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AGNP AANC Boards > Womens Health > Flashcards

Womens Health Flashcards

1
Q

Absolute Contraindications for OCP

A

MY CUPLETS

Migraine > 35
CAD of CVA
Undx gental bleeding
Pregnant 
Liver tumor or liver dx
Estogen dependent tumor 
Thrombus or emboli 
S: smoker age 35 or OLDER

less that 21 days post-partum

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2
Q

Relative Contraindications for OCP

A 
cigarette smoking < 35 
DM w/ NO vascular complications
Fibriods
Obesity
Mirgraine < 35 (on both)
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3
Q

advantages of COC and OCP’s

A

decreased problems with

  • cramps ( increased prostaglandins)
  • light more reg periods ( less anemia)
  • acne ( suppression of ovaries)
  • ovarian cysts ( suppression of ovaries)
  • fibrocyctic breasts ( decrease in progestrone)
  • lower risk of PID ( progesterone thicken mucus pug)
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4
Q

How do OCP’s work?

A

thicken mucus plug

and surpresses ovulation

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5
Q

what hormone stays the same amount in OCP’s

A

estrogen its the progesterone that changes

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6
Q

POP keys

A

safe for breast feeding mothers

if dose taken 3 hours late - take when remember but use condom for 48 hours

miss one day: take two tablets that day and then back up for 48 hours

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7
Q

Ortho Evra

A

transdermal patch change each week x 3 weeks

has more estogren exposure

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8
Q

Nuvaring

A

insert once a month, must be in vagina 7 days to be effective

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9
Q

keys to starting birth control

A

can start at any time during cycle
use back up method for 7 days

just r/o preg ( no need to get a pelvic or STI testing)

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10
Q

BTB ( breakthrough bleeding) Unscheduled bleeding

A

likely to occur in first 3 months of new perscription

r/o other things

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11
Q

missed two OCP’s pills

A
  1. take two active pills ASAP
  2. take one pill daily until finished 21 day active pills
  3. Skip placebo and start new pack
  4. use condoms
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12
Q

drug interactions with OCP’s

A

” triple A”
Anticonvulsants : phenobarb, phenytoin
Antifungal : griseofulvin
Antibiotics : amplicilin, tertracyline, rafampin

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13
Q

Pill danger signs

A 
ACHES
Abdominal pain
Chest pain 
Headache
Eye problems
Severe leg pains
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14
Q

Plan B

A

contains levonorgestrol ( tyep of progresterone)

take 1 st dose asap ( upt 72 hours) after unprotected sex

take second dose within 12 hours of first dose

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15
Q

ParaGuard

A

IUD - good for 10-12 years

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16
Q

Mirena

A

5 years

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17
Q

contraindications for IUD’s

A 
recent infection or abortion
STD
uterine cancer
preg
undx vaginal bleeding
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18
Q

Depo-provera

A

injection lasting 3 months

not for women who want to get pregnant in 12-18 months

long term > 5 years use can cause: osteoporosis and weight gain

rec to only use for 2 years or less

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19
Q

Diaphram w/ gell

A

shouldnt feel it if proper size
can leave inside for 24 hours
additonal spermacide after every act of intercourse
leave in on for 6-8 hours after intercourse

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20
Q

Nexplanon

A

sudermal only containing progestin

effective for 3 years

use back up

21
Q

Birth control options for smokers greater than 35 or where estrogen is contraindicated

A 
barrriers
IUD
Nexplanon
Depo- Provera
Progresten only pills
22
Q

dysmenorrhea

A

uterine pain die first few days of menstraul period caused by prostaglandins

considered OCP’s, Ponstel (nsaid)

23
Q

Uterine Leiomyomas (fibroids)

A

benign tumors of the uterus

middle age women complains of heavy menstraul bleeding w/ lower back pain

will see smooth muscular mass on the uterine that is not tender

get a pelvic and transvaginal US

24
Q

fibroids in post-menapausal women

A

new onset or rapidly enlarging fibroid - r/o cancer

25
Q

Drugs contraindiacted in pregnancy

A

Live anntenuated virus vaccines
- measles, mumps, rubella, varicela, flumist, shingles, oral polio, rotavirus

Quinolones ( achililes tendon, hyperglycemia)

Trimethoprom-sulfamethazole ( hemolytic anemia, can also cause hyperkalemia if mixed ace and arb)

Tetracycline (stain on tooth enamil)

Ace /Arb ( poor kidney formation)

26
Q

BV

A

not STI its overgrowth of bacteria on vagina

strong odor, off white thin runny d/c

increased risk of PID, pre-term labor

DX : microscopy / wet smear (amsel criteria)

  • will see clue cells > 20 %, WBC and mobiluncus bacteria (squamous epithelial cells whose surfaces and edges are coated with large numbers of bacteria )
  • whiff test + and ph > 4.5

tx : metronidazole for 7 days or gel for 5 days

27
Q

What is a disulferam - like drug reaction

A

if flaygl is mixed with alcohol ( n/v/ HA high BP)

28
Q

Trichomonias

A

STI
unicellular protozoan w/ flagellas infects W and M

severe vulvar and vaginal pruritis w/ green dicharge
vagina will look irritated and red
cervix = punctate hemorrhages and petecchiae ( strawberry cervix)
copious yellow/green frothy discharge

dx: Microscopy / Wet smear ( low power)
- look for protozoa w/ flagelle adn WBC’s

TX: Flagly x 7 dyas

tx sexual partner

29
Q

Candida Vaginitis

A

yeast infection

itching and burning, curd liek d/c

DX: Microscopy/wetsmear
- large # WBC’s, pseudohyphae and spores *, may have some RBC if inflammation

TX: OTC clotrimazole or miconazol
can give perscription fluconazole if resistant one dose

30
Q

Cervical Ectropion

A

glandular cells inside and around the os. Appears as bright bumps on the cervical surface covered in clear mucus. Teens and younger girls have larger ones.

31
Q

Nabothian Cyst

A

a normal fingins. mucous retention cyst

32
Q

HPV /pap smear testing for under 20

A

do not screen

33
Q

HPV /pap smear testing for 21-65

A

if co-testing every 5 years if not testing HPV then pap q 3 years

34
Q

HPV /pap smear testing for > 65

A

no rec if no hx of cancer in 20 years

35
Q

HPV /pap smear testing for people who have under gone a hysterectomy?

A

if no hx of cancer than can d/c

36
Q

coloposcopy does what

A

obtains cervical and endocervical biopsies

37
Q

endometrial biospy for what?

A

do when suspecting endometrial hyperplasia cancer ( post-menopausal bleeding), pap smear with presence of grandular cells . NOT for the cervix

38
Q

Cytology/pap must include what

A

both endocervical and squamous epithelial cells

repeat pap if not have both

39
Q

Atypical squamous cells in pap smear sig age 20 and below

A

repeat pap in 1 year

40
Q

Atypical squamous cells in pap smear sig age 21-24

A

repeat pap in 1 year

41
Q

Atypical squamous cells in pap smear sig age 25 and older

A

order HPV testing . if HPV pos but strains are non-oncogenic then repeat in 1 year

if oncogenic types #16 and #18 then refer for colposocopy and cervical biopsy

42
Q

Atypical glandular cells

A

common in 40-60 age women

associated with premalignant refer for endometrial and endocervical biopsy

43
Q

Low-grade squamous intraepithelial lesions and high grade squamous epithelial lesions

A

do HPV and refer for colposcopy, biopsy and tx

44
Q

LEEP

A

leep is a device that cuts through cervix to treat cervical cancer. Depedning on result of biopsy the cancerous can be removed by cryotherapy for mild lesions

45
Q

Perimenapause

A

hot flashes, nigh sweats, insomnia, dysfunctional uterine bleeding

meds: soy milk, tofu, wild yams, SSRI, exercise

46
Q

Menopause

A

amenorrhea for 12 consectutive months

increased risk of osteoporosis and cad

47
Q

should you be able to palpate uterus and right ovary in menapuasal person?

A

no, if you feel ovary w/ smooth surface adn non tender then you should order pelvic and intravaginal US to r/o ovarian cancer

48
Q

Atrophic Vaginitis

A

normal part of menapause
chronic lack of estrogen affects the labia, vagina, urethra/

TX: vaginal lubricants
topical and oral estogen rec first ( check if no risk factors)

vaginal ring avail - if intact uterus then add progesterone for 10-12 days a month to prevent hyperplasia of the endometrium

49
Q

Hormone replacement therapy

A

its combined estrogen and progesterone
increase risk of : heart disease, stroke breast and unterine cancer dvt adn emboli

if given, give the lowest dose for lowest amoutn of time ( only for people who have moderate - severe menopauseal symptpoms

AGNP AANC Boards (27 decks)

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