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Advanced Health Assessment > module 16 women abnormalities 2 > Flashcards

module 16 women abnormalities 2 Flashcards

1
Q

gonorrhea

A
  • subjective: partner with STI, no s/s or s/s of PID
  • objective: purulent discharge from cervix; Skene/Bartholin gland inflammation; cervix and vulva may be inflamed
  • Dx: gram stain, culture, DNA probe
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2
Q

chlamydia

A
  • subjective: often no s/s, spotting after intercourse or urethritis
  • objective: purulent discharge; cervix may or may not be red or friable
  • Dx: DNA probe
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3
Q

atrophic vaginitis

A
  • subjective: dysparenunia, vaginal dryness, peri/postmenopausal
  • objective: pale, thin vaginal mucosa
  • Dx: wet mount: folded, clumped epithelial cells
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4
Q

allergic vaginitis

A
  • subjective: new bubble bath, soap, douche, or other hygiene products
  • objective: foul smell, erythema
  • Dx: wet mount: WBC
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5
Q

foreign body

A
  • subjective: red and swollen vulva, vaginal discharge, hx of use of tampon, condom, diaphragm
  • objective: bloody or foul-smelling discharge
  • Dx: wet mount: WBC
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6
Q

cervical cancer patho

A

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

  • squamous: dysplastic or premalignant lesion at active squamocolumnar junction
  • adenocarcinoma:
    • usually caused by HPV
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7
Q

cervical cancer subjective

A

usually no s/s

may report unexpected vaginal bleeding or spotting

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8
Q

cervical cancer objective

A
  • often no findings on physical exam
  • hard granular surface at or near the cervical os
  • lesion can evolve to form extensive irregular cauliflower growth that bleeds easily
  • early lesions are indistinguishable from ectropion
  • precancerous and early cancer changes detected by pap smear
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9
Q

uterine prolapse patho

A

descent or herniation of the uterus into or beyond the vagina
- weakened supporting structures of the pelvic floor

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10
Q

uterine prolapse subjective

A 
sensation of pelvic heaviness and or uterus follow out
tissue protruding from vagina
urine leakage or urge incontinence
difficulty having a BM 
low back pain
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11
Q

uterine prolapse objective

A

1st degree: cervix remains within the vagina
2nd degree: cervix is at the introitus
3rd degree: cervix and vagina drop outside the introitus

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12
Q

uterine bleeding patho

A

abnormality in menstrual bleeding and inappropriate uterine bleeding are common gynecologic problems

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13
Q

uterine bleeding subjective

A

shortened or lengthened interval between periods
absence of menstruation
normal intervals between periods, inc. or dec. flow, longer duration
irregular intervals between periods with excessive flow and duration
bleeding between periods

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14
Q

uterine bleeding objective

A

dysfunctional: none
endocrinopathies:
- pelvic exam normal, physical findings consistent with endocrine disorder
Coagulopathies:
- findings consistent with specific coagulaopathy
Pregnancy related:
- consistent with stage of pregnancy

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15
Q

myoma (leiomyomas, fibroids) patho

A

common, benign, uterine tumors

- arise from the overgrowth of smooth muscle and connective tissue in the uterus

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16
Q

myoma subjective

A

related to the number of tumors as well as location and size, may include

  • heavy menses
  • abd. cramping usually felt during menstruation
  • urinary freq., urgency, and/or incontinence from pressure on bladder
  • constipation, difficult defecation ,or rectal pain from pressure on the colon
  • generalized pelvic and or lower abd discomfort
17
Q

myomas objective

A

firm, irregular nodules in the contour of the uterus on bimanual exam
uterus may be enlarged

18
Q

endometrial cancer patho

A

most often in postmenopausal pt
cancers of the glandular cells in the lining of the uterus
- inc. risk: pt with uterus taking tamoxifen

19
Q

endometrial cancer subjective

A

postmenopausal vaginal bleeding

- red flag for endometrial cancer

20
Q

endometrial cancer objective

A

none

dx with endometrial biopsy

21
Q

ovarian cyst patho

A

fluid-filled sac in an ovary

  • follicle undergoes varying rates of maturation and cysts can occur
  • > hypothalmaic-pituitary dysfunction, native anatomic defects
22
Q

ovarian cyst subjective

A

usually no s/s
may report lower abd. pain: sharp, intermittent, sudden, and severe
sudden onset of abd. pain suggest cyst rupture

23
Q

ovarian cyst objective

A

pelvic mass may be palpated

cervical motion tenderness may be elicited

24
Q

ovarian cancer patho

A
  • epithelial: arise from a layer of germinal epithelium on the outside of the ovary
  • stromal: from connective tissue cells that help form the structure of the ovary and produce hormones
  • germ cell: from germ cells (produce the egg)
25
Q

ovarian cancer subjective

A

no s/s at first
pt > 40 with persistent and unexplained vague GI s/s
- abd. discomfort, gas, indigestion, pressure, swelling, bloating, cramps, felling full even after a light meal

26
Q

ovarian cancer objective

A

no physical findings

bimanual exam: enlarged ovary in premenopausal pt or a palpable ovary in postmenopausal pt

27
Q

tubal/ectopic pregnancy patho

A

pregnancy occurring outside the uterus

28
Q

tubal pregnancy subjective

A 
abnormal vaginal bleeding
low back pain
mild cramping on one side of the pelvis
pain in lower abd. or pelvic area
if pregnancy ruptures: s/s may worsen 
light-headed/syncope
pain in shoulder area
severe, sharp and sudden pain in lower abd.
29
Q

tubal pregnancy objective

A
  • marked pelvic tenderness, with rigidity of the lower abdomen
  • cervical motion tenderness; tender, unilateral adnexal mass may indicate site of pregnancy
  • tachycardia, hypoTN: reflect hemorrhage of a ruptured pregnancy into the peritoneal cavity
    • surgical emergency
30
Q

PID patho

A

infection of the uterus, fallopian tubes, and the other reproductive organs
- common complication of STI

31
Q

PID subjective

A 
s/s may be mild or absent
vaginal discharge with foul odor
painful intercourse
painful urination
irregular menstrual bleeding 
pain in the upper abdomen
32
Q

PID objective

A

acute PID
- very tender, bilateral adnexal areas
- pt guards and usually cannot tolerate bimanual exam
Chronic PID
- bilateral, tender, irregular, and fairly fixed adnexal areas

33
Q

salpingitis patho

A

inflammation or infection of the fallopian tubes

- often associated with PID

34
Q

salpingitis subjective

A 
lower quadrant pain 
- dull, cramping, worse with motion or sex 
coexisting purulent vaginal discharge
abnormal vaginal bleeding
nausea, vomiting, fever
35
Q

salpingitis objective

A

cervical motion tenderness and/or adnexal tenderness on bimanual exam
mucopurulent cervical discharge

Advanced Health Assessment (57 decks)

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