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Quarter 4 > womens health exam 1 last review > Flashcards

womens health exam 1 last review Flashcards

1
Q

Screening mammogram

A

2 craniocaudals

2 mediolateral obliques

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2
Q

diagnostic mammogram

A

craniocaudal
mediolateral oblique
AND more views

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3
Q

FNA (fine needle aspiration) helpful for

A

initial method to evaluate a mass with low pretest prob of CA

Determine if lump is a SIMPLE CYST

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4
Q

Cyclical mastalgia (pain)

A

Fibrocystic changes

bilateral, diffuse

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5
Q

Noncyclical mastalgia

A

Meds

Large, pendulous breasts

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6
Q

First line tx of Mastalgia (pain)

A

Reassurance
Physical support (better bra)
NSAIDs or Acetaminophen (analgesics)

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7
Q

Hard, red, tender swollen area

Staph

A

Mastitis

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8
Q

Tx for Mastitis

A

Dicloxicillin or Cephalexin

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9
Q

Peak age of breast cyst

A

35-50

Smooth, mobile mass

often well defined on palpation

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10
Q

Management for simple cyst

A

none needed

FNA IF symptomatic

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11
Q

Management for Complex cyst (1-24% CA)

A

Biopsy

possible excision

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12
Q

Fibroadenoma

A

Benign, SOLID tumor with glandular and fibrous tissue

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13
Q

Usually firm and NONTENDER well defined mobile mass

Can inc with Estrogen use and pregnancy

A

Fibroadenoma

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14
Q

Mgmt for Fibroadenoma

A

Core needle biopsy

If increase in size, must excise

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15
Q

Fibroepithelial tumor

A

Phyllodes Tumor

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16
Q

Fibroadenoma typical age

A

15-35 YO

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17
Q

Breast cyst typical age

A

35-50 YO

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18
Q

Cause of pathologic discharge (bolded)

A

Intraductal papilloma

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19
Q

Biggest two risk factors for Breast CA

A

Female

Older age

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20
Q

Men with what gene have higher risk of Breast CA

A

BRCA2

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21
Q

BRCA gene (+), what now?

A

Increased surveillance
Treat with Tamoxifen (if older than 35)
Surgical prevention

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22
Q

Best time for exam, follicular or luteal phase?

A

Follicular

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23
Q

Mammogram screening,

A

ALL women 50 or older,

STOP at age 75

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24
Q

How often to screen from age 50-75?

A

Every 1-2 yrs

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25
Most common clinical sx of breast CA
palpable mass
26
which type of breast CA is more aggressive- Ductal or Lobular?
Ductal treated as CA bc it has potential to become invasive
27
On mammogram, how does DCIS appear?
Clustered pleomorphic CALCIFICATIONS
28
LCIS
does NOT become invasive if left untreated
29
What meds are used for Breast CA?
Tamoxifen | Arimidex
30
LCIS and DCIS are non invasive types....vs what types are invasive?
IDC- infiltrating ductal CA and ILC- infiltrating lobular CA
31
What is the MOST COMMON Breast CA?
Infiltrating Ductal Carcinoma IDC
32
How does IDC (the most common breast CA) usually present?
Palpable mass, or | Mammogram abnormality
33
ILC- Infiltrating Lobular CA is usually..
Bilateral
34
Pagets is scaly usually underlying CA
Scaly, raw, vesicular, or ulcerated lesions begins on nipple and spreads to the areola pain, burning, itching may occur even before the dz 85-88% have an underlying breast CA!!
35
Inflammatory (orange) Breast CA
Very AGGRESSIVE
36
Inflammatory Breast CA (IBC)
Pea'd'orange Erythema rapidly progressing, tender, firm, enlarged breast
37
Is IBC- Inflammatory breast CA usually assoc w lymph node involvement?
YES | almost always, adn 1/3 with distant METS
38
Primary spread of Breast CA
Axillary nodes
39
Hematogenous (blood) spread of Breast CA
Lung and Liver
40
Radiation is almost always used, usually when?
AFTER surgery
41
Types of radiation
External beam 4-7 wks Brachytherapy: seeds/wires places in or near tumor, shorter duration (days)
42
Chemo
Primary and METS Breast CA and ALL PTS with (+) LYMPH NODES
43
Chemo used for
High Oncotype DX recurrence scores
44
Neoadjuvant chemo
given BEFORE surgery to shrink
45
Adjuvant Chemo
AFTER surgery
46
SERM breast CA tx if pre-menopausal
Tamoxifen
47
Aromatase inhibitor breast CA tx if post-menopause
Arimidex (Anastrozole)
48
How long to use hormone therapy for breast CA?
5-10 years
49
What to use if pt has HER2 gene
Herceptin (trastuzumab) targets HER2 protein
50
When to use Chemoprevention? Tamoxifen
>35 YO | increased risk
51
High risk unintended preg
``` 18-24 Black or Hispanic low education poverty live together b4 married ```
52
Make sure woman NOT preg before giving birth control if pt meets ANY of these, 99% sure not pregnant
``` <7 days after start of menses <7 days after iabortion within 4 wks last baby fully/nearly breasfeeding, no period, AND 6 mo postpartum no sex since last menses correctly using birth conrol ```
53
Natural family plannind
Standard days: abstain from sex on days 8-19 Calendar: avoid during fertil period
54
Rise in temp 0.5-1 F
ovulation abstain from end of menses until 3 days after temp increase
55
Barrier methods
``` Diaphragm Condoms Cervical cap Cervical sponge Spermicide ``` GOOD; no effect on menses BAD; no protection of HIV, UTI risk w diaphragm
56
Condom more likely to slip/break
Polyurethane
57
Emergency Contraception
Plan B/Preven; 2 doses of bc taken w/in 72 hr IUD inserted w/in 5 d Ulipristal Acetate "Ella", an SPRM
58
Short acting/frequent use are good for
women who have short interval prior to wanting a pregnancy, woman using for non contraceptive benefits, uninsured w money concerns
59
COC concern
Test BP prior to startting
60
mechanism of COC
ovulation suppression!!!! inhibit GnRH, LF, FSH, and LH surge and thicken mucus
61
Risk of COC
HTN Blood Clot MI and Stroke Lipid/metabolic changes
62
Progestin only
Mini pill, POP, | norethindrone and Drospirenone
63
Norethindrone and Drospirenone
Progestin Only
64
use Prog only in | norethindrone and drospirenone
Nursing mothers Estrogen is contra thickens cervical mucus
65
downfall of Prog only
limited window for missed pills, taking >3 hrs late will decrease effectiveness
66
LARC are
Long Acting Reversible Contraceptives
67
LARCs
Subdermal implants (Nexplanon) Levonorgestrel IUD Copper IUD
68
Levonorgestral IUD | Mirena
3-6 yrs of use | thicken mucus, change endometrium to preven implant
69
Copper IUD
10 years of use! inhibits SPERM motility may INCREASE menstrual blood loss and dysmenorrhea
70
Risk of all IUD
ectopic pregnancy spontaneous abortion preterm delivery

Quarter 4 (10 decks)

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