Women's health Flashcards
(31 cards)
The follicular phase is also known as…
The proliferative phase. Estrogen is the main hormone during this phase
A 13-year-old is concerned because she has not yet begun to menstruate. Physical examination indicates that the patient is at Sexual Maturity Rating IV and is of average height and weight. What would be the most appropriate response to this patient?
“Your development is exactly as expected for your age; you’ll probably begin to have periods within a year.”
At this stage, girls generally have breast development with areola enlargement, and the breasts are nearly adult in size and shape. Additionally, pubic hair becomes more coarse and curly, spreading across the pubic area but not extending to the thighs yet. This is typical development for a 13-year-old female.
A female who is 1 year post menopause presents with fatigue and a 2-week history of moderate vaginal bleeding. Her complete blood count (CBC) reveals low Hgb and Hct. The most appropriate diagnostic procedure to be performed is a/an:
Endometrial biopsy.
Performing an endometrial biopsy in a postmenopausal woman with vaginal bleeding is essential to diagnose the underlying cause of the bleeding. This procedure helps in detecting endometrial cancer, identifying precancerous conditions like endometrial hyperplasia, and ruling out benign conditions such as polyps or atrophic changes. Early and accurate diagnosis through an endometrial biopsy allows for timely and appropriate management, which is crucial for improving patient outcomes and ensuring optimal care.
A patient is 28 weeks pregnant and presents with a single episode of vaginal bleeding. Prenatal progress is normal, and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate to determine a diagnosis?
Ultrasound is a critical diagnostic tool used to evaluate bleeding during pregnancy. It provides valuable information about the health and development of the pregnancy and helps identify potential causes of bleeding.
Presumptive pregnancy
Changes that are experienced by the client that leads to suspicion of pregnancy
Probable pregnancy
Changes are seen on physical exam that leads to suspicion of pregnancy
Positive pregnancy
Signs that are only explained by pregnancy
Inflammatory breast cancer
Acute onset of a red, swollen, and warm area in the breast of a middle-aged woman (median age 59 years) that is rapidly growing.
Symptoms develop quickly.
May have breast tenderness or itching. Can mimic mastitis. Often, there is no distinct lump on the affected breast. The skin may be pitted (peau d’orange) or appear bruised.
Cervical ectropion
Bright-red bumpy tissue with an irregular surface on the cervical surface around the os (Figure 17.1). It is a benign finding. It is made up of glandular cells (same cells that are inside the cervical os). It is more friable (bleeds easily) compared with the squamous epithelial cells on the surface of the cervix.
High levels of estrogen cause overgrowth of glandular cells
Treatment for cervical ectropion
None required if asymptomatic.
- Test for gonorrhea and chlaymidia
Follicular phase of menstrual cycles
Days 1-14 - Proliferative phase
- FSH stimulates the maturation of the follicles
- Estrogen stimulates the development and growth of the endometrial lining
Ovulatory phase of menstrual cycles
Day 14
Luteinizing hormone (LH) induces ovulation and the maturation of the dominant follicle on day 14
Luteal Phase (Days 14–28)
Progesterone is produced by the corpus luteum and helps to stabilize the endometrial lining.
Menopause
The unintentional cessation of menses for 12 consecutive months
Cervical cancer screening
Pap only ages 21-29
Pap + HPV age 30-65
ACS-US cells
Age 21-24 - repeat PAP 12 months
Age 25-29 - HPV preferred or repeat pap 12 months
Age 30-65 - Cotesting for high-risk HPV. If HPV positive, refer for colposcopy
ASC-H cells
Definitive atypical cells, may be precancerous. Refer for coloposcopy.
High-Grade Squamous Intraepithelial Lesions (HSILS)
- Age 21 to 24 years: Refer for colposcopy.
- Age 25 years or older: Refer for immediate excisional treatment or colposcopy. It can be done by LEEP (loop electrosurgical excision procedure) with cervical conization or surgery of the cervix.
Colposcopy
specialized “microscope” used to visualize the cervix, obtain cervical biopsies, and gain access to the cervix during cryotherapy or laser ablative therapy. The diagnostic test for cervical cancer is a biopsy of the cervix, which is obtained during a colposcopy.
Tzanck Smear test
Used as an adjunct for evaluating herpetic infection (oral, genital, skin). A positive smear will show large abnormal nuclei in squamous epithelial cells. Not commonly used.
How long does an IUD work for?
Cu-IUD lasts 10 to 12 years.
Mirena (progesterone IUD) lasts 5 years
Atrophic Vaginitis
lack of estrogen in estrogen-dependent tissue of the urogenital tract; results in atrophic changes in the vulva and vagina of postmenopausal women
vaginal dryness, itching, and pain with sexual intercourse (dyspareunia).
Treatment for atrophic vaginitis
Initial therapy: Nonhormonal vaginal moisturizers and lubricants
Moderate-to-severe symptoms: Topical conjugated estrogen preferred; it comes in several forms (cream, tablet, capsule, or vaginal ring
Treatment for PCOS
- OCs to suppress ovaries.
- Spironolactone is used to decrease and control hirsutism.
- Metformin (Glucophage) is used to induce ovulation (if desires pregnancy). Warn reproductive-aged diabetic females (who do not want to become pregnant) to use birth control.
- Weight loss reduces androgen and insulin levels.
