WH Dx 5 Flashcards
menorrhagia
heavy or prolonged menstrual bleeding
heavy or prolonged menstrual bleeding
menorrhagia
average length of bleeding
2-7 days
oligomenorrhea
Going longer than 35 days in between periods; < 9 periods a year
menorrhagia
3
prolonged or excessive bleeding
oligomenorrhea
bleeding between cycles
menorrhagia DD
3
uterine fibroids
uterine malignancy
STD
menorrhagia education
3
Many things can cause heavy menstrual bleeding for an ovary not releasing an egg, fibroids, bleeding disorders, and medication side effects.
Depending on the cause there may not be much you can do to reduce your risk of developing this.
You can manage s/sx by resting, wearing comfortable clothing, and keeping sanitary products on you.
menorrhagia meds
2
contraception - the pill or progestin only options
NSAIDs or Tylenol for pain/discomfort
menorrhagia test
3
pregnancy test
CBC
Coagulation panel
pelvic US
menorrhagia f/u
4-6 weeks to assess interventions
menorrhagia red flags
4
- worsening of symptoms
- symptoms don’t improve with treatment
- having to change a pad or tampon every 1-2 hours because it is soaked, large lumps or clots of blood
- change in discharge (consistency, odor)
menorrhagia AG
4
- get STD screening
- STD counseling if sexually active
- Pap smears q3-5 years
- get up to date on vaccines
osteoporosis is characterized by
low bone mass, skeletal fragility, with decreased bone strength and increased risk of fracture
low bone mass, skeletal fragility, with decreased bone strength and increased risk of fracture
osteoporosis
osteoporosis clinical manifestations
usually none until a fracture occurs
osteoporosis - most common fracture
vertebral fracture - symptoms include height loss
Clinical dx of osteoporosis may be made in the presence of
2
- fragility fracture (spine, hip, wrist, humerus, rib, or pelvic
OR - T score less than or equal to -2.5 on BMD measurement by DXA
In the absence of a fragility fracture, what is the standard test to dx osteoporosis
BMD assessment by DXA (should be done on everyone 65 years and older, q2years OR < 65 but past menopause with risk of fracture)
osteoporosis DD
4
- osteomalacia
- malignancy (tumor, met bone disease)
- physical abuse
- fracture unrelated to osteoporosis
osteoporosis education
6
- This is a condition that makes your bones weak.
- To keep bones healthy eat foods high in calcium, vitamin D, or take supplements
- stay active
- quit smoking
- limit alcohol intake
- reduce risk of falls leading to fx - remove rugs, tuck away electrical cords, light up walkways, wear sturdy shoes
osteoporosis meds
Pharmacotherapy is recommend for postmenopausal women with history of fragility fracture or with BMD + scan.
Bisphosphonates are first line therapy
bisphosphonates are first line therapy for
osteoporosis
bisphosphonates are contraindicated in
2
CKD
esophageal disorders
osteoporosis test
4
BMD assessment through DXA scan
Serum labs - calcium, creatinine, vit D
osteoporosis f/u
come back after DXA scan to review results 4-6 weeks
osteoporosis AG
4
- DXA scan q2years
- colon cancer screening
- mammogram
- up to date on vaccines
osteoporosis red flags
5
- worsening of symptoms
- signs and symptoms of a fracture
- increase in the number of fractures
- change in posture
- decreased strength
ovarian cysts
fluid-filled sacs that develop in or on the ovary
fluid-filled sacs that develop in or on the ovary
ovarian cysts
ovarian cysts sx or non-sx?
may be both
ovarian cysts symptoms can include
7
- pelvic pain or pressure
- abdominal fullness or pressure
- GI issues (nausea, vomiting, constipation, bloating)
- difficult or frequent urination
- dysmenorrhea
- fever
- AUB
pelvic pain, abdominal bloating, pelvic pressure
ovarian cysts
ovarian cysts DD
2
PID
endometriosis
ovarian cysts Education
5
- there are fluid filled sacs that develop in or on the ovaries
- the cause depends on if you still have your monthly period
- women with their period causes - ovulation, dermoid cyst, PCOS, endometriosis, pregnancy
- postmenopausal women causes include - noncancerous growths, fluid collection in the ovary, cancer
- exercise, stretch, use heat pads
ovarian cysts meds
2
None - watch and wait as most cysts will go away on their own
NSAIDs or Tylenol for discomfort
ovarian cysts test
3
pregnancy test
CBC
presumptive dx from US
ovarian cysts f/u
2 weeks to discuss US results and check on symptom management
ovarian cysts red flags
3
- worsening of symptoms
- increase in pain or discomfort
- signs of complicated cyst rupture - hypotension, tachycardia, heavy or ongoing blood loss
vaginal dryness with itching
atrophic vaginitis
off-white discharge, foul odor
BV
vaginal itching, burning
candida vulvovaginitis
abdominal pain and pressure, infertility, pelvic pain, vaginal tenderness
endometriosis
movable breast mass
fibroadenoma
discomfort when bladder filling
interstitial cystitis
abdominal fullness, bloating
ovarian cysts
dysmenorrhea, pelvic pressure and pain
ovarian cysts
irregular period, acne
PCOS
hair loss on head, obesity
PCOS
amenorrhea definition
no period for 3 or more months
oligomenorrhea definition
fewer than 9 periods a year
oligomenorrhea, hyperandrogenism
PCOS
