Sti/cancer Of Reproductive Organs

Front 1

Loss of H-producing lactobacilli & overgrowth of anerobic bacteria
Symptoms
Thin, watery, white/gray discharge with fishy odor
Risk of PID
Treatment
Metronidazole (Flagyl) or Clindamycin 2% vaginal cream

Back 1

Bacterial Vaginosis

Front 2

Candida albicans,
Predisposing factors
Glycosuria, use of antibiotics, pregnancy, DM, use of immunosuppressants
Symptoms
Thick, curdy vaginal discharge, itching, dysuria, dyspareunia, rash/excoriation
PE: thick, white cottage-cheese patches adhering to vaginal mucosa,
Treatment
:fluconazole & topical application of nystatin
Bathing with weak sodium bicarbonate solution, yogurt

Back 2

Vulvovaginal Candidiasis

Front 3

Trichomoniasis vaginalis protozoan
Symptoms
Yellow-green, frothy, odorous discharge, vulvular itching, dysuria, dyspareunia,
Treatment
Metronidazole (Flagyl) as single 2 gm dose or 500 mg BID for 7 days

Back 3

STI-Trichomoniasis

Front 4

Chlamydia trachomatis
Most common bacterial STI in USA
Major cause of nongonococcal urethritis, epididymitis & infertility in men
Major cause of PID, infertility & ectopic pregnancy in women
Symptoms
Largely asymptomatic
Treatment
Azithromycin or doxycycline. Tetracycline QID x 7-10 days
Sexual partners should be treated

Back 4

Sexually Transmitted Infections:Chlamydia

Front 5

Neisseria gonorrhoeae bacterium
Symptoms
Largely asymptomatic
Purulent, green-yellow malodorous discharge, dysuria, urinary frequency, vulvular inflammation, pelvic pain

Treatment
IM dose of ceftriaxone (Rocephin) IM
Reculture in 7-10 days
Treat with doxycline to treat high chance of coexisting chlamydia (or Tetracycline)

Back 5

Sexually Transmitted Infections:Gonorrhea

Front 6

Herpes simplex virus-2
Symptoms
Primary lesions
Single or multiple painful, open lesions
Enlargement of inguinal lymph nodes & flu-like symptoms
Dormant phase
Virus lives in nerve ganglia
Recurrences usually less severe
Treatment
Acyclovir,
Topical agents

Back 6

Sexually Transmitted Infections:Herpes Genitalis

Front 7

Treponema pallidum spirochete
Stages
Early (primary): painless chancre, weight loss, malaise
Secondary: condylomata, acute arthritis, enlargment of liver/spleen, nontender lymph nodes, chronic sore throat
Treatment
Penicillin G IM

Back 7

Sexually Transmitted Infections:Syphillis

Front 8

a wartlike growth on the skin, usually in the region of the anus or genitals

Back 8

Condylomata-

Front 9

Over 100 HPV types
40 types may infect the genital tract
5 types associated with anogenital cancer
Incubation period 3 weeks to 3 years
Symptoms
Single or multiple soft gray-pink warts
Treatment
Podofilox solution or imiquimod cream
Cryotherapy, trichloroacetic acid, surgical removal
Frequent PAP smears, use condoms

Back 9

Sexually Transmitted Infections:Human Papilloma Virus

Front 10

Phthirus parasite
Symptoms
Itching
Visualization of “crabs”
Treatment
Permethrin 1% crème
Wash clothing, linens or remove from contact for 72 hours

Back 10

Sexually Transmitted Infections:Pediculosis Pubis

Front 11

Sarcoptes scabiei parasite
Symptoms
Itching that worsens at night or when individual is warm
Erythematous, papular lesions or furrows
Treatment
Permethin cream 5%
Lindane 1% lotion
Wash clothing, linens

Back 11

Sexually Transmitted Infections:Scabies

Front 12

Clinical syndrome of inflammatory disorders of female genital tract
Often a polymicrobial infection
Symptoms
Bilateral pain, fever >101°F, chills, mucopurulent discharge, irregular bleeding, malaise, N/V
Treatment
Hospitalization if severely ill, IVF, pain medications, IV antibiotics, pelvic rest, removal of IUD, sitz baths

Back 12

Pelvic Inflammatory Disease

Front 13

Presence of lesion, Increased vaginal discharge or malodorous discharge, Burning with urination, Bleeding after intercourse, Pelvic pain
All cases of gonorrhea and syphilis (and in most states chlamydia) must be reported to state or local public health authorities

Back 13

Signs of STI

Front 14

Causes: STD, HPV, Early sex, multiple partners, smoking, poor nutrition

Manifestations: asymptomatic, vaginal bleeding or discharge
Pap tests
Treatment:
premalignant- cyrosurgery
invasive- hysterectomy, chemo, radiation

Back 14

Cervical CANCER

Front 15

Causes: cervical cancer

Manifestations: asymptomatic, vaginal bleeding or discharge

Treatment:
premalignant- cyrosurgery
invasive- hysterectomy, chemo, radiation
s/s or not
Postmenopausal bleeding is first sign of cervical cancer
Intrauterine implants=radioactive. Absolute bedrest, no turning, no more than 30 min a day 6ft from patient
Cryosurgery-the use of extreme cold to destroy tissue for therapeutic purposes

Back 15

Vaginal CANCER

Front 16

Causes:age, no term pregnancies, early menses, high fat diet, inactivity, ETOH, radiation, first-degree relative

Patho: Estrogens have proliferative effect on mammary gland epithelium, may increase susceptibility to carcinogens, mutations of BRCA

Manifestations: painless or painful lumps, nipple puckering & discharge, skin retraction over lesion

Back 16

Breast CANCER

Front 17

Leading cancer of women in us
Usually adenocarcinoma
Usually upper outer quad, left breast
35-50 first mammogram, 35 if family history
If mother had it, screen 10 years early than when mother was diagnosed
Annually after 50
Less than 4cm lump, usually curable
Post op, elevate, hemovac, no bp or blood draws.
Age is highest risk factor for b.c.
Malignant lesions usually hard, irregular shaped, non-tender, can move them around.
BRCA genes, 5-10% women have these genes
2 nodes + is bad, has spread, more chances of relapse, hormone receptor negative tumors have lower chances of being treated
Malignant tumors do not change during menstrual cycle
Less than 30 min per hour, no preg, or less than 16

Back 17

breast cancer

Front 18

surgery to remove lesion, chemo, radiation to prevent metastasis, hormones for hormone-dependant tumors, marrow transplant

Back 18

breast cancer treatment

Front 19

MEDICATION: Tamoxifen (Nolvadex)- antiestrogen agent that blocks estrogen-receptor sites of malignant cells.
5-fluorouracil: antimetabolite, cell cycle-phase specific

Back 19

breast cancer treatment drugs

Front 20

Need to know tamoxifen
10 year survival rate, lumpectomy and radiation
Most receptive tumorto chemo= breast tumor
Lymph nodes mapping 1-4 nodes that drain
Micromestasis even in stage 1, chemo shld be started
No kids after 5years, estrogen increases chances during this time, avoid aspirin, accidents, examine mouth or bleeding ulcers, small frequent meals, use wig, mild shampoo
Mastectomy predisposes infection to that arm, no injections, prop on pillow, swelling, elevate most important called lymphedema, on post-op side, immediately postop flex wrist

Back 20

post-op breast removal for breast cancer

Front 21

Cause: Unknown, obesity, no pregnancies, high-fat diet, late menopause, HTN

Manifestations: systemic, pain and abdominal swelling, postmenopausal bleeding

Treatment: surgery, staging, radiation when small lesion, chemo when extensive
Death sentence, occur in all ages, leading caus eof gyn cancer, early detection is key, by s/s is almost too late, laparascopy to stage
CT or ultrasound to diagnose

Back 21

ovarian cancer