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Self Care > Women's Health > Flashcards

Women's Health Flashcards

1
Q

Normal vagina

A

In normal mature vagina: 95% of organisms are lactobacillus ( vaginal flora):
-Hello to create an acidic environment PH 4-5
-conversion of glycogen to lactic acid
-acidic environment help to protect the vagina from infection with other bacteria
Vaginal discharge is normal ( increased during pregnancy, ovulation, after menses)

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2
Q

Bacterial Vaginosis

A

Thin, watery, fishy odor, discolored

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3
Q

Trichromoniasis

A

Frothy, copious, malodorous, discolored

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4
Q

Vulvovaginal candidiasis

A

Thick, cottage cheese like, no odor, normal pH

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5
Q

Vulvovaginal disorders

A

Many women who purchased nonprescription anti fungal products to treat vaginal symptoms actually did not have VVC symptoms
Non infectious conditions such as irritation or pruritus caused by allergic runs secondary to douching feminine hygiene products, latex rxns, spermicides or soaps may also add to the conclusion of diagnosis vaginal infection

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6
Q

Inappropriate use of vaginal anti fungal products

A

Unnecessary drugs use
Delay in effective treatment for actual conditions
Cost
Recommended the use of vaginal pH self testing device

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7
Q

VVC ( aka yeast infection)

Infectious agent

A

Candida fungi are the primary causative agent

- Candida albicans

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8
Q

VVC causes

A 
High dose combined oral contraceptives 
Estrogen 
Pregnancy 
Corticosteroids use
Food high in sugar 
Clothing tight fitting, nonabsorbent
Vagisil screening kit is available but has problems:
- vaginal swan to determine pH and pH <4.5 is favorable
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9
Q

Treatment goals for VVC

A

Relief of symptoms
Eradication of the infection
Reestablishment of normal vaginal flora

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10
Q

Uncomplicated VVC

A

May be candidate for self care
Infrequent episodes
Mild-moderate symptoms

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11
Q

Complicated VVC

A

More severe symptoms
Predisposing illness or medications
Recurrent VVC
-at least 4 documented infections/1 year period
- may be early signs of HIV or DM
-more resistant to imidazole anti fungal therapy
Need to be further evaluated by PCR
FDA warnings: symptoms that return within 2 months or infections that do not clear up easily upon treatment require medical evaluation

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12
Q

Exclusions to self care

A

Medically diagnosed with VVC at least once
Younger than 12 years old
Pregnant
Diabetes mellitus
HIV positive or aids
Have impaired immune system, including use of medications that may impair function of the immune system

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13
Q

Nonpharmacologic therapy if VVC

A 
Change diet: decrease sugar 
Life cultures yogurt 
Changing to low dose COC
Talk to md if other med are increasing risk such as antibiotic and immunosuppressants
-do not recommended to stop 
Avoid non absorbent clothing 
Sodium bicarbonate sits bath
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14
Q

Pharmacologic Treatment of VVC

A 
Imidazole: 
- butuconazole
-clotrimazole
-miconazole
-tioconazole
Available as such vaginal creams, suppositories and tablets 
Monistat Vaginal Drug Card
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15
Q

Imidazole MOA

A

Change fungal membrane permeability

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16
Q

Imidazole Treatment

A

1,3 or seven days

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17
Q

Imidazole ADE

A

Burning, Itching Irritation

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18
Q

Imidazole DDI

A

Warfarin
Miconazole
-Check INR

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19
Q

Clotrimazole 1% brand

A

Gyne-lotrimin 7 cream

Mycelex 7 cream

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20
Q

Clotrimazole 1% cream
Clotrimazole 100 mg tablets
Brand

A

Mycelex-7 combination pack

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21
Q

Clotrimazole 1% cream dose

A

Insert cream into vagina Daily for seven days

apply cream to Vulva devise daily for itching

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22
Q

Clotrimazole 1% tablet dosage

A

Insert tablet into vaginal daily for seven days

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23
Q

Clotrimazole 2% Brand

A

Gyne-lotrimin 3 cream

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24
Q

Clotrimazole 2% dosage

A

Insert Cream into vaginal daily for three days

Apply to Vulva twice daily for itching

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25
Q

Butoconasole nitrate 2% brand

A

Gynazole I

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26
Q

Tioconazole 6.5% brand

A

Vagistat -1 ointment 1 -day ointment

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27
Q

Butoconasole nitrate 2% dosage

A

Insert cream into vagina daily for one day

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28
Q

Tioconazole 6.5% direction

A

Insert ointment into vagina daily for 1 day

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29
Q

Monistat I combination pack day/night

Monistat I daytime ovule

A

Cream: miconazole nitrate 2% 1200 mg per applicator fI’ll
Suppository: miconazole nitrate 1200 mg

30
Q

Monistat I combination pack day/night
Monistat I daytime ovule
Direction

A

Apply cream to Vulva twice daily as needed for itching up to seven days
insert suppository into vagina daily (morning or bedtime) for one day

31
Q

Monistat 3 combination pack

A

Cream: miconazole nitrate 2%
Suppository: miconazole nitrate 200 mg per applicator full

32
Q

Monistat 3 combination pack

Derection

A

Apply cream to Vulva twice daily as needed for itching up to seven days
insert suppository into vagina for three days daily

33
Q

Monistat 3 cream

A

Miconazole nitrate 4%

34
Q

Monistat 3 cream

Direction

A

Insert cream into vagina daily for three days

Applied to Vulva twice daily as needed for itching

35
Q

Monistat 7 cream

femizol-M cream

A

Miconazole nitrate 2%

36
Q

Monistat 7 cream
femizol-M cream
Direction

A

Insert cream into vagina daily for seven days

apply to Vulva twice daily as needed for itching

37
Q

Monistat 7 combination pack

A

Cream: miconazole nitrate 2%
100 mg per applicator full
Suppository : miconazole nitrate 100 mg

38
Q

Monistat 7 combination pack

Direction

A

Apply cream Tavola twice daily as needed for itching

Insert suppository into vagina daily for seven days

39
Q

Patient counseling for VVC

A

Seek medical evaluation
-symptoms persist beyond 1 week after treatment or if they recur within 2 months
-more than three times in 12 months
-on warfarin
Use once a day ( night is preferred)
Symptoms resolution within 2-3 days but may take a week for complete resolution

40
Q

Complementary therapies for VVC

A

Lactobacillus preparation
Vaginal tea tree oil preparation
Gentian violet resistant VVC for 1-2 Times A day for up to five days
Boric acid 600 mg PV daily a day for 14 days
-non C. albicans infection

41
Q

Atrophic vaginitis

A

Inflammation of vagina to atrophy of vaginal mucosa

42
Q

Atrophic vaginitis etiology

A

Decreased estrogen such as menopause, after birth, or during breastfeeding
Medications: antiestrogenic drugs ( mpa, danazol, GNrH inhibitors)
Vaginal dryness, irritation, burning, dyspareunia: slight discharge or spotting
New episode of postmenopausal vaginal bleeding need medical referral to rule out endometrial cancer

43
Q

Atrophic vaginitis Treatment

A

Vaginal dryness => lubricant
Water-soluble to help Moisten tissues:
-no petrolatum due to difficulties removing
-Internal and external use
Examples: K-Y jelly, Astroglide
-glycerin, peg, hydroxyethylcellulose, hydroxypropyl methylcelulose
Moderate to severe symptoms might require the use of estrogen therapy

44
Q

Vaginal douching

A

Cleanser for after menstruation
May lead to adverse health outcomes
Contraindicated during pregnancy and should be postponed for at least 8 hours after intercourses if spermicide was used

45
Q

Vaginal douching

Increase risk of:

A 
Vaginal infection 
Ectopic pregnancy 
PID 
Decreased fertility 
change pH and vaginal frora
46
Q

Vaginal douching

Products

A

Water/vinegar ( acetic acid)
Povidine/iodine
Alternative cleansing method: luckwarm water and soap

47
Q

Menstruation cycle

A 
28 days
Day one is first day of menses 
Hypothalamic-pituitary-ovarian axis:
GNRH, LH, FSH levels are released as response to changes on progesterone and estrogen levels 
If pregnancy: human chronic gonadropin
48
Q

Menstruation disorders

A

Dysmenorrhea-painful in lower abdomen :
-primarily: cram-like pain in lower abdomen
-occurs at onset or 1-2 days before menstruation
-secondary: pelvic underlying pathology:
-variable pain cycle, throughout menses
Pathology:
-increased in prostaglandins and leukotrienes: Inflammation and pain, uterine contractions

49
Q

Nonpharmacologic Treatment Of menstruation disorders

A

Avoid secondhand smoke and smoking
Hot bath or heating pad
Regular exercise

50
Q

Pharmacologic Treatment Of menstruation disorders

A

OTC nsaid- first line begin at onset of manses or pain, Schedule doses not prn
- naproxen ibuprofen ASA - Need higher doses to get anti-inflammatory effects. ADE: GI symptoms Take with food
ASAP: 1000 mg four times a day still less effective than ibuprofen
COC, levonorgestrel IUD( mirena), medroxyprogesterone acetate( depo-pro era)

51
Q

Patient counseling for primary dysmenorrhea

A

Primary dysmenorrhea is normal
Understand when to seek medical evaluation
Nsaid are I preferred therapy
If Response to the first agent is not adequate another nsaid can be tried

52
Q

PMS

A

Cyclic disorder
Physical emotional and behavioral symptoms: depression irritability breast tenderness, bloating ( occurs during five days prior to manses)
PMDD is severe form of PMS

53
Q

Nonpharmacologic Treatment of PMS

A

Exercise
Changes in diet
Behavioral therapy
Try to avoid stress and develop stress copying strategies
During 7 to 14 days before menstrual period reduce salt caffeine chocolate and alcohol beverages
Eaton carbohydrate rich foods low protein During premenstrual interval

54
Q

PMS Treatment

A

Pyridoxine( b6) up to 100 mg daily
-ADE: neuropathy
Calcium and vitamin D 600 mg PO twice a day may cause constipation stomach upset
Mg 300 to 360 mg PO daily during premenstrual interval only food sources of Mg is spinach ,Swiss chard ,nuts ,vegetables and whole grains cereal‘s ; May diarrhea
Nsaid for HAand muscle joints pain and mood symptoms
Diuretics ( combined with APAP, nsaid) - Relieving water retention weight gain bloating swelling and feeling of fullness:
-ammonium chloride
-caffeine
-pamabrom
Midol products drug card

55
Q

Ammonium chloride dosage

A

3 g a day in three divided doses

56
Q

Ammonium chloride CI

A

Renal and liver impairment

57
Q

Caffeine dose

A

100 to 200 mg every 3 to 4Hours

58
Q

Caffeine MOA

A

Inhibits Renal tubular reabsorption of sodium and water

59
Q

Pamabrom

A

Derivative of theophylline

15 mg four times a day

60
Q

pamabrom 50 mg brand

A

Aqua-ban tablets;Diurex Max; Diurex Water Capletts

61
Q

Caffeine 100 mg brand

A

Diurex ultra water weight loss formula

62
Q 
Pamprin multisymptom;
Premsyn PMS ( ingredients)
A

Pamabrom 25 mg

Acetaminophen 250 mg; pyrilamine maleate 15 mg

63
Q

Pamprin Max (ingredients)

A

Caffeine 65 mg aspirin 250 mg acetaminophen 250 mg milligrams

64
Q

Midol extended relief

A

Naproxen sodium 220 mg

65
Q

Midol complete ( ingredients)

A

Coffeen 60 mg acetaminophen 500 mg pyrilamine maleate 15 mg

66
Q

Midol teen

A

Pamabrom 25 mg ASAP 500 mg

67
Q

Midol PM

A

AS PA 500 mg

Diphenhydramine 38 mg

68
Q

Toxic shock syndrome

A

Caused by Toxin producing strains of S aureus and S pyogenes

  • production of an inflammatory response
  • malaise, myalgia, chills Within two days
  • Severe symptoms including seizures high fever cardiac and respiratory problems
69
Q

Classic characteristics of TTS

A

Rush: sunburn like, diffuse, macular erythroderma, non pruritic
Skin desquamation: face, trunk, soles of feet and palms

70
Q

TSS prevention

A

Avoid tampons

Use low absorbing tampons

Self Care (6 decks)

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