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Maternal Newborn

Woman's Health Issues

Question	Answer
What is most common range of beginning of menarche	12-17 - if not by 17 then healthcare investigation to check hormones
Why are vaginal sprays and douching not recommended	sprays can cause irritation and douching increases vaginal infections
____ the absence of menarche or menstration	Amenorrhea (as in AMEN no more periods) May be due to primary (never starts) or secondary (occures after menstration starts) or r/t pregnancy
A dysfunctional uterine bleeding (DUB) or abnormal bleeding pattern where bleeding is excessive at REGULAR intervals	Menorrhagia
A dysfunctional uterine bleeding (DUB) or abnormal bleeding pattern where bleeding is EXCESSIVE between cycles or IRREGULAR	Metrorrhagia- Often referred to as spotting
What should be ruled out when faced with a dysfunctional uterine bleeding (menorrhagia or metrorrhagia)	Uterine fibroids, menopause, and endometral cancer
____ is a painful menstration occures one day before or at start of mencese and usually have relief by second day	Dysmenorrhea - there is an increase in prostaglandins so take NSAID, can double the dose
Differentiate between primary and secondary dysmenorrhea (painful menstration)	Primary is not related to an underlying condition or pathology where secondary is
Other than NSAID's, what is the management of dysmenorrhea	oral contraceptives (prevent ovulation), exercise (walking),rest, heat, nutrition and biofeedback
sociocultural impact of ____ is missing school or work and the emotional upset this causes	dysmenorrhea
____ is a symptom complex associated with menstral cycle, starts about a week prior to menstration with leuteal phase	Premenstrual syndrom (PMS)
Management of PMS	diet, vit B6, antidepressents
The psychosocial impact of ____ includes an emotional association with cycle, impact on family work and friends and increases incedent over age 30	PMS
____ is a normal process, not a disorder where ovaries stop producting estrogen	menopause - Dx after one year without menstration
surgical menopause is removal of ____	ovaries, not the uterus (hysterectomy)
____motor symptoms cause hot flashes (flushing and nightsweats) of menopause	vasomotor symptom
symptoms of menopause	hotflashes, sleep disturbances, emotional (depression and anxiety), vaginal atrophy and drying, weaking of pelvic floor and dyspareunia (painful intercourse)
Management of menopause	hormone replacement therapy (HRT), and Estrogen replacement therapy (ERT). If have uterus, ERT is bad causes hyperplasia but the heart likes estrogen
What do the three types of hysterectomy (TAV, TVH, and TAH BSO) stand for	Total abdominal hysterectomy, Total vaginal hysterectomy and Bilateral salpinges ooporectomy (take out the tubes and ovaries)
reproductive surgery is used for the treatment of which disorders	cancer, fibroids, severe endometriosis, chronic PID, abnormal uterine bleeding (AUB) and pelvic relaxation (cystocele and or rectocele due to weakening of the vaginal wall and the bladder or rectum pouch into vagina)
When is the best time to do a breast self examination	After period b/c hormones ar lowest
What percipitates the first pelvic exam & pap smears	If having sex without monogomus partner (identify STI's/vaginitis) or by age 18
Cervical cancer used to have a high mortality rate, why has it decreased significantly	Pap smear - cervical cytology to look for dysplasia (abnormal cells)
Name the two strands for atypical squamous cells (ASC) and what they mean	ASC-US some cells are abnormal (dysplasia) may be due to infection or HPV. ASC-H is dysplasia - small possibility of precancerous changes
dysplasia can be either low grade (LSIL low grade squamous intraepithelial lesion) or high grade (HSIL high grade squamous intraepithelial lesion) what is the significance of each	The risk of low grade dysplasia transforming into high grade dysplasia and, eventually, cancer is low. Treatment is usually straightforward. High grade dysplasia represents a more advanced progression towards malignant transformation
What two STI cause the majority of pelvic inflammator disease (PID)	Gonorrhea and Chlamydia
Etiology of pevic inflammatory disease	early and multiple sex partners
what is primary and secondary prevention of pelvic inflammatory disease	primary is screening yearly and education, secondary is early recognition (can be asymptomatic)
Why is follow up important for antibiotic therapy for PID	Symptoms may go away but still have disease. Test for cure in two weeks, may need hospitalization when oral antibiotics don't work and surgery to remove pelvic abscess (can be life threatening)
The goal of antibiotic therapy for PID is to prevent ____ of fallopian tubes	scarring
teritary prevention of PID includes what	completing course of antibiotic therapy, potential for recurring infection, chronic PID and outcome (loss of reproductive capabiity)
___ implantation of endometrial tissue outside the uterus	endometriosis - can adhear to organs - stick together and scarring
dysmenorrhea (pain), dyspareunia (painful intercourse), pelvic pain, constipation (pain on defecation) and infertility are all symptoms of	endometriosis
Why is dysparenunia a symptom of endometroisis	painful intercouse because of adheasions, the cervix hurts when moved, normally shouldn't
How is more severe endometriosis managed	pseudopregnancy (oral contraceptives) and pseudomenopause (androgenic agents such as Danazol & Lupron) or (GnRHa Leuprolide)
What are the surgical interventions for endometriosis	lacroscopy to remove endometrial foci, hysterectomy, and possible salpingo-oophorectomy
What is the difference between primary and secondary infertility	Both are inability to concieve despite unprotected intercourse for one year, but secondary happens whith previous conception
What is the incidence of infertility	10-15% of all couples have impared fertility. 1/3 male, 1/3 female and 1/3 both
etiology of male infertility	abnormal sperm, obstructed genital tract, abnormal genital tract secretions and ejactulation problems
female etiology of female infertility	unfavorable vaginal/cervical environment (natural antibiotics against sperm), lack of endometrial preparation or endometriosis, anovulation, ostuctions b/t cervix, uterus, tubes, ovaries, & PID
when is investigation or referral for infertility suggested	when the couple as tried unsuccessfully to concieve for 12 months or more
When is earlier infertility investigation or referral determined	Woman is over 35, irregular menses, has severe dysmenorrhea or dyspareunia or a medical hx of: mumps in male, repeated miscarriages, ectopic pregnancy, PID or pelvic surgery in female, and serious medical problems in either partner
secondary prevention (tests for infertility) include ovulation, endometrial biopsy and evaluation of what	cervical factors (spinnbarkeit or stretchy mucus and ferning under microscope)
When assessing for infertility, which hormones are reviewed	FSH, LH and progesterone
what are three methods a woman can use to see when she is ovulating	basal body temp (drops at ovulation then rises), cervical mucus (stretchy), and hormonal assessment kit (FSH & LH)
____ is evaluation of uterine structures and tubal patency	hysterosalpingogram
When assessing the male's sperm what is analyzed	motility, morphology and number
Tertiary prevention of infertility includes	resolve (support organization), counseling, adoption, and pregnancy after infertility
_____ is an abnormally heavy and prolonged menstrual period at regular intervals. Causes may be due to abnormal blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the uterus.	Menorrhagia Depending upon the cause, it may be associated with abnormally painful periods (dysmenorrhea).
_____ refers to vaginal bleeding among premenopausal women that is not synchronized with their menstrual period. It is often referred to as spotting.	Metrorrhagia-May or may not be associate with the post-menopausal period.

Created by: cgwayland

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