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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
Rectocele
Bulge due to rectum wall being weak
26
Uterine prolapse
Uterus drops into vagina canal
27
Main causes of pelvic floor issues?
Age Chronic cough displacing organs Constipation Child birth
28
Symptoms of pelvic floor issues?
Urinary leaks Constipation Sexual dysfunction if uterus prolapses
29
Pelvic floor treatment
kegels topical or systemic estrogen pessaries surgery
30
pessaries kegels
pelvic floor treatment that uses implants in vaginal canal to hold vagina up kegels are just floor exercises that can be done
31
Toxic shock syndrome Can this happen after child birth?
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
32
What was an old cause of TSS?
Absorbent tampons but now they're safer. Just can't leave them in for that long 3-6 hrs minimum.
33
Can you wear a tampon if you've had TSS before?
NOOOO. never wear one again
34
Nurses role in TSS?
Prevention and education
35
Symptoms of TSS
``` High fever Rash on trunk Dizzy Hypertensive Slough skin Sepsis Can die ```
36
How can someone die from TSS? | What organs should you check?
The staph infection or bacteria can affect multiple/3 organ systems. Check liver and kidneys
37
TSS treatment Meds for TSS?
Treat sepsis is first priority Next, treat symptoms May need to use aggressive antibiotics
38
Cervical Dysplasia
Abnormal cell changes in cervix Should be smooth and pink
39
Is cervical dysplasia a fast progressing cancer?
No, it takes years to develop into cancer.
40
How do they check for cervical dysplasia?
Do pap | Will also check for HPV
41
Severe dysplasia of cervix
Carcinoma in situ - but it is pre cancerous
42
What will they do next if they find abnormal pap smears?
Will probably colposcopy or procedure where they turn abnormal cells white with acidic acid. And then they take a biopsy.
43
What is done in a cervical ECC?
Scrape off the abnormal cells Endocervical procedure
44
LEEP procedure
Removal of abnormal cervical cells Loop Electro surgical incision procedure
45
Cryosurgery of cervix?
Freeze off abnormal cervical cells
46
What is the goal of removing any abnormal cells of the cervix?
Remove the abnormal cervix, let the cervix reheal, and have abnormal cells go away
47
What is an important thing to make sure cervical dysplasia patients know once they receive treatment?
They NEED to follow up. The abnormal cells can regrow.
48
Cervical cancer
The true malignancy of the cervix It is prevented w pap smears though.
49
Leading trigger for cervical cancer?
HPV
50
How to prevent cervical cancer?
``` Delay sex Have one partner Don't smoke Increase folic acid in diet vaccination ```
51
HPV vaccine name high risk hpvs strains
Gardasil or Cervarix (lasts 6-8 years) ``` 6 11 16 18 are all high risk ```
52
High risk hpv age group symptoms?
20-50 yrs old no early symptoms
53
What referral will you get for cancer?
oncology
54
Benign growths of the uterus
Uterine fibroids (leiomyomas)
55
T/F | Second leading cause of GYN surgery
False. | It is actually the first leading cause
56
risk factors for uterine fibroids
women of color | obesity
57
Uterine fibroid symptoms
abnormal bleeding | pain in lower regions such as bladder, bowel, abdomen due to displacement of tissues
58
Do all uterine fibroids need treatment?
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
How will they treat uterine fibroids if needed?
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
Where can uterine fibroids be located?
anywhere surrounding the uterus
61
What is Uterine Cancer?
Endometrial cancer or cancer of the inner lining of the uterus
62
What age group is this the most common cancer for
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
What are other risk factors of uterine cancer
``` obesity high fat diet infertility nulliparity diabetes late onset menopause family hx use of unopposed estrogen or without progesterone ```
64
symptoms of uterine cancer
post menopausal bleeding
65
Testing and treatment for uterine cancer of endometrium
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
What is polycystic ovarian syndrome? Hormones?
Endocrine disorder known as PCOS that throws your hormones out of whack High estrogen, testosterone and LH Low FSH
67
Symptoms of PCOS?
irregular menses or amenhorrea androgen excess so more hair, acne, deep voice insulin resistance infertility obesity
68
PCOS management
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
What is the nursing role in PCOS
educate Help women w body image Refer to support groups #1 encourage follow up and long term care
70
Ovarian Masses Types?
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
Are most cysts benign or cancerous
benign
72
For any benign mass what do we need to rule out before we agree it is an ovarian cyst?
Ecoptic or tubal pregnancy Infection Appendicitis
73
How long do we observe an ovarian cyst for? What if it grows to be bigger than 7cm?
1-2 months but most will disappear Will do laparoscope or laparotomy
74
Can you get pregnant w one ovary?
Yes
75
Ovarian cancer . how fatal? risk factor
Cancer of ovaries and is most fatal female cancer - bc it is difficult to diagnose family history and advancing age
76
Ovarian cancer symptoms
Bloating, increased abdomen girth, pelvic pain, can't eat very much
77
What other cancers does ovarian cancer increase
breast cancer
78
How we diagnose ovarian cancer
hx physical abdominal exam + sonogram
79
Treatment for ovarian cancer
surgical laparoscope radical hysterectomy relatively poor prognosis
80
If a woman is passed menopause and there's a mass on the ovary what is it?
It is cancer bc cysts don't grow if you don't have access to estrogen
81
Procedures for ovarian cancer
Hysterectomy or radical Salpingectomy or removal of tubes Oophorectomy or removal of ovary

Maternal Exam 1 (9 decks)

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