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OB > women's health (unit 3) > Flashcards

women's health (unit 3) Flashcards

1
Q

menarche

A
  • avg. age 12.5 yrs

* irregular and scant

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2
Q

menstrual cycle

A
  • 28 day duration

* 1st day of period=1st day of cycle

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3
Q

leading causes of death in women

A
  • heart dz
  • cancer
  • cerebrovascular dz
  • pneumonia, influenza
  • chronic lung dz
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4
Q

education prior to pelvic exam

A
  • schedule b/t periods
  • don’t douch or have sex 48 hr
  • no vag. meds, sprays, etc
  • empty bladder
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5
Q

Papanicolaou (Pap) test

A
  • screening for cancer
  • speculum, spatula, and brush used to collect cells
  • first @ 21 y/o
  • qyr to 30
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6
Q

bimanual examination

A
  • purpose is to palpate size, position, and consistency of uterus and cervix
  • any ovarian tumors found are advanced
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7
Q

breast exams

A 
•yearly by MD
•monthly by self
•mammogram yearly afte  40
•q2yrs after 50
*lawn mower starting at axilla
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8
Q

inspection during breast exam

A
  • texture/color
  • nipple position
  • symmetrical movement
  • dimpling or masses
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9
Q

palpation during breast exam

A
  • lymph nodes

* while sitting and lying

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10
Q

fibroadenoma

A
  • benign breast disorder
  • firm hard, feely mobile mass (NOT cancer)
  • DONT change w/ cycle
  • teens/20s
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11
Q

fibrocystic changes***

A
  • benign breast disorder
  • bilateral pain/tenderness
  • occurs prior to menopause
  • CHANGES during cycle
  • tx: OTC pain meds (NSAIDs); no caffeine
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12
Q

ductal ectasia

A
  • benign breast disorder
  • ducts become distended and filled
  • irregular mass
  • enlarged axillary nodes
  • nipple retraction and d/c
  • occurs near menopause
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13
Q

intraductal papilloma

A
  • benign breast disorder
  • d/c from nipple
  • occurs near menopause
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14
Q

high risk of breast cancer

A
  • personal/fam hx of breast CA
  • hx of uterine/ovarian/colon CA
  • > 50 y/o
  • nulliparity or AMA
  • early menarche/late menopause
  • lifestyle factors
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15
Q

invasive breast cancer

A

•when tumor growth expands into tissue surrounding duct

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16
Q

metastasis

A
  • cells are spread from tumor by both blood and lymph

* common end sites are lungs, liver, bones

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17
Q

inflammatory breast cancer

A
  • blocks lymph vessels in breast skin
  • Peau de’ orange
  • aggressive
  • dx by biopsy
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18
Q

breast cancer dx

A
  • fine needle biopsy

* incisional biopsy (lumpectomy)

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19
Q

lumpectomy

A
  • breast cancer tx

* lump and surrounding tissue are removed

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20
Q

simple mastectomy

A

•entire breast removed

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21
Q

modified radical mastectomy

A

•entire breast and surrounding lymph nodes removed

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22
Q

lumpectomy/mastectomy post-op

A

*prevent lymph edema
•no venipuncture/BP on affected arm
•arm above heart in RR
•exercise arms

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23
Q

breast cancer tx adjuvant therapies

A

•radiation
•chemo
•hormones (SERMs)
*depends on age and stage of CA

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24
Q

tamoxifen

A 
•hormone breast CA adjuvant therapy
•only works on estrogen receptive tumors
•blocks estrogen in body
•SE: similar to menopause
*SERM- selective estrogen receptor modulator
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25
Q

candidiasis

A 
•vaginal infection r/t moniliasis or yeast
•pH < 4.5
•white, thick, curdy, no odor d/c
•itching
•not sexually transmitted
*recurrent yeast r/t HIV+
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26
Q

candidiasis med tx

A
  • Monistat
  • gyne-lotrimin
  • mycostatin
  • diflucan
  • vagistat
  • terazol
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27
Q

bacterial vaginosis

A
  • malodorous, profuse dc that is thin gray/white or yellow/green
  • pH >5
  • not sexually transmitted
  • refrain from sex until cured
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28
Q

bacterial vaginosis med tx

A
  • metronidazole

* clinda cream

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29
Q

gonorrhea

A
  • green d/c, dyspareunia, dysuria

* abx tx

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30
Q

chlamydia

A
  • yellow d/c
  • asymptomatic in women
  • can lead to infertility or PID if no tx
  • tx: abx
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31
Q

trichomoniasis

A
  • thin malodorous green/yellow d/c
  • itching, redness, edema
  • strawberry cervix
  • looks like sperm
  • tx: metronidazole
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32
Q

syphilis

A
  • painless chancre (male ID)
  • primary, secondary, tertiary stages
  • VDRL or RPR
  • tx: PCN ONLY
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33
Q

herpes

A
  • blisters, severe vulvular pain, dyspareunia
  • no cure
  • tx: acyclovir (anti-viral)
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34
Q

immunioquid

A

•immune system stimulant to get body to fight itself

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35
Q

human papilloma virus

A
  • genital warts
  • strong association w/ cervical cancer
  • tx: remove wart via TCA
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36
Q

is HIV/AIDs sexually transmitted?

A

•yes

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37
Q

is hep B or C sexually transmitted

A

•yes

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38
Q

is GBS sexually transmitted

A
  • no

* not exclusively transmitted by blood/body fld.

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39
Q

pelvic inflammatory dz (PID)

A
  • infection of upper genital tract usually d/t “silent” STD
  • abd pain, cervical motion tenderness, fever, N/V, anorexia
  • tx:
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40
Q

toxic shock syndrome

A
  • fatal cndt. caused by staph aureus
  • can lead to hypovolemia, hypotension, and shock
  • s/sx: fever, flu-like, hypotension, rash
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41
Q

toxic shock syndrome tx

A
  • fluid
  • vasopressor drugs
  • antimicrobials
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42
Q

toxic shock prevention

A
  • hand washing before tampon/diaphragm
  • change tampon q4hr
  • no diaphragm during menses
  • remove diaphragm as directed
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43
Q

causes of menstrual disorders

A
  • PG complications
  • anatomic lesions
  • drug-induced bleeding
  • systemic d/o
  • failure to ovulate
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44
Q

menstrual d/o management

A
  • treat cause
  • treat any anemia
  • surgery- D&C, hyst, laser ablation
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45
Q

normal amnt of bleeding after menopause

A

NONE!!

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46
Q

primary amenorrhea

A
  • menarche after 16

* menarche 1 yr later than mom and same age as sister

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47
Q

secondary amenorrhea

A
  • absence of menstruation of 3 cycles after regular cycles established
  • most common cause is PG
48
Q

amenorrhea tx

A
  • PG test
  • treat underlying cause
  • nutritional counseling
  • hormone replacement
  • ovulation stimulation
  • periodic progesterone
49
Q

polycystic ovarian syndrome (PCOS)

A
  • endocrine d/o r/t imbalance of male/female hormones
  • cysts in ovaries
  • s/sx: infertility, acne, thining hair, hirsutism, inulin resistance, irregular/absent cycles
50
Q

mittelschemerz

A

•pelvic pain that occurs with ovulation

51
Q

primary dysmenorrhea

A
  • menstrual pain w/o pathology
  • occurs hrs from start of menses
  • spasmotic, colicky
  • most common in nulliparous
52
Q

secondary dysmenorrhea

A 
•menstrual pain that occurs b/c of dz process 
-fibroids
-endometriosis
-PID
•tx: OCPs, NSAIDs
53
Q

endometriosis

A
  • development of endometrial implants outside uterus
  • implants enlarge/stretch, causing pain
  • cause unkn
  • often causes infertility b/c of tube or ovary occluding/strangling
  • dx by laparoscopy
54
Q

endometriosis tx

A
  • hormone supression
  • ablation
  • hysterectomy
55
Q

premenstrual syndrom (PMS)

A

•s/sx must be cyclic and recur after luteal phase
•s/sx free during follicular phase
•s/sx severe and interfere w/ life
*etiology unkn

56
Q

physical s/sx PMS

A
  • edema
  • wt gain
  • bloating
  • hot flashes
  • constipation
  • HA
  • acne
  • breast pain
57
Q

behavioral s/sx PMS

A
  • anxiety
  • depression
  • irritability
  • mood swings
  • aggressive
  • inc. appetite
  • fatigue
  • insomnia
58
Q

PMS management

A
  • good nutrition
  • vit. B
  • avoid caffeine, simple sugars, salt, etoh
  • stress management
  • exercise
  • adequate sleep
59
Q

Premenstrual dysphoric disorder (PMDD)

A
  • severe PMS

* high r/o suicide

60
Q

infertility

A

•inability to conceive after 1 yr of unprotected intercourse
•d/t delayed childbearing or physiological factors
-male responsible 40% of time

61
Q

female infertility causes

A
  • ovulatory d/o***
  • abnormal tubes/cervix
  • repeated PG loss
62
Q

repeated PG loss causes

A
  • fetal chromosomal abnormalities
  • cervix/uterus abnormals
  • endocrine abnormalities
  • immune abnormalities
  • infection
  • environmental factors
63
Q

male infertility causes

A
  • infection
  • ED
  • seminal fld./sperm abnormal (pH)
  • environmental
  • ejaculation probs.
64
Q

infertility tx

A
  • treat cause (thyroid d/o, etc)
  • artificial insemination
  • invitro fertilization
  • sperm/ovum donation
  • meds: Clomid
65
Q

basal body temperature and ovulation

A

•increases and stays higher if PG

66
Q

menopause

A
  • end of menses
  • avg. age 51
  • can be induced/created artificially
67
Q

artificial induction of menopause

A

•surgical removal of ovaries
•destruction of ovaries by radiation
*s/sx more severe than natural

68
Q

body changes of menopause

A
  • cessation of estrogen/progesterone production
  • vag. atrophy/dryness
  • forgetful, diff. concentrating, insomnia, BA, HA, depression
  • mood swings
  • hot flashes
  • bladder/urethra atrophy
69
Q

why hot flashes

A

•dec. endogenous estrogen

*most common reason women seek care

70
Q

why insomnia during menopasue

A

•lack of estrogen on hypothalamus

71
Q

uterine leiomyomas

A
  • benign uterine tumors
  • may cause bleeding, anemia, pressure
  • tx: myomectomy, hyst, GnRH agonists
72
Q

ovarian cysts

A
  • benign tumors of ovary
  • luteal are painful
  • tx: OCPs, U/S, surgery
73
Q

endometrial cancer key s/sx

A

•bleeding after menopause

74
Q

cervical cancer almost always caused by

A

•HPV

75
Q

most effective and safest method of contraception

A

abstinence

76
Q

basal body temperature method of contraception

A
  • natural family planning method
  • temp drops prior to ovulation and then rises for several days after
  • several months of graphs
77
Q

calendar (rhythm) method of contraception

A
  • natural family planning

* record menstrual cycles for 6-8 months to ID shortest/longest

78
Q

billings method of contraception

A
  • natural family planning

* based on cervical mucus changes through cycle

79
Q

barrier contraceptive methods

A

•Diaphragm
•cervical cap
•condoms (male/female)
*some reduce risk of STDs

80
Q

diaphragm

A
  • requires fitting by provider
  • DOESNT protect against STDs
  • used with spermicidal jelly
  • insert 6 hrs a and leave in place 6-8 hrs p sex
  • don’t use if hx of UTI
  • replace q2-3yr or 10 lb wt change
  • r/o toxic shock
81
Q

cervical cap

A
  • rubber cup w/ firm round rim
  • filled w/ spermicide prior to insertion
  • place 30 min a sex
  • leave in for 6-8 hrs p sex
  • 48 hr protection
  • DOESNT protect against STD
82
Q

spermicides

A

•used 15-30 min a intercourse
•reapply w/ each encounter & q1h
•DOESNT protect against STDs
*use with other method for best results

83
Q

male condom

A
  • oldest form of contraception
  • protects against HIV and some STDs
  • use w/ spermicide -> 99% effective
  • easy to break
84
Q

female condom

A
  • traps sperm in sheath placed in uterus
  • placed 8 hrs prior to sex
  • may prevents STDs better than male
  • more expensive than male
85
Q

coitus interruptus

A

•withdrawal method of contraception
•ejaculate deposited away form vag.
•DOESNT protect against STDs
*REMEMBER preejaculate can contain sperm

86
Q

intrauterine device

A
  • interferes w/ sperm transport to tubes
  • lasts 1-8 yrs
  • DOESNT protect against STDs
  • medicated w/ copper or progesterone
  • contraindicated in PID, STD, nullparous
87
Q

PAINS

A 
*IUD warning signs
Period late, abn, spotting
Abdominal pain, pain w/ sex
Infection exposure/discharge
Not feeling well (fever, chills)
String missing
88
Q

combined oral contraceptives (COC)

A
  • combo of estrogen (estradiol) and progesterone (many kinds)
  • suppresses ovulation***
  • thickened cervical mucus
  • effects endometrial lining
89
Q

COC advantages

A
  • dec. menstrual s/sx
  • treats menstrual irreg.
  • lighter cycle
  • improves acne
  • manipulates cycle
  • dec. # cycles
  • enhanced sexual enjoyment
  • dec. r/o cancer, cysts, PID, etc
90
Q

Beyaz & Safryal

A

•new COC that adds folic acid, which remains consistent for 20 wks after discontinuation

91
Q

Natazia

A

•new estrogen w/ diff. timing and only 2 placebo pills

92
Q

Lo loestrin Fe

A

•lowest estrogen to date and 2 day placebo pills (Fe tablets)

93
Q

COC disadvantages

A
  • spotting during beginning of tx
  • missed period/amenorrhea
  • depression, anxiety, irritability, fatigue
  • inc. r/o adenocarcinoma cervical cancer
  • N/V, hunger, HA, HTN, wt gain
  • inc. r/o DVT, MI, stroke*** (lower if don’t smoke, have HTN, or migraines)
94
Q

Seasonale

A
  • tricycle regimen
  • 63 active pills in a row, then 7 days off
  • ALL monophasic (one dose of hormones every day)
95
Q

Lybrel

A
  • continuous contraception
  • advantageous if menstrual complications, migraines, epilepsy, etc
  • dec. r/o breast cancer
96
Q

what meds decrease COC effectiveness

A
  • ampicillin
  • doxycycline
  • tetracycline
97
Q

ACHES

A 
*COC s/sx needing MD contact
Abdominal pain (severe)
Chest pain, cough, SOB
HA, dizziness/weakness/numbness
Eye problems
Severe leg pain
*DONT just stop pill
98
Q

combined vaginal contraceptive

A
  • vaginal ring
  • once a month BC inserted by pt
  • releases hormones that are absorbed thru vaginal canal
  • same drugs as pill
99
Q

combined topical contraceptive

A
  • patch changed weekly
  • placed on abd/upper torso/butt/upper arm (NOT breast)
  • lots of complications
  • not effective in > 195 lbs
100
Q

progestin-only pill (mini-pill)

A

•contraception of choice for lactating moms b/c doesn’t effect milk
•works by changing endometrium and cervical mucous
•best if > 40 y/o
•DOESNT protect against STDs
*must take at same time everyday

101
Q

implanon

A 
•long-acting progestational agent
•prevents PG for 3 yrs
•device implanted under skin
-prevents ovulation
-cervical mucous
-thins endo
•reversible
102
Q

depo-provera

A 
•oil-based long acting progesterone 
•admin q12wk
•injection
•prevents ectopic PG
•may take 10 months to get PG after discontinue
•r/o dec. bone density and wt gain
-reverses after d/c
103
Q

when is postcoital contraception used

A 
•woman had unprotected intercourse
•failed method (ex: condom break)
•rape
•intermittent isolated intercourse
*89% chance no PG
*ineffective if already PG (NOT abortion)
104
Q

Postcoital (emergency) contraception side effects

A
  • N/V

* menstrual changes

105
Q

medical abortion

A

•RU-486
•misoprostal
-blocks folic acid and causes uterine cramping
•methotrexate (antineoplastic)

106
Q

female sterilization

A

•surgery to ligate, clip, or destroy part of fallopian tube
•ovulation still occurs, but ovum absorbed
•must be > 21 y/o
•used if for sure don’t want kids or for medical purposes
•r/o ectopic PG
*NOT STD protection

107
Q

Essure

A 
•non-surgical female sterilization
•coil in place of fallopian tube
•natural scarring (after 3 months)
-need BC during (no IUD)
•MUST have 3 month confirm test
•r/o ectopic PG
108
Q

male sterilization

A

•must use alt. contraception for 3 months
•fertility after reversal is 50%
*NOT STD protection

109
Q

most likely spot to have atypical (cervical cancer) cells

A
  • transformation zone

* changing from cervical cells to endocervical cells

110
Q

abnormal cell characteristics

A
  • no or multiple nucleus
  • macro/micro-nucleus
  • cell wall abnormality
111
Q

Peau de’ orange

A
  • abnormal breast tissue texture

* indicative of inflammatory aggressive breast cancer

112
Q

why is AMA or no PG higher risk for breast cancer

A
  • no break for hormones

* connected to estrogen receptive breast cancer tumors

113
Q

when can’t take ANY type of COC…

A
  • over 35 and smoke, HTN, migraine

* have had previous thrombolytic complication

114
Q

when to start COC

A

•day after menstrual cycle starts

115
Q

what to do if have COC side effects

A
  • call MD

* DONT stop abruptly

OB (17 decks)

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