LECTURE 46 - preventative care / nonhormonal contraception Flashcards
What are the recommendations for clinical breast exams?
Every 1-3 years for women 25-39 YO
Annually for women 40+ YO
What are the recommendations for mammograms?
Start at age 40-50 & repeat (bi)annually
(continue screening until 75)
HIGH-RISK WOMEN
- start at age 30 & repeat annually
What are the recommendations for pelvic exams?
Not recommended routinely in asymptomatic patients
Recommended to be performed when indicated by PMH / symptoms
SYMPTOMS
- abnormal bleeding
- dyspareunia
- pelvic pain
- sexual dysfunction
- vaginal dryness
- vaginal bulge
- urinary issues
- inability to insert a tampon
What are the recommendations for cervical cancer screening?
Pap smear and/or HPV testing based on age
21-29 YO (with cervix) - pap smear every 3 years
30-65 YO (choose one)
- pap smear every 3 years
- HPV testing every 5 years
- Co-testing (pap & HPV every 5 years)
NO SCREENING
> 65 YO or
Hysterectomy w/ removal of cervix
What are the current recommendations for breast self-exams?
NOT recommended for average-risk women
INSTEAD → breast “self-awareness”, know when something is off
What is considered “high-risk” for mammogram screening recommendations
- BRCA1 or BRCA2 gene mutations
- First-degree relatives w/ breast cancer
Describe HPV
- leading cause of cervical cancer
- most common STI in the US
- testing: swap from the vagina/cervix
- treatment:
can be cleared spontaneously
persistent infarction can lead to genital warts, pre-cancer, or cancer
How can HPV be transmitted?
Anogenital contact
Via oral sex or genital - genital contact
How can HPV be prevented?
Condoms
Limiting number of sex partners
Abstinence
HPV VACCINE !!
List contraindications for the HV vaccine
Hypersensitivity to yeast
Pregnancy
List precautions for the HPV vaccine
Not recommended during moderate - severe acute illness (defer until symptoms resolve)
List adverse reactions that can be caused by the HPV vaccine
Injection site reactions
Dizziness / Fatigue
N/V
Headache
Describe the HPV vaccine schedule for ages 9-14 years
2 dose series (0, 6-12 months)
Describe the HPV vaccine schedule for ages 15+ years
3 dose series (0, 1-2 months, 6 months)
If a person is </= 26 YO & received one dose of the HPV vaccine between 9-14 YO, what additional doses are needed?
1 additional dose
If a person is </= 26 YO & received two doses of the HPV vaccine between 9-14 YO, what additional doses are needed?
no additional doses - series complete
If a person is </= 26 YO & started & did not complete OR did not start the HPV vaccine series by age 15, what additional doses are needed?
3 dose series (0, 1-2 months, 6 months)
If a person is 27-45 YO & initiated but did not complete the HPV vaccine series between 9-14 YO, what additional doses are needed?
2 dose series
List some reasons that patients might want / need to use non-hormonal contraception
- Back-up for hormonal method
- Side effects / contraindications to hormones
- No need for ongoing contraception
- No alteration to the body’s natural menstrual cycle
List the options for non-hormonal contraception
- Behavioral methods
- Barrier methods
- Long-term methods (IUD)
- Sterilization (permanent)
List & describe the different behavioral methods for contraception
CYCLE TRACKING - fertility awareness
- calendar methods
(calendar rhythm, standard days) - cervical mucus methods
- symptothermal methods
List different barrier methods for contraception
male & female condoms
(w/ or w/o spermicide and/or sponge)
List the non-hormonal long-term contraceptive method
copper IUD
List the options for sterilization
Male vasectomy
Tubal ligation
