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Women's health Flashcards

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1
Q

s/s of ectopic pregnancy

A

low back or abd pain/cramping

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2
Q

risk factors for ectopic pregnancy

A

hx of PID, hx of tubal ligation, previous ectopic pregnancy, IUD

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3
Q

hCG levels in ectopic pregnancy

A

rise at the same rate as normal pregnancy but plateau in 4-6 weeks

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4
Q

s/s of breast cancer

A

painless, firm, fixed mass; dimpling of skin (peau d’orange), nipple retraction, clear nipple discharge

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5
Q

risk factors for breast cancer

A

age greater than 50, first degree family hx, early menarche, late menopause, nulliparity, obesity, Jewish

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6
Q

s/s of Paget’s disease (ductal carcinoma)

A

scaly, red rash on the nipple that doesn’t heal; itchy

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7
Q

s/s of inflammatory breast cancer

A

acute onset of red, swollen, warm area in breast of young woman

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8
Q

risk factors for ovarian cancer

A

age greater than 60, hx of breast cancer, family hx

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9
Q

s/s of ovarian cancer

A

bloating, dyspepsia, abdominal pressure/pain, urinary frequency, constipation

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10
Q

Has been shown to decrease risk of ovarian cancer

A

OCP, multiparity, breastfeeding

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11
Q

women with hx of breast cancer have a high risk of

A

ovarian cancer

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12
Q

where the majority of breast cancer is located

A

tail of spence

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13
Q

bright red tissue with an irregular surface on top of the os; common in adolescents

A

cervical ectropion

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14
Q

s/s of uterine fibroids

A

heaving menstrual bleeding, pelvic pain/cramping, spotting

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15
Q

follicular phase (days 1-14)

A

FSH stimulates estrogen production that stimulates the growth of endometrial lining

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16
Q

Ovulatory phase (day 14)

A

LH is secreted

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17
Q

Luteal phase (days 14-18)

A

Progesterone is the predominant hormone that stabilizes the endometrial lining

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18
Q

Menstruation phase

A

If not pregnant, both estrogen and progesterone fall, causing menses

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19
Q

fertile time in a women is

A

5 days before and 1-2 days after ovulation (near day 14)

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20
Q

Menstrual cycle phases

A

follicular phase, ovulatory phase, luteal phase, menstruation

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21
Q

ASCUS result on pap

A

If woman less than 24, repeat pap in 1 year. If woman greater than 24, then order HPV reflex, if positive then colposcopy

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22
Q

monophasic pills (Loestrin 1/20)

A

21 consecutive days of same dose of estrogen and progesterone

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23
Q

Triphasic pills (Ortho Tri-cyclen)

A

21 days of active pills with hormones that vary every week

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24
Q

pills that can be adjunctively used for acne

A

triphasic (Ortho Tri-cyclen)

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25
extended cycle pill (Seasonale)
contains 3 months of estrogen/progesterone with 7 day pill-free interval
26
Uses drospirenone (a spironolactone analog) instead of progestin. Used for women with acne, PCOS, hirsutism, or PMDD
Yaz or Yasmin
27
Yaz/Yasmin have ___ active pills and ___ placebo pills
24; 4
28
Yaz/Yasmin have a high risk of
hyperkalemia, DVT
29
OCP safe for breastfeeding women
progestin-only pill (minipill)
30
absolute contraindications of oral contraceptive pills mneumonic
``` My CUPLETS My: migraines with focal neurologic aura C: CAD or CVA U: undiagnosed genital bleeding P: pregnant L: high LFTs E: Estrogen-dependent tumor T: thrombus or emboli S: smoker age 35 or older ```
31
advantage of OCP is a lower risk of
endometrial and ovarian cancer
32
Instructions on starting OCP
1. Take first pill on first Sun of menstrual period 2. Take the pill on the first day of period 3. Use back up method for the first 2 weeks of first pack
33
s/s of endometriosis
severe cramping and heavy periods in young women
34
Education if pissed 2 consecutive days of OCP
take 2 today, then 2 tomorrow; use condoms for the rest of the cycle
35
these drugs can decrease efficacy of OCP
anticonvulsants, antifungals, ampicillin, tetracycline, St. john's wort
36
administration of morning after pill
Effective up to 72 hours after unprotected sex, but most effective if taken within first 24 hours
37
danger signs of OCP
``` ACHES: Abdominal pain; Chest pain; Headaches; Eye problems, change in vision; Severe leg pain ```
38
administration of copper containing IUD
Paraguard; effective for up to 10 years; may cause increased bleeding/spotting
39
administration of hormone-containing IUD
effective for up to 5 years
40
____, a hormone-containing IUD contains _____
Mirena; levonorgestrel
41
contraindications of IUD
hx of PID, hx of ectopic pregnancy
42
Education about IUD
check for string after each menstrual period
43
Administration of Depo Provera
injection every 3 months, start on first 5 days of cycle
44
Education about Depo Provera
can cause amenorrhea d/t lack of estrogen; can cause osteoporosis
45
Women should not use Depo Provera if
they plan on getting pregnant in the next year as it causes delayed return of fertility
46
black box warning with Depo Provera
should not be used for more than 2 years d/t increased risk of osteoporosis
47
contraindication of Depo Provera use
anorexia
48
administration of diaphragm
Must be used with spermicidal gel; leave in for 6-8 hours after intercourse (can remain for up to 24 hours)
49
Nuvaring contains
both estrogen and progesterone
50
Administration of Nuvaring
left for 3 weeks, then removed for 1 week.
51
Ortho Evra patch contains
both estrogen and progesterone
52
administration of Ortho Evra patch
applied once a week for 3 weeks
53
risks with Ortho Evra patch
higher risk of VTE d/t high levels of estrogen
54
s/s of too much estrogen
nausea, bloating, breast tenderness
55
s/s of too much progestin
increased appetite, weight gain, fatigue
56
woman with asymptomatic gonorrhea or chlamydia with a IUD
can be treated with IUD in place
57
Implanon/Nexplannon contains
progestin
58
Implanon/Nexplannon administration
changed every 3 years
59
Education about Implanon/Nexplannon
Quick return of fertility after removal.
60
s/s of fibrocystic breasts
breast tenderness and lumps that begin up to 2 weeks before period, then goes away once period begins; lumps are symmetrical, tender, mobile, and rubbery.
61
trx for fibrocystic breasts
wear bra daily, decrease sodium and caffeine before periods
62
s/s of PCOS
hirsutism, irregular periods, acne
63
diagnostics for PCOS
LH/FSH greater than 2.5:1; increase in testosterone, prolactin, high fasting glucose; transvaginal US
64
trx for PCOS
low dose OCP, spironolactone, Metformin
65
pathophysiology of PCOS
high insulin and obesity cause an increase in androgen production and decrease SHBG (bind to and excrete testosterone).
66
risk factors of candida vaginitis
diabetics, HIV, steroids, amoxicillin, pregnancy
67
s/s of candida vaginitis
white cheese-like discharge, itching and redness
68
diagnostic for candida vaginitis
KOH prep, vaginal pH less than 4.5
69
treatment for candida vaginitis
diflucan x1, terconazole vaginal cream
70
If patient gets candida from this atbx: ____, recommend to _____
amoxicilin; daily yogurt and lactobacillus pill
71
replacement of normal, hydrogen-peroxide Lactobacillus with anaerobic bacteria
BV
72
These are NOT considered STDs
BV, candida vaginitis
73
s/s of BV
fishy vaginal odor after intercourse; milk-coated vaginal walls
74
diagnostics with BV
vaginal pH greater than 4.5; "clue cells" (squamous epithelial cells) on wet mount; positive "whiff test"
75
trx for BV
metronidazole 500 mg bid x 7 days; avoid with alcohol | clindamycin cream x 7 days
76
recurrence of BV
common; perform test of cure 2-3 weeks after therapy
77
s/s of trichomoniasis
pruritic, red vulvovaginal area; gray/green frothy discharge; strawberry cervix
78
diagnostic for trichomoniasis
vaginal pH greater than 4.5; motile, flagellated trichomonads on saline wet mount
79
trx for trichomoniasis
metronidazole 2 g PO x 1, treat sexual partners
80
s/s of atrophic vaginitis
vaginal dryness, itching, pain with intercourse
81
atrophic vaginitis may cause this to be abnormal
pap smear (atrophic changes)
82
trx for atrophic vaginitis
estrogen cream; need progesterone supplementation if intact uterus
83
risk of osteopororis
postmenopausal women, chronic steroids, autoimmune disorders, low testosterone, hyperthyroidism, alcoholics, smokers
84
perform DEXA scan every
every 1-2 years with those on trx; otherwise every 2-5 years
85
trx for osteoporosis
weight bearing exercise (walking, jogging, biking, aerobics); calcium with vit D (1200 mg/day) and vitamin D3 (800-1000 IU daily)
86
side effects of biphosphonates
PUD, esophagitis
87
biphosphonates
Fosamax (alendronate), Actonel (risedronate)
88
administration of biphosphonates
take right upon awakening with full glass of water; wait 30 min before lying down; do not crush/split tablets; never take with other meds
89
Evista (raloxifene)
SERM for osteoporosis
90
approved for use only after menopause; NOT used to trx menopausal symptoms
SERM
91
Hormone replacement therapy increases risk of
DVT, heart disease, endometrial cancer
92
Mefenamic acid (Ponstel)
NSAID effective for menstrual pain
93
hormone therapy has been approved for
trx of vasomotor symptoms, trx of atrophic vaginitis, and prevention of osteoporosis
94
differential diagnosis for women with lower abd pain/cramping
IBS, endometriosis, endometrial cancer, ovarian cyst, uterine fibroids, PID

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