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Advanced Health Assessment > module 16 women abnormalities > Flashcards

module 16 women abnormalities Flashcards

1
Q

fibrocystic changes patho

A

benign fluid filled cyst formation caused by ductal enlargement

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2
Q

fibrocystic changes subjective

A

tender and painful breasts and/or palpable lumps that fluctuate with menses
usually worse premenstrually

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3
Q

fibrocystic changes objective

A

round, soft-to-firm, tense, mobile masses with well-delineated borders
usually tender
usually bilateral
multiple or single

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4
Q

fibroadenoma patho

A

benign tumors composed of stromal and epithelial elements that represent a hyperplastic or proliferative process in a single terminal ductal unit

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5
Q

fibroadenoma subjective

A

painless lumps that do not fluctuate with the menstrual cycle
may be asymptomatic with discovery on clinical breast examination or breast imaging

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6
Q

fibroadenoma objective

A

round or discoid, firm, rubbery, mobile masses with well-delineated borders
usually non-tender
usually bilateral
single; may be multiple
biopsy often performed to rule out carcinoma

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7
Q

malignant breast tumors patho

A

ductal carcinoma arises from the epithelial lining of ducts; lobular carcinoma originates in the glandular tissue of the lobules.

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8
Q

malignant breast tumors subjective

A

painless lump, change in size, shape, or contour of breast
axilla may be tender if lymph nodes involved
may be asymptomatic with discovery on clinical breast exam or breast imaging

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9
Q

malignant breast tumors objective

A

may have palpable mass that is usually single, unilateral, irregular, or stellate in shape
poorly delineated borders, fixed, hard or stone-like, non-tender
- breast may have dimpling, retraction, prominent vasculature
- skin may have peau d’orange or thickened appearance
- nipple may be newly inverted or deviate in position

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10
Q

fat necrosis patho

A

benign breast lump occurs as inflammatory response to local injury

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11
Q

fat necrosis subjective

A

hx of trauma to the breast

painless lump

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12
Q

fat necrosis objective

A
  • firm, irregular mass, often appearing as an area of discoloration
  • may mimic breast malignancy on clinical examination or breast imaging, requiring biopsy for diagnosis
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13
Q

intraductal papilloms and papillomatosis patho

A

benign tumors of the subareolar ducts that produce nipple discharge

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14
Q

intraductal papillomas and papillomatosis subjective

A

spontaneous nipple discharge
usually unilateral
usually serous or bloody

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15
Q

intraductal papillomas and papillomatosis objective

A

single-duct unilateral nipple discharge provoked on physical examination
mass behind the nipple may or may not be present
may need excisional biopsy to rule out malignancy

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16
Q

duct ectasia patho

A

benign condition of the subareolar ducts that produces nipple discharge

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17
Q

duct ectasia subjective data

A

spontaneous nipple discharge
discharge often green or brown in color
discharge may be sticky

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18
Q

duct ectasia objective

A

single or multi-ductal discharge provoked on physical examination
mass behind the nipple may or may not be present
breast may or may not be tender
nipple retraction may be present

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19
Q

galactorrhea patho

A

lactation not associated with childbearing

inc. levels of prolactin: disruption of communication between the pituitary and hypothalamus

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20
Q

galactorrhea subjective

A

spontaneous nipple discharge
- bilateral, serous or milky
possible hx:
- amenorrhea, pregnancy, post abortion, hypothyroidism, cushing syndrome, CRF
possible med hx:
- phenothiazines, tricyclic antidepressants, some anti-HTN, estrogens, H2 Rc blockers, marijuana, amphetamines, opiates
possible physiologic hx:
- suckling, stress, dehydration, exercise, nipple stimulation

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21
Q

galactorrhea objective

A

multi-ductal nipple discharge may or may not be provoked on physical examination
no mass

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22
Q

paget disease patho

A

surface manifestation of underlying ductal carcinoma

  • migration of malignant epithelial cells from the intraductal to the nipple skin
  • tumor cells disrupt the epithelial barrier, allowing extracellular fluid to seep out onto the nipple surface
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23
Q

paget disease subjective

A

crustiness of the nipple, areola, and surrounding skin

pruritus of the nipple

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24
Q

paget disease objective

A

red, scaling, crusty patch on the nipple, areola, and surrounding skin
may be unilateral or bilateral
appears eczematous but does not respond to steroids

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25
Q

mastitis patho

A

inflammation and infection of the breast tissue

most common in lactating pts

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26
Q

mastitis subjective

A

sudden onset of swelling, tenderness, redness, and heat in the breast
fever and chills

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27
Q

mastitis objective

A

tender, hard breast mass, with and area of fluctuation, erythema, and heat
may have discharge of pus
underlying pus-filled abscess may impart a bluish tinge to the skin

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28
Q

gynecomastia patho

A

breast enlargement in males
testosterone levels low relative to estrogen
inc. body fat -> inc. estrogen

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29
Q

gynecomastia subjective

A

breast enlargement
med hx:
- estrogens, anti-androgens, anabolic steroids, tricyclid antidepressants, spironolactone, 5a reductase inhibitors, ketoconazole, cimetidine, recreational drugs

30
Q

gynecomastia objective

A

smooth, firm, mobile, tender disk of breast tissue located behind the areola
usually non-tender
may be unilateral or bilateral

31
Q

premature thelarche patho

A

breast enlargement in girls younger than 8

32
Q

premature thelarche subjective

A

breast enlargement

33
Q

premature thelarche objective

A

degree of enlargement: slight to fully developed
usually bilateral
other signs of sexual maturation may be absent

34
Q

premenstrual syndrome patho

A

collection of physical, psychological, and mood symptoms related to the menstrual cycle
- usually begins in late 20’s

35
Q

premenstrual syndrome subjective

A

may include
- breast swelling and tenderness, acne, bloating, wt gain, headache, joint pain, food cravings, irritability, difficulty concentrating, mood swings, crying spells, depression
s/s 5-7 days before menses and subside with onset of menses

36
Q

premenstrual syndrome objective

A

none

dx based on s/s and temporal relationship to menstrual cycle

37
Q

infertility patho

A

inability to conceive over a period of 1 year of unprotected sex

38
Q

infertility subjective

A

unsuccessful attempts to become pregnant

39
Q

infertility objective

A

varies with underlying cause

often no physical findings

40
Q

endometriosis patho

A

the presence and growth of endometrial tissue outside the uterus
- possible retrograde reflux of the menstrual tissue from the fallopian tubes during menstruation

41
Q

endometriosis subjective

A

pelvic pain, dysmenorrhea, heavy or prolonged menstrual flow

42
Q

endometriosis objecitve

A

no findings

bimanual exam: tender nodules may be palpable along the uterosacral ligaments

43
Q

condyloma acuminatum (genital warts) patho

A

warty lesions due to STI with HPV

44
Q

condyloma acuminatum subjective

A

soft, painless, wartlike lesions

hx of sexual contact

45
Q

condyloma acuminatum objective

A

flesh-colored, whitish pink to reddish brown, discrete, soft growths on labia, vestibule or perianal area
lesions may occur singly or in clusters and may enlarge to form cauliflower-like masses

46
Q

molluscum contagiosum patho

A

viral infection of the skin and mucous membranes
- STI in adults, not in children
caused by poxvirus, enters through small breaks in hair follicles

47
Q

molluscum contagiosum subjective

A

painless lesions in genital area

48
Q

molluscum contagiosum objective

A
  • white or flesh-colored dome-shaped papules that are round or oval
  • surface with central umbilication from which thick creamy core can be expressed
  • lesions may last from months to years
49
Q

syphilitic chancre patho

A

skin lesion associated with primary syphilis

  • bacterium Treponema pallidum
  • 2 weeks after exposure
50
Q

syphilitic chancre subjective

A

often no lesion noted, as it may be internal
painless genital ulcer
sexually active

51
Q

syphilitic chancre objective

A

solitary lesion; firm, round, small, painless
indurated borders with a clear base
scrapings from ulcer show spirochetes

52
Q

condyloma latum patho

A

lesions of secondary syphilis

appear 6-12 weeks after infection

53
Q

condyloma latum subjective

A

healed solitary genital lesion

54
Q

condyloma latum objective

A

flat, round, or oval papules coved by a gray exudate

55
Q

genital herpes patho

A

SHI viral infection of the skin and mucosa

- HSV

56
Q

genital herpes subjective

A

painful lesions in the genital area
hx of sexual contact
burning or pain with urination

57
Q

genital herpes objective

A

superficial vesicles in the genital area, internal or external
- may be eroded
initial infection often extensive
- recurrent infection is usually confined to small localized patch

58
Q

inflammation of the bartholin gland patho

A

may be acute of chronic

59
Q

inflammation of the bartholin gland subjective

A

pain and swelling in the groin

60
Q

inflammation of the bartholin gland objective

A

hot, red, tender, fluctuant swelling of the bartholin gland that may drain pus
chronic inflammation results in a non-tender cyst on the labium

61
Q

vaginal carcinoma patho

A

classified according to the type of tissue from which the cancer arises

  • squamous: epithelial lining of vagina
  • adenocarcinoma: glandular tissue
  • melanoma: pigment-producing cells, melanocytes
  • sarcoma: deep in the wall of vagina
62
Q

vaginal carcinoma subjective

A 
abnml vaginal bleeding
difficult of painful urination 
pain with sex
pain in the pelvic area, back, or legs
edema in the legs 
risk factor: exposed in utero to DES
63
Q

vaginal carcinoma objective

A

vaginal discharge, lesions, and masses
melanoma: lower or outer portion of the vagina
tumors vary in size, color, and growth pattern

64
Q

vulvar carcinoma patho

A

classified according to the type of tissue from which the cancer arises

  • squamous: epithelial lining of vagina
  • adenocarcinoma: Bartholin glands, vulvar sweat glands
  • melanoma: pigment-producing cells, melanocytes
  • basal cell: sun-exposed areas, rare
65
Q

vulvar carcinoma subjective

A
  • lump or growth in or on the vulvar area or a patch of skin that is differently textured or colored
  • ulcer persists longer than 1 month
  • bleeding from vulvar area
  • change in appearance of existing mole
  • persistent itching, pain, soreness, or burning
  • painful urination
66
Q

vulvar carcinoma objective

A
  • Squamous: ulcerated or raised lesion on vulva/labia
  • Adenocarcinoma: ulcerated or raised lesion on sides of vaginal opening
  • Melanoma: dark colored lesion most often on clitoris or the labia minora
  • Basal cell: ulcerated lesion
67
Q

physiologic vaginitis

A

subjective: inc. in discharge
objective: clear or mucoid discharge
dx: wet mount, 3-5 WBC; epithelial cells

68
Q

bacterial vaginosis

A

subjective: foul-smelling discharge “fishy”
objective: homogenous thin, white or gray discharge
dx: +KOH “whiff” test, wet mount: + clue cells

69
Q

candida vulvovaginitis

A

subjective: pruritic discharge, labia to thighs
objective: white, curdy discharge. cervix may be red, may have erythema of perineum and thighs
dx: KOH prep: mycelia, budding, branching yeast, pseudohyphae

70
Q

Trichomoniasis

A

subjective: dysuria, dysparenunia w/ severe infection
- watery, foul discharge
objective: profuse, frothy, greenish discharge, red friable cervix with petechiae “strawberry cervix”
dx: wet mount: round or pear-shaped protozoa, motile gyrating flagella

Advanced Health Assessment (57 decks)

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