Female GU Flashcards
0
Q
Sexual history
A
Pain with intercourse Hx of sexual or physical abuse Hx of STDs Sexual preference Ask r/ship status- single, involved, married
1
Q
Health history of female GU
A
Menstrual hx, preg hx, meds- current, hx, exposure, side effects Pain with menses or intercourse Vaginal discharge, odor, itching Chronic illness or disabilities Urinary and bowel function Surgical/ procedure hx
2
Q
PLISSIT
A
Permission Limited information Specific Suggestions Intensive Therapies
3
Q
Examinations
A
Pelvic exam
Pap smear
4
Q
Dx tests
A
Colposcopy and cervical biopsy Cryotherapy and laser therapy Cone biopsy Loop electrosurgical incision ( LEEP) Endometrial biopsy Dilation and curattage Laparoscopy (pelvic peritoneoscopy) Hysteroscopy
5
Q
Def coloscopy
A
Microscope exam
6
Q
Def Cryotherapy
A
Freezing of the cell
7
Q
What is the most common std
A
HPV
8
Q
What is the name of the vaccine for HPV
A
Gardasil
9
Q
How many injections is the gardasil vaccine
A
3
10
Q
What conditions is HPV assoc w/
A
Cervical dysplasia
Cervical cancer
11
Q
What screening can be done to detect HPV
A
Annual Pap smear
12
Q
List the menstrual disorders
A
Premenstrual syndrome
Dysmenorrhea
Amenorrhea
13
Q
List the abnormal menstrual disorders
A
Menorrhagia
Metrorhagia
Post menopausal bleeding
14
Q
List the female reproductive malignancies
A
Cervical Uterine Vaginal Vulvar Ovarian
15
Q
T/F- there are early s&s of female reproductive malignancies
A
False- usually no s&s
16
Q
S&s of reproductive malignancies
A
Depends on location Vaginal discharge Pain Bleeding Systemic systems - weight loss - anemia
17
Q
What components are vital to dx of reproductive malignancies
A
Prevention
Screening
Early detection
18
Q
Reproductive malignancy therapies
A
Chemotherapy
Radiation
Surgery
Combo
19
Q
Is reproductive malignancy therapies curative or palliative
A
Both
20
Q
What is the 3rd most common reproductive cancer
A
Cervical ca
21
Q
How can cervical cancer be dx
A
Pap smear
22
Q
List the cells of cervical cancer
A
Squamous cell carcinoma
Adrenocarcinoma.
23
Q
Risk factors for cervical cancer
A
Sexual activity before 18 Multiple sex partners Sex partners who are not circumcised Sexual partners who have had previous partners with cervical ca Early childbearing HIV, exposure to HPV Smoking Fam hx Nutritional deficiencies- folate, vitamin c
24
Cervical s&s
```
Early- none
Thin watery vaginal discharge
Irregular bleeding
Pain or bleeding after intercourse
Dark, foul discharge
```
25
Late s&s of cervical cancer
Leg or rectal pain
26
Dx of cervical cancer
Abnormal pap
Biopsy- CIN III, or Carcinoma in situ
Invasive cancer
D&C to stage the cancer
27
What procedure may be done to stage the cervical cancer
D&C
28
Tx for Precursor or Pre-invasion lesions
Colposcopy
Cryotherapy
LEEP
Conization
29
Tx for invasive cancer
```
Depends on stage and location
Hysterectomy
BIL lymphadenectomy
Pelvic exenteration
Radical trachelectomy
```
30
What is the leading cause of gun cancer deaths
Ovarian cancer
31
When is the peak for ovarian cancer
40-80
32
What decreases the risks for ovarian cancer
Pregnancy
| OCP- oral contraception pill
33
T/F- there is no correlation bx ovarian cancer and breast cancer
False- there is a correlation
34
Why is dx ing ovarian cancer difficult
Difficult to detect
| No early screening
35
What tests can dx ovarian cancer
Vaginal ultrasound
CA-125
Pelvic imaging
36
S&s of ovarian cancer
```
Abdominal bloating/ incr abdominal girth
Pelvic pressure
Back pain
Constipation, urinary urgency, indigestion, flatulence
Leg pain
Pelvic pain
```
37
Ovarian cancer medical mgmt
Tumor debulking/ removal
Borderline tumor- removal if affected ovary
Chemo
38
How is ovarian cancer staged
TNM I- IV
39
Pre-op protocols for ovarian surgery
```
Barium enema
Cystoscope
UGI series
CT Scan
Chest x to r/o mets
```
40
Complications of advanced ovarian cancer
Pleural effusion
| Ascites
41
Interventions to treat complications of ovarian cancer
```
Thoracentesis
IVF
I& O
TPN
Comfort measures
```
42
What is the most common gyn cancer
Uterine cancer
43
Risk factors for uterine cancer
```
>55
White> black (more deaths though)
Obesity
Unopposed estrogen therapy (estr w/o proegesterone)
Nullipaity
Truncal obesity
Late menopause
Use of tamoxifen
```
44
S&s of uterine cancer
Irregular bleeding
| Post menopausal bleeding
45
What is uterine cancer aka
Endometrial cancer
46
T/F- vaginal cancer is common
False- rare
47
Risk factors for vaginal cancer
```
Previous cervical, vaginal, vulvar cancers
In-utero exposure to DES
Previous radiation therapy
Hx HPV
Pessary use
```
48
S&s of vaginal cancer
```
No symptoms
Slight bleeding after intercourse
Spontaneous bleeding
Vaginal discharge
Pain
Urinary/rectal symptoms
```
49
Tx of early vaginal lesions
Topical chemo
| Local excision
50
Detection of vulvar cancer
Pelvic exams
Pap smears
Self exam
51
Risk factors for vulvar cancer
Smoking
HPV
HIV
Immunosuppressant therapy
52
S&s of vulvar cancer
Long standing pruritis and soreness
Chronic dermatitis
Lump, mass, ulcer
53
Late s&s of vulvar cancer
Bleeding
Foul smelling discharge
Pain
54
Vulvar cancer tx
```
Extra uterine bleeding
Sonogram
TAH- total abdominal hysterectomy
TAH/BSO- bilateral salpingo oopherectomy
Brachytherapy
Chemo
```
55
Define fibroids
Aka myomas
| Benign growth of muscle tissue
56
Fibroids risk factors
Genetic predisposition
| Age 25-40
57
Fibroids are the most common reason for ______ secondary to _______
Hysterectomy
| Menorrhagia
58
S&s of fibroids
```
Abnormal vaginal bleeding
Pain
Backache
Bloating
Constipation
Urinary problems
Menorrhagia
Metrorrhagia
```
59
Fibroids may interfere with ________
Fertility
60
Surgical options for fibroids
```
Myomectomy
Hysterectomy
Laparoscopic mayolysis/ cryomyolysis
Uterine artery embolization (UAE)
Magnetic resonance guided u/s
```
61
Meds for fibroids
Gonadotropin releasing hormone
| Mifepresone
62
Def endometriosis
- Benign lesions that proliferate the uterine lining and can grow anywhere in the pelvic cavity
- ectopic tissue bleeds into cavity with no outlet and causes adhesions and pain
63
Endometriosis risk factors
Family hx
64
Endometriosis can cause ______ and ______
Infertility
| Chronic pelvic pain
65
Endometriosis s&s
```
Dysmenorrhea
Dyspareunia
Pelvic discomfort
Dyschezia - constipation
Infertility
Depression
```
66
Endometriosis dx
Menses pattern
Limited urine mobility
Fixed tender nodules on bi manual exam
Laparoscopic to stage I-IV
67
Medical mgmt options for endometriosis
Based on desire for pregnancy and stage of disease
Symptom mgmt
Hormonal therapy
Surgical
68
Symptom mgmt for endometriosis
NSAIDS
| OCP
69
Hormonal therapy for endometriosis
Androgens
| Gn-RH Agonists
70
Surgical interventions for endometriosis
```
Laparoscopic fulgeration
Endoagulation
Electrocoagulation
TAH
TAH/ BSO
```
71
Nsg focus for endometriosis
Address inability to conceive
| Symptom mgmt
72
Name the 2 types of hysterectomies
Total
| Radical
73
Hysterectomy approaches
Laparoscopic
vaginal
Incisional through abdomen
74
Potential complications of hysterectomy
Bleeding
*** DVT***
Bladder dysfunction
75
Risk factors for breast cancer
```
Female, age, fam and personal hx (genetic mutations)
Hormonal factors
Exposure to radiation
Hx of benign breast disease
Obesity
High fat diet
ETOH intake
```
76
Early detection of breast cancer
20-30 yo- CBE q 3 yrs, SBE monthly
> 40- CBE annually, mammography annually
If pt has significant hx, screening may be done earlier or in shorter intervals - MRI, u/s
77
List the breast disorders
Benign
| Malignant
78
Benign breast disorders
Breast pain
Cysts
Fibroadenomas
benign proliferative breast disease
79
Benign proliferative breast disease types
Atypical hyperplasia
| Lobular carcinoma in situ
80
Breast cancer dx tests
```
Mammography
Galactography
Ultrasonography
MRI
Biopsy
```
81
Types of biopsies for breast cancer
- Percutaneous- fine needle aspiration, core biopsy
| - surgical- excision, incision, wire needle localization
82
Breast cancer surgical mgmt
```
Breast conservation tx
Total mastectomy
Radical mastectomy
Sentinel node biopsy
Axillary lymph node dissection
Breast reconstruction surgery
```
83
Def DIEP flap
Breast reconstruction surge in which blood vessels inferior epigastric perforators and the skin and fat connected to them are removed from the lower abdomen and transferred to chest to reconstruct chest without extracti abdominal muscle
84
Benefits of DIEP Flap
Less painful
| Quicker recovery time
85
Medical mgmt of breast cancer
Radiation
Chemo
Hormonal
Targeted
86
Radiation therapy for breast cancer
External beam
| Brachytherapy
87
Hormonal therapy for breast cancer
- Estrogen and progest assay receptor
- Selective estrogen receptor modulators - tamoxifen
- Aromatase inhibitors- anastrazole, lestrozole, exemestane
88
Targeted therapy for breast cancer
Seeds
89
Potential complications of breast surgery
Lymph edema
Hematoma, seroma formation
Infection
90
Arm exercise quantity post op
TID X 20 min
91
Benefits of arm exercises
- incr circulation and muscle strength
- prevents stiffness and contractures
- restores ROM
92
Breast drain mgmt
- referral for home care
- removed when < 30 mL drains in a 24 hr period (7-10 days)
- drain site and incision care
