Exam 1: Reproductive Concerns, STIs, & Contraception/Abortion Flashcards by Kalyn21Blessing .

Absence of menstrual flow

amenorrhea

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most common cause of amenorrhea

pregnancy

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Signs amenorrhea is caused by a disorder (3)

-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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pain before or during menstruation

dysmenorrhea

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

Premenstrual syndrome (PMS)

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severe variant of PMS with specific criteria fro dx

premenstrual dysphoric disorder (PMDD)

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decreased menstruation in amount and/or duration (infrequency)

Oligomenorrhea (hypomenorrhea)

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inter-menstrual bleeding that occurs in between normal menses

Metrorrhagia

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excessive menstrual bleeding in either duration for amount

Menorrhagia (hypermenorrhea)

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

Abnormal uterine bleeding

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Abnormal uterine bleeding:
Pregnancy related conditions (5)

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

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Abnormal uterine bleeding
Lower Reproductive Tract Infections (4)

-cervicitis
-endometritis
-myometritis
-salpingitis

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Abnormal uterine bleeding
Benign Anatomic Abnormalities (3)

-Adrenomyosis
-Leiomyomata
-Polyps of the cervix or endometrium

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Abnormal uterine bleeding
Neoplasms (4)

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

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Abnormal uterine bleeding
Malignant Lesions (5)

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

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Abnormal uterine bleeding
Trauma (3)

-Genital injury
-Foreign body
-Lacerations

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Abnormal uterine bleeding
Systemic Conditions (8)

-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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Abnormal uterine bleeding
Iatrogenic causes (7)

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

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presence and growth of endometrial tissue outside of the uterus

endometriosis

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________% of those who have endometriosis are infertile

30-45%

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Major symptoms of endometriosis: (3)

-dysmenorrhea
-deep pelvic dyspareunia
-painful intercourse

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one year without a period marking the complete cessation of menses

menopause

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perimenopausal period includes (4)

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

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

-osteoporosis
-coronary heart disease

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Physiological characteristics of menopause include (3)

-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

Transitional phase during which ovarian function and hormone production declines

Climacteric

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

estrogen and progesterone

Perimenopausal care plan/interventions (5)

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

Primary prevention of STIs includes _____ and _______

abstinence and condom use

Secondary prevention of STIs includes ________ and ________

timely diagnosis and treatment

STI risk reduction includes (4)

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

Most common and fastest spreading STI

Chlamydia

Chlamydia Screening: Treatment:

S: asymptomatic and pregnant women T: doxycycline, azithromycin

Second most common reported STI

Gonorrhea

Gonorrhea Screening: Treatment:

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

Gonorrhea Microbiology: Signs:

M: aerobic, gram neg diplococcus S: women are often asymptomatic

IMPORTANT factor concerning Gonorrhea moms

risk for gonococcal infection of neonate if mother is positive

Syphilis Highest Risk: Microbiology: Stages:

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)

Syphilis Screening: Treatment:

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

STI is most common cause of vaginal symptoms

Bacterial Vagninosis

Bacterial vaginosis Signs: Treatment:

S: "fishy" vaginal odor T: oral metronidazole

Bacterial STIs (5)

Chlamydia Gonorrhea Syphilis Bacterial Vaginosis Group B Streptococci

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

Group B streptococci

Group B Streptococci Screening: Treatment:

S: 36-37 weeks of gestation T: intrapartum IV penicillin (prophylactically)

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

HPV

HPV Prevention Screening Treatment

P: HPV vaccination for men & women S: pap, viral screening T: spontaneously resolving

HSV is abbreviation of:

Herpes simplex virus

cold sore transmitted non sexually

HSV1

sexual transmission of herpes

HSV2

HSV Signs: (5) Treatment: (3)

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

IMPORTANT consideration with HSV moms

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

HIV Signs: (9)

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

HIV Screening Treatment

S: antibody testing, offered early in pregnancy T: antiretroviral therapy

IMPORTANT considerations with HIV moms

C-section no breastfeeding

Most life threatening STI to fetus and neonate

Hepatitis B

Hep B Can cause: delivery: prevention:

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

the intentional prevention or pregnancy during sexual intercourse

contraception

the vice or practice that decreases the risk of conceiving

birth control

the conscious decision on when to conceive throughout the reproductive years

family planning

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

Abstinence

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

Coitus interruptus

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

Natural family planning

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

breastfeeding (lactational amenorrhea method)

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

Condoms

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

Diaphragm/spermicides

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

Combined oral contraceptives

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

mini pill

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

Depo-Provera

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

vaginal ring

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

Intrauterine Device (IUD)

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

ensure/transcervical sterilization

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

Bilateral tubal ligation

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

Vasectomy

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

emergency contraception

"ACHES" for oral contraception

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

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

Elective abortions

removal of pregnancy required for the life of the mother

Therapeutic abortion

Post-abortion care: (2)

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