OB exam 1- Repro Health & Fam 2 Flashcards by Jane Daum

fibrocystic breast changes

thickening of normal breast tissue caused by imbalance in estrogen and progesterone

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fibrocystic breast changes: sx

cyclic pain
tenderness
swelling right before menses

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fibrocystic breast changes: dx

mammography MRI or fine needle aspiration

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fibrocystic breast changes: tx

limit caffeine
decrease sodium
use oral contraceptives

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endometriosis

presence of endometrial tissue outside of uterine cavity d/t an unknown cause but possibly backflow of menstrual flow, inflammation of endometrium or an immune defect

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endometriosis: sx

pelvic pain usually at time of menses

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endometriosis: dx

confirmed by laparoscopy

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endometriosis: tx

surgical removal endometrial tissue, NSAIDS, oral contraceptives

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POS

ovaries enlarged and contain numerous small cysts along outer edge of ovaries d/t unknown cause

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POS: sx

irregular to absent menses
elevated testosterone & androgen levels
obesity
insulin resistance
infertility

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POS: dx

H&P
labs
vaginal US to evaluate uterus and ovaries

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POS: tx

oral contraceptives
glucophage & spironolactone

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toxic shock

a disease of a women in their reproductive years around menses or postpartum caused by toxin released from staph A

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toxic shock: sx

fever
rash on trunk that resembles a sunburn
vomiting
hypotension
inflamed mucus membranes

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toxic shock: dx

elevated BUN, AST, ALT, billi
low platelets

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toxic shock: tx

hospitalization
IVF to maintain BP
abx

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bacterial vaginosis (BV)

decrease in normal vaginal flora cause by overgrowth of bacteria probably d/t douching or frequent sex

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BV: sx

increase amount of thin, watery, whitish/grey fluid w/ fishy smell

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BV: dx

vaginal pH greater then 4.5
slide prep

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BV: tx

flagyl (metronidazole)
clindamycin vaginal cream

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vaginal candidiasis

yeast infection caused by abx, oral contraceptives, immunosuppressants and/or DM

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vaginal candidiasis: sx

thick, curdy vaginal discharge
severe itchy
rash

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vaginal candidiasis: dx

spores under microscope

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vaginal candidiasis: tx

diflucan (fluconazole)
nystatin

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trichomoniasis

STI caused by trichomoniasis vaginalis

trichomoniasis: sx

yellow/green discharge inflammation itching dysuria

trichomoniasis: dx

visualization of organism on microscope slide

trichomoniasis: tx

flagyl (metronidazole) non treatment

chlamydia

the most common STD caused by chlamydia trachomatis

chlamydia: sx

thin, purulent discharge dysuria lower abd pain

chlamydia: dx

lab culture

chlamydia: tx

azithromycin

gonorrhea

STD that increases risk for pelvic inflammatory disease cause by bacteria neisseria gonorrhoeae

gonorrhea: sx

purulent, green/yellowish discharge dysuria vulva swelling

gonorrhea: dx

lab culture

gonorrhea: tx

rocephin (ceftriaxone) + azithromycin

gonorrhea: complication if pregnant and not treated

gonococcal ophthalmia neonatorum **severe eye issues in infants**

herpes

HSV-1: cold sore HSV-2: genital infection caused by herpes simplex virus

herpes: sx

single, blister like vesicle in genital area

herpes: dx

culture of lesion

herpes: tx

no cure acyclovir to help keep virus dormant

syphilis

chronic infection from contact with open wound or acquired congenitally caused by spirochete treponema pallidum

syphilis: sx

chancre than later wart like plaque on vulva fever weight loss malaise

syphilis: dx

blood test VDRL or RPR

syphilis: tx

penicillin

HPV

sexually transmitted through vaginal, oral or anal sex, usual cause of cervical cancer produced by human papillomavirus

HPV: sx

genital warts

HPV: dx

biopsy lesion

HPV: tx

cryotherapy shave excision acid removal

pelvic inflammatory disease (PID)

inflammatory disorder of upper female genitalia, can cause tubal damage and infertility cause by multiple sexual partners, use of IUD, untreated gonorrhea and chlamydia

PID: sx

bilateral, sharp cramping pain, fever, chills, purulent vaginal drainage

PID: dx

cultures CBC VDRL RPR

PID: tx

multiple abx combos

lower UTI

cystitis cause by E.coli, enterococcus or staph

lower UTI: sx

low grade temp hematuria painful urination

lower UTI: dx

urine specimen labs

lower UTI: tx

abx

upper UTI

pyelonephritis caused by lower infection

upper UTI: sx

high temp chills flank pain

upper UTI: dx

urine specimen labs

upper UTI: tx

IVF IV abx pain meds

infertility

unprotected sexual intercourse over a 12 month time period where conception does not occur

secondary infertility

unable to conceive or sustain a pregnancy after 1 or more successful pregnancies

essential components of fertility: female

-favorable cervical mucus -patent tubes w/ normal motility -ovaries that produce and release normal ova -no obstruction between ovary & uterus -favorable endometrium -adequate reproductive hormones

essential components of fertility: male

-normal quality, quantity, and motility of sperm -unobstructed genital tract -normal genital tract secretions -ejaculated sperm able to reach cervix

ways to improve fertility

-no douching or artificial lubricants -retain & avoid leaking sperm for at least 20-30 min after sex -sex every other day during fertile period -decrease anxiety and stress -adequate nutrition

infertility meds

-clomid -progesterone -gonadotropins -parlodel

infertility treatment: therapeutic insemination

donor or husband's sperm deposited at cervical os or uterus mechanically

infertility treatment: in vitro fertilization

egg collected from ovary, fertilized in lab and placed in uterus after embryo development starts

infertility treatment: gamete intrafallopian transfer

egg removed by laparoscopy and placed with sperm, fertilization occurs in fallopian tube and then egg travels to uterus to implant

infertility treatment: zygote intrafallopian transfer

eggs retrieved and incubated with sperm and placed back into fallopian tubes once fertilization occurs

karyotype

pictorial view of chromosomes

phenotype

observable expression of trait

how to write a downs karyotype in words (for a female)

Down Syndrome 47, XX, +21

autosomal dominant inheritance

-affected individual has affected parent -50% chance of passing to child -severity varies from parent to child -need at least one A **affected parent: Aa, non: aa ; child will have it if Aa**

autosomal recessive inheritance

-affected individuals has clinically normal parents but are carries -when both are carries, 25% of passing defect and 50% of being a healthy carrier -need at least two a **carrier parents: Bb ; healthy non carrier: BB, healthy carrier: 50%, disorder: 25%**