19-8 Clinical Care OBGYN Flashcards
(111 cards)
1
Q
what is the second most common cancer in women
A
female breast carcinoma
2
Q
what is the second leading cause of cancer deaths
A
female breast carcinoma
3
Q
what is the most significant risk factor for female breast carcinoma
A
age
4
Q
what is the most reliable means of detecting breast cancer before a mass can be palpated
A
mammography
5
Q
mammography can identify most slow growing cancers within how many years before they are palpable
A
2 years
6
Q
what is the diagnostic procedure of choice in both palpable and image detected abnormalities
A
core needle biopsy
7
Q
local and distant recurrences for female breast carcinoma occur most frequently within what time frame
A
within the first 2-5 years
8
Q
how often should a female with breast carcinoma be examined during the first 2 years
A
every 6 months and then annually thereafter
9
Q
what disease condition in males increase their risk of male breast carcinoma
A
men with prostate cancer
10
Q
which condition has the worse prognosis, male breast carcinoma or female breast carcinoma
A
male breast carcinoma
11
Q
what is described as a painless, hard, ill defined, non tender mass beneath the nipple or areola
A
male breast carcinoma
12
Q
what is described as a painful bilateral, breast mass that worsens during premenstrual phase cycle
A
fibrocystic changes
13
Q
what is the most frequent lesion of the breast
A
fibrocystic changes
14
Q
what is described as a round, rubbery, discrete, mobile, nontender mass of the breast
A
fibroadenoma
15
Q
what is a common benign neoplasm (of the breast) that occurs most frequently in young women
A
fibroadenoma
16
Q
what is the cause of fat necrosis
A
- trauma (MVA or assault)
- segmental resection
- radiation therapy
- flap reconstruction after mastectomy
17
Q
what are risk factors for female breast carcinoma
A
- age
- FMH of breast cancer or ovarian cancer
- BRCA1/BRCA2 mutation
- nulliparous
- early menarche
- late menopause
- PMH of endometrial cancer or cancer in the other breast
18
Q
what is considered early menstrual cycle
A
under 12
19
Q
what is considered late menopause
A
after 55
20
Q
what is described as a single nontender, firm to hard breast mass, with ill defined borders
A
female breast carcinoma
21
Q
what is the treatment for fibrocystic changes
A
- NSAIDs
- avoid trauma
- wear supportive bra
- decrease dietary fat intake
- eliminate caffeine
- vitamin E, 400IU daily
- BSE
22
Q
what causes milky discharge in non lactating women
A
hyperprolactinemia
23
Q
what type of medications can cause lactation in men and women
A
antipsychotic drugs
24
Q
what is the normal range for menstrual bleeding
A
2 to 7 days
25
what is the average number of days for normal menstrual bleeding
5 days
26
what is the mean blood loss per menstrual cycle
40ml
27
blood loss over 80ml
menorrhagia
28
bleeding between periods
metrorrhagia
29
bleeding that occurs more often than every 21 days
polymenorrhea
30
bleeding that occurs less frequently than every 35 days
oligomenorrhea
31
what are structural causes of abnormal uterine bleeding
- polyp
- adenomyosis
- leiomyoma
- malignancy (hyperplasia)
32
what is the most common anovulation cause of abnormal uterine bleeding
ovulatory dysfunction
33
what are the common sequalae of sexual violence
- anxiety disorders
- PTSD
- rape trauma syndrome
34
what are the two principle phases of rape trauma syndrome
- immediate or acute
- late or chronic
35
what is "quickening"
perception of first movement noted
36
at how many weeks can "quickening" be felt
18th week
37
at how many weeks does softening of the cervix occur
around 7 weeks
38
what is chadwick sign
bluish to purple color of the cervix
39
at how many weeks is the uterine fundus palpable above the pubic symphysis
12-15 weeks from the last menstrual period
40
at how many weeks can fetal heart tones be heard
8-10 weeks
41
at how many weeks will the uterine fundus be palpable at the umbilicus
20-22 weeks
42
how long can pregnant women remain on the ship
up until 20th week
43
what is a threatened abortions
- bleeding or cramping occurs
- pregnancy continues
- the cervix is not dilated
44
what type of abortion has a dilated cervix
incomplete abortion
45
what type of abortion is it when the cervix is not dilated
threatened abortions
46
what causes functional amenorrhea
hypothalamic pituitary
47
what are the complications of premature menopause
increased risk of coronary disease, stroke, and mortality
48
what is the most common cause of secondary amenorrhea in premenopausal women
pregnancy
49
any female with vaginal bleeding, a positive hCG, and abdominal pain is experiencing what condition
ectopic pregnancy
50
what trimester does ectopic pregnancies usually occur
first trimester 2% of the time
51
what are the risk factors for ectopic pregnancy
- infertility
- PID
- ruptured appendix
- prior tubal ligation
52
what is the most common cause of maternal death during the first trimester
ectopic pregnancy
53
what condition does the patient have:
- unilateral pelvic pain
- vaginal bleeding
- adnexal tenderness
- positive hCG
ectopic pregnancy
54
treatment for ectopic pregnancy
- laparoscopy
- methotrexate 50mg/mm IM
55
what are complications of ectopic pregnancy
- shock
- anemia
- repeat tubal pregnancy
56
how often does repeat tubal pregnancies occur
10%
57
what is the procedure of choice to confirm and remove ectopic pregnancy
laparoscopy
58
what causes mastitis
staph aureus
59
what condition must be considered if mastitis occurs in nonlactating breast
inflammatory carcinoma
60
what antibiotics are used for mastitis caused by MSSA
- cephalexin (keflex)
- clindamycin
61
what antibiotics are used for mastitis caused by MRSA
- trimethroprim/sulfamethoxazole (bactrim)
62
what are the complications of mastitis
- abscess formation
- sepsis
63
within how many hours should a patient with mastitis be referred to supervising physician if no improvement
72 hours
64
what is primary amenorrhea
- failure of menarche to appear
65
what age does menarche ordinarily occur
11-15 years
66
what is secondary menarche
absence of menses for 3 consecutive months in women who have began menses
67
what is the terminal episode of naturally occurring menses
menopause
68
when can a diagnosis of menopause be made
after 6 months of amenorrhea
69
nearly 70% of adnexal torsions occur on what side
right
70
What type of abortion is it when:
- products of conception are completely expelled
- pain stops
- cervical os is closed
- blood in vaginal vault
- spotting may persist
complete abortion
71
What type of abortion is it when:
- the cervix is dilated
- some products of conception remains in the uterus
- mild cramps
- bleeding is excessive
incomplete abortion
72
what type of abortion has
- brownish vaginal discharge but no active bleeding
- pain stops
- cervix is semi firm and slightly patulous
- adnexal are normal
- uterus is smaller
- products of conception has not been expelled
missed abortion
73
what are the complications of pregnancy loss
- hemorrhage
- anemia
- recurrent abortion
74
what instruction governs pregnancy
opnavinst 6000.1
75
what is the instruction that governs sexual assault patient
SECNAVINST 1752.4
76
when is uterine catherization contraindicated
- high riding/ free floating prostate
- blood at urethral meatus
- perineal hematoma
77
where is the urethral meatus located
lies in the superior fornix of the vulva above the vaginal opening and below the clitoris
78
how many times do you clean the area before inserting a foley in a female
4-5 times
79
how many times do you clean the area before inserting a foley into a male
3-4 times
80
under what conditions are pregnant service women allowed to stay on the ship
- up til 20th week of pregnancy
- while in port
- during short underway
(if MEDEVAC is within hours)
81
what type of nipple discharge is more likely benign fibrocystic changes
serous (clear)
82
what type of discharge is more likely neoplastic papilloma or carcinoma
bloody
83
bilateral nipple discharge is likely associated with what
non neoplastic ENDOCRINE etiology
84
what causes inflammation of the vagina
- pathogens
- allergic reactions to contraceptives
- vaginal atrophy
- friction
85
what condition has
- vaginal irritation
- pain
- unusual or malodorous discharge
- pelvic inflammation
- cervical motion tenderness
- adnexal tenderness
vaginitis
86
what are things that predispose patients to vulvovaginal candidiasis
- broad spectrum antibiotics
- pregnancy
- diabetes
- corticosteroids
- heat
- moisture
- occlusive clothing
87
what condition is:
- pruritis
- vulvovaginal erythema
- white curd like discharge
- NOT malodorous
vulvovaginal candidiasis
88
what condition is:
- sexually transmitted protozoal
- infects vagina, skene ducts, and lower urinary tract
- pruritis
- malodorous frothy, yellow-green, discharge with diffuse vaginal erythema
- strawberry cervix
trichomonas vaginalis
89
which vaginitis is caused considered to be a polymicrobial disease that is not sexually transmitted and chronic in nature
bacterial vaginosis
90
what is caused by an overgrowth of gardnerella and other anerobes
bacterial vaginosis
91
what is increased malodorous discharge without obvious signs of vulvitis or vaginitis
bacterial vaginosis
92
what is the treatment for vulvovaginal candidiasis
antifungals (fluconazole)
93
what is the treatment for trichomonas
metronidazole (antibiotic)
- treat both partners
94
what is the treatment for bacterial vaginosis
metronidazole
clindamycin vaginal cream
95
what patient education should be given to someone with vaginits
- avoid nonabsorbent undergarments
- avoid douching
- delay sexual intercourse until tx is complete
96
what age should cervical cancer screening begin
21
97
how many years is cervical screening and PAP requirements for age 21-65
every 3 years
98
at what age is HPV testing conducted
at age 30
99
how often are PAP and cervical screenings required in women aged 30-65 with negative HPV risk factors
every 5 years
100
in what 2 ways can PAP be described
1. ASC-US (Atypical Squamous Cell of Unknown Significance)
2. SIL (Squamous intraepithelial Lesions)
101
what system is used to report PAP smear
bethesda system
102
when is the follow up for women with ASC-US and negative HPV screening
1 year
103
What is indicated if a woman have ASC-US and a positive HPV screen
colposcopy
104
what vaccination is recommended for the prevention of HPV
gardasil
105
what age is gardasil recommended
age 9 and older
106
what is the treatment for cervical dysplasia
- cryosurgery
- CO2 laser
- LEEP
- Conization
107
most common benign neoplasm of the female genital tract
leiomyoma
108
what condition is described as a discrete, round, firm, often multiple uterine tumor
leiomyoma
109
where are lesions from endometriosis typically located
- pelvis
- bowel or diaphragm
110
when is early menopause
before age 45
111
when is premature menopause
before age 40
