Week 1 pt 1 Highlights Flashcards
Subspecialties recognized by the American Board of Obstetrics & Gynecology (ABOG) include what?
1) Maternal-fetal medicine
2) Gynecologic oncology
3) Reproductive endocrinology-infertility
4) Female reproductive medicine & reconstructive surgery (aka urogynecology)
1) Obstetrician-gynecologist specialist referred to as _________
2) There’s a ________________ approach
1) OB/GYN
2) Multidisciplinary
List 4 elements of the ethical practices of women’s health
Nonmaleficence, beneficence, autonomy, justice
“Life-course” perspective of women’s health:
1) What does it start with?
2) What does it continue into?
3) What does it provide?
1) Starts with preconception health
2) Throughout pregnancy + during postpartum period
3) A perspective for healthy living
What begins with preconception health?
“Life-course” perspective of women’s health
Genetics likely only responsible for ~_________ of direct causes
~1/3
Barker hypothesis
Adaptive developmental plasticity
Allostasis
These all describe what?
Origin of disease
___________ or conditions during ___________ that account for epigenetic changes may lead to future CVD, obesity, DM, stroke
Perturbations; pregnancy
True or false: A normal pregnancy will not be protective of disease later in life
False; a normal pregnancy may be protective of disease later in life
What health should be a priority to promote a healthy first pregnancy?
Preconception
1) What is the goal of primary prevention? Give an example of this type of prevention
2) Define secondary prevention
1) To eliminate or decrease risk factors for disease
-Immunizations
2) Screening tests for disease in asymptomatic patients
Recommended vaccines for women include HPV vaccine (11-26yo) to prevent what?
Cervical neoplasia & cancer
Who can’t get the HPV vaccine, MMR, or live vaccines in general?
Pregnant women
1) What does secondary prevention involve? (3 things)
2) What are the only effective screening tests for gyn cancers?
3) Are there effective screening tests for ovarian, endometrial, vaginal, or vulvar cancers?
1) Screening, evaluation, & counseling
2) Pap (Papanicolaou) smear [for cervical CA] & mammography for breast CA
3) No
The goal of screening for CA is to detect _____________ disease in healthy, asymptomatic patients to
preclinical
American College of Obstetricians & Gynecologists (ACOG)*
American Cancer Society (ACS)
United States Preventive Services Task Force (USPSTF)
What do these 3 things have in common?
Breast cancer publishers of clinical screening guidelines
What do we use ACOG for?
Breast cancer screening recommendations
What are the 3 major screening exams for women at average risk for breast cancer?
Clinical breast exam, screening mammogram, & patient self-screening
What are the ACOG recommendations for breast cancer screening?
1) Clinical breast exam (CBE):
25-39 years – every 1-3 years
40 years & older – annual
2) Screening mammogram:
40-75 years –screen annually or biennially
Older than 75 years – continue annually or biennially based on shared decision-making
3) Breast self-exam: not universally recommended (breast self-awareness encouraged)
40-75 years: screen annually or biennially for what?
Breast cancer
What is encouraged in lieu of breast self-exam?
Breast self-awareness
HPV is a risk factor for what?
Cervical CA
Pregnant women are screened for what 4 STIs?
“important to know”
HIV, chlamydia, gonorrhea, syphilis
Metabolic disease screening for osteoporosis can be done via ______ testing for all women starting at 65 years (q>2yrs)
BMD
DEXA
1) SD from the mean peak BMD of a normal, young adult population is called what?
2) SD from the mean BMD of a population of the same sex, race, age is what?
3) Normal BMD T-score is what?
1) T score
2) Z score
3) >/= -1
______thyroidism may present in older women as dementia
Hypo
Autonomy also includes the patient’s right to do what?
Refuse care
Informed consent:
1) Derived from what?
2) What cannot be delegated?
3) What must it be?
1) Autonomy
2) Responsibility of performing physician (clinician) to gain informed consent
3) Voluntary
What is the checklist to guide the informed consent process?
1) Plan
2) Reason
3) Expectation
4) Preferences
5) Alternatives
6) Risks
7) Expenses
8) Decision
What 3 things are crucial to patient healthcare enrichment & decreasing potential for litigation?
1) Pt safety
2) Ethical practice
3) Value
What is the goal of culturally competent care?
Everyone afforded the same quality of care no matter where you are from, socioeconomic status, etc.
Care must be ____________ competent and _________- based on women from diverse backgrounds.
culturally; sensitive
What are some limitations of the traditional model of the female sexual response?
1) Women are sexual for many reasons
2) Sexual stimuli are integral to response
3) Phases of desire and arousal overlap
4) Orgasm may not be necessary
5) Outcome may influence motivation
6) Dysfunctions may overlap
__________________ Model includes positive and negative feedback loops of sexual function
Intimacy-based
Physiological components of female sexual response include what? (3 things)
1) Autonomic nervous system (ANS)
2) Positive neurotransmitters
3) Negative neurotransmitters
1) What does female sexual dysfunction include?
2) ~1/3 of women with sexual dysfunction have what?
1) Pain disorders
2) clinically depressed
Medical conditions commonly affecting sexual response are associated with what 2 things?
Loss of adrenal androgen production and/or loss of estrogen production
What are some medical risk factors for female sexual dysfunction? (6)
1) Depression (with or without antidepressants)
2) Breast CA that req. chemo
3) Radical hysterectomy for cervical CA
4) HTN
5) DM
6) Sexual abuse
What are some biological and psychological risk factors for female sexual dysfunction?
1) Healthy pregnancy
2) Complicated pregnancy where intercourse and orgasm are precluded
3) Postpartum considerations
4) Recurrent miscarriage
5) Therapeutic abortion
6) Infertility
7) Perimenopause, natural menopause, and premature menopause
8) OCPs
Screening for Sexual Dysfunction requires what?
Respectful & nonjudgmental approach
1) What should you not do during HPI?
2) Use “_________ ” instead of “husband”
3) Use “______________ ” instead of “intercourse”
1) Don’t make assumptions about partner(s)
2) partner
3) sexual activity
Most common cause of reduced libido is _____________ .
depression
Antidepressants may ___________ libido (side effect).
decrease
