WH Dx 4 Flashcards
interstitial cystitis
an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms for more than 6 weeks in the absence of infection or other identifiable causes
an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms for more than 6 weeks in the absence of infection or other identifiable causes
interstitial cystitis
interstitial cystitis characteristic features
2
- pain associated with bladder filling and relieved by bladder emptying
- pelvic tenderness on exam
pain associated with bladder filling and relieved by bladder emptying and pelvic tenderness on exam
interstitial cystitis
chronic bladder pain in the absence of other etiologies
interstitial cystitis
interstitial cystitis clinical symptoms
4
- urinary urgency
- daytime frequency
- pain
- nocturia
interstitial cystitis pain location
usually suprapubic or urethral
void frequently to avoid discomfort with bladder distention
interstitial cystitis
interstitial cystitis DD
2
UTI
bladder cancer
interstitial cystitis Education
4
- avoid food and drink that trigger symptoms
- avoid activities that make this condition worse
- get treated quickly for bladder infections which can make symptoms worse
- PFPT may help with pelvic floor tenderness
interstitial cystitis meds
2
NSAID
Elmiron (may help repair the lining of the bladder but doesn’t make symptoms go away completely)
interstitial cystitis test
No test - r/o UTI and STD
interstitial cystitis f/u
4 weeks, it may take weeks for Elmiron to start working
interstitial cystitis red flags
4
- worsening symptoms
- hematuria
- incomplete bladder emptying
- urinary incontinence
irregular menstruation - average cycle is
28-35 days with 4-6 days of bleeding
irregular menstruation - do what exam
pelvic exam
irregular menstruation DD
3
pregnancy
STD
fibroids
irregular menstruation Education
4
- A variety of conditions can cause irregular menstruation from hormone changes, pregnancy, infection and more
- report any changes to menstruation
- always use protection when having sex
- get vaccinated for STDs
irregular menstruation medication
with no known etiology - estrogen progestin contraceptives
irregular menstruation test
3
pregnancy
CBC - anemia
STD testing
irregular menstruation f/u
4-6 weeks
irregular menstruation AG
3
- get up to date on vaccines
- get HPV vaccines
- get cervical cancer screening
irregular menstruation red flags
5
- worsening of symptoms
- heavy bleeding > 7 days, passing large clots
- persistent bleeding despite treatment
- change in discharge
- abdominal, pelvic, or vaginal pain
mastitis
inflammation of the breast tissue that may or may not be accompanied with infection
inflammation of the breast tissue that may or may not be accompanied with infection
mastitis
Non-lactating mastitis
2
- periductal mastitis - young women smoking; clinical dx, treat with empiric abx
- IGM - rare benign, young parous women, within 5 years of pregnancy; get US, treat with abx
lactational mastitis is most common when
4-6 weeks into breast feeding
lactational mastitis s/sx
2
localized swelling
redness
infectious lactational mastitis s/sx
7
firm
red
painful
swollen area
possible fever
diminished milk secretion
flu-like sx
inflammation in duct of young smoking women
periductal mastitis
periductal mastitis tx
clinical dx
if there is discharge get culture
empiric abx
IGM mastitis clinical dx based on
solitary peripheral tender inflammatory breast mass
IGM mastitis tx
clinical dx
can get US
biopsy is only definitive dx way
if infection is suspected, drain and tx with abx, send culture
mastitis DD
2
malignancy - breast cancer
galactocele
mastitis education
6
- do frequent, on demand feeding and proper breast technique
- minimize breast pump usage
- drink plenty of water
- wear appropriately fitting bras
- quit smoking
- It is ok to keep feeding your baby on the affect breast
mastitis meds
3
- Ibuprofen or Tylneol (both safe during BF) for pain
- Abx if symptoms persist 24-48 hours after, fever, or systemic symptoms
- choose abx safe for breastfeeding
mastitis f/u
3
- Within the first 24 hours, watch and wait
- If symptoms do not start to improve or they worsen in the first 24 hours then come back in (acute pain, sx > 24 hours, or signs of systemic infection)
- Refer to lactation specialist
mastitis AG
PPD screening
mastitis red flags
3
- worsening of symptoms
- symptoms don’t improve with tx
- signs of severe infection (low BP, tachycardia, fever not controlled by Tylenol)
Menopause
The permanent cessation of menstrual periods, determined after a women experiences 12 months of amenorrhea.
The permanent cessation of menstrual periods, determined after a women experiences 12 months of amenorrhea.
Menopause
Menopause median age
51
Menopause hallmark sx
8
hot flashes
night sweats
new onset depression
sleep disturbances
cognitive changes
headache
joint pain
vaginal dryness
hot flashes
Menopause
Menopause DD
3
hyperthyroid
pregnancy
pheochromocytoma
Menopause education
7
- This is a time in life when periods naturally stop.
- Ovaries stop releasing eggs and stop making the hormones estrogen and progesterone.
- Usually starts 45-55 years
- This can cause osteoporosis
- Protect your bones by taking supplements and being active (calcium, vitamin D)
- For hot flashes - quit smoking, use cold and wet washcloth on neck, keep home at cool temp
- for sleep - get on a sleep schedule, avoid caffeine in the afternoon
Menopause meds
3
- Hormone therapy can help with sx
- If no uterus, estrogen-only therapy
- If there is a uterus, estrogen-progestin therapy to prevent endometrial hyperplasia
Menopause - contraindications to HRT 8
- breast cancer
- heart disease
- prior VTE
- stroke
- active liver disease
- unexplained vaginal bleeding
- endometrial cancer
- TIA
Menopause test
no imaging or test - dx based on no period for 12 months
Menopause f/u
3-4 weeks to check interventions
Menopause AG
3
- Annual mammogram
- colon cancer screening
- get up to date on vaccines
Menopause red flags
2
- worsening of symptoms
- if you start to bleed again, even if it’s just one spot
