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OSCI > WH Dx 2 > Flashcards

WH Dx 2 Flashcards

1
Q

breast cancer - breast mass s/sx

A

hard, immovable, single lesion with irregular borders

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2
Q

breast cancer signs of locally advanced disease
4

A
  1. axillary adenopathy
  2. skin erythema
  3. skin thickening
  4. dimpling of overlying skin
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3
Q

breast cancer dx
2

A

simple cyst
breast adenosis

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4
Q

breast cancer patient education
4

A
  1. Can occur when normal cells in the breast change and grow out of control.
  2. The right treatment will depend in part on the stage of your cancer.
  3. Make sure to follow all your provider’s instructions about visits, tests, and screening tools.
  4. Make sure to take care of your emotional health during this time.
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5
Q

breast cancer medication
2

A
  1. early stage usually undergo primary surgery (lumpectomy or mastectomy)
  2. systemic therapy like chemo may be needed
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6
Q

breast cancer test
3

A

Biopsy is the only definitive Dx:
1. <30 y.o. do an US, then possible biopsy
2. 30-39 breast US, possible biopsy
3. 40 and older do a diagnostic mammogram

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7
Q

breast cancer follow up

A

In two weeks to go over imaging results and appropriate referrals will be made from there.

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8
Q

Breast cancer red flags
4

A
  1. new lumps/mass
  2. pain in your bones, chest, or stomach
  3. trouble breathing
  4. headaches
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9
Q

candida vulvovaginitis risk factors
5

A
  1. DM
  2. antibiotic use
  3. increased estrogen levels (pregnancy, postmenopausal therapy)
  4. immunosuppression
  5. genetics
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10
Q

candida vulvovaginitis s/sx
8

A
  1. vulvar itching*
  2. burning
  3. soreness
  4. irritation
  5. erythema of vulva and vaginal mucosa
  6. vulva edema
  7. little or no discharge - may be white, thick, and clumpy
  8. discharge with none or minimal odor
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11
Q

vaginal itching

A

candida vulvovaginitis

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12
Q

candida vulvovaginitis dd
2

A

BV
trichomoniasis

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13
Q

candida vulvovaginitis education
5

A
  1. you start to feel better a few days into treatment
  2. there are risk factors to developing this but some may not be able to be controlled like abx use, hormone changes, and birth control
  3. avoid soaps and OTC vaginal products as they may irritate the area
  4. clean with plain water
  5. dry thoroughly afterward
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14
Q

candida vulvovaginitis med
2

A
  1. oral antifungal (non-pregnant)
  2. vaginal antifungal (pregnant)
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15
Q

candida vulvovaginitis test

A

vaginal swab to test discharge pH and perform a microscopy

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16
Q

candida vulvovaginitis f/u

A

not necessary if symptoms resolve

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17
Q

candida vulvovaginitis red flags
5

A
  1. worsening of symptoms
  2. change in discharge such as increase, odor
  3. recurrent infection
  4. pelvic pain
  5. bleeding no associated with menstruation
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18
Q

contraceptive management IUD
2

A
  1. LNG IUD - releases progestin daily; last 3-8 years; failure 0.1-0.4%; contraindicated in breast cancer hx, distortion of uterine cavity, and acute pelvic infection
  2. copper IUD - no hormones; 10 year; failure 0.8%
19
Q

contraceptive management hormonal methods
6

A
  1. implant - rod in upper arm; progestin; 3 years; failure 0.1%
  2. Injection/shot - progestin in buttock or arm every 3 months; failure 4%
  3. the pill - combination estrogen-progestin pill, failure rate 7%
  4. mini pill - progestin only; failure 7%
  5. Patch - progestin and estrogen; new patch weekly, three weeks on 1 week off; failure 7%
  6. vaginal ring - progestin and estrogen; 3 weeks on; fail 7%
20
Q

the pill contraindications
7

A
  1. > 35 who smokes
  2. history of blood clots
  3. history of breast cancer
  4. heart disease
  5. CVD risk factors (older age, DM, obese)
  6. cirrhosis
  7. migraines with an aura
21
Q

mini pill contraindications
4

A
  1. known or suspected breast cancer
  2. undiagnosed uterine bleeding
  3. benign or malignant liver tumors
  4. cirrhosis
21
Q

contraceptive management education

A

Education will depend on type of BC you choose. Make sure to use barrier protection for the first seven days when starting a new BC. Know that these methods will not protect you from STDs.

22
Q

contraceptive management test

A

pregnancy test

22
Q

contraceptive management f/u

A

1-3 months to evaluate satisfaction of method, provide support, address concerns, and assess changes in health status.

23
Q

contraceptive management red flags
5

A
  1. fever
  2. abd pain
  3. unusual heavy vaginal bleeding
  4. foul smelling vaginal discharge
  5. pregnancy-like symptoms
24
Q

dysfunctional uterine bleeding

A

abnormal uterine bleeding is bleeding of abnormal quantity, duration, or schedule

25
Q

bleeding of abnormal quantity, duration, or schedule

A

dysfunctional uterine bleeding

26
Q

dysfunctional uterine bleeding dd
4

A
  1. STD
  2. malignancy
  3. polyps
  4. uterine fibroids
27
Q

dysfunctional uterine bleeding education
3

A
  1. can be caused by many different conditions
  2. premenopausal women can have abnormal bleeding from changes in hormone levels, pregnancy, infection and more
  3. menopausal women can have abnormal bleeding from atrophy of tissue, cancer, structural changes, infection and more
28
Q

dysfunctional uterine bleeding medications

A
  1. Known primary etiology then treat the issue (structural, infection, endocrine, bleeding)
  2. unknown etiology - combination oral contraceptive or hormonal IUD
29
Q

dysfunctional uterine bleeding test
6

A
  1. urine pregnancy test
  2. CBC
  3. coagulation panel
  4. Pap smear with HPV test
  5. STD testing
  6. Pelvic US
30
Q

dysfunctional uterine bleeding f/u

A

in two weeks to discuss labs and interventions

31
Q

dysfunctional uterine bleeding red flags
4

A
  1. worsening of sx
  2. increase in bleeding
  3. abnormal uterine discharge
  4. pelvic pain
32
Q

dysmenorrhea

A

painful menstruation

33
Q

painful menstruation

A

dysmenorrhea

34
Q

dysmenorrhea risk factors
3

A
  1. adolescents
  2. smoking
  3. stress
35
Q

dysmenorrhea s/sx
6

A
  1. recurrent cramping of lower abd during menses
  2. nausea
  3. diarrhea
  4. fatigue
  5. headache
  6. malaise
36
Q

pain that begins just prior to or with the onset of menstrual flow and typically resolves within 12-72 hours

A

dysmenorrhea

37
Q

dysmenorrhea DD
2

A

endometriosis
PID

38
Q

dysmenorrhea education
3

A
  1. exercising during this time may help decrease symptoms
  2. use a heat compress for discomfort
  3. some dietary changes have shown to help some individuals such as a low fat vegetarian diet
39
Q

dysmenorrhea meds

A

NSAIDs first, then hormonal contraception (estrogen-progestin options)

40
Q

dysmenorrhea test

A

no lab tests but can r/o STD with testing and urine sample for UTI

41
Q

dysmenorrhea f/u

A

After next menstrual period to determine effectiveness

42
Q

dysmenorrhea red flags

A
  1. worsening of symptoms
  2. bleeding between periods
  3. change in vaginal discharge such as an odor

OSCI (20 decks)

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