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Therapeutics > 43: Nonhormonal and Preventative Health > Flashcards

43: Nonhormonal and Preventative Health Flashcards

1
Q

Reproductive Tract overview

A
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2
Q

Menstrual Cycle phases

A

-follicular (menses -> ovulation)
-luteal (ovulation –> menses)

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3
Q

Follicular phase

A

-menses to ovulation

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4
Q

luteal phase

A

ovulation to menses

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5
Q

ovulation mech

A

-drop in estrogen
-LH surge
-release of matured follicle

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6
Q

Preventative Health

A

-annual exam (vital, breast, pelvic screening)

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7
Q

breast exam for avg risk women

A

-self/clinical exam
-mammogram (start at 40-50 until 75 every 1-2 years)

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8
Q

breast exam for HIGH risk women

A

-BRCA1/2 mutations
-breast MRI and mammogram ANNUALLY (start at age 30)

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9
Q

Pelvic Exam screens for

A

-STI
-gyno cancers
-pelvic inflammatory disease
-ovarian cysts, polyps, fibroids

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10
Q

Pelvic exam components

A

-assess external genitalia
-internal speculum exam or recto vaginal exam

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11
Q

Pelvic exam recommendations

A

-not really for asymptomatic patients
-performed when indicated by medical history or symptoms

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12
Q

Cervical Screening (PAP smear)

A

-swab inserted into vagina to collect cells

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13
Q

Cervical Screening recommendations

A
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14
Q

What groups don’t really need cervical screening?

A

-under 21 years
-over 65 years w normal prior screenings
-hysterectomy w cervix removal

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15
Q

Cervical Screening recommendations age 21-29

A

-Pap smear every 3 years

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16
Q

Cervical screening recommendations for 30-65 years

A

-choose one:

-pap every 3 years
-HPV test every 3 years
-PAP and HPV every 5 years

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17
Q

big takeaway of cervical screenings

A

-age 21-29 start
-every 3 years

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18
Q

most common STI in US

A

-HPV

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19
Q

HPV (human papillomavirus)

A

->150 viruses
-42.5% of adults 18-59
-warts (papilloma) but also asymptomatic

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20
Q

HPV genital warts may lead to

A

-inc risk of multiple cancers

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21
Q

HPV transmission

A

-skin-to-skin contaact
-vaginal, anal, oral sex

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22
Q

HPV-associated cancers in women

A

-Cervix (most)
-Vagina
-Vulva
-Anus (most)
-Oropharynx

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23
Q

HPV-associated cancers in men

A

-penis
-anus (most)
-oropharynx

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24
Q

HPV prevention

A

-barrier protection
-mutual monogamy
-male circumcision
-HPV screening
-vax

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25
Q

HPV screening for pts w cervix

A

-follow recommended cervical screening guidelines

26
Q

HPV screening for pts w penis

A

-no recommended routine screening
-high risk pt may benefit from anal PAP smear

27
Q

patients w penis at higher risk of HPV include

A

-men who have sex w men
-HIV+ men

28
Q

HPV vax

A

-Gardasil 9
-Cervarix and Gardasil discontinued

29
Q

Gardasil 9 indication

A

-HPV vax against 9 strains
-males and females age 9-45

-recommended to start. 9-11 years old

30
Q

Gardasil 9 admin schedule

A

-if UNDER 15: 2 doses
-if OVER 15: 3 doses

31
Q

Gardasil 9 admin in <15yo

A

-2 doses
-0 months
-6-12 months

32
Q

Gardasil 9 admin in >15yo

A

-3 doses
-0 month
-2 month
-6 month

33
Q

Gardasil 9 vax efficacy in ages 19-26

A

-98-100% prevention of HPV-cancers in females
~75% in males

34
Q

Gardasil 9 vax efficacy in ages 27-45

A

-88-95%
-slightly less effective
-provides less benefit after exposure!

35
Q

Gardasil 9 side effects

A

-injection site reactions
-dizzy/fatigue
-headache
-syncope
-vomitting
-myalgia

36
Q

Patient Case:

-19 y/o F
-only received one dose of Gardasil at age 16

How many additional doses should she receive to complete series

A

-2 more doses

-3 dose series bc she started after age 15

37
Q

Role of provider

A

-educate about HPV risk
-give recs
-utilize standing orders
-process and monitor for follow up

38
Q

Non-hormonal contraception

A

-

39
Q

Stats of contraception

A

-65% of women aged 15-49 are on contraception

40
Q

Reasons for non-hormonal contraception

A

-back up hormonal method
-side effects/contraindications
-no need for ongoing contraceptives
-no alteration to body’s natural cycle

41
Q

Behavioral Contraceptive methods

A

-Coitus interuptus (withdrawal)
-Lactation Amenorrhea Method (LAM)
-Fertility Awareness Methods (FAM)
-Natural Family Planning (NFP)

42
Q

FAM + NFP methods

A

-Basal Body Temp (BBT)
-Billings Ovulation Method
-Calander/Rhythym method
-standard days method
-two-day method

43
Q

Basal Body Temp (BBT)

A

-predict ovulation
-regular cycles
-take temp every morning
-record in chart

44
Q

BBT change that signifies ovulation

A

-slight drop in temp followed by large inc in temp (1 degree)

45
Q

Billing Ovulation method

A

-monitor cervical mucus
-clearer,thinner mucus is fertile
-irregular cycles

46
Q

cervical mucus during fertility

A

-clearer
-thinner

47
Q

Calander/rhythym method

A

-based on past cycles
-Fertile days = shortest cycle -18 days and longest cycle - 11 days

48
Q

Standard days method

A

-26-32 day cycle
-move rubber band around colored beads like a calander

49
Q

2-day method

A

-cervical secretions
-pregnancy UNLIKELY if no secretions for 2 days

50
Q

FAM + NFP monitoring

A

-sympothermal
-electronic (detect LH)
-marquette

51
Q

Natural Cycles App

A

-first app approved by FDA for contraception
-based on BBT and cycle data
-App will prompt use to use protection on fertility days
-1-7% failure rate

52
Q

Advantages to FAM and NFP

A

-no effect on hormones/cycle
-no side effects
-inexpensive/free
-culturally acceptable

53
Q

Disadvantages to FAM +NFP

A

-no STI protection
-hard for irregular cycles
-consistent montioring
-requires abstinence/back up contraception

54
Q

Barrier methods

A

-prevent sperm from entering uterus
-fewer side effects but less efficacy

55
Q

Barrier devices

A

-condoms
-vaginal sponge
-diaphragm
-cervical cap
-gel/spermicide

56
Q

Long-term non-hormonal birth control

A

-Copper IUD
-sterilization

57
Q

Copper IUD

A

-up to 10 years
-can be used as emergency
-inserted and removed by HCP
-copper is spermicide
-no STI prevention

58
Q

IUD side effects

A

-heavy bleeding
-spotting

59
Q

Sterilization

A

-male vasectomy
-tubal ligation

60
Q

Contraception efficacy

A
  1. implant, IUD, sterilization
  2. injection, pill, patch, ring, diaphragm
  3. condom, sponge
  4. FAM and spermicide
61
Q

pt case

wants to try effective non-hormonal but wants children later

A

-copper IUD

Therapeutics (78 decks)

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