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Rheumatoid Arthritis (RA): > reproductive > Flashcards

reproductive Flashcards

1
Q

describe dysfunctional bleeding

A

abnormal uterine bleeding that occurs less than 21 days or >36 days or in
excessive amounts w/clots lasting > 7 days

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2
Q

with dysfunctional bleeding what must be ruled out

A

anatomical endometrial lesion must be ruled out

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3
Q

Ovulatory bleeding

A

Normal variant - “migelschmertz”
Normal (23-39 days {mean 29}, 2-7 days w/most blood loss in 1st few days)
Menorrhagia (normal in timing, excessive in amount &duration)
Intermenstrual (occurs between regular menses)

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4
Q

Ovulatory bleeding causes

A 
fibroids
Ca of the cervix 
endometrial Ca 
polyps, erosions , infection 
foreign bodies
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5
Q

what is anovulatory

A

disturbance w/in hypothalamic- pituitary-ovarian axis

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6
Q

when can you see an anovulatory state

A

Seen typically w/mild dysfunc;on of above w/irregular menses from situa-onal stress, wt. loss, exercise training

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7
Q

PCOs Presents

A

Irregularperiods:oligomenorrhea(<9menses/yr)oramenorrhea(nomensesfor3or
more consecu;ve months) infer;lity

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8
Q

Physical signs of PCOs

A

Hirsutism, obesity, amenorrhea, acne, DUB, Acanthosis Nigricans, HTN

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9
Q

Ovarian androgen overproduc;on is linked to

A

insulin resistance

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10
Q

Complications of PCOs

A

ncreased risk of T2DM r/t obesity, insulin resistance, impaired glucose tolerance,& dyslipidemia predispose to CHD
Nonalcoholic steatohepatitis
Mood disorders (depression & anxiety)

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11
Q

diagnostic test for ovulation evaluation

A

FSH (>40 ovarian failure),
LH, Prolactin,
serum progesterone,
testosterone

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12
Q

S/S of Menorrhagia

A

H/o prolonged heavy menses > 7 days •

Usual cycle interval

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13
Q

S/S Intermentstrual Bleeding:

A

mid cycle bleeding that is unpredictable • Regular ovulatory menses

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14
Q

s/s of Anovulatory Bleeding:

A

Menstruation that occurs without ovulation
Evidence of hyperandrogenemia –
Body build, hair distribution

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15
Q

Diagnostic labs with annovulatory bleeding

A 
evaluation –  
B-hCG
–  CBC
–  Thyroid, prolac;n, cortisol
–  Testosterone
–  Endometrial Bx- >35, severely obese, abn. blg >5 yrs
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16
Q

s/s of Amenorrhea

A

absence of menstrual bleeding

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17
Q

Types of Ammenorrhea

A

Primary-
– No bleeding by the age of 14 in the absence of 2nd sex characteristics

no bleeding by age 16 regardless of the presence of normal G & D w/ 2nd sex characteristics

Secondary- previously menstruating & misses 3 cycles

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18
Q

Primary Ammenorhea is due to

A

result of gene;c disorders or premature loss of follicles

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19
Q

secondary Ammenorhea is due to

A

Secondary- lack of gonadatropin s;mula;on to normal ovaries

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20
Q

ammenorheia is associated with

A

elevated prolactin and galactorrhea.

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21
Q

Menopause is

A

Permanent cessa;on of menstrua;on following the decline of

ovarian estrogen production

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22
Q

Peri-menopause is

A

the period extending from immediately before to after the menopause (45-55 yrs), transi;on lasts 4 years, marked by altered ovarian functi on

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23
Q

S/S of menopause

A

irregular menses, hot flashes, dyspareunia r/t vaginal dryness, night sweats, dry skin or hair, joint stiffness, urinary changes, H/A, irritability, insomnia, depression, loss of sense of well being,

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24
Q

Diagnostic test for menopause is

A 
Pap smear:
–  Endometrial bx
–  Mammogram yearly after 40
–  Cholesterol baseline data rpt q 5 yrs –  BS – baseline data
–  TSH, T4
–  Prolactin , FSH
–  Pregnancy test
–  FOB annual exam for women>40
–  Sigmoidoscopy q 5 yrs after 50
25
Q

vaginal discharge

A

Bacterial vaginosis (BV) (gardnerella) caused by change in normal flora = overgrowth of anaerobic bacteria

26
Q

Candida infections occur when

A 
natural flora (candida albicans
& nonalbicans candida) proliferate
27
Q

Trichomoniasis caused by protozoan trichomonas vaginalis & is considered a

A

a sexually transmitted disease

28
Q

S/S of Bacterial Vaginosis:

A

Increased vaginal discharge, vaginal burning aoer intercourse, strong “fishy” odor, no associated symptoms of inflammation

29
Q

S/S of Candidiasis:

A

C/o itching (severe), burning w/urina;on, dysparuenia or burning w/intercourse, discharge is thick, white & curd-like

30
Q

s/s of Trichomoniasis

A

Foul-smelling yellow-green discharge, external itching,

burning, dyspareunia & postcoital bleeding,

31
Q

what is the incubation period for Trichomoniasis

A

4-28 days average 1 week

32
Q

external genitaila with Trih

A

excoriated,
erythema, edema,
ulcerations,
lesions

33
Q

vaginal mucosa with Trich

A

may notice red papules

34
Q

vaginal mucosa with BV is

A

normal may have coaty white discharge

35
Q

Cervix with Tich is

A

strawberry – like appearance

36
Q

Discharge with Trich is

A

greenish,
yellow,
malodorous,
frothy

37
Q

discharge with BV is

A

grayish,
fishy,
musty odor

38
Q

Discharge with Candidiasis

A

thick,
odorless,
white,
curd-like

39
Q

Vulvovaginitis: Diagnostic Test

A

pH (normal: 3.8 - 4.5)

40
Q

Ph with BV

A

> 4.5

41
Q

Ph with Cadidiasis

A

<4.5

42
Q

Ph withTrich is

A

> 5

43
Q

NS wet mount with candidiasis is

A

negative

44
Q

NS wet mount for BV

A

Clue cells > 20

45
Q

NS wet mount for Trich is

A

highly motile, oval cells

46
Q

KOH for Candidiasis

A

pseudohypae, budding yeast

47
Q

KOH for BV

A

yields + whiff test

48
Q

BV can increase a women susceptibility to

A

other STDs, such as herpes simplex virus (HSV), Chlamydia and gonorrhea
HIV

49
Q

Trich can increase a women susceptibility to

A

HIV

50
Q

Chlamydia:

Definition

A

chlamydia trachoma.s a bacterial agent causing sexually transmiged
disease of the reproductive tract mucous membranes

51
Q

Is Chlamydia reported to the CDC

A

Yes

52
Q

Chlamydia: Pathogen

A

Chlamydia Trachomatis

53
Q

Chamydia complications in men

A

NGU –nongonococcal urethritis

Acute epididymitis, pain, & rare sterility

54
Q

Gonorrhea:

– Diagnostic tests

A

Wet prep : increased WBCs, decreased normal flora

• Gram stain: identification of intracellular gram – diplococci provides immediate dx

55
Q

Balanitis:

A

infection frequent in uncircumcised males Mucocutaneous candidiasis fungal infection

56
Q

inflammation of the urethra not caused by gonococcal infection

A

NGU

Chlamydia trachomatis

57
Q

NGU can lead to

A

Reiter’s syndrome
urethritis
conjunctivitis
lesions of the skin and mucous membranes

58
Q

NGU is the most common

A

STD in men

Rheumatoid Arthritis (RA): (7 decks)

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