WH Dx 2 Flashcards
breast cancer - breast mass s/sx
hard, immovable, single lesion with irregular borders
breast cancer signs of locally advanced disease
4
- axillary adenopathy
- skin erythema
- skin thickening
- dimpling of overlying skin
breast cancer dx
2
simple cyst
breast adenosis
breast cancer patient education
4
- Can occur when normal cells in the breast change and grow out of control.
- The right treatment will depend in part on the stage of your cancer.
- Make sure to follow all your provider’s instructions about visits, tests, and screening tools.
- Make sure to take care of your emotional health during this time.
breast cancer medication
2
- early stage usually undergo primary surgery (lumpectomy or mastectomy)
- systemic therapy like chemo may be needed
breast cancer test
3
Biopsy is the only definitive Dx:
1. <30 y.o. do an US, then possible biopsy
2. 30-39 breast US, possible biopsy
3. 40 and older do a diagnostic mammogram
breast cancer follow up
In two weeks to go over imaging results and appropriate referrals will be made from there.
Breast cancer red flags
4
- new lumps/mass
- pain in your bones, chest, or stomach
- trouble breathing
- headaches
candida vulvovaginitis risk factors
5
- DM
- antibiotic use
- increased estrogen levels (pregnancy, postmenopausal therapy)
- immunosuppression
- genetics
candida vulvovaginitis s/sx
8
- vulvar itching*
- burning
- soreness
- irritation
- erythema of vulva and vaginal mucosa
- vulva edema
- little or no discharge - may be white, thick, and clumpy
- discharge with none or minimal odor
vaginal itching
candida vulvovaginitis
candida vulvovaginitis dd
2
BV
trichomoniasis
candida vulvovaginitis education
5
- you start to feel better a few days into treatment
- there are risk factors to developing this but some may not be able to be controlled like abx use, hormone changes, and birth control
- avoid soaps and OTC vaginal products as they may irritate the area
- clean with plain water
- dry thoroughly afterward
candida vulvovaginitis med
2
- oral antifungal (non-pregnant)
- vaginal antifungal (pregnant)
candida vulvovaginitis test
vaginal swab to test discharge pH and perform a microscopy
candida vulvovaginitis f/u
not necessary if symptoms resolve
candida vulvovaginitis red flags
5
- worsening of symptoms
- change in discharge such as increase, odor
- recurrent infection
- pelvic pain
- bleeding no associated with menstruation
contraceptive management IUD
2
- LNG IUD - releases progestin daily; last 3-8 years; failure 0.1-0.4%; contraindicated in breast cancer hx, distortion of uterine cavity, and acute pelvic infection
- copper IUD - no hormones; 10 year; failure 0.8%
contraceptive management hormonal methods
6
- implant - rod in upper arm; progestin; 3 years; failure 0.1%
- Injection/shot - progestin in buttock or arm every 3 months; failure 4%
- the pill - combination estrogen-progestin pill, failure rate 7%
- mini pill - progestin only; failure 7%
- Patch - progestin and estrogen; new patch weekly, three weeks on 1 week off; failure 7%
- vaginal ring - progestin and estrogen; 3 weeks on; fail 7%
the pill contraindications
7
- > 35 who smokes
- history of blood clots
- history of breast cancer
- heart disease
- CVD risk factors (older age, DM, obese)
- cirrhosis
- migraines with an aura
mini pill contraindications
4
- known or suspected breast cancer
- undiagnosed uterine bleeding
- benign or malignant liver tumors
- cirrhosis
contraceptive management education
Education will depend on type of BC you choose. Make sure to use barrier protection for the first seven days when starting a new BC. Know that these methods will not protect you from STDs.
contraceptive management test
pregnancy test
contraceptive management f/u
1-3 months to evaluate satisfaction of method, provide support, address concerns, and assess changes in health status.
contraceptive management red flags
5
- fever
- abd pain
- unusual heavy vaginal bleeding
- foul smelling vaginal discharge
- pregnancy-like symptoms
dysfunctional uterine bleeding
abnormal uterine bleeding is bleeding of abnormal quantity, duration, or schedule
bleeding of abnormal quantity, duration, or schedule
dysfunctional uterine bleeding
dysfunctional uterine bleeding dd
4
- STD
- malignancy
- polyps
- uterine fibroids
dysfunctional uterine bleeding education
3
- can be caused by many different conditions
- premenopausal women can have abnormal bleeding from changes in hormone levels, pregnancy, infection and more
- menopausal women can have abnormal bleeding from atrophy of tissue, cancer, structural changes, infection and more
dysfunctional uterine bleeding medications
- Known primary etiology then treat the issue (structural, infection, endocrine, bleeding)
- unknown etiology - combination oral contraceptive or hormonal IUD
dysfunctional uterine bleeding test
6
- urine pregnancy test
- CBC
- coagulation panel
- Pap smear with HPV test
- STD testing
- Pelvic US
dysfunctional uterine bleeding f/u
in two weeks to discuss labs and interventions
dysfunctional uterine bleeding red flags
4
- worsening of sx
- increase in bleeding
- abnormal uterine discharge
- pelvic pain
dysmenorrhea
painful menstruation
painful menstruation
dysmenorrhea
dysmenorrhea risk factors
3
- adolescents
- smoking
- stress
dysmenorrhea s/sx
6
- recurrent cramping of lower abd during menses
- nausea
- diarrhea
- fatigue
- headache
- malaise
pain that begins just prior to or with the onset of menstrual flow and typically resolves within 12-72 hours
dysmenorrhea
dysmenorrhea DD
2
endometriosis
PID
dysmenorrhea education
3
- exercising during this time may help decrease symptoms
- use a heat compress for discomfort
- some dietary changes have shown to help some individuals such as a low fat vegetarian diet
dysmenorrhea meds
NSAIDs first, then hormonal contraception (estrogen-progestin options)
dysmenorrhea test
no lab tests but can r/o STD with testing and urine sample for UTI
dysmenorrhea f/u
After next menstrual period to determine effectiveness
dysmenorrhea red flags
- worsening of symptoms
- bleeding between periods
- change in vaginal discharge such as an odor
