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112 Cards in this Set
- Front
- Back
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what does the hypothalamus control
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secretion of GnRH
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what does GnRH stimulate
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release of homrones from pituitary
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where does estrogen come from
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ovariers
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what is the most potent hormone from the ovaries
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estrodial
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what does estrogen protect agains
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bone loss
skin vascualr structure loss vasular disease >HDL <chole <ace / renin levels <plt aggregation >stroke volume >clotting factors vascular injury decreased cerebral flow loss of cognitive fucntion |
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pituitary hormones
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FSH
LH prolactin oxytocin |
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ovarian hormones
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estrogen
progesterone androgens |
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SERMs definition
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activates and blocks estrogen receptors selectively
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the corpus luteum is responsible for the
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increased secretion of estrogen and progesterone
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SERM drug to know
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tamoxifen
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how does tamoxifen work
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activates estrogen
breast cancer tx protects against osteoporosis produces hot flashes risk of endometrial cancer and hypogonadism |
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what is tamoxifen indicated for
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breast cancer
helps with osteoposrosis |
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female sex hormones secreted by oarias and adrenal cortex
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esstrone
estradiol estriol |
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what is Raloxifene
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SERM
does not activate estrogen protects against breast cancer, osteoporosis promotes thromboembolism induces hot flashes BIGGEST RISK FOR THROMBOEMBOLISM |
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where is estrogen secreted from
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ovararies and adrenal ortex
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what are the fucntions of estrogen
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growth and development
reproduction (breast duct growth in prego) metabolic effects |
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complicatsions of estrogen modulataion
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clots
endometrial cancer hot flashes |
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progesterone: in pregrancy
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important in maintaining
prevent premature contractions so that we can keep the pregnancy helps keep endometriam in good place for fertalized eg has role in lactation, causes milk production to begin |
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what hormone that lets the milk come out
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oxytocin
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progesterone side effects
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flatulance
nausea comiting constipation edema |
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adverse effects of progestin manipulation
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teratogenic effects
gynecologic effects breast cancer happens when you mess with the levels |
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therapeutic uses of progestin
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used with severe issues in bleeding (gushing)
keeps pregnancy valid amenorrhea |
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need approx % fat to have normal menstrual cycles
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25%
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how to progestins work in tumor treatment?
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cant cure but will reduce the size
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cervical mucus
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can be to thin or to thick. determines whether or not sperm gets inside.
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too much cerviacl mucus, give
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progesterone
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what effects content of cervical mucus
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estrogen, progesterone
then you analyze what is in it and use the appropriate drug to manipulate it |
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most common conditions seen during perimenopausal women
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depression
anxiety hot flashes irritability night sweats |
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when should hormone start
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it must be done as soon as symtpoms start
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what is the thing about glycemic control and hormone therapy?
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we know that if glucose is kept between 80-140 then our tissues have better 02, longer life, organ health is better
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lock of estrogen can cause what kind of bleeding?
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irregular
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lack of progesterone can cause what to the follicles/menses
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immature folicles
no menses |
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inadequate estrogen/progesterone can do what to ovulation
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cause no ovulation
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some other pathology r/t abdonrmal bleeding
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polyps
fibroids bleeding disorders cancer cystic disease |
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dysmenorrhea
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hurts to have a period
headaches that put you in bed not just dyscomfort |
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endometriosis
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growth of the endometrium elsewhere than the uterus.
those parts of the body has periods. so bleeding in other places |
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how to manage dysmennorrhea
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treat symptoms
if hormone imbalace you use oral contraceptives asa |
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pms
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not psychiatric
dyscomfort/uncomfortable not life changing |
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pmdd
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dysphoric disorder
disconnect from reality |
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pms symptoms
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breast pain
edmea bloating gi symptoms cravings pain emotionally labile irritable headaceh |
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hormonal links to pms
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estrogen: anxiety, tension
progesterone: depression prolactic: increases water retention endorphin alteration: binge eating, depression |
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how long does it take to dx someone with psychiatric disorder?
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6mo of symptoms
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what ph should the vagina be
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3.8-4.5
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oxytoci
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stimulates uterine contractions
induction or augmentation of labor control of postpartum bleeing induction of abortion |
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tocolytic
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suppresses contractions
supression of preterm labor |
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magensium sulfate is given to
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slow down uterine contractions
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pitocin (oxytocin)
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peptide hormone produced by post pituitary
uterine stimulation milk ejection water retention uterine ruptures can occur water retention |
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when a women is bleeding post partum, what do we do firsT?
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check to see if placenta is all gone
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what is dinoprostone used for?
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to ripen the cervix
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cervicitis etiology
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std
chronic infection |
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cervicitis tx
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if never goes away cryosurgery
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is bleeding after sex normal?
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never
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adenomyosis
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endometrium is displaced in myometrium throughout fertility
multiparous common s/s: heavy bleeding, pain w/ menses, pain intercourse dx w/tx: pelvic exam, mri, color doppler |
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what causes induced menapause?
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removing the ovaraies
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ladies who go induce menopause will or will not be treated with hormones
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will
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endometriosis
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endometrail tissue outside of uterus: ovary, pelvis, perineum, intestine, uterine ligaments.
tx: NSAIDS oral contraceptives CnRH progesterones sx: laparoscopy hysterectomy w/ bilateral salpingo-oophorectomy |
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leuprolide
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leuprolide
suppresses ovarian hormone production therapeutic uses: -endometriosis -fibroids |
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AE leuprolide
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hot flashes
decreased libido headache vaginal dryness nasal irritation |
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danocrine
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drugs for endometriosis
AE: -acne -deeping of voice -growth of facial hair -edema -thromboitc events -hepatotoxicity -intensify effect of warfarin |
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fribroids
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smooth muscle neoplasm
most common age >35 and AA in myometrium or subserosal estrogen ^ size |
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debulking
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cutting off circulation
used in tumor |
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s/s firbroids
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symptomatic or pain
heaving bleeding rectal pressure urinary frequency |
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fallopian tubes and ectopic pregnancy
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fertilized ovum impoanting in fallopian tube
decreased tubal motility or distorted tube shap |
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s/s of ectopic pregancacy
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pelvic pain
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dx ectopic pregnancy
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ultrasound and HCG levels
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tx ectopic pregnancy
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prevent tubule rupture
hemmorhage r/o ovarian cyst rupture, appendicitis, miscarriage, firbroid, PID laprocopy vs laparotomy methotrexate |
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ligament function in pelvic disorders. 3 common conditions
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cystocele
rectocele uterine prolapse |
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cystocele
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bladder herniation into the vagina
s/s -pain -uti s/s over 50 yrs at risk |
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rectocele
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rectal herniation into the vagina
s/s: -fecal material in your vagina -pain -can empty rectum |
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enterocele
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weak uterolateral ligaments form sac
small bowel protrudes |
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uterine prolapse
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uterus herniation inot the vagina
3 degrees of prolapse found often during sex |
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PID etiology
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gonorrhea
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PID s/s
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pain in abd and back
painful intervourse purulent discharge painful cervix on manual exam fever w/ increased sed rate and WBC |
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PID tx
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antibiotics per cdc guide
prevent adhesions, infertility, ectopics, abscesses |
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mastitis
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post partum/infxn/trauma/tumor obstruction
tx: remove mass |
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ductal etasia
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post menopausl women
greenish grey dishcarge with pain, burn, itch, and theckening tx remove mass |
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fibrocystic breasts
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fibroadenoma: firm, defined, rubbery ( no worries)
fibrocysts: cyclical at times, hard to distiguish between solid/cysts; painful detection: SBE, mammogram/ultrasound biopsy if not sure Tx: mild analgesia warm/cold support avoid xanthines time your exams with period! |
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breast cancer risk factors
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age
family hx no child bearing wt inactivity diet htn etoh |
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tumor marker breast cancer
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BRCA1/2
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prophylaxis for breast cancer
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mastectomie and oopherectomies
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detection of breast cancer
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SBE
mammography ultrasound diopsy MRI/digital mammography for dense breasts |
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how to identify breast cancer
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solid, painless, immovable, poor definition
uppper outer breast area core biopsy best for differentiating type of cancer hormone testing of tissue key for prognostication and tx |
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cervical cancer
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liked with hpv
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gardasil
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only targets certain types of viruses
targets 16/18 hpv |
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dysplasia
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cancer breeding ground
look for it with papsmear |
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endometrail cancer = ___ plasia
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hyper plasia
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endometrial cancer tx
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sx + rad
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type 2 endometrial cancer
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palliative care
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ovarian cancer mortality
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high mortality rate
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IBS in women, symptoms are heaviness and gi, but could also mean..
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ovarian cancer
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ovarian cancer can be caused by
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age over 65
fam hx fatty diet talcum powder |
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someone is considered infertle if they cant concieve within... year
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1 year
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primary infertility
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no prior conceptions
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secondary infertility
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had a baby, now cant get prego
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female fertility issues
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multifactorial
ovulatory dysfunction cerviacl mucus uterine abdnormalities tubal abnormalities |
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drugs to teat female infert action
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blocks receptors for estrogen
promote foliccular maturation and ovulation |
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AE of female drug for infert
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hot flash
nausea bloating abd discomfort breast engorgement visual disturbances multiple births |
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hCG
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polypeptide hormone produced by placenta
promotes follicular maturation and ovulation AE ovarian hyperstiumlation syndrome edmea injection site pain CNS disturbances |
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dostinex
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used to correct amenorrhea and infertility
AE fainting. orthostatic hypotension |
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bromocriptine
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used to correct amennorrea and
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IVF process
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involves hormone replacement
ovary superstimulation artificla insemination with sperm fertilized eggs places in uterus with transvervial catheter can also place ova into fallopian tubes with laproscopy |
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birth control is...
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interfegin with the respoductive process at any step from gametogenesis to nidation (inplantation of a fertilized ovum)
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oral contraceptive 3 major subgroups
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monophasic
biphasic triphasic |
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oral contraceptisve interfere with ....
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ovulation
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AE contraceptive
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**thromboembolic disorders
htn** ca teratogenic effects abnormal uterine bleeing effects related to estrogen or progestin imbalance use in pregnancy and lactation benign hepatic ademoma mutlpe births glucose intolerance |
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OCs do what to warfarin
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decrease effectivenss
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OC rings problems
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infection, displacement, increased bleeiding
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subdermal OC implants doesnt work in...
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obese ppl
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what is true about monphasic OC
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same dose throughout the month
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what is true about biphasic OC
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estrogen same dose
progestin increases twoards 2nd half of cycle |
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triphasic OC
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progesterin doses change more often
can use lower doses |
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mifepristone ae
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bleeding
cramping nausea vomiting diarrhea headache |
