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Clinical Medicine > womens healh > Flashcards

womens healh Flashcards

1
Q

when to start an infertility work up?

A

after 1 year

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2
Q

when to start an infertility workup before 1 year

A

age >35, previous infertility, previous infection/disease/surgery, DES exposure

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3
Q

definition of infertility

A

No pregnancy after 1 year of frequent unprotected intercourse

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4
Q

important points of hx in females in infertility workup

A 
HPI
intercourse schedule
PMH previous pregnancies, menstrual cycle, puberty, STIS, endocrine disorders
meds
SH exercise, stress, sleep
FH DES, spontaneous abortions
ROS hair growth, breast discharge
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5
Q

what should a health vaginal canal look like?

A

• Presence of pink, moist, rugated vaginal mucosa as evidence of good estrogen

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6
Q

some male conditions related with infertility

A 
•	Hypospadias infertility from surgeries for this
•	Cryptorchidism
•	Varicocele
•	Hydrocele
ED
hypogonadism
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7
Q

tests to rule out other causes of infertility

A 
STI screen ==> R/O disease/infection
	UPT==> R/O pregnancy
	TSH==> Assess thyroid function
	Prolactin ==> Assess pituitary function
	\+/- LH &FSH==>Assess ovary and feedback loop
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8
Q

what are tests rec’d for checking ovulatation?

A

OPK, sergum progresterone, progesterone challenge

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9
Q

if progesterone challenge doesn’t work, what next?

A

check LH

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10
Q

if LH low…? if LH high?

A

if low, check FSH

if high check pituitary

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11
Q

if LH normal, if FSH high, low estrogen?

A

primary ovarian failure

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12
Q

if LH normal, and FSH normal..?

A

Hypothalamic-pituitary vs. outflow disorder

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13
Q

what percent of infertility is unexplained?

A

10-15%

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14
Q

• Inflammation or infection of the vaginal canal

A

vaginitis

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15
Q

usual etiology of candidate vaginitiis

A

• Candida albicans

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16
Q

types of HPV with warts

A

6 and 11

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17
Q

types of HPV with cervical dysplasia

A

types 16 and 18

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18
Q

methods that proves ovulation

A

regular cycles, OPKs,

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19
Q

pros of OCPs

A

Effective contraception
Decrease in pregnancy-related deaths
Non-contraceptive Benefits
 Better cycle control
 Decrease in iron deficiency anemia
 Maintenance or improvement in bone density
 Protection from ovarian and endometrial CA

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20
Q

cons of OCPs

A 
No protection against STDs
Adverse effects
  risk of thromboembolism and stroke
 May elevate BP
 Estrogenic and progestin side effects
Drug interactions
Daily pill taking
Cost > $30/month
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21
Q

effects of too much estrogen

A 
Nausea
 Breast tenderness
 Increased BP
 Melasma
 Headache
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22
Q

contraindications to ocp

A 
Absolute Contraindications
 Hx of thromboembolic disease
 Hx of stroke or CAD
 Hx of breast cancer
 Hx of estrogen-dependent neoplasm
 Undiagnosed abnormal uterine bleeding
 Pregnancy (known or suspected)
 Heavy smokers ( ≥ 15 cigarettes/day) over the age of 35
 Hx hepatic tumors
 Active liver disease
 Migraine HA with focal neurologic symptoms
 Postpartum (during 1st 21 days as well as days 21-42 in women with additional TE risk factors)
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23
Q

RELATIVE CI

A

 Smoking 50 years

 Elective major surgery requiring immobilization (planned in the next 4 weeks)

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24
Q

too little estrogen

A

Early or mid-cycle breakthrough bleeding
 Increased spotting
 Hypomenorrhea

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25
Q

too much progesterone

A

Breast tenderness
 Headache
 Fatigue
 Mood changes

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26
Q

too little progesteron

A

late breakthrough bleeding

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27
Q

too much androgen

A 
 Increased appetite
 Weight gain
 Acne, Oily skin
 Hirsutism
  LDL,  HDL
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28
Q

abx that can decrease dose of OCP

A

griseofulvin, penicillins, or

tetracyclines

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29
Q

pt ed on OCPs during abx use

A

An alternate or
additional form of birth control may be advisable
during concomitant use & for 7 days after

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30
Q

take extra dose if miss one or vomit?

A

yes, if vomit within one hour after taking dose

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31
Q

OCPs FDA approved for acne

A

Ortho-TriCyclen, Estrostep, Yaz

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32
Q

who should be considered for extended cycle oCP?

A

PMS, HA, anemia, endometriosis

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33
Q

pt ed of OCPs

A

Directions for Use
 Adherenc, star,,,,,t missed pills
 Other Topics
 Identify backup method (provide a few condoms)
 OCs will not protect against STDs
 Discuss the transient nature of most OC side effects in new users, especially spotting and
bleeding
 Discuss noncontraceptive benefits of OCs
 Five possible warnings of serious trouble

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34
Q

spotting on OCPs could be a sign of what?

A

nonadherence

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35
Q

how soon should you take oral EC agents?

A

within 72 hours

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36
Q

OTC emergency contraception

A

plan b one step for all ages, my way and next choice for >17

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37
Q

T or F: EC can disrupt a fertilize egg after implantation

A

F

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38
Q

what is yuzpe method for emergency contraceptoin

A

take multiple doses of normal OCP +antiemetic

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39
Q

based on ACOG guidelines, EC should be offered after how many hours?

A

120

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40
Q

pros and cons of patch

A

pros: easy, high adherence, cons: breast tenderness, increased risk of clots

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41
Q

pros and cons of vaginal ring

A

pros: convenient, effective, reversible cons: FB sensation, coital problems, expulsion, irritation/infection

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42
Q

mechanism of patch, ring, depo shot birth control pill

A

anovulatory

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43
Q

pros/cons of depo

A

pros: bleeding absent, non daily, affordable, immediately effective cons: office visit every 90 days, decreased bone density, weight gain, fatigue

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44
Q

pros and cons of subnormal implant

A

pros: can leave in for 3 years
cons: may be felt under skin

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45
Q

pros and cons of iUd

A

pros: effective, easy, no hormones
cons: r/o PID, req office visit for insertion/removal

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46
Q

when is IUD insertion done?

A

• Usually done during menses- open os, not pg

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47
Q

IUD insertion procedure

A

clean cervix, get uterine depth, insert with tube, trim tail

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48
Q

how long are iUDs good for?

A

3-10 years

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49
Q
  • Mechanical barrier between cervix and vaginal canal

* Circular ring fitted for each individual

A

diaphragm

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50
Q

how often does male contribute to infertility?

A

20% of the time

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51
Q

pmS sx suggest ovulation T or F

A

T

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52
Q

best drug to induce ovulation (increases FSH and LH by tricking body into thinking low estrogen)

A

clomiphene citrate (clomid or serophene)

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53
Q

what is primary sx of vaginitis?

A

change or increase in discharge

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54
Q

thick white discharge, intense pruritis of vagina and vulva and no odor makes you think of what?

A

candidiasis

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55
Q

tests for all with discharge

A

pH, wet prep (could combine with koh)

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56
Q

vaginal hygiene patient education

A

wipe front to back, wear cotton underwear, avoid baths or foreign bodies (esp during vaginitis), avoid douching and perfumed stuff

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57
Q

normal vaginal flora

A

staph, strep, lactobacillus

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58
Q

etiology of bacterial vaginosis

A

gardnerella vaginalis, mobiluncus spp., mycoplasma spp., bacteroides

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59
Q

RFs of bacterial vaginosis

A

multiple partners, douching, vaginal irritants, smoking

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60
Q

non irritating, thin/gray-white/yellow discharge with foul odor makes you think of?

A

bacterial vaginosis

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61
Q

what are the 4 damsel criteria for bacterial vaginosis? must have 3.

A

abnormal discharge (color with foul odor), abnormal or high pH, positive whiff test, clue cells on wet prep

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62
Q

profuse frothy discharge + odor and pruritus makes you think of? +/- petechia on cervix

A

trichomonas

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63
Q

pH over 4 indicates? 4.5? 5?

A

4: candidiais
4.5 BV
5 trichomonas

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64
Q

T or F: viral shedding is possible with hPV even if not warts visible

A

t

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65
Q

tx of HPV warts

A

difficult, cryotherapy, electrocautery/currettage, laser, surgery, chemical

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66
Q

risk factors for spontaneous abortions

A
  • Known: Age (AMA- advanced maternal age, > 35 years), Previous SAb, Smoking, BMI 25kg/m2
  • Potential: Alcohol (>3 drinks/weeks), NSAIDS, Caffeine (100F
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67
Q

MC cause of spontaneous abortion

A

abnormal chromosomes

68
Q

Vaginal bleeding through a closed cervical os

A

threatened abortion

69
Q

T or F: threatened abortion means the fetus will not survive

A

F

70
Q

signs of a threatened abortion

A
  • Vaginal bleeding
  • Pelvic pain/cramping
  • Cervical os: Open or closed- should stay closed during pregnancy
  • Products of conception: Passed or retained-
71
Q

• A spontaneous abortion in which the entire contents of the uterus are expelled

A

complete abortion

72
Q

common time of complete abortions

A
73
Q

signs and sx of septic abortion

A 
signs of infection
•Fever, chills
•	Tachycardia
•	Vaginal discharge- usually purulent
•	Peritonitis- diffuse abdominal pain
•	Septicemia
signs of abortion
•	Vaginal bleeding
•	Pelvic tenderness
•	Cervical os open- how infection got in
•	Uterus tender and boggy
74
Q

how do you evaluate history of a spontaneous abortion?

A 
•	LMP (last menstrual period): Confirm pregnancy, Dating
•	Signs of spontaneous abortion
•	Signs of sepsis
•	Consider Differential Diagnosis
−	Physiologic – due to implantation
−	Ectopic pregnancy
−	Cervical, vaginal or uterine pathology
75
Q

definition of recurrent pregnancy loss

A

• 3 or more losses before 20 weeks (0.4-1% of pregnancies)

76
Q

what Must you rule out in any woman of reproductive age with abdominal/pelvic pain or irregular bleeding

A

ectopic pregnancy

77
Q

where are most ectopic pregnancies?

A

fallopian tubes

78
Q

what are risk factors for ectopic pregnancies?

A
  1. Pelvic infections: Douching, multiple partners
  2. Previous ectopic pregnancy
  3. Age >35
  4. In vitro, infertility treatments
  5. History of abdominal or pelvic surgeries
  6. IUD in place
  7. Exposures to DES
79
Q

signs of ectopic pregnancy

A

severe abdominal pain, abornaml uterine bleeding, amenorrhea, pregnancy sx, dizziness, signs of sepsis..

80
Q

how to make dx of HSV

A

serology or PCR best b/c can detect asx or clinical

81
Q

must take PO antivirals for herpes within how many hors of onset?

A

24-72

82
Q

tx for chlamydia and gonorrhea

A

AZT po 1 gm x1 or doxy 100 mg x 7 days (or ceftriaxone 250 mg IM + AT po 1 gm x1 for gonorrhea)

83
Q

MC sx of chlamydai and gonorrhea

A

discharge from cervix (mucopurulent in chlamydia or watery and profuse milky/mucopurulent with gonorrhea), fever, pelvic pain

84
Q

signs of primary s yphilis

A

pain hard indurated ulcer

85
Q

complications of PID

A

tubal occlusion, infertility, ectopic pregnancy risk

86
Q

sx of PID

A

low abdominal pain MC, dyspareunia, vaginal discharge +/- odor, N/V, F/C, dysuria, irregular bleeding

87
Q

what sign is pathopneugmonic for PID?

A

cervical motion tenderness

88
Q

gene related to ovarian malignancies

A

CA-125

89
Q

cancers associated with CA-125

A

ovarian, endometrial, breast, colon

90
Q

important points to discuss with pt and partner before conception

A

Risks of maternal health/development
Genetic testing options (cystic fibrosis, hereditary)
Family history

91
Q

what are 3 main mechanisms that cause sx of pregnancy?

A
  1. Hormonal changes
  2. Maternal structural changes
  3. Unknown
92
Q

gi changes in pg

A

reflux, hemorrhoids, constipation, decreased gallbladder function, N/V

93
Q

pulm changes in pregnancy

A

increased o2 demands, increased rest drive, can hyperventilate, sob

94
Q

CV changes

A

increased CO, could compress vena cava when laying, roll on side

95
Q

optical weight gain in pg for normal BMI and rate

A

25-35 lbs, about 3-5

96
Q

gravida

A

of pg

97
Q

para

A

of completed pregnanites

98
Q

what does the 4 parts of para stand for?

A

term, preterm, abortion induced or missed, living

99
Q

important parts of initial visit hisotry

A
  • Personal and demographic information
  • Past OB history: Miscarriages, deliveries, OB complications- preterm labor, mode of delivery, birth weight
  • Personal and family medical history- HTN, DM, pre-eclampsia, Preterm labor/delivery
  • Past surgical history
  • Genetic history
  • Menstrual and gynecological history
  • Current pregnancy history
  • Psychosocial information- Single mom, partner info, supportive SO/family, drug use, homeless
100
Q

chadwicks sign

A

increased vasculature of the cervix in first trimester, causes blue coloring, normal

101
Q

parts of physical for pg initial visit

A
  • Baseline BP, weight- Over/under weight
  • Complete physical
  • Focus on CV, Respiratory, pelvic, neurology
  • Pelvic Exam
102
Q

safe abx in pg

A
  • Amoxicillin
  • Ampicillin
  • Clindamycin
  • Erythromycin
  • Penicillin
  • Cephalosporins
103
Q

avoid these abx in p if

A
  • Tetracyclines
  • Nitrofurantoin (not best in 1st trimester and term) though people use it a lot
  • Sulfonamides
  • Fluoroquinolones
104
Q

at what age is fetus most susceptible to drugs and disease?

A

days 17-56

105
Q

when is is important to start counting fetal kick counts and gestational diabetes glucose tolerance test?

A

28 weeks

106
Q

at what point do you give rhogam?

A

28 weks

107
Q

which gestational age?
• Appearance of a tadpole
• Measured in crown-rump length by ultrasound because legs are not well developed yet
• Cardiac motion can be detected by US
• Fetus is most susceptible to drugs, disease and other factors that interfere with normal growth between days 17-56- prenatal vitamins, stop drug/alcohol/smoking

A

6 wks

108
Q 
which gestational age?
●	Presents for initial prenatal H&P (see previous slides)
Common symptoms:
●	Nausea and Vomiting
●	Heartburn
●	Constipation
●	Urinary Frequency
●	Fatigue
●	Backache
A

8-10 wks

109
Q

which gestational age?
• The embryo has multiplied to more than 250 cells by day 6.
• Specialization of cells:
• Outer layer- Nervous System, Skin and Hair
• Inner layer- Respiratory and Digestive Systems
• Middle layer- Skeleton, Muscles, Circulatory System, Kidneys, and Sex Organs
• Home pregnancy tests are now positive- Some are sensitive up to 6 days after a missed period
• Serum pregnancy test is most accurate

A

4 weeks gestation

110
Q

which gestational age?
• Pt generally feeling better in 2nd trimester, feel stronger flutters/fetal movement
• Fundus at umbilicus
• Fetal Anatomy Screen (FAS) US completed for anomalies
• Weight – 140 gm (5 oz) size of a banana
• Nervous system starts to function
• Fetus can hear
• Sex genitalia fully developed
• Patient should be able to feel fetal movement- second time mother might feel as soon as 13 weeks
• Lips developing—can see clef palate?

A

20 weeks

111
Q

which gestational age?• Development of bones and muscles
• External parts: face and ears
• Most organs developed and functioning

A

16 weeks

112
Q

which gestational age?
• Crown rump length (CRL) 38mm (1.5 in)
• Weight – 14 grams (1/2 oz)
• Organs now present- Maturation occurs in 2nd and 3rd trimesters
• Most critical development has occurred
• Rates of miscarriage drops after this week.
• By end of week placenta has taken over
• Mom typically feels better at this point

A

12 weeks

113
Q

which gestational age?
• Weight – ½ kg (1 lb)
• Fetus responds to sounds by movement or increase in heart rate
• Bone marrow begins to make blood cells
• Lower airways develop (begins producing surfactant)
• Fat stores begin
• If fetus not moving can provoke to get movements
• Fundal height is 24 cm
• Begin assessing for preterm labor (PTL) sx
• Can start to obtain testing for PTL
• Can give betamethasone for lung development prn
• Can give terbutaline prn PTL contractions
• Pt should be feeling fetus by now

A

24 weeks

114
Q

which gestational age?
• Weight – 2.5–3 kg ( 6.5 lbs)
• Brain developing rapidly
• Lungs nearly developed
• Vertex position (97%)
• Early term labor, considered full term at 37 weeks
• Group B strep culture obtained
• Cervical exams begin
• Assessing dilation, effacement, station, consistency
• If fetus not vertex, may undergo external cephalic version (ECV)
• Weekly appts begin

A

36 weeks

115
Q

which gestational age?
• Weight – 1.8 kg (4 lbs)
• Layer of fat forming
• Fetus will gain more than half its weight between now and delivery
• Pregnancy sx may return
• Blood volume has increased 40-50% since beginning of pg
• Continuing assess PTL risks
• Pt may begin feeling Braxton-Hicks contractions, known as tightening and releasing discomfort without pain (practice ctx, not changes cervix)
• Begin assessment of fetal position (Leopold’s Maneuvers)

A

32 weeks

116
Q

which gestational age?
• Weight – 1 kg ( 2 lbs 4 oz)
• Brain wave patterns appear like full-term newborn
• Lungs continue developing–Viability rates increased
• Start measuring fetal movements (fetal kick counts) daily
• Screen for gestational diabetes (GDM) with 1hr glucose tolerance test. Confirm with 3hr
• If RH negative, recheck antibody screen and give Rhogam 300mcg injection
• Recheck hemoglobin
• Give Tdap at >27 weeks
• Begin follow ups every 2 weeks

A

28 weeks

117
Q

what is leopold maneuver?

A

feeling for what position baby is in

118
Q

method to determine IUGR

A

doppler velocimetry

119
Q

typical signs of ectopic pregnancy

A

abdominal pain and vaginal bleeding

120
Q

risks for placenta previa

A
  • Prior C/S or hx of uterine curettage
  • ? Damage to myometrium or endometrium
  • Cocaine
  • Advanced maternal age
  • Tobacco
  • Increasing parity
  • Hx previous previa- Recurrence rate is 6-12x in subsequent pregnancies
121
Q

what does a painless bleed in 2nd/3rd trimester indicate?

A

placenta previa

122
Q

2nd/3rd trimester painful bleeding indicates?

A

placental abruption

123
Q

risk factors for placental abruption

A

Risk Factors
• Hypertensive disorders- Pre-eclampsia
• Maternal trauma- MVA, assaults, falls, nosocomial infections
• Substance abuse- Tobacco (90% increased risk), Cocaine, Alcohol do a tox screen
• Rupture of Membranes (ROM)
− Prolonged (>24 hours)
− Over distention of the uterus with acute decompression from loss of amniotic fluid
− PROM/PPROM
• Retroplacental fibromyoma or uterine anomaly- placenta implanted on uterine fibroids, septum
• Previous abruption
• Multiparity, multiple gestations
• Previous C-section
• Thrombophilia
• Short umbilical cord
• Maternal age (extremes of age): 35 yrs

124
Q

clinical presentation of placental abruptoin

A
  • Vaginal bleeding- Concealed, could present just with cramping/pelvic pain but no bleeding
  • US to assess placental location- Not all US detect abruptions, often a clinical diagnosis
  • Painful contractions
  • Uterus tender to palpation- tetanic (hard uterus)
125
Q

MC medical disorder in pregnancy

A

HTN

126
Q

dx of preecamplsia

A

• Proteinuria > 0.3 g protein in a 24-hour urine specimen
• In the absence of proteinuria, increased BP accompanied by
1. Symptoms of headache (different from normal HA), blurred vision, abdominal pain
2. Abnormal laboratory tests: Low platelet counts, abnormal liver enzymes

127
Q

• Gestational BP elevation after 20 weeks of gestation in a woman with previously normal BP

A

preecmpalsia-eclampsia

128
Q

leading cause of iUGR in pg

A

chronic HTN

129
Q

drugs to give to treat acute HTN in pregnancy

A

hydralaizine (arterial vasodilator), beta blocker (only labetalol), nifedipine (calcium antagonist), sodium nitropruside,

130
Q

greatest risk for post part HTN

A

antenatal preeclamspsia

131
Q

elampsia

A

preeclampsia + seizures

132
Q 
what do each of these mean?
White Scheme- DM Classification KNOW!
A1
A2
B
C
D
F
R
H
T
A

White Scheme- DM Classification KNOW!
A1 - GDM not requiring insulin- majority of pregnancies
A2 - GDM requiring insulin
B - Onset > age 20 years or duration 20 years
F - Nephropathy
R - Proliferative retinopathy or vitreous hemorrhage
H - atherosclerotic heart disease clinically evident
T - Renal transplant

133
Q

indications for c/s in diabetics

A

EFW >4500g or DM with prolonged second stage or arrest of descent with EFW >4000g

134
Q

etiologies of post part hemorrhage

A

atony, retained placental fragments, coagulopathy, lacerations of vagina or cervix, uterine rupture or inversion

135
Q

T or F: you should not breastfeed if you re hIV + even if undetectable viral loads

A

T, excpe tin 3rd world (r/o malnutrition greater than HIV transmission)

136
Q

CI to vacuum extractor

A

• Fetal prematurity (

137
Q

indications for C/S

A
  • Failure to dilate
  • Failure to descend
  • Malpresentation ~11%
  • Non-reassuring FHR ~10%
  • Previous uterine scar ~30%
  • Maternal request • Abnormal placentation-
  • Placenta previa, vasa previa, placenta accreta
  • Maternal infection- HSV or HIV
  • Multiple gestation • Fetal bleeding diathesis
  • Mechanical obstruction to vaginal birth previous obstruction with labor
  • Large leiomyoma or condyloma acuminata, severely displaced pelvic fracture, macrosomia, fetal anomalies such as severe hydrocephalus
138
Q

% of breast cancer that is hereditary

A

5-10%

139
Q

RFs for breast cancer

A

12.8% by age 90
• Menarche before age 12 higher # of cycles in life=higher risk
• First live birth after age 30
• Nulliparity
• Menopause after age 55
• Atypical hyperplasia or LCIS dx by breast biopsy
• Postmenopausal obesity
• HRT
• Alcohol use (>2 drinks/day)
• Previous therapeutic radiation to chest or upper body
• Family history of breast cancer

140
Q

T or F: you are at an increased risk of prostate, pancreatic and colon, uterine and melanoma with + BRCA

A

T

141
Q

when to suspect a hereditary cancer

A

in >2 close relatives, dx

142
Q

red flags for hereditary cancer

A
  • Breast cancer before 50
  • Ovarian cancer at any age b/c 25% chance hereditary
  • Male breast cancer at any age- 13% of positive BRCA
  • Multiple primary cancers
  • Ashkenazi Jewish ancestry
  • Relatives of a BRCA mutation carrier
  • Triple negative breast cancers (ER-/PR-/Her2-)
143
Q

2 genetic testing methods

A

sequencing (determine code) and MLPA or Q-PCR to find whole deletions or duplications

144
Q

T or F: you can reach detection rate in 100%

A

F

145
Q

if genetic test done 5 years ago, no need to get it again

A

false, tests and fm hx can change

146
Q

T or F: Family history is the most effective screening tool for assessing cancer risk

A

T

147
Q

causes of uterine displacement

A
  • Childbirth
  • Heavy physical labor
  • Connective tissue labor- Marfans-absence of strong support
  • Family tendency
  • Age plus gravity
148
Q

tx of uterine prolapse

A

nothing, pessary or surgery (hysterectomy)

149
Q

sx of cystocele

A
  • Pressure
  • Feeling something bulging “feels like egg in vagina when I’m showering”
  • Urinary incontinence, retention
  • Frequent UTIs
150
Q

non surgical options for cystocele

A

pessaries, kegels, double voiding, surgery

151
Q

history clues to rectocele

A
  • Pressure
  • Feeling something bulging
  • Stool incontinence- incomplete emptying, odor
  • “when I am running little balls of poop come out” or “can’t seem to wipe away all the stool”
152
Q

causes of vaginal fistulas

A
  • Childbirth injuries: lacerations, necrosis
  • Previous surgery- urologic procedures
  • Crohn’s disease- most common cause of rectovaginal fistulae
153
Q

FSH > what indicates post menopause?

A

> 30

154
Q

GU problems in menopause

A

atrophy of estrogen dependent tissues: atrophic vaginitis/dryness, itching, burning, more susceptible to UTIs, endometrial atrophy and spotting, cystocele, etc dysuria and frequency

155
Q

menoapuse

A

• 12 months of amenorrhea immediately following last menstrual period- clinical diagnosis

156
Q

when to consider premature ovarian failure

A
  • 1% of women who undergo menopause 30 IU/L

* Causes infertility and perimenopausal/menopausal symptoms

157
Q

lifestyle modifications for hot flashes

A

keep cool, exercise, medication, relaxation, stress reduction, avoid spicy food, caffeine, alcohol, and nicotine

158
Q

most common fx sites in osteoporosis?

A

Vertebrae, hip, and distal radius

159
Q

diff btwn primary and secondary osteoporosis

A

secondary d/t other dz

160
Q

diff between type I and II primary osteoporisis

A

type I d/t increased osteoclastic bone resorption, type II d/t decreased osteoblastic activity

161
Q

conditions involved in secondary osteoporosis

A
  • Malignancies
  • Corticosteroid use
  • GI disorders- poor absorption
  • Endocrine disorders- thyroid problems • Disuse from prolonged immobilization- MS
  • Medications such as heparin or AEDs
  • Alcohol use
162
Q

osteopenia

A

bone density below normal, if catch here can prevent osteoporosis

163
Q

RFs for osteoporosis

A 
•	Alcoholism
•	Smoking
•	Small, thin body build
•	Weight  25	•	Sedentary lifestyle
•	Low calcium and vitamin D
•	Corticosteroid use
•	Prolonged immobilization
and age, causion or asian, female gender, family hx
164
Q

dowager’s thump

A

thoracic kyphosis

165
Q

screening rec’d for bone screen

A

postmenopausal >65, postmenopausal

166
Q

interpretation of T score -1 to -2.5 SD

A

osteopenia

Clinical Medicine (19 decks)

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