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WH Dx 4 Flashcards

1
Q

interstitial cystitis

A

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

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2
Q

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

A

interstitial cystitis

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3
Q

interstitial cystitis characteristic features
2

A
  1. pain associated with bladder filling and relieved by bladder emptying
  2. pelvic tenderness on exam
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4
Q

pain associated with bladder filling and relieved by bladder emptying and pelvic tenderness on exam

A

interstitial cystitis

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5
Q

chronic bladder pain in the absence of other etiologies

A

interstitial cystitis

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6
Q

interstitial cystitis clinical symptoms
4

A
  1. urinary urgency
  2. daytime frequency
  3. pain
  4. nocturia
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7
Q

interstitial cystitis pain location

A

usually suprapubic or urethral

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8
Q

void frequently to avoid discomfort with bladder distention

A

interstitial cystitis

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9
Q

interstitial cystitis DD
2

A

UTI
bladder cancer

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10
Q

interstitial cystitis Education
4

A
  1. avoid food and drink that trigger symptoms
  2. avoid activities that make this condition worse
  3. get treated quickly for bladder infections which can make symptoms worse
  4. PFPT may help with pelvic floor tenderness
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11
Q

interstitial cystitis meds
2

A

NSAID
Elmiron (may help repair the lining of the bladder but doesn’t make symptoms go away completely)

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12
Q

interstitial cystitis test

A

No test - r/o UTI and STD

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13
Q

interstitial cystitis f/u

A

4 weeks, it may take weeks for Elmiron to start working

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14
Q

interstitial cystitis red flags
4

A
  1. worsening symptoms
  2. hematuria
  3. incomplete bladder emptying
  4. urinary incontinence
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15
Q

irregular menstruation - average cycle is

A

28-35 days with 4-6 days of bleeding

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16
Q

irregular menstruation - do what exam

A

pelvic exam

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17
Q

irregular menstruation DD
3

A

pregnancy
STD
fibroids

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18
Q

irregular menstruation Education
4

A
  1. A variety of conditions can cause irregular menstruation from hormone changes, pregnancy, infection and more
  2. report any changes to menstruation
  3. always use protection when having sex
  4. get vaccinated for STDs
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19
Q

irregular menstruation medication

A

with no known etiology - estrogen progestin contraceptives

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20
Q

irregular menstruation test
3

A

pregnancy
CBC - anemia
STD testing

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21
Q

irregular menstruation f/u

22
Q

irregular menstruation AG
3

A
  1. get up to date on vaccines
  2. get HPV vaccines
  3. get cervical cancer screening
23
Q

irregular menstruation red flags
5

A
  1. worsening of symptoms
  2. heavy bleeding > 7 days, passing large clots
  3. persistent bleeding despite treatment
  4. change in discharge
  5. abdominal, pelvic, or vaginal pain
24
Q

mastitis

A

inflammation of the breast tissue that may or may not be accompanied with infection

25
inflammation of the breast tissue that may or may not be accompanied with infection
mastitis
26
Non-lactating mastitis 2
1. periductal mastitis - young women smoking; clinical dx, treat with empiric abx 2. IGM - rare benign, young parous women, within 5 years of pregnancy; get US, treat with abx
27
lactational mastitis is most common when
4-6 weeks into breast feeding
28
lactational mastitis s/sx 2
localized swelling redness
29
infectious lactational mastitis s/sx 7
firm red painful swollen area possible fever diminished milk secretion flu-like sx
30
inflammation in duct of young smoking women
periductal mastitis
31
periductal mastitis tx
clinical dx if there is discharge get culture empiric abx
32
IGM mastitis clinical dx based on
solitary peripheral tender inflammatory breast mass
33
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
34
mastitis DD 2
malignancy - breast cancer galactocele
35
mastitis education 6
1. do frequent, on demand feeding and proper breast technique 2. minimize breast pump usage 3. drink plenty of water 4. wear appropriately fitting bras 5. quit smoking 6. It is ok to keep feeding your baby on the affect breast
36
mastitis meds 3
1. Ibuprofen or Tylneol (both safe during BF) for pain 2. Abx if symptoms persist 24-48 hours after, fever, or systemic symptoms 3. choose abx safe for breastfeeding
37
mastitis f/u 3
1. Within the first 24 hours, watch and wait 2. 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) 3. Refer to lactation specialist
38
mastitis AG
PPD screening
39
mastitis red flags 3
1. worsening of symptoms 2. symptoms don't improve with tx 3. signs of severe infection (low BP, tachycardia, fever not controlled by Tylenol)
40
Menopause
The permanent cessation of menstrual periods, determined after a women experiences 12 months of amenorrhea.
41
The permanent cessation of menstrual periods, determined after a women experiences 12 months of amenorrhea.
Menopause
42
Menopause median age
51
43
Menopause hallmark sx 8
hot flashes night sweats new onset depression sleep disturbances cognitive changes headache joint pain vaginal dryness
44
hot flashes
Menopause
45
Menopause DD 3
hyperthyroid pregnancy pheochromocytoma
46
Menopause education 7
1. This is a time in life when periods naturally stop. 2. Ovaries stop releasing eggs and stop making the hormones estrogen and progesterone. 3. Usually starts 45-55 years 4. This can cause osteoporosis 5. Protect your bones by taking supplements and being active (calcium, vitamin D) 6. For hot flashes - quit smoking, use cold and wet washcloth on neck, keep home at cool temp 7. for sleep - get on a sleep schedule, avoid caffeine in the afternoon
47
Menopause meds 3
1. Hormone therapy can help with sx 2. If no uterus, estrogen-only therapy 3. If there is a uterus, estrogen-progestin therapy to prevent endometrial hyperplasia
48
Menopause - contraindications to HRT 8
1. breast cancer 2. heart disease 3. prior VTE 4. stroke 5. active liver disease 6. unexplained vaginal bleeding 7. endometrial cancer 8. TIA
49
Menopause test
no imaging or test - dx based on no period for 12 months
50
Menopause f/u
3-4 weeks to check interventions
51
Menopause AG 3
1. Annual mammogram 2. colon cancer screening 3. get up to date on vaccines
52
Menopause red flags 2
1. worsening of symptoms 2. if you start to bleed again, even if it's just one spot

OSCI (20 decks)

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