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Maternal Exam 1 > Female Reproductive Conditions > Flashcards

Female Reproductive Conditions Flashcards

1
Q

What is AUB or abnormal uterine bleeding?

Types?

A

It is any type of bleeding that is irregular.

Menorrhagia
Oligomenorrhea
Polymenorrhea
Metrorrhagia/Intermenstrual

Also each issue could be acute or chronic

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2
Q

Menorrhagia

What may be present due to the excessive bleeding?

How much blood is typically lost?

A

Heavy menstrual bleeding or that lasts longer

Clots can be present.

More than 80 ml of blood lost per cycle - need to be screened for anemia

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3
Q

What can Menorrhagia or heavy menstrual bleeding lead to

A

Anemia so check H&H

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4
Q

What causes Menorrhagia or heavy menstrual bleeding

A 
hormone imbalance
disease
neoplasms or tumors
infections
IUD contraception
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5
Q

Oligomenorrhea is what?

Major cause?

A

Not bleeding enough for longer than 35 days OR when there is a decrease in flow at normal intervals

Major cause of Oligomenorrhea is oral contraceptive use since lining doesn’t build up (this isn’t anything unusual tho in this case)

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6
Q

Polymenorrhea

A

Menstrual cycle is shorter & so there’s more bleeding than usual

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7
Q

Metrorrhagia /instrmentrsual

A

spotting in between periods

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8
Q

How will they treat AUB?

A

Treat based on cause and desire to have children

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9
Q

Acute vs chronic bleeding

A

acute - recent

chronic - longer than 6 months

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10
Q

PALM COEIN

A

helps determine if something is structural or nonstructural

P- polyps
A- Adenomyosis
L-Leiomyoma
M- malignancy

C- coagulopathy - van willebrand disease as common cause
O- ovulatory
E- endometrial
I- Iatrogenic 
N- not yet classified
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11
Q

Endometriosis

A

Tissue found outside the uterine cavity

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12
Q

Endometriosis is commonly found where?

Elsewhere?

A

Pelvic cavity and causes pain

peritoneal, bladder, lung, spine, brain, & GI

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13
Q

Endometriosis most common symptom?

other symptoms?

A

Pain increased w menses and is chronic. Chocolate places bleed anywhere they are & the cysts of the tissue swell and become inflamed

dyspareunia (painful intercourse) and abnormal uterine bleeding

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14
Q

etiology of endometriosis?

percentile rate?

A

unknown

effects 10% of women

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15
Q

T/F

Endometriosis doesn’t affect fertility

A

False.
Endometriosis is the leading cause of infertility

In fact, it’ll generally only occur in women who happen to not be able to get pregnant due to association. Women who are able to get pregnant won’t have this

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16
Q

What are menses like with endometriosis?

Any GI issues?

GU?

A

Menses will be abnormal

Diarrhea or constipation

Urinary complaints

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17
Q

How do they diagnose endometriosis?

How is it staged?

A

Look at history and do physical exam of the uterus for nodules
But the gold standard is a Laparoscopy w biopsy

By severity 1-4

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18
Q

Is there a cure for endometriosis?

A

No there is not. Just have to control comfort levels.

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19
Q

T/F

Endometriosis tissue growth can be slowed

A

True! They can do this with medications.

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20
Q

How can you get pregnant with endometriosis?

A

There are treatments but main point is you’ll want to do this as fast as possible

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21
Q

Treatment for endometriosis

Lesions

Hormones

GnRH

IUD

Presacral neurectomy

Hysterectomy

A

Remove lesions

Testosterone/Androgen derivative in order to inhibit endometrial growth
- must be short term

GnRH agonist med to antagonize estrogen
- 6 moths

Use IUD to thicken mucus and atrophy endometrium

Presacral neurectomy but only to relieve pain

Hysterectomy - just remove

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22
Q

What are the chocolate cysts in endometriosis?

A

Old bleeding and endometrial tissue

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23
Q

Pelvic floor relaxation is what?

A

When support structures of bladder fail

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24
Q

Cystocele

A

bladder bulging into uterus

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25
Q

Rectocele

A

Bulge due to rectum wall being weak

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26
Q

Uterine prolapse

A

Uterus drops into vagina canal

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27
Q

Main causes of pelvic floor issues?

A

Age
Chronic cough displacing organs
Constipation
Child birth

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28
Q

Symptoms of pelvic floor issues?

A

Urinary leaks
Constipation
Sexual dysfunction if uterus prolapses

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29
Q

Pelvic floor treatment

A

kegels

topical or systemic estrogen

pessaries

surgery

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30
Q

pessaries

kegels

A

pelvic floor treatment that uses implants in vaginal canal to hold vagina up

kegels are just floor exercises that can be done

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31
Q

Toxic shock syndrome

Can this happen after child birth?

A

staph infection that occurs in childbearing years only during menstruation and is when symptoms develop within 5 days of menses

yes can happen after child birth so wait 6-8 weeks

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32
Q

What was an old cause of TSS?

A

Absorbent tampons but now they’re safer. Just can’t leave them in for that long 3-6 hrs minimum.

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33
Q

Can you wear a tampon if you’ve had TSS before?

A

NOOOO. never wear one again

34
Q

Nurses role in TSS?

A

Prevention and education

35
Q

Symptoms of TSS

A 
High fever
Rash on trunk
Dizzy
Hypertensive 
Slough skin 
Sepsis
Can die
36
Q

How can someone die from TSS?

What organs should you check?

A

The staph infection or bacteria can affect multiple/3 organ systems.
Check liver and kidneys

37
Q

TSS treatment

Meds for TSS?

A

Treat sepsis is first priority
Next, treat symptoms

May need to use aggressive antibiotics

38
Q

Cervical Dysplasia

A

Abnormal cell changes in cervix

Should be smooth and pink

39
Q

Is cervical dysplasia a fast progressing cancer?

A

No, it takes years to develop into cancer.

40
Q

How do they check for cervical dysplasia?

A

Do pap

Will also check for HPV

41
Q

Severe dysplasia of cervix

A

Carcinoma in situ - but it is pre cancerous

42
Q

What will they do next if they find abnormal pap smears?

A

Will probably colposcopy or procedure where they turn abnormal cells white with acidic acid. And then they take a biopsy.

43
Q

What is done in a cervical ECC?

A

Scrape off the abnormal cells

Endocervical procedure

44
Q

LEEP procedure

A

Removal of abnormal cervical cells

Loop Electro surgical incision procedure

45
Q

Cryosurgery of cervix?

A

Freeze off abnormal cervical cells

46
Q

What is the goal of removing any abnormal cells of the cervix?

A

Remove the abnormal cervix, let the cervix reheal, and have abnormal cells go away

47
Q

What is an important thing to make sure cervical dysplasia patients know once they receive treatment?

A

They NEED to follow up. The abnormal cells can regrow.

48
Q

Cervical cancer

A

The true malignancy of the cervix

It is prevented w pap smears though.

49
Q

Leading trigger for cervical cancer?

A

HPV

50
Q

How to prevent cervical cancer?

A 
Delay sex
Have one partner
Don't smoke
Increase folic acid in diet 
vaccination
51
Q

HPV vaccine name

high risk hpvs strains

A

Gardasil or Cervarix (lasts 6-8 years)

6
11
16
18 
are all high risk
52
Q

High risk hpv age group

symptoms?

A

20-50 yrs old

no early symptoms

53
Q

What referral will you get for cancer?

A

oncology

54
Q

Benign growths of the uterus

A

Uterine fibroids (leiomyomas)

55
Q

T/F

Second leading cause of GYN surgery

A

False.

It is actually the first leading cause

56
Q

risk factors for uterine fibroids

A

women of color

obesity

57
Q

Uterine fibroid symptoms

A

abnormal bleeding

pain in lower regions such as bladder, bowel, abdomen due to displacement of tissues

58
Q

Do all uterine fibroids need treatment?

A

No not small ones. If they’re large enough then you may want them removed because they can cause pregnancy complications
They’ll also shrink after menopause bc they are estrogen dependent

59
Q

How will they treat uterine fibroids if needed?

A

Will do myomectomy or just remove the muscle myometrium

uterine artery ablation or cut off blood supply (good for people who don’t want to get pregnant)

Hysterectomy (also good for those who dont want pregnancy)

hormones

nsaids for pain

iron for anemia

60
Q

Where can uterine fibroids be located?

A

anywhere surrounding the uterus

61
Q

What is Uterine Cancer?

A

Endometrial cancer or cancer of the inner lining of the uterus

62
Q

What age group is this the most common cancer for

A

50-70

So if these women are post-menopasul and then start bleeding – this is a bad indication but can be ok if found early

63
Q

What are other risk factors of uterine cancer

A 
obesity
high fat diet
infertility
nulliparity
diabetes
late onset menopause
family hx 
use of unopposed estrogen or without progesterone
64
Q

symptoms of uterine cancer

A

post menopausal bleeding

65
Q

Testing and treatment for uterine cancer of endometrium

A

uterine ultrasound to measure thickness of lining
(if its getting thicker or bigger than 4 mm - bad sign)

biopsy for office procedure but can miss stuff

D&C - remove the whole lining and make sure they get it all

hysterectomy of varying degrees

66
Q

What is polycystic ovarian syndrome?

Hormones?

A

Endocrine disorder known as PCOS that throws your hormones out of whack

High estrogen, testosterone and LH

Low FSH

67
Q

Symptoms of PCOS?

A

irregular menses or amenhorrea

androgen excess so more hair, acne, deep voice

insulin resistance

infertility

obesity

68
Q

PCOS management

A

Using BC or progesterone to control menses

Anti-androgens - Spironolactone treats androgen excess

Metformin/glucophage - inhibits glucose production and improve uptake in order to better regulate endocrine system

69
Q

What is the nursing role in PCOS

A

1 encourage follow up and long term care

educate
Help women w body image
Refer to support groups

70
Q

Ovarian Masses

Types?

A

felt on abdominal exam and palpitation & are benign

Ovarian cyst or fluid filled

Demoid cyst or dermoid material like bones and hair and stuff

Endometriosis or chocolate cysts

71
Q

Are most cysts benign or cancerous

A

benign

72
Q

For any benign mass what do we need to rule out before we agree it is an ovarian cyst?

A

Ecoptic or tubal pregnancy
Infection
Appendicitis

73
Q

How long do we observe an ovarian cyst for?

What if it grows to be bigger than 7cm?

A

1-2 months but most will disappear

Will do laparoscope or laparotomy

74
Q

Can you get pregnant w one ovary?

A

Yes

75
Q

Ovarian cancer . how fatal?

risk factor

A

Cancer of ovaries and is most fatal female cancer - bc it is difficult to diagnose

family history and advancing age

76
Q

Ovarian cancer symptoms

A

Bloating, increased abdomen girth, pelvic pain, can’t eat very much

77
Q

What other cancers does ovarian cancer increase

A

breast cancer

78
Q

How we diagnose ovarian cancer

A

hx
physical
abdominal exam + sonogram

79
Q

Treatment for ovarian cancer

A

surgical laparoscope
radical hysterectomy
relatively poor prognosis

80
Q

If a woman is passed menopause and there’s a mass on the ovary what is it?

A

It is cancer bc cysts don’t grow if you don’t have access to estrogen

81
Q

Procedures for ovarian cancer

A

Hysterectomy or radical

Salpingectomy or removal of tubes

Oophorectomy or removal of ovary

Maternal Exam 1 (9 decks)

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