% of those who have endometriosis are infertile

A

30-45%

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21
Q

Major symptoms of endometriosis: (3)

A

-dysmenorrhea
-deep pelvic dyspareunia
-painful intercourse

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22
Q

one year without a period marking the complete cessation of menses

A

menopause

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23
Q

perimenopausal period includes (4)

A

-bleeding
-genital changes
-vasomotor instability (hot flashes
-mood and behavior responses

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24
Q

After menopause, women are now at increased risk for: (2)

A

-osteoporosis
-coronary heart disease

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25
Q

Physiological characteristics of menopause include (3)

A

-Anovulation occurs more frequently, and menstrual cycles increase in length

-Ovarian follicles become less sensitive to FSH and LH; ovulation occurs less frequently and FSH becomes elevated

-Progesterone is not produced by the corpus lutetium

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26
Q

Transitional phase during which ovarian function and hormone production declines

A

Climacteric

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27
Q

Menopausal hormone therapy (MHT) is generally composed of _______ and _______ compounds

A

estrogen and progesterone

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28
Q

Perimenopausal care plan/interventions (5)

A

-Sexual counseling, nutrition, and exercise promotion
-Medication for osteoporosis prevention
-Midlife support group

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29
Q

Primary prevention of STIs includes _____ and _______

A

abstinence and condom use

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30
Q

Secondary prevention of STIs includes ________ and ________

A

timely diagnosis and treatment

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31
Q

STI risk reduction includes (4)

A

-Knowledge of partner / reduction of number of partners
-Low-risk sexual behavior
-Avoiding exchange of body fluids
-Vaccination for HPV and Hep B

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32
Q

Most common and fastest spreading STI

A

Chlamydia

33
Q

Chlamydia
Screening:
Treatment:

A

S: asymptomatic and pregnant women

T: doxycycline, azithromycin

34
Q

Second most common reported STI

A

Gonorrhea

35
Q

Gonorrhea
Screening:
Treatment:

A

S: all high-risk women, pregnancy in 1st trimester and 36 weeks

T: ceftriaxone + Azithromycin

36
Q

Gonorrhea
Microbiology:
Signs:

A

M: aerobic, gram neg diplococcus

S: women are often asymptomatic

37
Q

IMPORTANT factor concerning Gonorrhea moms

A

risk for gonococcal infection of neonate if mother is positive

38
Q

Syphilis
Highest Risk:
Microbiology:
Stages:

A

R: highest in women ages 20-24 and black women

M: treponema pallidum (spirochete)

S:
Primary (5-90 days)
Secondary (6w-6m)
Tertiary (10-30y)

39
Q

Syphilis
Screening:
Treatment:

A

S: non-treponemal screening test (RPR) and treponemal diagnostics

T: penicillin G

40
Q

STI is most common cause of vaginal symptoms

A

Bacterial Vagninosis

41
Q

Bacterial vaginosis
Signs:
Treatment:

A

S: “fishy” vaginal odor

T: oral metronidazole

42
Q

Bacterial STIs (5)

A

Chlamydia
Gonorrhea
Syphilis
Bacterial Vaginosis
Group B Streptococci

43
Q

Normal vaginal flora in 25% of healthy pregnancy women, but associated with poor pregnancy outcomes

A

Group B streptococci

44
Q

Group B Streptococci
Screening:
Treatment:

A

S: 36-37 weeks of gestation

T: intrapartum IV penicillin (prophylactically)

45
Q

Most common viral STI; “genital warts”; primary cause of cervical neoplasia

A

HPV

46
Q

HPV
Prevention
Screening
Treatment

A

P: HPV vaccination for men & women

S: pap, viral screening

T: spontaneously resolving

47
Q

HSV is abbreviation of:

A

Herpes simplex virus

48
Q

cold sore transmitted non sexually

A

HSV1

49
Q

sexual transmission of herpes

A

HSV2

50
Q

HSV
Signs: (5)
Treatment: (3)

A

S: painful lesions, fever, chills, malaise, severe dysuria (stress can trigger outbreak)

T: acyclovir, valacyclovir, famcyclovir

51
Q

IMPORTANT consideration with HSV moms

A

mother can deliver vaginally, but C-section required if visible lesions are present at time of delivery

52
Q

HIV
Signs: (9)

A

-fever
-headache
-night sweats
-malaise
-generalized lymphadenopathy
-myalgia
-N/V/D
-weight loss
-sore throat
-rash

53
Q

HIV
Screening
Treatment

A

S: antibody testing, offered early in pregnancy

T: antiretroviral therapy

54
Q

IMPORTANT considerations with HIV moms

A

C-section
no breastfeeding

55
Q

Most life threatening STI to fetus and neonate

A

Hepatitis B

56
Q

Hep B
Can cause:
delivery:
prevention:

A

-can cause liver disease and silence infections
-C-section decreases risk of parental transmission to neonate
-Vaccination series available at birth

57
Q

the intentional prevention or pregnancy during sexual intercourse

A

contraception

58
Q

the vice or practice that decreases the risk of conceiving

A

birth control

59
Q

the conscious decision on when to conceive throughout the reproductive years

A

family planning

60
Q

best form of both control (100% effective)
not always achievable or a reasonable plan for patients

A

Abstinence

61
Q

can be used in case of emergency, cheap method
not totally effective

A

Coitus interruptus

62
Q

can be used to prevent or plan a pregnancy using calendar-based methods, symptom-based methods, or biological marker methods

A

Natural family planning

63
Q

Used postpartum as hormonal regulation, but mom must be strictly participating until she switches to another contraceptive
-Highly effective temporary method

A

breastfeeding
(lactational amenorrhea method)

64
Q

Fairly effective at preventing pregnancy, great method to prevent transmission of STIs

A

Condoms

65
Q

No longer used due to risk of toxic shock syndrome
nonoxynol-9 used to reduce sperm motility, 29% failure rate

A

Diaphragm/spermicides

66
Q

Estrogen and progesterone oral medications that have high efficacy if taken correctly

A

Combined oral contraceptives

67
Q

progestin only oral contraception often given to postpartum, breastfeeding mothers
failure rate 9%

A

mini pill

68
Q

progesterone injection that lasts 3 months
-may cause weight Gian
-fertility may not return for 10 months following last dose

A

Depo-Provera

69
Q

Inserted into vagina, good for 1 month
-form of hormonal, slow-release medication
-major issues if becomes dislodged

A

vaginal ring

70
Q

Paraguard copper, Mirena, Liletta, Skyla
-releases levonorgestrel for 3-5 years with 0.2% failure rate

A

Intrauterine Device (IUD)

71
Q

Form of tubal occlusion for permanent sterilization
-no longer used due to pain

A

ensure/transcervical sterilization

72
Q

invasive surgery with interruptive of fallopian tubes for permanent sterilization
-highly effective but requires general anesthesia

A

Bilateral tubal ligation

73
Q

surgical interruption of male vas deferent
-high efficacy rate but not considered effective until semen specimen shows no sperm

A

Vasectomy

74
Q

Levonorgestrel tablet that must be taken within 5 days of unprotected sex
-better efficacy associated with sooner administration

A

emergency contraception

75
Q

“ACHES” for oral contraception

A

A: abdominal pain may indicate liver or gallbladder problems

C: Chest pain or SOB may indicate clotting in the lungs or heart

H: Headaches (sudden or persistent) may result from CVA or HTN

E: eye problems may indicate CVA or HTN

S: Severe leg pain may indicate thromboembolic process

76
Q

removal of pregnancy not medically necessary, but decided due to other socioeconomic factors

A

Elective abortions

77
Q

removal of pregnancy required for the life of the mother

A

Therapeutic abortion

78
Q

Post-abortion care: (2)

A

-provide education on physical changes and signs of infection
-provide emotional support and understanding (women may feel relief or distress)

OBGYN (6 decks)

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