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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
Q

Most common clinical sx of breast CA

A

palpable mass

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26
Q

which type of breast CA is more aggressive- Ductal or Lobular?

A

Ductal

treated as CA bc it has potential to become invasive

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27
Q

On mammogram, how does DCIS appear?

A

Clustered pleomorphic CALCIFICATIONS

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28
Q

LCIS

A

does NOT become invasive if left untreated

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29
Q

What meds are used for Breast CA?

A

Tamoxifen

Arimidex

30
Q

LCIS and DCIS are non invasive types….vs what types are invasive?

A

IDC- infiltrating ductal CA
and
ILC- infiltrating lobular CA

31
Q

What is the MOST COMMON Breast CA?

A

Infiltrating Ductal Carcinoma

IDC

32
Q

How does IDC (the most common breast CA) usually present?

A

Palpable mass, or

Mammogram abnormality

33
Q

ILC- Infiltrating Lobular CA is usually..

A

Bilateral

34
Q

Pagets is scaly

usually underlying CA

A

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
Q

Inflammatory (orange) Breast CA

A

Very AGGRESSIVE

36
Q

Inflammatory Breast CA (IBC)

A

Pea’d’orange
Erythema
rapidly progressing, tender, firm, enlarged breast

37
Q

Is IBC- Inflammatory breast CA usually assoc w lymph node involvement?

A

YES

almost always, adn 1/3 with distant METS

38
Q

Primary spread of Breast CA

A

Axillary nodes

39
Q

Hematogenous (blood) spread of Breast CA

A

Lung and Liver

40
Q

Radiation is almost always used, usually when?

A

AFTER surgery

41
Q

Types of radiation

A

External beam 4-7 wks

Brachytherapy: seeds/wires places in or near tumor, shorter duration (days)

42
Q

Chemo

A

Primary and METS Breast CA and ALL PTS with (+) LYMPH NODES

43
Q

Chemo used for

A

High Oncotype DX recurrence scores

44
Q

Neoadjuvant chemo

A

given BEFORE surgery to shrink

45
Q

Adjuvant Chemo

A

AFTER surgery

46
Q

SERM breast CA tx if pre-menopausal

A

Tamoxifen

47
Q

Aromatase inhibitor breast CA tx if post-menopause

A

Arimidex (Anastrozole)

48
Q

How long to use hormone therapy for breast CA?

A

5-10 years

49
Q

What to use if pt has HER2 gene

A

Herceptin (trastuzumab) targets HER2 protein

50
Q

When to use Chemoprevention?

Tamoxifen

A

> 35 YO

increased risk

51
Q

High risk unintended preg

A 
18-24
Black or Hispanic
low education
poverty
live together b4 married
52
Q

Make sure woman NOT preg before giving birth control

if pt meets ANY of these, 99% sure not pregnant

A 
<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
Q

Natural family plannind

A

Standard days: abstain from sex on days 8-19

Calendar: avoid during fertil period

54
Q

Rise in temp 0.5-1 F

A

ovulation

abstain from end of menses until 3 days after temp increase

55
Q

Barrier methods

A 
Diaphragm
Condoms
Cervical cap
Cervical sponge
Spermicide

GOOD; no effect on menses
BAD; no protection of HIV, UTI risk w diaphragm

56
Q

Condom more likely to slip/break

A

Polyurethane

57
Q

Emergency Contraception

A

Plan B/Preven; 2 doses of bc taken w/in 72 hr

IUD inserted w/in 5 d

Ulipristal Acetate “Ella”, an SPRM

58
Q

Short acting/frequent use are good for

A

women who have short interval prior to wanting a pregnancy, woman using for non contraceptive benefits, uninsured w money concerns

59
Q

COC concern

A

Test BP prior to startting

60
Q

mechanism of COC

A

ovulation suppression!!!!

inhibit GnRH, LF, FSH, and LH surge

and thicken mucus

61
Q

Risk of COC

A

HTN
Blood Clot
MI and Stroke
Lipid/metabolic changes

62
Q

Progestin only

A

Mini pill, POP,

norethindrone and Drospirenone

63
Q

Norethindrone and Drospirenone

A

Progestin Only

64
Q

use Prog only in

norethindrone and drospirenone

A

Nursing mothers
Estrogen is contra

thickens cervical mucus

65
Q

downfall of Prog only

A

limited window for missed pills, taking >3 hrs late will decrease effectiveness

66
Q

LARC are

A

Long Acting Reversible Contraceptives

67
Q

LARCs

A

Subdermal implants (Nexplanon)

Levonorgestrel IUD

Copper IUD

68
Q

Levonorgestral IUD

Mirena

A

3-6 yrs of use

thicken mucus, change endometrium to preven implant

69
Q

Copper IUD

A

10 years of use!
inhibits SPERM motility

may INCREASE menstrual blood loss and dysmenorrhea

70
Q

Risk of all IUD

A

ectopic pregnancy
spontaneous abortion
preterm delivery

Quarter 4 (10 decks)

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