Gynecology Flashcards
gynecology
the branch of medicine that deals with the health maintenance and the diseases of women, primarily of the reproductive organs
obstetrics
the branch of medicine that deals with the care of women throughout pregnancy
most common emergency gynecological complaints
abdominal pain
vaginal bleeding
dysmenorrhea
painful menstruation
dyspareunia
painful sexual intercourse
in the female patient of child bearing age, always document what ?
LMP (last menstrual period)
pain and fever tend to..
increase HR/RR and BP
significant bleeding will cause
increased HR/RR as well as narrowing pulse pressures. (difference between systolic/diastolic). perform a tilt test to assess orthostatic changes.
Pelvic inflammatory disease (PID)
an acute infection of the reproductive organs that can be caused by a bacteria, virus or fungus.
organs most commonly involved in PID are?
uterus, fallopian tubes and ovaries.
most common causes of PID?
gonorrhea (Neisseria gonorrhoeae)
chlamydia (chlamydia tachomatis)
Assessing a patient with PID?
abdominal pain
often diffuse and located in lower abdomen
may be hard to distinguish between PID and appendicitis
pain may intensify before or after menstrual period.
In SEVERE cases - fever, nausea, vomiting, or sepsis.
patients often have foul smelling vaginal discharge, often yellow in colour as well as irregular menses.
ruptured ovarian cyst
cysts are fluid filled pockets. when they rupture they can be the source of abdominal pain.
cystitis
infection of the urinary bladder
dysuria
painful urination often associated with cystitis
mittelschmerz
abdominal pain associated with ovulation
endometrititis
infection of the endometrium
miscarriage
commonly used term to describes a pregnancy that ends before 20 weeks gestation; may also be called spontaneous abortion
endometriosis
conditon in which endometrial tissue grows outside of the uterus
ectopic pregnancy
the implantation of a developing fetus outside of the uterus, often in a fallopian tube
treatment for abdominal pain
make patient comfortable
transport
menorrhagia
excessive menstrual flow
most common cause of non traumatic vaginal bleeding is?
spontaneous abortion (miscarriage)
treatment for vaginal bleeding
absorb blood flow, but do not pack the vagina
transport
initiate oxygen therapy and Iv access on the basis of the patient’s condition
why does a ruptured ovarian cyst cause a female pain?
when the cyst ruptures, a small amount of blood is spilled into the abdomen, because blood irritates the peritoneum it can cause abdominal pain and rebound tenderness.
why does cystitis cause pain?
the bladder lies anterior to the reproductive organs and when inflamed caused pain, generally immediately above above the pubis. in untreated the infection can progress into the kidneys
assessing a patient with cystitis
abdominal pain may report urinary frequency pain or burning when they urinate low grade fever **Occasionally urine may be blood tinged
why does mittelschmerz cause pain?
it is thought that the pain is related to peritoneal irritation due to follicle rupture or bleeding at the time of ovulation.
the unilateral lower quadrant pain is usually self-limiting and may be accompanied by mid-cycle spotting.
assessing a patient with mittelschmerz
abdominal pain mid-cycle
may report low grade fever **temp. does however increase when a woman ovulates until onset of Menstrual period.
Signs and symptoms of endometritis
mild to severe lower abdominal pain
bloody, foul-smelling discharge
fever 38.3 - 40
Onset of symptoms are usually 48 - 72 hours after gynecological procedure or miscarriage.
what causes pain in Endometriosis?
tissue responds to hormonal changes associated with the menstrual cycle and thus bleeds in a cyclical manner. this bleeding causes inflammation, scarring of adjacent tissues and the subsequent development of adhesion’s, particular in the pelvic cavity
signs and symptoms of Endometriosis
dull, cramping pelvic pain that is usually related to menstruation.
dyspareunia and abnormal uterine bleeding
painful bowel movements
