Female Repro Flashcards
What two hormones influence Fibroids (Leiomyomas)
Estrogen and progesterone!!!!!!!
What is the MOST COMMON CAUSE of fibroids (Leiomyomas)???????***
dysfunctional uterine BLEEDING!!!!!!!!!!
(Bleeding, bleeding, bleeding!)
How do we prep for Physical exam???
- Comfort and dignity
- Position: Lithotomy position, and feet in stirrup position
- BOWEL PREP
What is the the 3 pelvic exams?
- PAP Smear
- HPV test
- Bimanual and Rectovaginal exam
What is PAP smear and what is the Timing and Frequency for taking the test?????
- Check for cancerous or precancerous cells
- LUBE with WATER ONLY!!!!
1) Timing:- Between periods
- NO SEX 24 HOURS BEFORE
- NO douche, vaginal meds or DEODORANT
2) Frequency: - Starts at age 21, Q3 yrs from 21 to 29 y/o. (earlier than 21 if they’ve been sexually active early)
- From 30-35 y/o, Q3-5 years
- Discharge screening for low risk women at age 65!
What do you LUBE PAP smear with??????
LUBE with WATER only!!!!!!!
What is HPV testing for???
- Cervical cells are collected
- Check for virus associated with CERVICAL CANCER!!!!
What are the Cervical cancer key points???
- Early stage = none
- Late stage: Bleeding, discharge with odor, pain, and pain with sex
- Risk factors:
1) Multiple sex partners
2) Early sexual activity
3) Having sexual transmitted infections
4) Weak immune system
5) Obesity & smoking - Screenings: PAP smear and HPV
Which screenings would you do for cervical cancer patients????
PAP smear and HPV testing!!!
What are the late stage of cervical cancer????
Bleeding, discharge with odor, pain, and pain with sex.
What are the risk factors of cervical cancer????
Risk factors:
1) Multiple sex partners
2) Early sexual activity
3) Having sexual transmitted infections
4) Weak immune system
5) Obesity & smoking
What is Bimanual and Rectovaginal exam???
- Palpating the tubes, vagina, cervix, uterus, and ovaries
- Rectal exam: Older patients & FOBT
- Limitations: the more fat the patient has, the harder it is for surgeon to palpate!
What are the key points for Endometrial Cancer?????
- Manifestations: Post menopausal bleeding, bleeding between periods, & PELVIC pain
- Screenings: Bimanual exam
- Risk factors: Obesity, Older patients, Estrogen exposure, and TAMOXIFEN!!!
- POST EXAM CONSIDERATIONS:
1) provide wipe for cleaning perineum
2) post procedure spotting is normal!!!
3) Follow up for PAP smear and HPV results!
What are post exam considerations for endometrial cancer???
POST EXAM CONSIDERATIONS:
1) provide wipe for cleaning perineum
2) **post procedure spotting is normal!!!
3) Follow up for PAP smear and HPV results!
What happens if after bimanual exam for endometrial cancer the result show dysplasia???
- Repeat PAP testing
- COLPOSCOPY or cone biopsy
- HPV DNA testing, possible surgery!!
What is a medication that is included in the RISK FACTOR of Endometrial cancer????????????
TAMOXIFEN!!!
What are the key points for OVARIAN Cancer?????
- Early stage: None
- Late Stage: Symptoms are vague! “ABBUW”: Abd & pelvic discomfort, back pain, bowel habit change, urinary frequency, weight loss & fatigue!
- NO SCREENING TEST!
- Risk factor:
1) BRCA 1 & 2 mutations
2) Family hx
3) Obesity
4) Older age
5) Estrogen exposure
6) Endometriosis!
What are the late symptoms of OVARIAN cancer????
Symptoms are vague!
“ABBUW”
1. Abd & pelvic discomfort
2. Back pain
3. Bowel habit change
4. Urinary frequency
5. Weight loss & fatigue!
What are the risk factors for endometrial cancer????
Obesity, Older patients, Estrogen exposure, and TAMOXIFEN!!!
What is Dysmenorrhea???
Pain with menstrual cycle
What is the Primary dysmenorrhea? (What IS IT DUE TO?)****
**Cramp due to Prostaglandins and LEUKOtrienes!!!!!!
1. 1/2 women have it, 10% are incapacitated for 1-3 days
2. GI symptoms: N/V, diarrhea, headache
3. WORSEN WITH SMOKING
WHAT IS Secondary Dysmenorrhea????
- Accompanies with Endometriosis, PID, cysts, and Fibroids!!
What is endometriosis???
- Endometrial tissue OUTSIDE of the uterus!
- Implants bleed/spotting when menstruating
- Backflow of the blood
- Trapped blood cause cysts and scars
What are the NON-pharmacological options for dysmenorrhea???
- Heat pack on the stomach
- Exercise, Calcium, and Mag
- AVOID Smoking and Alcohol
- Exercise lower back and abdomen
WHAT MEDICATION WOULD YOU GIVE TO SOMEONE WHO HAS DYSMENORRHEA??????
NSAIDS (Ibuprofen and Aspirin)!!!!!!!!!!!!