Women's health Flashcards

1
Q

The follicular phase is also known as…

A

The proliferative phase. Estrogen is the main hormone during this phase

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2
Q

A 13-year-old is concerned because she has not yet begun to menstruate. Physical examination indicates that the patient is at Sexual Maturity Rating IV and is of average height and weight. What would be the most appropriate response to this patient?

A

“Your development is exactly as expected for your age; you’ll probably begin to have periods within a year.”

At this stage, girls generally have breast development with areola enlargement, and the breasts are nearly adult in size and shape. Additionally, pubic hair becomes more coarse and curly, spreading across the pubic area but not extending to the thighs yet. This is typical development for a 13-year-old female.

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3
Q

A female who is 1 year post menopause presents with fatigue and a 2-week history of moderate vaginal bleeding. Her complete blood count (CBC) reveals low Hgb and Hct. The most appropriate diagnostic procedure to be performed is a/an:

A

Endometrial biopsy.

Performing an endometrial biopsy in a postmenopausal woman with vaginal bleeding is essential to diagnose the underlying cause of the bleeding. This procedure helps in detecting endometrial cancer, identifying precancerous conditions like endometrial hyperplasia, and ruling out benign conditions such as polyps or atrophic changes. Early and accurate diagnosis through an endometrial biopsy allows for timely and appropriate management, which is crucial for improving patient outcomes and ensuring optimal care.

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4
Q

A patient is 28 weeks pregnant and presents with a single episode of vaginal bleeding. Prenatal progress is normal, and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate to determine a diagnosis?

A

Ultrasound is a critical diagnostic tool used to evaluate bleeding during pregnancy. It provides valuable information about the health and development of the pregnancy and helps identify potential causes of bleeding.

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5
Q

Presumptive pregnancy

A

Changes that are experienced by the client that leads to suspicion of pregnancy

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6
Q

Probable pregnancy

A

Changes are seen on physical exam that leads to suspicion of pregnancy

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7
Q

Positive pregnancy

A

Signs that are only explained by pregnancy

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8
Q

Inflammatory breast cancer

A

Acute onset of a red, swollen, and warm area in the breast of a middle-aged woman (median age 59 years) that is rapidly growing.

Symptoms develop quickly.

May have breast tenderness or itching. Can mimic mastitis. Often, there is no distinct lump on the affected breast. The skin may be pitted (peau d’orange) or appear bruised.

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9
Q

Cervical ectropion

A

Bright-red bumpy tissue with an irregular surface on the cervical surface around the os (Figure 17.1). It is a benign finding. It is made up of glandular cells (same cells that are inside the cervical os). It is more friable (bleeds easily) compared with the squamous epithelial cells on the surface of the cervix.

High levels of estrogen cause overgrowth of glandular cells

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10
Q

Treatment for cervical ectropion

A

None required if asymptomatic.

  • Test for gonorrhea and chlaymidia
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11
Q

Follicular phase of menstrual cycles

A

Days 1-14 - Proliferative phase

  • FSH stimulates the maturation of the follicles
  • Estrogen stimulates the development and growth of the endometrial lining
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12
Q

Ovulatory phase of menstrual cycles

A

Day 14
Luteinizing hormone (LH) induces ovulation and the maturation of the dominant follicle on day 14

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13
Q

Luteal Phase (Days 14–28)

A

Progesterone is produced by the corpus luteum and helps to stabilize the endometrial lining.

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14
Q

Menopause

A

The unintentional cessation of menses for 12 consecutive months

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15
Q

Cervical cancer screening

A

Pap only ages 21-29
Pap + HPV age 30-65

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16
Q

ACS-US cells

A

Age 21-24 - repeat PAP 12 months
Age 25-29 - HPV preferred or repeat pap 12 months
Age 30-65 - Cotesting for high-risk HPV. If HPV positive, refer for colposcopy

17
Q

ASC-H cells

A

Definitive atypical cells, may be precancerous. Refer for coloposcopy.

18
Q

High-Grade Squamous Intraepithelial Lesions (HSILS)

A
  • Age 21 to 24 years: Refer for colposcopy.
  • Age 25 years or older: Refer for immediate excisional treatment or colposcopy. It can be done by LEEP (loop electrosurgical excision procedure) with cervical conization or surgery of the cervix.
19
Q

Colposcopy

A

specialized “microscope” used to visualize the cervix, obtain cervical biopsies, and gain access to the cervix during cryotherapy or laser ablative therapy. The diagnostic test for cervical cancer is a biopsy of the cervix, which is obtained during a colposcopy.

20
Q

Tzanck Smear test

A

Used as an adjunct for evaluating herpetic infection (oral, genital, skin). A positive smear will show large abnormal nuclei in squamous epithelial cells. Not commonly used.

21
Q

How long does an IUD work for?

A

Cu-IUD lasts 10 to 12 years.

Mirena (progesterone IUD) lasts 5 years

22
Q

Atrophic Vaginitis

A

lack of estrogen in estrogen-dependent tissue of the urogenital tract; results in atrophic changes in the vulva and vagina of postmenopausal women

vaginal dryness, itching, and pain with sexual intercourse (dyspareunia).

23
Q

Treatment for atrophic vaginitis

A

Initial therapy: Nonhormonal vaginal moisturizers and lubricants

Moderate-to-severe symptoms: Topical conjugated estrogen preferred; it comes in several forms (cream, tablet, capsule, or vaginal ring

24
Q

Treatment for PCOS

A
  • OCs to suppress ovaries.
  • Spironolactone is used to decrease and control hirsutism.
  • Metformin (Glucophage) is used to induce ovulation (if desires pregnancy). Warn reproductive-aged diabetic females (who do not want to become pregnant) to use birth control.
  • Weight loss reduces androgen and insulin levels.
25
Q

Bacterial vaginosis

A

Caused by an overgrowth of anaerobic bacteria in the vagina.

-fish-like vaginal odor that is worse after intercourse
- milky vaginal discharge
- Clue cells: Made up of squamous epithelial cells with a large amount of bacteria coating the surface that obliterates the edges of the squamous epithelial cells

26
Q

Treatment for BV

A

PO or vaginal metronidazole

27
Q

Vulvovaginal Candidiasis s/s

A

White cheese-like (“curd-like”) vaginal discharge accompanied by severe vulvovaginal pruritus, swelling, and redness, pruritis.

Treat with fluconazole, clortrimazole…

28
Q

Treatment for Trichomoniasis

A

Metronidazole (Flagyl) 2 g PO × 1 dose OR 500 mg BID × 7 days

28
Q

Trichomoniasis

A

Unicellular protozoan parasite with flagella that infects genitourinary tissue (both males and females). Infection causes inflammation (pruritus, burning, and irritation) of vagina/urethra

29
Q

S/S trichomoniasis

A

Adult female complains of very pruritic, reddened vulvovaginal area. May complain of dysuria. Copious grayish-green and bubbly vaginal discharge

30
Q
A