Women's Health Lecture 1 Flashcards
abdominal pain in primary care- you should always assume is what?
pregnancy until proven otherwise
At what age do you refer a young female who has not had a period?
16 years old. Refer to endo or gyno
Early onset of menses (7 or 8yo) is associated with what? What is important for these patients?
Early menses associated with increased body fat because increased body fat induces menses in women. Anticipatory guidance in relation to this is very important for parent and child.
in regards to reproduction, what hormone does the hypothalamus release? where does it go?
hypothalamus releases GnRH “I want to get pregnant” hormone- gets sent to pituitary
pituitary then secretes what, which does what?
FSH, which “gets the eggs ready” so stimulates egg growth within follicles in the ovaries
meanwhile, estrogen is building up. What is its job? When it gets to ___ picograms, what happens?
Its job is to “get the nest ready” When it gets to 200 picograms, LH level surges which stimulates one egg/ follicle to leave the ovary and go to the uterus AKA ovulation
After ovulation what happens?
Surge in progesterone signaling that the body is “ready to support pregnancy until placenta is ready.” If sperm = pregnancy. If no sperm progesterone level falls and the whole process starts all over again
how many days is a normal menstrual cycle?
28 days +/- 7 is normal
What is the first phase of the cycle called and what is the predominant hormone of this phase?
1st phase is called the follicular phase-predominant hormone is estrogen (estrodial mostly)
What is the second phase of the cycle called and what is the predominant hormone of this phase?
2nd phase is called luteal phase- progesterone dominates in this phase- its roll is to support fertilized egg/ support the pregnancy until the uterus can take over.
what hormone level remains high throughout pregnancy?
progesterone
which phase of the menstrual cycle varies?
follicular phase
What is the importance of a prenatal vitamin?
Need 400mcg of folic acid, ideally 3-6 months prior to conceiving to prevent neural tube defects.
Once pregnancy is confirmed, what is needed in the PNV?
DHA
Which vaccines are recommended DURING pregnancy?
flu and pertussis (Tdap) Tdap booster recommended during EACH pregnancy (CDC)
Which vaccine is important to have BEFORE becoming pregnant?
MMR
Explain getting your basal body temperature.
Should take your temp. first thing in the morning, before even moving (have it at your bedside). Need to be consistent, need to look at retrospective data of past several months. We are looking for a rise of 0.5 degrees F
The ovulation predictor kits that are sold OTC are monitoring what?
they detect a surge in LH (signals ovulation)
What does gravida mean?
number of times pt has been pregnant
What does para mean?
number of time pt has given birth past 22 weeks
What is the thick egg- white mucous substance called that is expelled from the vagina? What does it signify?
“mittelschmerz” signifies that ovulation is imminent- occurs just before ovulation (temp lowers slightly, then spikes when ovulation occurs)
What is the difference between a qualitative and quantitative hCG test?
Qualitative- gives you yes or no answer- simple urine dip that is sold OTC.
Quantitative- measures the serum level of hCG (level needs at least 50 to be read); used to test viability of pregnancy. (Hcg should double or triple in 48- 72hrs if pregnancy is viable)
these are equally as accurate
presumptive/ probable/ positive signs of pregnancy
see cards on Chapter 19
When does hCG peak?
60- 90 days post fertilization
How does Plan B work?
Makes conditions unfavorable for implantation. 85% effective
What are the “M&M” abortion drugs?
Mifepristone- “antiprogestin” blocks endometrial growth, detaches
Methotrexate- prevents placental villi proliferation
Misoprostol (cytotec)- causes uterine contractions (used for ripening in labor)
Uterine sizing- non- pregnant
lemon; it is firm, non- tender
Uterine sizing- 8 weeks
tennis ball/ orange- Hegar, Goodell, CHadwick all +