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62 Cards in this Set
- Front
- Back
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Amenorrhea |
Absence or suppression of menstruation Causes: hormonal disturbances, stress, neoplasms (ovarion, adrenal, or pituitary tumors) |
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Amenorrhea Treatment |
Aimed at the underlying cause, hormonal supplementation, surgery (tumor removal) |
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Abnormal Uterine Bleeding Patterns: Metrorrhagia (spotting/breakthrough bleeding) |
Bleeding between menstrual periods Causes: slight bleeding from endometrium during ovulation, uterine malignancy, cervical erosions, endometrial polyps, and estrogen therapy |
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Abnormal Uterine Bleeding Patterns: Hypomenorrhea |
Deficient amount of menstrual flow Causes: endocrine or systemic disorders interfering with hormones, partial obstruction of menstrual flow |
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Abnormal Uterine Bleeding Patterns: Oligomenorrhea |
Infrequent menstruation Cause: endocrine/systemic disorder causing failure to ovulate |
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Abnormal Uterine Bleeding Patterns: Menorrhagia |
Increase in amount or duration of bleeding Cause: lesions of reproductive organs |
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Abnormal Uterine Bleeding Patterns: Dysfunctional Uterine Bleeding |
Abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or hormonal effects Common around time of menarche and menopause Not common between 20 and 25 years of age |
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Dysfunctional Uterine Bleeding in Adolescents |
Immaturity in functioning of the pituitary and ovary |
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Dysfunctional Uterine Bleeding in Perimenopause |
Progressive function and failure of the ovary to produce estrogen |
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Dysfunctional Uterine Bleeding Treatment |
Surgery, oral contraceptives, and/or antiprostaglandins |
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Dysmenorrhea |
Painful menstruation |
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Dysmenorrhea Primary |
Develops 1-2 years after menarche Results from an increase in prostaglandin that promotes uterine contractions an ischemia of endometrial capillaries Sharp, suprapubic cramping severe enough to limit activity, nausea, vomiting, and diarrhea |
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Dysmenorrhea Secondary |
Associated with pelvic disorders such as endometriosis or pelvic adhesions Dull quality and may increase with age |
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Dysmenorrhea Treatment |
Prostaglandin inhibitors Oral contraceptives Laparoscopy, medical/surgical therapy |
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Uterine Prolapse |
Prolapse (sinking) of the uterus from its normal position into the vagina Results from the relaxation of pelvic structures and cervix Can occur at any age and is common |
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Uterine Prolapse Causes |
Congenital Defects (not as common) Pregnancy Childbirth Age |
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Uterine Prolapse First Degree |
Uterus halfway between vaginal introitus and level of ischial spines |
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Uterine Prolapse Second Degree |
End of cervix begins to protrude through the introitus |
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Uterine Prolapse Third Degree (complete prolapse) |
Body of uterus is outside the vaginal introitus |
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Uterine Prolapse Signs and Symptoms |
Depend on severity of prolapse Sensation of fullness, vaginal discomfort Discomfort in walking/sitting Difficulty urinating Bleeding, ulceration of cervix from friction, ulceration |
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Uterine Prolapse Treatment |
Hysterectomy Pessary (for nonsurgical candidates) |
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Retrodisplacement of the Uterus |
Body of uterus is displaced from usual location overlying bladder to posterior of the pelvis Very common (20%-30%) Can be detected in 20%-30% of women May be present throughout woman's life or develop after childbirth |
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Retrodisplacement of the Uterus Causes |
Congenital Pregnancy Childbirth |
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Retrodisplacement of the Uterus: Five Positions |
Anteverted Midposition Anteflexed Retroflexed Retroverted |
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Retrodisplacement of the Uterus: Signs and Symptoms |
In many women, no symptoms occur Pelvic pain or pressure Dysmenorrhea Dyspareunia (painful sexual intercourse) |
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Retrodisplacement of the Uterus: Treatment |
No treatment if no symptoms Pessary or surgical correction (severe symptoms) |
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Cystocele |
Protrusion of a portion of the urinary bladder into a weakened part of the anterior vagina |
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Cystocele Causes |
Injury during childbirth or surgery Aging Obesity Heavy lifting |
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Cystocele Symptoms |
Depends on severity Vaginal pressure and fullness Dysuria (pain during urination) Back pain |
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Cystocele Treatment |
Surgical repair of vagina to restore bladder to normal position |
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Rectocele (Proctocele) |
Protrusion of anterior rectal wall into a weakened area of posterior vagina Causes: Injury during childbirth Weakness with aging Multiparity Obesity Postmenopausal status |
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Rectocele Symptoms |
Depends on severity Constipation Painful bowel evacuation Painful intercourse |
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Rectocele Treatment |
Surgical repair of vagina to restore rectum to proper position |
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Pelvic Inflammatory Disease |
Any acute, subacute, recurrent, or chronic infection of the oviducts, ovaries, and adjacent reproductive organs Cervicitis (cervix) Endometritis (uterus) Salpingitis (oviducts) Oophoritis (ovaries) Parametritis (when connective tissue underlying these structures is involved) |
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Pelvic Inflammatory Disease Common Organisms |
Neisseria gonorrhoeae Chlamydia trachomatis |
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Pelvic Inflammatory Disease Causes |
Alteration of cervical mucus that prevents bacterial agents from ascending into the uterus Pelvic surgery, insertion of intrauterine device, abortion procedures, infection during /after pregnancy |
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Pelvic Inflammatory Disease Signs and Symptoms |
Abdominal symptoms Cervical/adnexa pain or tenderness on palpation Fever Elevated white blood cell count |
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Pelvic Inflammatory Disease Treatment |
Early and aggressive antibiotic therapy If indicated, hospitalization and surgery to remove infected area Inflammation can lead to scarring which can lead to infertility demanding an immediate antibiotic response |
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Vulvovaginitis |
Inflammation of the vulva and vagina Common organisms: Candida albicans (most common ,yeast infection) Trichomonas vaginalis Haemophilus vaginalis Neisseria gonorrhoeae Human papillomavirus (HPV) Herpesvirus type 2 |
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Vulvovaginitis Factors |
Chemical irritation from feminine hygiene products Trauma Allergic reactions Antibiotic therapy |
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Vulvovaginitis Symptoms |
Thick, white vaginal discharge Red, edematous mucous membranes Intense itching Malodorous, purulent discharge |
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Vulvovaginitis Treatment |
Local and systemic antibiotic, antifungal, or antiviral medications Avoidance of factors that promote irritation |
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Bartholinitis
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Inflammation of the Bartholin glands (located on the sides of vaginal orifice that lubricate vaginal introitus) |
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Bartholinitis Signs and Symptoms |
Abscess causing tenderness, swelling, and pus Fever and malaise |
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Bartholinitis Treatment |
Appropriate antibiotic therapy Surgical incision and drainage |
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Uterine Leimyomas |
Myomas or fibroids (benign tumors) More common uterine tumor Affects approx 20% women older than 35 years Blacks 3 times more than whites Make appearance and grow during reproductive years Growth enhanced by high estrogen and GH levels |
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Uterine Leimyomas Signs and Symptoms |
Abnormal vaginal bleeding and discharge If large mass: abdominal pain and pressure, backache, constipation, urinary frequency/urgency |
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Uterine Leiomyomas Treatment |
Depends on size, symptoms, location, patient age Small mass: monitor carefully for growth patterns Large or multiple mass: surgical removal, hysterectomy (if indicated) |
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Ovarian Cysts |
Sacs on an ovary that contain fluid or semisolid material Found only in women of childbearing age |
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Ovarian Cysts: Follicular |
Maturing ovarian follicle fails to release an ovum Instead the follicle continues to enlarge and produce estrogen Ovum is supposed to be release but does not and becomes a cyst Most common type |
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Ovarian Cysts: Corpus Luteum |
Corpus luteum fails to degenerate normally Cyst grows and produces progesterone Women is not pregnant but the corpus luteum is still present, this then becomes a cyst Produces progesterone |
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Ovarian Cysts: Theca-lutein |
Commonly bilateral and filled with clear straw-colored fluid Associated with hydatidiform mole, hormone therapy, or choriocarcinoma Fluid type of cyst |
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Ovarian Cysts: Signs and Symptoms |
Normally produces no symptoms When ruptured, causes intraperitoneal hemorrhage and abdominal pain |
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Ovarian Cysts: Treatment |
Immediate surgical intervention to control the hemorrhage and repair site of rupture |
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Endometriosis |
Increased risk in nulliparous women less than 30-40 years of age Benign disease but tends to infiltrate and spread to adjacent tissues Presence of endometrial tissue outside the lining of the uterine cavity Abnormal tissue implant is called endometrioma |
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Endometriosis (cont.) |
Once implanted, ectopic tissues periodically rupture and bleed in response to reproductive hormones Spilling of irritative discharge into peritoneum causes irritation Repeated irritation causes the formation of dense tissue adhesions |
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Endometriosis Etiology Theories: Transportation |
Endometrial tissues flows backward through oviducts during menstrual cycle implanting on ovary, peritoneal surfaces, and other areas |
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Endometriosis Etiology Theories: Metaplasia |
Inflammation or a hormonal change triggers conversion of one tissue to another form that is not normal |
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Endometriosis Etiology Theories: Induction |
Combination of transportation and metaplasia; regurgitated epithelium induces mesenchyma to form endometrial epithelium |
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Endometriosis: Sites of Occurrence |
(in order of frequency) Pelvis Ovary Peritoneum of cul-de-sac or pouch of Douglas Uterosacral ligaments Round ligament Oviduct Peritoneal surface of the uterus Bladder or intestine (less common) |
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Endometriosis: Signs and Symptoms |
Dysmenorrhea Pain in lower adomen, vagina, posterior pelvis, back Dyspareunia (difficulty/pain during sex) Pain with defecation Excessive menstrual bleeding |
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Endometriosis Treatment |
Varies according to extent of disease Induction of menopause-like state with hormonal agents (progestational steroids, antigonadotropic agents) Surgical excision |
