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101 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Absence or cessation of menstrual flow.
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Amenorrhea
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Clinical sign most commonly associated with pregnancy and is a classic sign of anorexia nervosa.
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Amenorhhea
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Often r/t the suppression of of the hypothalamus by stress or sudden/severe wt loss, eating disorders, strenuous exercise, or mental illness.
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Hypogonadotropic Amenorrhea
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3 components of the female athlete triad
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Disordered eating, amenorrhea, and premature osteoporosis
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Dysmenorrhea
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Painful menstruation
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one of the most common gynecological problem for women of all ages.
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When do symptoms of Dysmenorrhea usually occur?
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shortly before or during menstruation
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dysmenorrhea = painful menstruation
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Type of painful menstruation that occurs as a result of a physiological alteration in some women.
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Primary dysmenorrhea
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When does primary dysmenorrhea usually appear?
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6 - 12 months after menarche
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requires estrogen and progesterone to occur...so ovulation must be established
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Type of painful menstruation that usually occurs after the age of 25 and is associated with pelvic abnormality.
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Secondary dysmenorrhea
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Cluster of physical, psychologic, and behavioral symptoms beginning in the luteal phase of the menstrual cycle.
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Premenstrual Syndrome (PMS)
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3 criteria needed for a diagnosis of PMS
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1. Sx occur in luteal phase and resolve within a few days of menses
2. Sx free in follicular phase 3. Sx are recurrent |
Think about the phases of the menstruation cycle.
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Menstrual disorder characterized by the presence and growth of endometrial tissue outside of the uterus.
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Endometriosis
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In endometriosis, endometrial tissue responds to hormonal stimulation. In which phases of the menstral cycle does growth of this tissue take place?
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Proliferative and Secretory phases
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In endometriosis, what causes the fibrosis and adhesions of adjacent organs?
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Bleeding during or immediately after menstruation resulting in an inflammatory response causes this damage.
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symptoms of endometriosis
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Dysmenorrhea
Deep pelvic dysparenunia Diarrhea Pain w/ defecation Constipation |
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Adhesions around the uterus and uterine tubes caused by endometriosis may result in..
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Impaired fertility
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Any form of uterine bleeding that is irregular in amount, duration, or timing and is not r/t regular menstrual bleeding.
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Abnormal uterine bleeding
(AUB) |
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Subset of AUB defined as excessive uterine bleeding with no demonstrable cause.
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Dysfunctional uterine bleeding (DUB)
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DUB is most frequently associated with __________.
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Anovulation
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occurs at extremes of a woman's reproductive years
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First line meds for tx of primary dysmenorrhea
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NSAIDs
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Age group most affected by endometriosis
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30's - 40's
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Nafarelin (Synarel) is a GnRh agonist. How does it treat endometriosis.
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Suppresses endogenous estrogen production and subsequently endometrial lesion growth.
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GnRH = gonadotropin releasing hormone
agonist = suppression |
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Explain how nafarelin (synarel) works to suppress endometrial growth.
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Suppresses GnRH release from pituitary -> decreased stimulation of ovaries by FSH and LH -> decreased ovarian function -> medically induced menopause (amenorrhea, anovulation)
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Med that suppresses FSH and LH secretion, producing anovulation and hypogonadotropinism, resulting in decreased secretion of estrogen and progesterone and regression of endometrial tissue.
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Danazol (danocrine),
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mildly androgenic steroid
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The only definitive cure for endometriosis
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total abdominal hysterectomy (TAH) w/ bil salpingo-oophrectomy (BSO)
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Primary dysmenorrhea is most often r/t ...
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excessive secretion of prostoglandin during ovulatory cycle.
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Infections or infectious disease syndromes that are primarily trasmitted by close intimate contact
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STDs
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the most common types of STDs are...
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Clamydia
Gonorrhea Syphilis HPV HSV-2 HIV |
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Safer sex practices
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know partner
decrease # of partners low risk sex avoid body fluid exchange |
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Physical barriers promoted to prevent sexual transmission of HIV and other STDs.
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Condoms
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Bacterial infection that is the most common and fastest spreading STD in American women; often silent and highly destructive to the reproductive tract
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Chlamydia
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The oldest communicable disease in the US; reportable communicable disease
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Gonorrhea
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One of the earliest STDs caused by Treponema pallidum, a spirochete.
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Syphilis
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3 types of syphylis
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Primary, secondary, tertiary
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Characterized by a lesion or chancre that appears 5-90 days after infection.
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Primary syphylis
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Occurs 6 weeks to 6 months after appearance of primary lesion and is characterized by widespread symmetric maculopopular rashes on the palms and soles and generalized lymphadenopathy.
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Secondary syphilis
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Symptoms of secondary syphilis.
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fever
headache malaise condoylomata lata - vulva, perineum, and anus |
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What happens if a person with secondary syphilis is not treated?
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Enters latent phase; asymptomatic for most people
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Type of syphilis characterized by neurological, cardiovascular, musculoskeletal, and multiorgan system complications.
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Tertiary syphylis
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Infectious process that most commonly involves the uterine tubes, uterus or more rarely, the ovaries and peritoneal surfaces.
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Pelvic inflammatory disease
(PID) |
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When does the ascending spread of microorganisms most often occur, causing PID?
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Near end or after menses
After childbirth After pelvic surgery |
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Infection previously named genital warts; now most common STI seen in ambulatory care settings.
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Human papillomavirus (HPV)
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Condoylomata acuminata
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Visible lesions caused by HPV
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Viral infection trasmitted sexually and is characterized by painful recurrent genital ulcers.
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Herpes simplex virus 2
(HSV-2) |
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Symptoms of initial or primary infection of HSV-2.
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Multiple painful lesions
Fever Chills Malaise Severe dysuria |
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How long does a primary HSV-2 outbreak usually last?
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2-3 weeks
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Viral infection acquired primarily through a fecal-oral route by ingestion of contaminated food.
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Hepatitis A Virus
(HAV) |
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Common sources/carriers of HAV.
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Milk
Shellfish Polluted water person to person |
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Viral infection involving the liver that is transmitted parenterally, perinatally, and through intimate contact.
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Hepatitis B Virus
(HBV) |
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Which type of Hepatitis can infants, children and adults be protected from by recieving a vaccine?
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HBV
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Most common blood-borne infection in the US; disease of the liver transmitted parenterally or via intimate contact. No vaccine available.
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Hepatitis C Virus
(HCV) |
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Retrovirus that is transmitted primarily through exchange of body fluids; associated with severe depression of cellular immunity function
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HIV
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Normal vaginal flora that is present in 9-23% of healthy pregnant women and is associated with poor pregnancy outcomes
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Group B Streptococcus (GBS)
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Implicated as an important factor in perinatal and neonatal morbidity and mortality if vertically transmitted to the newborn during birth.
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GBS (group B strep)
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Most common type of vaginal infection/vaginitis.
Characterized by profuse, thin, and white, gray, or milky discharge. |
Bacterial Vaginosis
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Characteristic odor associated with bacterial vaginosis
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"fishy" odor
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Second most common vaginal infection in US;
Yeast infection |
Candidiasis
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Common S/S of Candidiasis
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Pruritis
Dryness Itching Painful vulva during urination (due to excoriation from itching) |
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Describe the discharge commonly associated with Candidiasis.
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Thick, white, lumpy
cottage-cheese like |
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Describe physical assessment findings that may be observed in a patient with Candidiasis.
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Patchy appearance of vaginal walls, cervix, and labia.
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Vaginal infection caused by anaerobic one-celled protozoan with characteristic flagella.
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Trichomoniasis
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Describe the discharge typical of a Trichomoniasis infection.
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yellowish green, frothy, mucopurulent, and malodorous
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Age group most affected by Gonorrhea
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20 yrs and younger
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How can Chlamydia be transmitted?
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Direct sexual contact or exposure at birth
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Who does the CDC recommend be screened for Chlamydia at their yearly Pap smear?
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all sexually active women between the ages of 20 and 34
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Women over age ___ have the lowest rate of infection for Chlamydia.
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30
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How is Gonorrhea spread?
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Direct contact with infected lesions;
Genital-genital; genital-oral; anal-oral |
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Preferred drug for the Tx of Syphilis.
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Penicillin
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Causes at least half of all cases of PID.
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C. trachomatis
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The different types of HPV are characterized by _____?
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Appearance of visible warts
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Are HPV infections more common in pregnant or non-pregnant women?
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Pregnant women
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Describe the lesions characteristic of recurrent HSV-2 infections.
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Unilateral - begin as vesicles and progress rapidly to ulcers
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Fastest growing population with HIV and AIDS
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women
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Once HIV enters the body, seroconversion to HIV positivity occurs within _____ to ____ weeks.
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6 to 12 weeks
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Can HIV be transmitted through breastmilk?
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Yes
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Medication used to tx HIV in pregnant women
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Aidovudine (AZT)
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Can a pregnant woman be vaccinated for Hepatitis B?
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Yes
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Recommended tx for woman in labor that tests positive for GBS.
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Penicillin
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Risk factors for STDs
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Unknown partner
Multiple partners Sharing drug/tatoo/piercing needles Blood transfusion No barrier Hx of STDs Rape |
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clinical manifestations of chlamydia
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usually asymptomatic; bleeding btwn periods or after coitus; mucoid or purulent discharge; dysuria and pelvic pain
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Clinical manifestations of Gonorrhea.
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- Menstrual irregularities
- Pelvic/lower abdominal pain - Mucoid/purulent discharge - Dysuria, pelvic pain |
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Clinical manifestations of HPV.
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- Vaginal discharge
- Itching - Post-coital bleeding - Dysparenunia - C/o "bumps" on vulva or labia |
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Clinical manifestations of HSV.
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Painful, recurrent genital ulcers; itching, swelling, tenderness
Systemic s/s: fever, chills, malaise, dysuria lasting 2-3 weeks initially |
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Clinical manifestations of bacterial vaginosis.
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"Fishy odor"
Itching, irritation, pruritis Profuse, milky, thin discharge |
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Clinical manifestations of Candidiasis.
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Cottage-cheese like discharge
Itching (esp. after sex) Vulvar/vaginal ruritis Dryness Patches on vaginal walls, cervix, labia Yeasty/Musty odor Vulva, labial folds, vagina and cervix may be swollen |
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Clinical manifestations of Trichomoniasis.
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Yellowish-green, frothy, mucopurulent, malodorous, discharge that increases in amount during/after menses
Inflammation of vulva/vagina Pt c/o irritation, pruritis, dysuria, dyspareunia Petechiae or "strawberry spots" on cervix/vaginal walls Cervix may bleed on contact If severe - acute inflammation of vulva, vagina, and cervix |
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Most common means of infecting a woman with HIV.
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Heterosexual transmission
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Clinical manifestations that may be exhibited during seroconversion to HIV positivity.
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Sore throat
Viremic Flu-like symptoms (fever, malaise, headache, night sweats, lymphadenopathy, myalgia, N/V, diarrhea, wt. loss, rash) |
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Care management for women who test positive for HIV
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Education r/t progression of disease, measures to prevent transmission and maintain resistance to infections, healthy lifestyle practices, contraception, s/s of opportunistic infections; prophylactic medications; counseling; referrals PRN
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Meds used to tx a pt infected with Chlamydia, who is not pregnant
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Doxycycline, Azithromycin
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Meds used to tx Gonorrhea
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Cefixime
Ceftriaxone |
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Treatment for HPV
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No cure; many treatment modalities
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Management of HSV
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Treat primary and recurrent lesions
Prevention Self-help measures Counseling |
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Management of Candidiasis
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Monistat, Gyne-Lomotrin
See MD for 1st infection; subsequent infections may be tx'd w/ OTC meds; recurrent/chronic infections should be discussed with MD - Vaginal debridement of purulent drainage with cotton swab followed by medication - Sitz bath - Aveeno powder - Don't use tampons during menses while on meds (they will absorb in tampon) - Avoid sex during tx/use a condom - Don't wear underwear @ HS |
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Management of Trichomoniasis
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Flagyl 2g PO x 1
Partner should be tx or infection will recur Education about sexual transmission of disease, unable to determine time of transmission b/c s/s may not appear for months after infection |
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Typically fibrocystic change is noted as...
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lumpiness in both breasts.
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Most common benign breast problem.
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Fibroadenoma
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How do fibroadenomas change in size during pregnancy.
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increase
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Used to visualize/distinguish cysts from solid tumors in the breast.
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Ultrasonography
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What food can be eliminated from the diet to reduce tenderness associated with fibrocystic breast changes?
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Caffeine
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Transmission of HIV
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Blood, semen, vaginal secretions
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