WH Flashcards
Prolactin
Assess pituitary function
A major endocrine gland. A pea-sized body attached to the base of the brain, the pituitary is important in controlling growth and development and the functioning of the other endocrine glands
Hyperlactinemia may can amenorrhea d/t pituitary tumor
ACOG Pap Recommendations
30-65yo - Pap c HPV q5y or just pap q3y.
*>65yo c hx of 3 consecutive normals AND no abnormals in past 10y AND most recent in last 5y = stop screening
Begin routine HPV screening @21yo
Risk factors for cervical cancer
1 = HPV Infection
Dysmenorrhea
Tx: NSAIS (ibuprofen), exercise, OCPs & high fiber diet
Trichomoniasis
Metronidazole 2g dose ONCE
OR
500mg BID x7d
Bacterial Vaginosis
Metronidazole 500mg PO bid x7
Clindamycin
Biphosphonate
Upright 30min after
Take on empty stomach and wait 1 hour before eating
May cause n, abd pain & loose BMs
Risedronic acid, alendronic acid (fosamax) & ibandronic acid are Biphosphonates used to tx osteoporosis
Concerning breast exam findings
Nontender mass, >2cm, non mobile, irregular borders
Metronidazole can be used to tx
BV, trichomoniasis, giardiasis
Primary amenorrhea
PRIMARY = No menses by 15yo
- r/t anatomical or genetic abnormality
- r/o secondary causes b/f referring to endocrine
SECONDARY = pregnancy test, FSH (primary ovarian insufficiency), TSH, serum prolactin (hyperprolactinemia), physical exam (BMI >30 r/t PCOS; BMI
Pap results that should be referred to a specialist
PCP may monitor:
Atypical squamous cells of undetermined significance
AND
CNI mild dysplasia
Refer to specialist:
CNII moderate dysplasia
AND
CNIII carcinoma in situ
FU abnormal pap in 3-6 months
How to reduce fibrocystic breast changes
Decrease caffeine intake and dietary sodium
Warm compresses
Calcium recommendations
Calcium rich foods
1000mg/day for women ages 50-64 who are on estrogen therapy
1500mg/day for women ages 50-64 who aren’t taking estrogen
1500mg/day for women >65
Leafy greens, dairy, sardines & salmon (oily fish)
Trichomoniasis
BV
Candidiasis
Chlamydia
S/s: dyspareunia, greenish-yellow d/c, strawberry patches on cervix
BV: grayish, watery d/c
Candidiasis: thick white & curdy
Chlamydia: d/c
BB, candidiasis & trichomoniasis may lead to vulvovaginitis
Premenstual syndrome
Vs
Dysmenorrhea
Body aches, breast tenderness & mood swings
HA, back aches & cramping
Menopause
Absence of menses for >12 months
Elevation in FSH and LH indicates woman is approaching menopause
These two hormones are associated with reproduction, stimulation a development & release
Preeclampsia
Risk factors: >40, 20wks, edema, proteinuria, HA, AMS, epigastric pain & visual disturbances
B-methasone injection for fetal lung maturation if delivery
Naegele’s rule
LMP +1 year - 3 months + 7 days
Pregnancy drug categories
Category A: no fetal risk, controlled human studies
Category B: animal studies show no risk, no controlled human studies
Category C: animal studies show fetal risk, no controlled human studies
Category D: positive evidence of human fetal risk
Category X: animal studies demonstrate fetal abnormalities
Nausea
B6 found to reduce nausea
Smaller frequent low fat meals
Placental abruption
Risk factors: smoking, AMA, HTN
Separation of placenta after 20th week
Folic acid
No risk factors= 0.4-0.8 mg daily
*no increased dose d/t smoking, DM, twins
Hx of neural tube defects= 4mg starting 1 month before conception & for at least the first three month gestation
GDM
Screen after 24 wk if no risk factors or 20 weeks if at risk
Risk factors: DM, AMA, hx GDM, obese, at risk ethnicity
Weight gain
25-35lbs c BMI 19-25
15-25lbs c BMI 26-29
15lbs c BMI >29
35-45lbs c BMI
