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Women's health Flashcards

1
Q

s/s of ectopic pregnancy

A

low back or abd pain/cramping

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2
Q

risk factors for ectopic pregnancy

A

hx of PID, hx of tubal ligation, previous ectopic pregnancy, IUD

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3
Q

hCG levels in ectopic pregnancy

A

rise at the same rate as normal pregnancy but plateau in 4-6 weeks

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4
Q

s/s of breast cancer

A

painless, firm, fixed mass; dimpling of skin (peau d’orange), nipple retraction, clear nipple discharge

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5
Q

risk factors for breast cancer

A

age greater than 50, first degree family hx, early menarche, late menopause, nulliparity, obesity, Jewish

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6
Q

s/s of Paget’s disease (ductal carcinoma)

A

scaly, red rash on the nipple that doesn’t heal; itchy

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7
Q

s/s of inflammatory breast cancer

A

acute onset of red, swollen, warm area in breast of young woman

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8
Q

risk factors for ovarian cancer

A

age greater than 60, hx of breast cancer, family hx

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9
Q

s/s of ovarian cancer

A

bloating, dyspepsia, abdominal pressure/pain, urinary frequency, constipation

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10
Q

Has been shown to decrease risk of ovarian cancer

A

OCP, multiparity, breastfeeding

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11
Q

women with hx of breast cancer have a high risk of

A

ovarian cancer

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12
Q

where the majority of breast cancer is located

A

tail of spence

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13
Q

bright red tissue with an irregular surface on top of the os; common in adolescents

A

cervical ectropion

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14
Q

s/s of uterine fibroids

A

heaving menstrual bleeding, pelvic pain/cramping, spotting

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15
Q

follicular phase (days 1-14)

A

FSH stimulates estrogen production that stimulates the growth of endometrial lining

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16
Q

Ovulatory phase (day 14)

A

LH is secreted

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17
Q

Luteal phase (days 14-18)

A

Progesterone is the predominant hormone that stabilizes the endometrial lining

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18
Q

Menstruation phase

A

If not pregnant, both estrogen and progesterone fall, causing menses

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19
Q

fertile time in a women is

A

5 days before and 1-2 days after ovulation (near day 14)

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20
Q

Menstrual cycle phases

A

follicular phase, ovulatory phase, luteal phase, menstruation

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21
Q

ASCUS result on pap

A

If woman less than 24, repeat pap in 1 year. If woman greater than 24, then order HPV reflex, if positive then colposcopy

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22
Q

monophasic pills (Loestrin 1/20)

A

21 consecutive days of same dose of estrogen and progesterone

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23
Q

Triphasic pills (Ortho Tri-cyclen)

A

21 days of active pills with hormones that vary every week

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24
Q

pills that can be adjunctively used for acne

A

triphasic (Ortho Tri-cyclen)

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25
Q

extended cycle pill (Seasonale)

A

contains 3 months of estrogen/progesterone with 7 day pill-free interval

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26
Q

Uses drospirenone (a spironolactone analog) instead of progestin. Used for women with acne, PCOS, hirsutism, or PMDD

A

Yaz or Yasmin

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27
Q

Yaz/Yasmin have ___ active pills and ___ placebo pills

A

24; 4

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28
Q

Yaz/Yasmin have a high risk of

A

hyperkalemia, DVT

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29
Q

OCP safe for breastfeeding women

A

progestin-only pill (minipill)

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30
Q

absolute contraindications of oral contraceptive pills mneumonic

A 
My CUPLETS
My: migraines with focal neurologic aura
C: CAD or CVA
U: undiagnosed genital bleeding
P: pregnant
L: high LFTs
E: Estrogen-dependent tumor
T: thrombus or emboli
S: smoker age 35 or older
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31
Q

advantage of OCP is a lower risk of

A

endometrial and ovarian cancer

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32
Q

Instructions on starting OCP

A
  1. Take first pill on first Sun of menstrual period
  2. Take the pill on the first day of period
  3. Use back up method for the first 2 weeks of first pack
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33
Q

s/s of endometriosis

A

severe cramping and heavy periods in young women

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34
Q

Education if pissed 2 consecutive days of OCP

A

take 2 today, then 2 tomorrow; use condoms for the rest of the cycle

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35
Q

these drugs can decrease efficacy of OCP

A

anticonvulsants, antifungals, ampicillin, tetracycline, St. john’s wort

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36
Q

administration of morning after pill

A

Effective up to 72 hours after unprotected sex, but most effective if taken within first 24 hours

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37
Q

danger signs of OCP

A 
ACHES:
Abdominal pain;
Chest pain;
Headaches;
Eye problems, change in vision;
Severe leg pain
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38
Q

administration of copper containing IUD

A

Paraguard; effective for up to 10 years; may cause increased bleeding/spotting

39
Q

administration of hormone-containing IUD

A

effective for up to 5 years

40
Q

____, a hormone-containing IUD contains _____

A

Mirena; levonorgestrel

41
Q

contraindications of IUD

A

hx of PID, hx of ectopic pregnancy

42
Q

Education about IUD

A

check for string after each menstrual period

43
Q

Administration of Depo Provera

A

injection every 3 months, start on first 5 days of cycle

44
Q

Education about Depo Provera

A

can cause amenorrhea d/t lack of estrogen; can cause osteoporosis

45
Q

Women should not use Depo Provera if

A

they plan on getting pregnant in the next year as it causes delayed return of fertility

46
Q

black box warning with Depo Provera

A

should not be used for more than 2 years d/t increased risk of osteoporosis

47
Q

contraindication of Depo Provera use

A

anorexia

48
Q

administration of diaphragm

A

Must be used with spermicidal gel; leave in for 6-8 hours after intercourse (can remain for up to 24 hours)

49
Q

Nuvaring contains

A

both estrogen and progesterone

50
Q

Administration of Nuvaring

A

left for 3 weeks, then removed for 1 week.

51
Q

Ortho Evra patch contains

A

both estrogen and progesterone

52
Q

administration of Ortho Evra patch

A

applied once a week for 3 weeks

53
Q

risks with Ortho Evra patch

A

higher risk of VTE d/t high levels of estrogen

54
Q

s/s of too much estrogen

A

nausea, bloating, breast tenderness

55
Q

s/s of too much progestin

A

increased appetite, weight gain, fatigue

56
Q

woman with asymptomatic gonorrhea or chlamydia with a IUD

A

can be treated with IUD in place

57
Q

Implanon/Nexplannon contains

A

progestin

58
Q

Implanon/Nexplannon administration

A

changed every 3 years

59
Q

Education about Implanon/Nexplannon

A

Quick return of fertility after removal.

60
Q

s/s of fibrocystic breasts

A

breast tenderness and lumps that begin up to 2 weeks before period, then goes away once period begins; lumps are symmetrical, tender, mobile, and rubbery.

61
Q

trx for fibrocystic breasts

A

wear bra daily, decrease sodium and caffeine before periods

62
Q

s/s of PCOS

A

hirsutism, irregular periods, acne

63
Q

diagnostics for PCOS

A

LH/FSH greater than 2.5:1; increase in testosterone, prolactin, high fasting glucose; transvaginal US

64
Q

trx for PCOS

A

low dose OCP, spironolactone, Metformin

65
Q

pathophysiology of PCOS

A

high insulin and obesity cause an increase in androgen production and decrease SHBG (bind to and excrete testosterone).

66
Q

risk factors of candida vaginitis

A

diabetics, HIV, steroids, amoxicillin, pregnancy

67
Q

s/s of candida vaginitis

A

white cheese-like discharge, itching and redness

68
Q

diagnostic for candida vaginitis

A

KOH prep, vaginal pH less than 4.5

69
Q

treatment for candida vaginitis

A

diflucan x1, terconazole vaginal cream

70
Q

If patient gets candida from this atbx: ____, recommend to _____

A

amoxicilin; daily yogurt and lactobacillus pill

71
Q

replacement of normal, hydrogen-peroxide Lactobacillus with anaerobic bacteria

A

BV

72
Q

These are NOT considered STDs

A

BV, candida vaginitis

73
Q

s/s of BV

A

fishy vaginal odor after intercourse; milk-coated vaginal walls

74
Q

diagnostics with BV

A

vaginal pH greater than 4.5;
“clue cells” (squamous epithelial cells) on wet mount;
positive “whiff test”

75
Q

trx for BV

A

metronidazole 500 mg bid x 7 days; avoid with alcohol

clindamycin cream x 7 days

76
Q

recurrence of BV

A

common; perform test of cure 2-3 weeks after therapy

77
Q

s/s of trichomoniasis

A

pruritic, red vulvovaginal area; gray/green frothy discharge; strawberry cervix

78
Q

diagnostic for trichomoniasis

A

vaginal pH greater than 4.5; motile, flagellated trichomonads on saline wet mount

79
Q

trx for trichomoniasis

A

metronidazole 2 g PO x 1, treat sexual partners

80
Q

s/s of atrophic vaginitis

A

vaginal dryness, itching, pain with intercourse

81
Q

atrophic vaginitis may cause this to be abnormal

A

pap smear (atrophic changes)

82
Q

trx for atrophic vaginitis

A

estrogen cream; need progesterone supplementation if intact uterus

83
Q

risk of osteopororis

A

postmenopausal women, chronic steroids, autoimmune disorders, low testosterone, hyperthyroidism, alcoholics, smokers

84
Q

perform DEXA scan every

A

every 1-2 years with those on trx; otherwise every 2-5 years

85
Q

trx for osteoporosis

A

weight bearing exercise (walking, jogging, biking, aerobics); calcium with vit D (1200 mg/day) and vitamin D3 (800-1000 IU daily)

86
Q

side effects of biphosphonates

A

PUD, esophagitis

87
Q

biphosphonates

A

Fosamax (alendronate), Actonel (risedronate)

88
Q

administration of biphosphonates

A

take right upon awakening with full glass of water;
wait 30 min before lying down;
do not crush/split tablets;
never take with other meds

89
Q

Evista (raloxifene)

A

SERM for osteoporosis

90
Q

approved for use only after menopause; NOT used to trx menopausal symptoms

A

SERM

91
Q

Hormone replacement therapy increases risk of

A

DVT, heart disease, endometrial cancer

92
Q

Mefenamic acid (Ponstel)

A

NSAID effective for menstrual pain

93
Q

hormone therapy has been approved for

A

trx of vasomotor symptoms, trx of atrophic vaginitis, and prevention of osteoporosis

94
Q

differential diagnosis for women with lower abd pain/cramping

A

IBS, endometriosis, endometrial cancer, ovarian cyst, uterine fibroids, PID

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