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Repro Flashcards

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1
Q

Pelvic inflamm disorder (what organs does it involve, is it always acutely known, what can form as a result)

A

infectious condition of the pelvic cavity
May involve infection of cervix, fallopian tubes, and pelvic peritoneum

Ovarian abscess may form (Pocket full of pus)

May be “silent” when women do not perceive any symptoms; others will be in acute distress

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2
Q

PID often results from

A

Often the result of untreated cervicitis

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3
Q

Most common organisms causing PID

A

Chlamydia and Gonorhea

Also
anaerobes, mycoplasma, streptococci, enteric Gram-negative rods

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4
Q

How do organisms gain entrance

A

during sexual intercourse and after pregnancy termination, pelvic surgery, or childbirth

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5
Q

When should people be tested

A

Women at risk for chlamydial infections should be routinely tested

Younger women in repro years
People with more than one partner
People having intercourse with more than one partner

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6
Q

PID clinical man

A

Lower abdominal pain
Starts gradually & becomes constant
Varies from mild to severe
Pain with intercourse

Spotting after intercourse
Purulent cervical or vaginal discharge
Fever & chills

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7
Q

Less acute ss of PID

A

Increased cramping pain with menses, irregular bleeding, some pain with intercourse

May be undiagnosed & untreated if mild

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8
Q

PID diagnosis

A

Based on ss

Bimanual portion of pelvic exam

Abnormal discharge

C&S

Pregnancy tst to rule pit ectopic pregnancy

Vaginal Ultrasound

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9
Q

PID Complications

A

Septic shock (If abcesses rupture)

Fitz-Hugh-Curtis syndrome – PID spreads to liver

Pelvic or generalized peritonitis

Embolisms

Adhesions & strictures in fallopian tubes
- increased risk of ectopic pregnancy (10x)

Risk of recurrent infection
Infertility

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10
Q

PID collab care

A

Treated as outpt

Broad spectrum antibiotics – e.g. Cefoxitin & Doxycycline
No intercourse for 3 weeks

Examination & treatment of partner
Rest
Oral fluids

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11
Q

Tx of abcess

A

Hospitalization
Corticosteroids
Bed rest in semi-Fowler’s position
Drainage of abscess
Hysterectomy

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12
Q

Endometriosis

A

presence of endometrial epithelial and/or stromal cells normally found in the lining of your uterus growing in sites outside the uterus
Most frequent sites are in or near the ovaries, uterosacral ligaments and uterovesical peritoneum.

Can also be in other locations: stomach, lungs, intestines, & spleen

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13
Q

How does endometriosis cause SS?

A

Tissue responds to hormones of ovarian cycle & undergoes a “mini-menstrual cycle like the uterine endometrium but because it has nowhere to exit becomes trapped irritating tissues and causing scar tissue and adhesions.

Typical patient is late 20s or early 30s, white, never had a full-term pregnancy
Not life-threatening but can cause considerable pain

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14
Q

Why does endometriosis occur?

A

Poorly understood- Retrograde menstrual flow passes through fallopian tubes carrying viable endometrial tissues into pelvis  tissue attaches to various sites

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15
Q

SS of endometriosis

A

Secondary dysmenorrhea
Infertility
Pelvic pain
Painful intercourse
Irregular bleeding

Backache
Painful bowel movements
Dysuria

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16
Q

Collab care of endometriosis

A

History & physical
Pelvic exam
Laparoscopy, U/S, MRI

tx of endometriosis
- Watch and wait

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17
Q

Drug tx of endometriosis

A

NSAIDS
Oral contraceptives
Danazol - synthetic andorgoen (Ovarian suppression)
Gonadotropin hormone agonist

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18
Q

Sx tx of endometriosis

A

Laparotomy
Total hysterectomy & removal of ovaries

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19
Q

Types Benign Ovarian Tumors

A

Cysts: soft; surrounded by thick capsule
Detected during reproductive years

Neoplasms: Cystic or solid
Small or extremely large
May originate from germ cells & can contain bits of any type of body tissue (e.g. hair, teeth)

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20
Q

Tx of ovarian tumor

A

Immediate surgery necessary for ovarian torsion (twistinging)

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21
Q

Why is ovarian cancer so deadly

A

Most go without SS, and aren’t caught until it’s too late

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22
Q

Ovarian cancer ss

A

Often result in bowel blockage
Bloating
Irregular periods

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23
Q

Those at risk for Ovarian cancer

A

Family hx - breast or colon
BRCA1 and BRCA2 gene mutations
nulliparity, age, high-fat diet, increased ovulotory cycles ep

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24
Q

Types of ovarian cancer cells

A

About 90% are epithelial , 10% germ cell tumours

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25
Collab care of ovarian cancer
Chemotherapy, radiation and surgery
26
Cervical Cancer
2nd most common female cancer in the world  83% in under-resourced countries - Not appropriate screening
27
Most important prevention for cervical cancer is
HPV Vaccines against prevent 70% of types of cervical cancers
28
What is the number one prevention of cervical cancer
Regular pap tests - slow growing, can be caugt
29
BC cervical cancer screening
Start at age 25 if sexually active Every 3 years Stop at age 69 if results have always been normal
30
Link bw HPV and Cervical Cancer
HPV Includes > 100 different types of related viruses; 15 of these may cause anogenital cancer Very common – will affect almost all individuals at some point Most infections clear on their own Long-term infection with high-risk HPV (hr-HPV) can cause precancerous changes to cells of cervix  can lead to cervical cancer if left undetected or untreated
31
HPV Vaccine
have been developed and approved for use in Canada Protect against HPV types 16 and 18 which cause approx. 70% of cervical cancers, 80% of anal cancers & a significant proportion of other cancers Also protect against HPV types 6 and 11 which cause approx. 90% of anogenital warts
32
Do vaccinated people need to be screened for Cervical cancer?
Yes, bc vaccination does not mean you don't have to be screened
33
Interventions for repro problems
Reduce shame Reccomend counselling
34
Risk factors for BPH
Family history Western cultures (more likely to experience obstructive problems) Obesity Diet high in zinc, butter, & margarine
35
Protective factors against BPH
Diet of fruit & veggies; lycopene (Cooked tomatoes) Physical activity Moderate alcohol consumption
36
Cause of BPH
Endocrine changes with ages - Excessive accumulation of aggressive form of testosterone causing local growth of prostate Patho: Develops in inner part of the prostate
37
Where is cancer more likely to develop in prostate
In the outer therefore prostate will fell abnormally shaped
38
BPH develops in what part of prostate
Develops in inner part of prostate
39
Bothersome “LUTS”
Obstrutive symptoms Irritative symptoms Complications
40
Obstructive symptoms of BPH
Decrease in calibre & force of urinary stream, hesitancy, intermittency, dribbling
41
Irritative symptoms of BPH
Urinary frequency, urgency, dysuria, bladder pain, nocturia, incontinence
42
Complications of BPH
Urinary Retention, UTI, and possible sepsis, calculi, renal failure
43
Know diff bw obstuctive and irritative systems
44
Diagnostics of BPH
Hx and physical DRE PSA levels (would be increased) Urinalysis (Post void residual (Bladder scan after pee) Ultrasound Urethroscopy
45
Watchful waiting includes
Avoids Caffeines, artificial sweeteners Spicy foods
46
Drug therapy for BPH
5_-Reductase inhibitors- slow growth - Prevent conversion to the "super testosterone" Alpha-Adrenergic receptor blockers-relax smooth muscle of prostate and ureters - promotes urination
47
Invasive therapy for BPH
Transurethral resection of the prostate (TURP)-discussed next slide Transurethral incision of the prostate (TUIP) Prostatectomy
47
transurethral microwave thermotherapy
delivery of microwaves- heat causes death of tissue
48
transurethral needle ablation
increases temperature & causes localized necrosis (uses low radio frequency waves)
49
laser prostatectomy
_ visual or U/S guidance
50
intraprostatic urethral stents
if contraindications to surgery or anesthesia
51
TURP
52
Prostate Cancer
Malignant tumour of prostate gland Androgen-dependent adenocarcinoma - after the age of 50 most men have a decrease in testosterone, but have an increase in dihydrotestosterone (a potent form of testosterone) Majority of tumours in outer aspect of prostate Usually slow growing but progressive if left untreated Can metastasize through direct extension, lymph system, or bloodstream https://youtu.be/L-VH-uX2ka8 from
53
Prognosis for Porstate cancer
1 in 7 men will be diagnosed Most will survive
54
Prostate cancer risk factors
> 65 years of age Ethnicity:2X higher in Black > White > Asian Family history High levels of testosterone Diet high in fats & low in vegetables & fruits Occupational exposure to cadmium
55
Genetic mutationo idications of Prostate
links to BRCA1 and BRCA2 (genetic mutations causing breast cancer)
56
Prostate cancer SS
Blood in urine or semen Advanced Weight loss Fatigue Backache or sciatica-like pain, or swelling of legs that doesn’t go away
57
Prostate cancer Diagnosis
Occuring before symptoms occur DRE PSA Screening - Not specfici to prostate cancer - Biopsy required for diagnosis
58
PSA screening
Not required in BC If done, bw ages of 55 and 69 PSA (Prostate specific antigen) used forMonitoring established prostate cancer & metastatic disease or detection of early recurrence, where prostate cancer is already known
59
Living with prostate cancer
Losses of sexual funcitong Embarrassment etc
60
Medications used
Flomax (Tamulosin)
61

NURS232 (27 decks)

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