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Flashcards in women's health (unit 3) Deck (115)
1

menarche

•avg. age 12.5 yrs
•irregular and scant

2

menstrual cycle

•28 day duration
•1st day of period=1st day of cycle

3

leading causes of death in women

•heart dz
•cancer
•cerebrovascular dz
•pneumonia, influenza
•chronic lung dz

4

education prior to pelvic exam

•schedule b/t periods
•don't douch or have sex 48 hr
•no vag. meds, sprays, etc
•empty bladder

5

Papanicolaou (Pap) test

•screening for cancer
•speculum, spatula, and brush used to collect cells
•first @ 21 y/o
•qyr to 30

6

bimanual examination

•purpose is to palpate size, position, and consistency of uterus and cervix
•any ovarian tumors found are advanced

7

breast exams

•yearly by MD
•monthly by self
•mammogram yearly afte 40
•q2yrs after 50
*lawn mower starting at axilla

8

inspection during breast exam

•texture/color
•nipple position
•symmetrical movement
•dimpling or masses

9

palpation during breast exam

•lymph nodes
•while sitting and lying

10

fibroadenoma

•benign breast disorder
•firm hard, feely mobile mass (NOT cancer)
•DONT change w/ cycle
•teens/20s

11

fibrocystic changes***

•benign breast disorder
•bilateral pain/tenderness
•occurs prior to menopause
•CHANGES during cycle
•tx: OTC pain meds (NSAIDs); no caffeine

12

ductal ectasia

•benign breast disorder
•ducts become distended and filled
•irregular mass
•enlarged axillary nodes
•nipple retraction and d/c
•occurs near menopause

13

intraductal papilloma

•benign breast disorder
•d/c from nipple
•occurs near menopause

14

high risk of breast cancer

•personal/fam hx of breast CA
•hx of uterine/ovarian/colon CA
•> 50 y/o
•nulliparity or AMA
•early menarche/late menopause
•lifestyle factors

15

invasive breast cancer

•when tumor growth expands into tissue surrounding duct

16

metastasis

•cells are spread from tumor by both blood and lymph
•common end sites are lungs, liver, bones

17

inflammatory breast cancer

•blocks lymph vessels in breast skin
•Peau de' orange
•aggressive
•dx by biopsy

18

breast cancer dx

•fine needle biopsy
•incisional biopsy (lumpectomy)

19

lumpectomy

•breast cancer tx
•lump and surrounding tissue are removed

20

simple mastectomy

•entire breast removed

21

modified radical mastectomy

•entire breast and surrounding lymph nodes removed

22

lumpectomy/mastectomy post-op

*prevent lymph edema
•no venipuncture/BP on affected arm
•arm above heart in RR
•exercise arms

23

breast cancer tx adjuvant therapies

•radiation
•chemo
•hormones (SERMs)
*depends on age and stage of CA

24

tamoxifen

•hormone breast CA adjuvant therapy
•only works on estrogen receptive tumors
•blocks estrogen in body
•SE: similar to menopause
*SERM- selective estrogen receptor modulator

25

candidiasis

•vaginal infection r/t moniliasis or yeast
•pH < 4.5
•white, thick, curdy, no odor d/c
•itching
•not sexually transmitted
*recurrent yeast r/t HIV+

26

candidiasis med tx

•Monistat
•gyne-lotrimin
•mycostatin
•diflucan
•vagistat
•terazol

27

bacterial vaginosis

•malodorous, profuse dc that is thin gray/white or yellow/green
•pH >5
•not sexually transmitted
•refrain from sex until cured

28

bacterial vaginosis med tx

•metronidazole
•clinda cream

29

gonorrhea

•green d/c, dyspareunia, dysuria
•abx tx

30

chlamydia

•yellow d/c
•asymptomatic in women
•can lead to infertility or PID if no tx
•tx: abx

31

trichomoniasis

•thin malodorous green/yellow d/c
•itching, redness, edema
•strawberry cervix
•looks like sperm
•tx: metronidazole

32

syphilis

•painless chancre (male ID)
•primary, secondary, tertiary stages
•VDRL or RPR
•tx: PCN ONLY

33

herpes

•blisters, severe vulvular pain, dyspareunia
•no cure
•tx: acyclovir (anti-viral)

34

immunioquid

•immune system stimulant to get body to fight itself

35

human papilloma virus

•genital warts
•strong association w/ cervical cancer
•tx: remove wart via TCA

36

is HIV/AIDs sexually transmitted?

•yes

37

is hep B or C sexually transmitted

•yes

38

is GBS sexually transmitted

•no
•not exclusively transmitted by blood/body fld.

39

pelvic inflammatory dz (PID)

•infection of upper genital tract usually d/t "silent" STD
•abd pain, cervical motion tenderness, fever, N/V, anorexia
•tx:

40

toxic shock syndrome

•fatal cndt. caused by staph aureus
•can lead to hypovolemia, hypotension, and shock
•s/sx: fever, flu-like, hypotension, rash

41

toxic shock syndrome tx

•fluid
•vasopressor drugs
•antimicrobials

42

toxic shock prevention

•hand washing before tampon/diaphragm
•change tampon q4hr
•no diaphragm during menses
•remove diaphragm as directed

43

causes of menstrual disorders

•PG complications
•anatomic lesions
•drug-induced bleeding
•systemic d/o
•failure to ovulate

44

menstrual d/o management

•treat cause
•treat any anemia
•surgery- D&C, hyst, laser ablation

45

normal amnt of bleeding after menopause

NONE!!

46

primary amenorrhea

•menarche after 16
•menarche 1 yr later than mom and same age as sister

47

secondary amenorrhea

•absence of menstruation of 3 cycles after regular cycles established
•most common cause is PG

48

amenorrhea tx

•PG test
•treat underlying cause
•nutritional counseling
•hormone replacement
•ovulation stimulation
•periodic progesterone

49

polycystic ovarian syndrome (PCOS)

•endocrine d/o r/t imbalance of male/female hormones
•cysts in ovaries
•s/sx: infertility, acne, thining hair, hirsutism, inulin resistance, irregular/absent cycles

50

mittelschemerz

•pelvic pain that occurs with ovulation

51

primary dysmenorrhea

•menstrual pain w/o pathology
•occurs hrs from start of menses
•spasmotic, colicky
•most common in nulliparous

52

secondary dysmenorrhea

•menstrual pain that occurs b/c of dz process
-fibroids
-endometriosis
-PID
•tx: OCPs, NSAIDs

53

endometriosis

•development of endometrial implants outside uterus
•implants enlarge/stretch, causing pain
•cause unkn
•often causes infertility b/c of tube or ovary occluding/strangling
•dx by laparoscopy

54

endometriosis tx

•hormone supression
•ablation
•hysterectomy

55

premenstrual syndrom (PMS)

•s/sx must be cyclic and recur after luteal phase
•s/sx free during follicular phase
•s/sx severe and interfere w/ life
*etiology unkn

56

physical s/sx PMS

•edema
•wt gain
•bloating
•hot flashes
•constipation
•HA
•acne
•breast pain

57

behavioral s/sx PMS

•anxiety
•depression
•irritability
•mood swings
•aggressive
•inc. appetite
•fatigue
•insomnia

58

PMS management

•good nutrition
•vit. B
•avoid caffeine, simple sugars, salt, etoh
•stress management
•exercise
•adequate sleep

59

Premenstrual dysphoric disorder (PMDD)

•severe PMS
•high r/o suicide

60

infertility

•inability to conceive after 1 yr of unprotected intercourse
•d/t delayed childbearing or physiological factors
-male responsible 40% of time

61

female infertility causes

•ovulatory d/o***
•abnormal tubes/cervix
•repeated PG loss

62

repeated PG loss causes

•fetal chromosomal abnormalities
•cervix/uterus abnormals
•endocrine abnormalities
•immune abnormalities
•infection
•environmental factors

63

male infertility causes

•infection
•ED
•seminal fld./sperm abnormal (pH)
•environmental
•ejaculation probs.

64

infertility tx

•treat cause (thyroid d/o, etc)
•artificial insemination
•invitro fertilization
•sperm/ovum donation
•meds: Clomid

65

basal body temperature and ovulation

•increases and stays higher if PG

66

menopause

•end of menses
•avg. age 51
•can be induced/created artificially

67

artificial induction of menopause

•surgical removal of ovaries
•destruction of ovaries by radiation
*s/sx more severe than natural

68

body changes of menopause

•cessation of estrogen/progesterone production
•vag. atrophy/dryness
•forgetful, diff. concentrating, insomnia, BA, HA, depression
•mood swings
•hot flashes
•bladder/urethra atrophy

69

why hot flashes

•dec. endogenous estrogen
*most common reason women seek care

70

why insomnia during menopasue

•lack of estrogen on hypothalamus

71

uterine leiomyomas

•benign uterine tumors
•may cause bleeding, anemia, pressure
•tx: myomectomy, hyst, GnRH agonists

72

ovarian cysts

•benign tumors of ovary
•luteal are painful
•tx: OCPs, U/S, surgery

73

endometrial cancer key s/sx

•bleeding after menopause

74

cervical cancer almost always caused by

•HPV

75

most effective and safest method of contraception

abstinence

76

basal body temperature method of contraception

•natural family planning method
•temp drops prior to ovulation and then rises for several days after
•several months of graphs

77

calendar (rhythm) method of contraception

•natural family planning
•record menstrual cycles for 6-8 months to ID shortest/longest

78

billings method of contraception

•natural family planning
•based on cervical mucus changes through cycle

79

barrier contraceptive methods

•Diaphragm
•cervical cap
•condoms (male/female)
*some reduce risk of STDs

80

diaphragm

•requires fitting by provider
•DOESNT protect against STDs
•used with spermicidal jelly
•insert 6 hrs a and leave in place 6-8 hrs p sex
•don't use if hx of UTI
•replace q2-3yr or 10 lb wt change
•r/o toxic shock

81

cervical cap

•rubber cup w/ firm round rim
•filled w/ spermicide prior to insertion
•place 30 min a sex
•leave in for 6-8 hrs p sex
•48 hr protection
•DOESNT protect against STD

82

spermicides

•used 15-30 min a intercourse
•reapply w/ each encounter & q1h
•DOESNT protect against STDs
*use with other method for best results

83

male condom

•oldest form of contraception
•protects against HIV and some STDs
•use w/ spermicide -> 99% effective
•easy to break

84

female condom

•traps sperm in sheath placed in uterus
•placed 8 hrs prior to sex
•may prevents STDs better than male
•more expensive than male

85

coitus interruptus

•withdrawal method of contraception
•ejaculate deposited away form vag.
•DOESNT protect against STDs
*REMEMBER preejaculate can contain sperm

86

intrauterine device

•interferes w/ sperm transport to tubes
•lasts 1-8 yrs
•DOESNT protect against STDs
•medicated w/ copper or progesterone
•contraindicated in PID, STD, nullparous

87

PAINS

*IUD warning signs
Period late, abn, spotting
Abdominal pain, pain w/ sex
Infection exposure/discharge
Not feeling well (fever, chills)
String missing

88

combined oral contraceptives (COC)

•combo of estrogen (estradiol) and progesterone (many kinds)
•suppresses ovulation***
•thickened cervical mucus
•effects endometrial lining

89

COC advantages

•dec. menstrual s/sx
•treats menstrual irreg.
•lighter cycle
•improves acne
•manipulates cycle
•dec. # cycles
•enhanced sexual enjoyment
•dec. r/o cancer, cysts, PID, etc

90

Beyaz & Safryal

•new COC that adds folic acid, which remains consistent for 20 wks after discontinuation

91

Natazia

•new estrogen w/ diff. timing and only 2 placebo pills

92

Lo loestrin Fe

•lowest estrogen to date and 2 day placebo pills (Fe tablets)

93

COC disadvantages

•spotting during beginning of tx
•missed period/amenorrhea
•depression, anxiety, irritability, fatigue
•inc. r/o adenocarcinoma cervical cancer
•N/V, hunger, HA, HTN, wt gain
•inc. r/o DVT, MI, stroke*** (lower if don't smoke, have HTN, or migraines)

94

Seasonale

•tricycle regimen
•63 active pills in a row, then 7 days off
•ALL monophasic (one dose of hormones every day)

95

Lybrel

•continuous contraception
•advantageous if menstrual complications, migraines, epilepsy, etc
•dec. r/o breast cancer

96

what meds decrease COC effectiveness

•ampicillin
•doxycycline
•tetracycline

97

ACHES

*COC s/sx needing MD contact
Abdominal pain (severe)
Chest pain, cough, SOB
HA, dizziness/weakness/numbness
Eye problems
Severe leg pain
*DONT just stop pill

98

combined vaginal contraceptive

•vaginal ring
•once a month BC inserted by pt
•releases hormones that are absorbed thru vaginal canal
•same drugs as pill

99

combined topical contraceptive

•patch changed weekly
•placed on abd/upper torso/butt/upper arm (NOT breast)
•lots of complications
•not effective in > 195 lbs

100

progestin-only pill (mini-pill)

•contraception of choice for lactating moms b/c doesn't effect milk
•works by changing endometrium and cervical mucous
•best if > 40 y/o
•DOESNT protect against STDs
*must take at same time everyday

101

implanon

•long-acting progestational agent
•prevents PG for 3 yrs
•device implanted under skin
-prevents ovulation
-cervical mucous
-thins endo
•reversible

102

depo-provera

•oil-based long acting progesterone
•admin q12wk
•injection
•prevents ectopic PG
•may take 10 months to get PG after discontinue
•r/o dec. bone density and wt gain
-reverses after d/c

103

when is postcoital contraception used

•woman had unprotected intercourse
•failed method (ex: condom break)
•rape
•intermittent isolated intercourse
*89% chance no PG
*ineffective if already PG (NOT abortion)

104

Postcoital (emergency) contraception side effects

•N/V
•menstrual changes

105

medical abortion

•RU-486
•misoprostal
-blocks folic acid and causes uterine cramping
•methotrexate (antineoplastic)

106

female sterilization

•surgery to ligate, clip, or destroy part of fallopian tube
•ovulation still occurs, but ovum absorbed
•must be > 21 y/o
•used if for sure don't want kids or for medical purposes
•r/o ectopic PG
*NOT STD protection

107

Essure

•non-surgical female sterilization
•coil in place of fallopian tube
•natural scarring (after 3 months)
-need BC during (no IUD)
•MUST have 3 month confirm test
•r/o ectopic PG

108

male sterilization

•must use alt. contraception for 3 months
•fertility after reversal is 50%
*NOT STD protection

109

most likely spot to have atypical (cervical cancer) cells

•transformation zone
•changing from cervical cells to endocervical cells

110

abnormal cell characteristics

•no or multiple nucleus
•macro/micro-nucleus
•cell wall abnormality

111

Peau de' orange

•abnormal breast tissue texture
•indicative of inflammatory aggressive breast cancer

112

why is AMA or no PG higher risk for breast cancer

•no break for hormones
•connected to estrogen receptive breast cancer tumors

113

when can't take ANY type of COC...

•over 35 and smoke, HTN, migraine
•have had previous thrombolytic complication

114

when to start COC

•day after menstrual cycle starts

115

what to do if have COC side effects

•call MD
•DONT stop abruptly