Final Review Ch 14

Front 1

health hx

Back 1

menarche, menstruation, menopause, postmenopausal; bleeding; pregnancy; vulvovaginal symptoms; sexual oriention/respnse; pelvic pain; STD/STI

Front 2

Menstrual hx

Back 2

Last menstrual period; How often; How regular; Light/heavy; Bleeding between; Bleeding with intercourse

Front 3

menarche

Back 3

age at onset of menses-usually 9-16, takes one year to become regular pattern. 24-32 days; flow last 3-days. Onset is dep on genetics, socioeconomic status, nutrition.

Front 4

Menopause definition

Back 4

Absence of menses for 12 consecutive months (48-55)

Front 5

S/S of menopause

Back 5

Mood shifts, hot flashes, vaginal drying, accelerated bone loss, increase chol, dysuria, dyspareunia, trouble sleeping.

Front 6

Body changes of menopause

Back 6

Pelvic ligaments-loose elasticity, cervix smaller/pallor. Vaginal drying, dysuria, and at times dyspareunia.

Front 7

Post menopausal bleeding

Back 7

Bleeding occurring >/=6 months after cessation. Causes: endometrial CA, HRT, uterine/cervial polyps.

Front 8

Primary amenorrhea

Back 8

Never started bleeding

Front 9

Secondary amenorrhea

Back 9

Cessation of periods after they have been established. Pregnancy, lactation, menopause, low body wt, malnutrition, anorexia, stress, chronic illness, hypothalamic pituitary-ovarian dsyfxn.

Front 10

Polymenorrhea

Back 10

less than 21 day intervals btwn menses

Front 11

Oligomenorrhea

Back 11

Infrequent bleeding.

Front 12

Menorrhagia

Back 12

Excessive flow (Amt or duration). Heavy periods lasting 10-12 days. Excess flow-bright red and may have clots.

Front 13

Abnormal bleeding causes

Back 13

Pregnancy, cervical or vaginal infection, cancer, fibroids, cervical or endometrial polpys, bleeding disorders and HRT.

Front 14

Postcoital bleeding

Back 14

suggests cervical cancer or polyps or in a an older woman atrophic vaginitis.

Front 15

Amenorrhea with pregnancy. S/S

Back 15

tenderness, tingling, or increased size of breasts, urinary frequency, n/v, easily fatigued, feeling baby is moving about 20 weeks.

Front 16

Amenorrhea followed by heavy bleeding suggests..

Back 16

threatened abortion or dysfunctional uterine bleeding d/t lack of ovulation.

Front 17

Gravidy

Back 17

total number of pregnancies

Front 18

Para (parity)

Back 18

outcomes of pregnancy F-ful term, A-abortion, and L-living child.

Front 19

Dysmenorrhea

Back 19

Pain with menses. Ask if the pain is before or after periods, how long it lasts and if it interferes with activities.

Front 20

Primary dysmenorrhea

Back 20

Caused by increased prostaglandin production during the luteal phase of the menstrual cycle.

Front 21

Secondary dysmenorrhea

Back 21

Can be caused by endometriosis, adenomyosis, PID, endometrial polyps.

Front 22

Trichomonal vaginitis

Back 22

protozoan may be sexually acquired. ; Yellow/green d/c-may be malodorous; Pruritus-not as bad as candida; Pain on urination; dyspareunia

Front 23

Trichomonal vaginitis vulva, vagina mucosa

Back 23

Vestibule and labia minor may be red; Vagina may be red w/ small granular spots/petechia; Mild cases-looks normal

Front 24

Candial vaginitis

Back 24

Candida albicans-yeast. Abx therapy prediposes; White and curdy, thick but may be thin d/c; Prurititis; Vaginal soreness; Pain on urination; dyspareunia

Front 25

Candial vulva, vagina mucosa

Back 25

Inflammed and swollen, red with white patches. Mucosa may bleed when white patches scrapped off. Mild cases-look normal

Front 26

Bacterial vaginosis

Back 26

Bacterial overgrowth, may be sexually transmitted; grey, white, thin, malodorous, fishy or musty d/c

Front 27

Bacterial vaginosis vulva and mucosa

Back 27

Usually normal; sniff for fishy odor after applying KOH (whiff test); vaginal secretions PH >4.5

Front 28

Normal vs vaginitis d/c

Back 28

Normal clear and white, not malodorous. Wipe off cervix with cotton, if no d/c is present in os, suspect vaginitis.

Front 29

Chlamydia screening (most reported US STD)

Back 29

Annual for all sexually active and pregnant women age 26 and younger and in older women at increased risk.

Front 30

Chlamydia/gonnorhea/HIV High risk

Back 30

less than age 24 and sexually active; prior infection w/ chlamydia; new or multiple partners; inconsistent condom use; occupational sex work

Front 31

Gonorrhea screening

Back 31

Routine screening- All sexually active women and all pregnant women who are at increased risk.

Front 32

Syphilis screening

Back 32

Routine screening- Sexually active women and pregnant women who are at increased risk

Front 33

HIV Screening

Back 33

Universal testing ages 13-64

Front 34

Screening cervical cancer

Back 34

1st screen-at age 21;

W-21-29-Every 3 yrs w/cytology.

W-30-65-Every 3 yrs w/cytology, if 3 negative (and no risk factors) may do every 5 years. W w/ hysterectomy-d/c screening

W > 65 d/c screening if 3 neg tests in a row and no abnormal tests in last 20 years.

Front 35

Other cervical cancer risk factors

Back 35

multiple sex partners; smoking; failure to screen; immunosuppression; long term oral contraceptive use; Chlamydia; prior cervical CA; parity

Front 36

HPV vaccine recommendations (gardasil)

Back 36

Girls before sexual contact, ~11/12 as early as 9 (3 doses); Boys 9-26

catch-up dose females aged 13-26 & sexually active

Front 37

HPV vaccine reduces risk of

Back 37

anogenital warts; invasive anogenital cancers; vulvar and vaginal cancer

Front 38

Ovarian Cancer risk factors

Back 38

W > 50; fam hx-BRCA1/BRCA2 gene mutation; 1st degree relative w/breast or ovarian cancer

Front 39

Decreased risk

Back 39

oral contraceptives; pregnancy; hx of breast feeding

Front 40

Ectopic pregnancy (ruptured tubal preg)

Back 40

Spills blood into peritoneal cavity causing severe abd pain. Guarding/Reboudn tenderness. Unilateral mass. Faintness, syncope, n/v, tachycardia, shock-reflect hemorrhage. May have prior hx of amenorrhea.

Front 41

Ovarian cyst

Back 41

Smooth, compressible tumor; Small mobile-usually benign; Usually non tender

Front 42

Polycystic ovary syndrome

Back 42

absent or irreg menses; hyperandrogenism; polycystic ovaries on ultrasound

Front 43

Ovarian Cancer

Back 43

rare, usually presents at advanced stage.; S/S pelvic pain, bloating, increased abd size, and urinary tract symptoms. Risk factor-Fam hx of breast or ovarian cancer; no effective screening tests

Front 44

PID

Back 44

Most often result of sexually transmitted infection of the fallopian tubes/ovaries. Caused by chlamydia, gonorrhea, or other organisms or after baby delivery/gyn sx.

Front 45

Acute PID

Back 45

very tender, bilateral adnexal mass, although pain makes it impossible to delineate them. Movement of cervix produces pain. Infertility or tubo-ovarian abscess may occur w/out tx.

Front 46

Uterine enlargement suggests...

Back 46

pregnancy, myomas or malignancy.