Final Exam - Ch. 27 Flashcards
What are leiomyomas (AUB-L)
Are benign tumors of the uterus – AKA uterine fibroids that are small or huge
What are benign tumors of the uterus called?
Leiomyomas
What can leiomyomas cause?
May cause abnormal, very heavy uterine bleeding, cramping, and pelvic pain or pressure
T/F: Leiomyomas can contribute to infertility.
True. May contribute to subfertility (might get in way of getting pregnancy depending on location, number, size, can make uterus irritated and easy to contract).
What AUB condition can contribute to the following:
- May cause abnormal, very heavy uterine bleeding, cramping, and pelvic pain or pressure
- May contribute to subfertility (might get in way of getting pregnancy depending on location, number, size, can make uterus irritated and easy to contract)
- Small increase to preterm labor risk; antepartum bleeding & placental abruption risk
Leiomyomas
Leiomyomas contribute to what conditions during pregnancy and labor?
Preterm labor
Antepartum bleeding
Placental abruption risk
How are leiomyomas diagnosed?
After report of symptoms, pelvic/abdominal exam & imaging
What are the three treatment options for leiomyomas?
Hormonal contraception
Myomectomy (removing fibroid tumor)
Hysterectomy
What are the causes of postmenstrual, intermenstrual, or heavy menstrual bleeding that are otherwise unexplained.
Malignancies and hyperplasias.
Vaginal bleeding after menopause is a cardinal sign of what?
Endometrial cancer
What are the main risks for developing uterine malignancies and hyperplasia?
Continuous exposure to estrogen unopposed by progestin including obesity, menopause, OCPs (oral contraceptive pills) that don’t have enough progesterone.
What is dysmenorrhea?
Dysmenorrhea is pain with menstruation that limits daily activities and responsibilities (work, exercise, self-care, etc.)
What are the two types of dysmenorrhea?
Primary and secondary
What is primary dysmenorrhea?
Primary dysmenorrhea occurs in the absence of another cause.
Usually begins 2 to 5 years after menarche.
Symptoms include cramps to lower abdomen that may also be felt in the back or thighs, fatigue, headache, diarrhea, nausea, and malaise.
What type of dysmenorrhea occurs in the absence of another cause?
Primary - occurs in the absence of another cause. Usually begins 2 to 5 years after menarche.
What are the symptoms of primary dysmenorrhea?
Cramps to lower abdomen that may also be felt in the back or thighs, fatigue, headache, diarrhea, nausea, and malaise.
What is secondary dysmenorrhea?
Secondary dysmenorrhea symptoms similar symptoms to primary (cramps to lower abdomen that may also be felt in the back or thighs, fatigue, headache, diarrhea, nausea, and malaise) but also an underlying cause such as endometriosis or adenomyosis.
What is adenomyosis?
A condition in which endometrial tissue exists within and grows into the uterine wall.
First line treatment for dysmenorrhea.
First-line treatment: non-steroidal anti-inflammatory meds (NSAIDs) (i.e. ibuprofen) and hormonal contraceptives.
Self-care measures for dysmenorrhea.
Self-care measures include warm packs to the lower abdomen, exercise, and a low-fat or vegetarian diet.
What is endometriosis?
Endometriosis = presence of endometrial tissue outside the uterus; lesions can be found in any organ system, but are most often in the pelvis.
What is retrograde menstruation in endometriosis?
Instead of everything working its way out through the vagina, it works its way out the other end.
What are the symptoms of endometriosis?
Symptoms include dysmenorrhea, dyspareunia (painful sexual intercourse), infertility, pelvic mass, or other pain.
The folllowing symptoms are for what condition?
Dysmenorrhea
Dyspareunia (painful sexual intercourse)
Infertility
Pelvic mass
Endometriosis
What is dyspareunia?
Painful sexual intercourse
What is painful sexual intercourse called?
Dyspareunia
T/F: Endometriosis cannot cause infertility.
False. It may cause infertility or subfertility depending on how bad it is.
What is the definitive diagnosis for endometriosis?
Definitive diagnosis – laparoscopy & tissue biopsy (invasive); visible on imaging.
What is the first-line treatment for endometriosis?
First-line treatment: non-steroidal anti-inflammatory meds (NSAIDs) and hormonal contraception.
For what two conditions are the first-line treatment non-steroidal anti-inflammatory meds (NSAIDs) and hormonal contraception?
Dysmenorrhea and endometriosis.
What is used for the definitive diagnosis for endometriosis?
Laparoscopy for definitive diagnosis and removal of endometrial lesions.
What condition can affect quality of life by increasing fall risk, sexual dysfunction, depression, anxiety, social isolation?
Urinary incontinence.
What are the risks for developing incontinence?
Risks for developing incontinence include aging, past pregnancy, vaginal birth, obesity, high caffeine intake, or family history.
What are stress, urgency and overflow?
3 main types of incontinence.
What is stress incontinence?
Stress incontinence: involuntary leakage due to increased intra-bdominal pressure (such as with sneezing, coughing, exercise).
What is urgency incontinence?
Urgency incontinence: sudden strong urge to void just before involuntary loss of urine control; often referred to as “overactive bladder.”
What type of incontinence is considered “overactive bladder?”
Urgency incontinence which is a sudden strong urge to void just before involuntary loss of urine control.
What is overflow incontinence?
Overflow incontinence may be caused by detrusor muscle underactivity or an obstruction of the bladder outlet (fibroids, pelvic organ prolapse, etc.)
T/F: Treatment for urinary incontinence depends on the type of incontinence and contributing factors.
True
What are the treatments for urinary incontinence?
May include pelvic floor exercises, weight loss, limiting alcohol and caffeine.
Should a person with urinary incontinence cut down on fluid intake?
No. They should avoid dehydration but but avoid fluids that are diuretics.
What is natural menopause?
Natural menopause is achieved when a woman has not menstruated for a full 12 months in the absence of any other reason; typically occurs around age 51 or 52.
At around what age does menopause happen?
Typically occurs around age 51 or 52.
For how long does a woman have to go without a period to be officially in menopause?
1 year.
What is the 4-5 years prior to menopause called?
Perimenopause
What is perimenopause?
The 4-5 years prior to reaching menopause.
What are the symptoms of perimenopause?
Perimenopause symptoms: menstrual irregularities, hot flashes, night sweats, increased anxiety, depression, and insomnia.
What causes vaginal mucosa to become progressively dry and less elastic in perimenopause?
Drop in estrogen levels
As estrogen levels drop in perimenopause, what happens to the vaginal mucosa?
Vaginal mucosa becomes progressively dry and less elastic.
What are the long-term consequences of lower estrogen in menopause?
Long-term consequences of lower estrogen include bone loss, cardiovascular disease & increased risk for falls.
What condition are bone loss, cardiovascular disease & increased risk for falls indicative of?
Menopause
Why is estrogen replacement therapy no longer recommended?
Long-term estrogen replacement therapy is no longer recommended for symptoms due to the risk for breast cancer, cardiovascular disease and osteoporosis.
What is a good indication of when you’ll go through menopause?
When your mother went through menopause.
The majority of breast cancers are discovered how?
Mammogram
When should a woman begin getting mammograms and how often?
Annually after age 40
How is breast cancer diagnosed?
Diagnosed by needle biopsy of the core lesion.
What are the prognosis factors in breast cancer?
Prognostic factors depend on factors such as tumor stage, gene expression, circulating tumor cells, age, race, and smoking status.
These are the prognostic factors of what condition: tumor stage, gene expression, circulating tumor cells, age, race, and smoking status.
Breast cancer
What are the four treatments for breast cancer?
- Surgery (radical mastectomy, modified radical mastectomy, simple mastectomy)
- Chemotherapy
- Radiation therapy
- Hormone therapy
T/F: Many women of reproductive age have fibrocystic breasts that have a ropey, lumpy texture but are considered a risk for breast cancer.
False. Many women of reproductive age have fibrocystic breasts that have a ropey, lumpy texture but are not at risk for breast cancer.
Cervical cancer develops from abnormal changes in cervical cells, often as a result of what?
Human papillomavirus (HPV) infection.
How are abnormal cervical tissue changes diagnosed?
Biopsied and assessed by a pathologist.
What are the treatment options for cervical changes?
Treatment may include cone biopsy, hysterectomy, chemotherapy, or radiation.
Ways to decrease risk of cervical cancer?
- Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer.
- HPV test looks for the virus
- HPV vaccine for those 25 years and younger. Only works if not yet exposed to virus.
- Don’t smoke
- Use a condom
