Reproductive System, Contraceptives, Breast Problems, & Structural Problems (Weeks 12 & 13) Flashcards
Amenorrhea
Chapter 6 - Reproductive System Concerns
Absence of menstration
- excercise & weight factors (anorexia & obesity)
- most commonly due to a pregnancy
Hypogonadotropic Amenorrhea
Chapter 6 - Reproductive System Concerns
Problem in the central hypothalamic-pituitary axis
*
*
Inability to produce FSH & LH
Hypothalamic suppression can be due to:
- stress
- weight loss or strenuous exercise
- eating disorders
- mental illness
Dysmenorrhea
Chapter 6 - Reproductive System Concerns
Painful menstruation
- extended release of prostaglandins (primary dysmenorrhea)
Secondary dysmenorrhea: menstrual pain acquired later in life, usually after age 25
Cyclic Perimenstrual Pain and Discomfort (CPPD)
Chapter 6 - Reproductive System Concerns
symptoms that occur during the menstrual cycle
Symptoms can include:
* mood swings
* pelvic pain
* physical discomfort
can occur for 1-2 days or last up to 2 weeks
Premenstrual Syndrome (PMS)
Chapter 6 - Reproductive System Concerns
Cluster of physical, psychological, & behavioral symptoms
- cyclic symptoms occuring in luteal phase
Premenstrual Dysphoric Disorder (PMDD)
Chapter 6 - Reproductive System Concerns
Severe variant of PMS
Endometriosis
Chapter 6 - Reproductive System Concerns
Presence & growth of endometrial tissue outside of the uterus
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*
Symptoms:
* retrograde menstruation
* pelvic heaviness
* deep pelvic pain
* pain radiating to thighs
* pain with exercise
* painful intercourse
* dysmenorrhea
retrograde menstruation: period flows upward through the fallopian tubes & into the pelvis, instead of it flowing out of the vagina
Oligomenorrhea
Chapter 6 - Reproductive System Concerns
infrequent menstruation
Hypomenorrhea
Chapter 6 - Reproductive System Concerns
scant menstruation
Menorrhagia (hypermenorrhea)
Chapter 6 - Reproductive System Concerns
excessive menstrual bleeding
Metrorrhagia
Chapter 6 - Reproductive System Concerns
Abnormal bleeding that occurs between periods
* may occur every few weeks & flow may be heavier than usual
Abnormal Uterine Bleeding (AUB)
Chapter 6 - Reproductive System Concerns
any form of uterine bleeding that is irregular in amount, duration, or timing, & is not related to regular menstrual bleeding
* defined as menstrual blood loss of 80 mL or greater
Menopause
Chapter 6 - Reproductive System Concerns
Cessation of menses for (at least) 1 year
*
* average age = 42-58 years old
Physiological Characteristics:
* anovulation occurs more frequently
* menstrual cycles increase in length
* ovarian follicles become less sensitive to hormonal stimulation
* ovulation occurs with less frequency
* progesterone is not produced
* FSH values are elevated
Perimenopausal Peirod
Chapter 6 - Reproductive System Concerns
Time prior to menopause
Signs & Symptoms:
* bleeding
* hot flashes (vasomotor instability)
* mood / behavioral changes
Increased risk of: osteoporosis & CAD
Tx = menopausal hormonal therapy (MHT)
What is endometriosis characterized by?
Key Points - KNOW THIS!!!!!
Chapter 6 - Reproductive System Concerns
- secondary amenorrhea
- dyspareunia (painful intercourse before, during, or after sex)
- abnormal uterine bleeding
- infertility
Osteoporosis
Key Point
Chapter 6 - Reproductive System Concerns
progressive loss of bone mass due to decreasing levels of estrogen after menopause
- can be prevented or minimized with lifestyle changes & medication
Why are postmenopausal women at increased risk for coronary artery disease (CAD)?
Key Points
Chapter 6 - Reproductive System Concerns
due to changes in lipid metabolism
A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse & has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to which of the following?
a.) Endometriosis
b.) Premenstrual syndrome (PMS)
c.) Primary dysmenorrhea
d.) Cyclic Perimenstrual Pain and Discomfort (CPPD)
Chapter 6 - Reproductive System Concerns
a.) Endometriosis
Contraception
Contraception Lecture
The intervention of pregnancy during sexual intercourse
BRAIDED mnemonic for Contraception
Contraception Lecture
Benefits
Risks
Alternatives
Inquires
Decisions
Explanations
Documentation
Coitus Interruptus
Contraception Lecture
Pull out method
- 80% effective
Fertility Awareness Based Methods (FABs)
Contraception Lecture
Calendar based birth control
- natrual family planning
- Rely on avoidance of vaginal penetrative intercourse during a woman’s fertile periods
Spermicide
Contraception Lecture
Agent that kills sperm
Barrier Methods
Contraception Lecture
Contraceptive methods that block the meeting of egg & sperm by means of a physical barrier
- Male condoms (external)
- Female condoms (internal)
- Diaphragm
- Cervical caps
Hormonal Methods
Contraception Lecture
estrogen-progesterone contraception (combined / CHCs)
- protects against ovarian & endometrial cancer
- Side Effects: stroke, MI, VTE, HTN
- Types: rings, patches, etc.
2 Categories:
1.) Progestin-Only Contraceptives
2.) Combined Hormonal Contraceptives (CHCs)
ACHES
Contraception Lecture
Side Effects of CHC Birth Control
Abdominal pain
Chest pain
Headaches
Eye problems
Severe leg pain
Progestin-Only Contraceptives
Contraception Lecture
mini-pills
* avoid estrogen-related side effects
- Also have injectables (most affective) & implantable devices
Who cannot use Combined hormonal contraceptives (CHCs) / who are they “ruled out” for?
Contraception Lecture
- smokers over age 35
- hx of blood clots
- migraine with aura
Emergency Contraception (EC)
Contraception Lecture
- Plan B
- One Step
- Copper IUD
- Ella by prescription
Intrauterine Devices (IUDs)
Contraception Lecture
Small, T-shaped plastic device inserted & left inside the uterus to prevent pregnancy for 5-10 years
*
*
Symptoms:
* pains, flu-like symptoms, period cessation
Sterilization
Contraception Lecture
Tubal occlusion / reconstruction, vasectomy
Lactational Amenorrhea Method (LAM)
Contraception Lecture
Breastfeeding 6 months postpartum
- increases hormones from strictly breastfeeding
What are the 4 categories of contraceptives?
Contraception Lecture
1.) “Lifestyle” Methods
* Coitus interruptus (pull-out method)
* Abstinence
* Lactational amenorrhea method (LAM)
2.) “Fertility Awareness” Methods
* Calendar-based methods
* Cervical mucus ovulation detection method
* Basal body temperature (BBT) method
* Symptothermal method (combines first 3)
* Biological marker method (home ovulation kits)
* Phone apps for fertility awareness methods
3.) Barriers & Spermicides
* Spermicides (Nonoxynol-9 / N-9)
* Male Condoms (“external”)
* Female Condoms (“internal”)
* Diaphragm
* Cervical caps
4.) Hormonal Methods
* Progestin-only contraceptives
* Combined Hormonal Contraceptives (CHCs)
5.) Intrauterine Devices (IUDs)
* Non-hormonal (copper IUD)
* Hormonal (progestin/progesterone IUD)
Combined Hormonal Contraceptives (CHCs) include:
* Pills
* Transdermal Contraceptive (“Patch”)
* Vaginal Ring
Progestin Only Contraceptives include:
* “mini-pill”
* Injectable – “Depo shot”
* Implantable – nexplanon
How does a progestin (progesterone) containing contraceptive prevent pregnancy?
KNOW THIS!!!! (3 ways)
Contraception Lecture
1.) Thickens cervical walls
2.) Thins uterine lining
3.) Stops ovulation
Induced abortion
Contraception Lecture
Purposeful interruption of pregnancy before 20 weeks gestation
Aspiration – 1st trimester
* methotrexate / misoprostol
Dilation & Evaccuation – 2nd trimester
- Teaching: bleeding (heavy period), fever, foul smell, abdominal tenderness
What are the different types of induced abortion during the 1st and 2nd trimester?
Contraception Lecture
1st Trimester = aspiration
* methotrexate / misoprostol
2nd Trimester = dilation & evaccuation (D&E)
Teachings:
* bleeding (heavy period)
* fever
* foul smell
* abdominal tenderness
Micromastia
Chapter 10 - Breast Problems
Underdevelopment of breast tissue
Macromastia
Chapter 10 - Breast Problems
Abnormally large breasts
- also called hypermastia
- surgical management can impact breast feeding
Fibrotic Changes
Chapter 10 - Breast Problems
Benign fluid-filled cyst formation caused by ductal enlargement
Fibroadenoma
Chapter 10 - Breast Problems
Benign breast mass
Mammary Duct Ectasia
Chapter 10 - Breast Problems
Benign, but sometimes painful condition of dilated ducts with surrounding inflammation, sometimes associated with masses
Breast Cancer
Chapter 10 - Breast Problems
Malignant tumor of the breast
- 50% genetic
- 3 subtypes
- TMN grading
- Tx: surgery, radiation, chemotherapy
TNM Grading System
KNOW THIS!!!!!!
Chapter 10 - Breast Problems
- T – tumor spread
- N – node involvement
- M – presence of distant metastasis
Cystocele
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Protrusion of the bladder** downward into the vagina**
Rectoele
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Herniation of the anterior rectal wall
- budlge in the vagina
Uterine Displacement
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Variation in normal uterine placement
What are the 2 types of uterine displacement?
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
- Retroversion = posterior placement of the uterus
- Retroflexion = anterior placement of the uterus
Ovarian Cysts
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Develop due to hormonal influences associated wtih menstrual cycle
Uterine Polyps
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Overgrowth of uterine tissue into the endometrial cavity
- endometrial or cervical in origin
- tumors on pedicles (stalks) arising from the mucosa
- common in multiparous women & 40+ years
Leiomyomas
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Benign tumors of the uterus; slow-growing & shrink after menopause
- fibroids
- Tx: medications, uterine artery embolization (UAE), surgery
Bartholin Cysts
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
Benign cysts lesions of the vulva; caused by obstruction
Endometrial Cancer
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
- most common malignancy of reproductive system
- slow growing
- hormone imbalance = significant risk factor
CARDINAL SIGN = abnormal uterine bleeding;
- late signs: mucosanguineous vaginal discharge, low back pain, & low pelvic pain
Ovarian Cancer
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
- 2nd most common type of reproductive cancer
- common in north american, european, & older women (60+)
- Risk Factors: nulliparity (no kids), infertility, previous breast cancer, family hx of breast or ovarian cancer
Vague Symptoms
* abdominal bloating
* increased abdominal girth
* pelvic & abdominal pain
* feeling full quickly
* urinary urgency or frequency
Tx: surgery, chemotherapy, radiation
Cervical Cancer
Chapter 11 - Reproductive System Structural Disorders & Neoplasms
- 3rd most common type of reproductive cancer
- 90% caused by HPV
- Most have gradual onset; metastasis common to the pelvis, lungs, & brain
- Invasive Carcinoma Sx = postcoital bleeding (bleeding after sex)
Signs & Symptoms
* abnormal bleeding (postcoital bleeding = bleeding after sex)
* rectal bleeding
* hematuria
* back pain
* leg pain
* anemia
Tx: surgery, radiation, chemotherapy
