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58 Cards in this Set
- Front
- Back
Uterine Fibroids
(Leiomyomas, myomas) |
benign tumors in the muscle tissue of the uterus.
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Uterine Fibroid Signs and Symptoms
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Abnormal vaginal bleeding (menorrhagia or metrorrhagia)
Pain, Backache, Bloating, Constipation, Urinary Frequency or urgency, intestinal obstruction |
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Uterine Fibroid Diagnosis
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Blood tests, palpaiton of the tumor, laparoscopy, D&C
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Uterine Fibroid Risk Factors
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Genetic predisposition, Ages 25-40 * a growth spurt in the decade before monepause*, May be related to high levels of estrogen
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Complications
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Menorrhagia, which can cause anemia
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Uterine Fibroid Treatments
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Observation, removal if it's large and produces pressure symptoms, blood transfusion, hysterectomy, hysteroscopic resection, laparoscopic myomectomy, laparoscopic myolysis, laparoscopic cryomyolsis, UAE, MRgFUS, Medication Therapy
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Uterine Fibroid Medication Therapy
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Leuprolide [Lupron] or other GnRH
Mifepristone [RU-486, Mifeprex] |
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Menorrhagia
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Excessive vaginall bleeding
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Metrorrhagia
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Irregular vaginal bleeding
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Hysteroscopic resection
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laser removal of uterine fibroids with no incision or overnight stay required.
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Laparoscopic myomectomy
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removal of a fibroid through a laparoscope.
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Laparoscopic myolysis
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a laser or electrical needles are used to cauterize and shrink the fibroid.
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Laparoscopic cryomyolsis
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electric current is used to coagulate the fibroid.
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Uterine artery embolization (UAE)
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polyvinyl alcohol or gelatin particles are injected into the blood vessels that supply the fibroid via the femoral artery, resulting in infarction and resultant shrinkage.
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UAE complications
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pain, infection, amenorrhea, necrosis, bleeding, death, ovarian failure.
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UAE
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Percutaneous image-guided therapy that is a good alternative to hormone therapy or surgery for uterine fibroids.
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Magnetic resonance-guided focused ultrasound surgery (MRgFUS)
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an outpatient treatment using ultrasonic energy is passed through the abdominal wall to target and destroy the fibroid.
Non-invasive treatment, not widely used. |
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MRgFUS is FDA approved for
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Premenopausal women with bothersome symptoms that do not want more children.
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Leuprolide [Lupron] or other gonadotropin-releasing hormones (GnRH)
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A monthly injection used to shrink fibroids by inducing a temporary menopause-like environment
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Leuprolide [Lupron] or other gonadotropin-releasing hormones (GnRH) side effects
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vaginal dryness
hot flashes |
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Long term side effects of Lupron or GnRH
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vasomotor symptoms and loss of bone density
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Mifepristone (RU-486, Mifeprex)
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a progesterone antagonist used to treat uterine fibroids
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Fibrocystic disease of the breast
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over growths of fibrous tissue in the area of the ducts forming small cysts that develop and disappear quickly
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Risk factors for Fibrocystic disease of the breast
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Ages 30-50
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Signs and Symptoms of Fibrocystic disease of the breast
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Occasional shooting sensation or dull ache
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Fibrocystic disease of the breast Diagnosis
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ultrasound
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Fibrocystic disease of the breast treatment
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aspiration of fluid
Medications: danocrine and analgesics |
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Colon Polyps
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a small clump of cells that form on the lining of the colon. Mostly harmless, may become cancerous over time.
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3 major types of colon polyps
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1. Adenometaous polyps
2. Hyperplastic polyps 3. Inflammatory polyps |
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Adenometaous polyps
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rarely become cancerous and consist of 2/3 of all polyps
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Hyperplastic polyps
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Occur most often in the left (descending) colon and rectum. Usually less than .5 cm or 5mm in size. They're very rarely malignant.
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Inflammatory polyps
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Follow a bout of ulcerative colitis or Crohn’s disease of the colon. Not a significant threat themselves, but the presence of ulcerative colitis or Crohn’s disease increase the overall risk of colon cancer.
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Colon polyps Signs and Symptoms
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Rectal bleeding (bright red blood); blood in stool (red streaks or black); constipation; diarrhea; narrowing of the stool; pain or obstruction; abdominal pain; and change in bowel habits that last longer than a week.
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Complications of colon polyps
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may turn into colon cancer.
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Risk factors for colon polyps
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age 50+, overweight, smoker, eat a high-fat or low fiber diet, history of colon polyps or cancer, African American, Ashkenazi Jew, or Eastern European decent
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Colon polyp diagnosis
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fecal occult (hidden) blood test; fexible sigmoidoscopy; barium enema; colonoscopy; computurized colongraphy (CTC); stool DNA testing; genetic testing (determines risk).
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Colon polyp treatment
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snare; surgery; endoscopic mucosal resection; colon and rectum removal; dietary changes; limit alcohol; smoking cessation; physically active and healthy body weight; medication therapy- ASA or hormone therapy
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Prostatic hyperplasia
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a normal, aging related, enlargement of the prostate gland that causes urinary outlet obstruction.
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Prostatic hyperplasia signs and symptoms
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reduce stream force and caliber of urine, a feeling of not emptying the bladder, urinary retention.
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Prostatic hyperplasia diagnosis
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rectal digital exam of the prostate, iv pyelogrpahy, elevated BUN and creatinine levels, ua and urine culture.
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Prostatic hyperplasia Treatment
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prostate massage, fluid restriction, sitz bath, regular sexual intercourse, TURP, and continuous irrigation.
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TURP (Transurethral Resection of the Prostate)
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an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow
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TURP Post-op
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1-2 days hospitalizaiton; catherer to remove blood or blood clots in the bladder.
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Avoid for 6 weeks post-op of a TURP
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strenuous activity, constipation, and sexual activity
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IV pyelography
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shows the kidneys, ureter, and bladder via x-ray imaging as the dye moves through the upper and then lower urinary system.
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Normal BUN
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10-20mg/dL
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Normal Serum Creatinine
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~0.7-1.4mg/dL
*increases as renal function decreases* |
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Dietary alterations for colon polyps
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Adequate amounts of calcium; plenty of fruits, vegetables, and whole grains; watch fat intake.
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Colon and rectum removal creates an
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Ileal pouch-anal anastomosis
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Ileal pouch-anal anastomosis
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a pouch is constructed from the end of the small intestine ileum that attaches directly under the anus. Allowing for normal waste expellation, through several watery bowel movements in a day.
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Endoscopic mucosal resection (EMR)
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Removal of larger polyps with a colonoscope. Liquid, such as saline, is injected under the polyp to elevate and isolate the poly from surrounding tissue making it easier to remove (avoids complications), higher rate of complications.
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Snare polyp removal
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removal of smaller polyps during a colonoscopy or sigmoidoscopy by snaring them with a wire loop that simultaneously cuts the stalk of the polyp and cauterizes it to prevent bleeding.
Risk for bleeding and perforation of the colon. |
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Laparoscopic snare polyp removal
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A laproscopic removal of large snares which provides for a faster and less painful recovery.
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Once the section of the colon is removed, the polyp can't recur at that area but can.....
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... develop in other areas of the colon in the future.
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Flexible sigmoidoscopy
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a slender lighted tube that is used to exam the rectum and sigmoid- approximately the last 2 feet of the colon. Where nearly half of all colon cancers are found.
Slight risk for colon perforation, but less than the colonoscopy. |
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Barium enema and Colon polyps
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A barium enema is given and x-rays to diagnose colon polyps.
Carries slight risk for colon perforation. No chance for doctor to perform a biopsy. |
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Colonoscopy
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a long, slender tube attached to a video camera and monitor allowing for a view of the entire colon and rectum.
Carries risk for colon perforation. |
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Computerized tomography colongraphy (CTC)
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an x-ray style virtual colonoscopy that does not require you to go inside of the body.
Pt will need colonoscopy if a biopsy is needed. |