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Flashcards in Women's health Deck (94):
1

s/s of ectopic pregnancy

low back or abd pain/cramping

2

risk factors for ectopic pregnancy

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

3

hCG levels in ectopic pregnancy

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

4

s/s of breast cancer

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

5

risk factors for breast cancer

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

6

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

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

7

s/s of inflammatory breast cancer

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

8

risk factors for ovarian cancer

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

9

s/s of ovarian cancer

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

10

Has been shown to decrease risk of ovarian cancer

OCP, multiparity, breastfeeding

11

women with hx of breast cancer have a high risk of

ovarian cancer

12

where the majority of breast cancer is located

tail of spence

13

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

cervical ectropion

14

s/s of uterine fibroids

heaving menstrual bleeding, pelvic pain/cramping, spotting

15

follicular phase (days 1-14)

FSH stimulates estrogen production that stimulates the growth of endometrial lining

16

Ovulatory phase (day 14)

LH is secreted

17

Luteal phase (days 14-18)

Progesterone is the predominant hormone that stabilizes the endometrial lining

18

Menstruation phase

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

19

fertile time in a women is

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

20

Menstrual cycle phases

follicular phase, ovulatory phase, luteal phase, menstruation

21

ASCUS result on pap

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

22

monophasic pills (Loestrin 1/20)

21 consecutive days of same dose of estrogen and progesterone

23

Triphasic pills (Ortho Tri-cyclen)

21 days of active pills with hormones that vary every week

24

pills that can be adjunctively used for acne

triphasic (Ortho Tri-cyclen)

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