Gynecologic problems

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Gynecologic problems
2011-12-09 13:24:17
gynecologic problems

gyenocologic problems
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  1. What is primary dysmenorrhea?
    one of the most common gynecologic problems occurring most often in women in their teens and early 20s
  2. Treatment for primary dysmenorrhea
    • NSAIDs
    • Acetaminophen
    • anti-prostaglandins
    • Oral contraceptives
    • Heat
    • Acupuncture
    • Relaxation
    • Dietary changes
  3. What is premenstrual syndrome?
    • a collection of symptoms that are cyclic in nature
    • change in NT - serotonin
    • changes in fluid shifts
  4. What are therapies for premenstrual syndrom?
    • Nutrition - Ca and Mg supplements
    • Drug therapy - hormone therapy, SSRIs
    • CAM - chaseberry supplements
  5. What is endometriosis?
    • endometrial tissue implantation outside the uterine cavity
    • on ovaries, cul de sac of Douglas, scarring on surrounding tissue
    • major cause of infertility and very painful
    • unknown cause
  6. Interventions for endometriosis
    • drug therapy - contraceptives to decrease stimulation to tissues
    • NSAIDs
    • androgenic agents
    • CAM - heat packs, relaxation, massage, Ca, Mg, meditation
    • surgery
  7. What is dysfunctional uterine bleeding?
    bleeding that is excessive or abnormal in amount or frequency - endometrial overgrowth
  8. What is dysfunctional uterine bleeding associated with?
    • endocrine disturbances
    • polycystic ovary disease
    • stress
    • obesity/underweight
    • long-term drug use
    • anatomic abnormalities
  9. Collaborative management of dysfunctional uterine bleeding
    • hormone manipulation
    • surgery
    • - dilation and curettage procedure - uterus scraping
    • - laser or balloon endometrial ablation - removal of built up uterine cells
    • - mymectomy - removal of fibroids
    • - hysterectomy
  10. What is menopause?
    normal biologic event marked for most women by the end of menstrual periods - 12 months of no periods
  11. S/S of menopause
    • hot flashes
    • night sweats
    • dry vagina
  12. How are symptoms of menopause managed?
    • Hormone replacement therapy - lowest dose for shortest amount of time
    • healthy lifestyle
    • physically active
    • Ca, vitamin D
    • relaxation
    • good nutrition
  13. What changes occur that indicate perimenopause?
    • changes in ovarian function
    • can happen over several years - gradual
  14. What is vulvovaginitis?
    • vaginal discharge and itching
    • inflammation of the lower genital tract resulting from a disturbance of the balance of hormones and flora in the vagina and vulva
  15. What are the S/S of vulvovaginitis?
    • Itching
    • change in vaginal discharge
    • odor
    • lesions
  16. What causes vulvovaginitis?
    • antibiotics
    • STIs
    • lice/scabies
  17. What is toxic shock syndrome (TSS)?
    • S. aureus produces endotoxins that into bloodstream, causing extreme illness
    • Don't leave your tampons in too long
  18. S/S of TSS
    abrupt onset of high temp, HA, sore throat, vomiting, diarrhea, generalized rash and hypotension
  19. How is TSS managed?
    • Restoring fluid, electrolytes
    • antibiotics
    • change your tampons
    • use a clean, new tampon each time
  20. What is uterine prolapse?
    downward displacement of the uterus
  21. At what age is uterine prolapse most common?
    • Elderly women
    • Can also occur in women who just had a baby
  22. What are S/S of uterine prolapse?
    • Dyspareunia
    • Backache
    • Pressure in the pelvis
    • Bowel or bladder problems
  23. Treatment for uterine prolapse
    • Passaries
    • surgery - suspend uterus or hysterectomy
  24. What is a bladder prolapse into the vagina?
  25. What is a rectum prolapse into the vagina?
  26. What is a fistula?
    abnormal opening between two adjacent organs or structures
  27. Types of fistulas?
    • Urethrovaginal
    • Vesicovaginal
    • Rectovaginal
  28. Causes of fistulas?
    • Traumatic child birth
    • surgery
    • radiation
    • cancer
  29. What are benign neoplasms?
    • Ovarian cyst
    • uterine leiomymomas
  30. What is a uterine leiomyoma?
    a fibroid that causes heavy bleeding and risk usually increases with age
  31. Management of uterine leiomyoma
    • NSAIDs
    • radiological procedure that stops blood supply to the fibroid
    • total hysterectomy
    • laparascopic removal
  32. What are cervical polyps?
    pedunculated tumors on stalks arising from the mucosa and extending to the opening of the cervical os
  33. What is endometrial cancer?
    a reproductive cancer of which adenocarcinomas are the most common type
  34. What are the S/S of endometrial cancer?
    • Main symptom is postmenopausal bleeding
    • CA-125 tumor marker
    • chest x-ray for metastasis
  35. Management of endometrial cancer
    • Radiation therapy - intercavity brachytherapy or external
    • drug therapy
    • chemotherapy
    • hormone therapy
    • CAM
  36. What is cervical cancer?
    progression from totally normal cervical cells to premalignant changes in appearance of cervical cells to changes in function and ultimately to cancer
  37. What is the most advanced premalignant stage with a cancer spot in cervical cancer?
    carcinoma in situ
  38. Where is preinvasive vs invasive cervical cancer located?
    • preinvasive is only in the cervix
    • invasive is spread to other structures
  39. What is the HPV (Gardasil) vaccine for?
    • protection against the highest risk/most common HPV's responsible for most cancers
    • 3 injections over 6 months
  40. Clinical manifestations of cervical cancer
    • often asymptomatic
    • painless vaginal bleeding - classic symptom
    • water, blood-tinged vaginal discharge that may become dark and foul smelling as disease progresses
    • leg pain along psiatic nerve
    • flank pain
    • unexplained weight loss
    • pelvic pain
    • dysuria
    • hematuria
    • rectal bleeding
    • chest pain
    • cough
  41. Diagnostic for cervical cancer
    Pap smear
  42. What is ovarian cancer?
    serous adenocarcinoma - most common
  43. What are S/S of ovarian cancer?
    • often asymptomatic and not detected until end stages
    • vague abdominal discomfort
    • dyspepsia
    • indigestion
    • gas
    • distention
    • looks like gallbladder disorders
    • ovarian antibody CA-125
  44. What is vulvar cancer?
    cancer of the female external genitals - most are squamous cell
  45. S/S of vulvar cancer
    • irritation or itching in perianal area
    • sore that won't heal
  46. What test is performed to identify abnormal cells in vulvar cancer, and what is used for tissue biopsy?
    • Toluidine blue
    • Keyes dermal punch
  47. Post-op care after vulvectomy
    • Wound care
    • Promote urinary and bowel elimination
    • Managing pain
    • Addressing sexuality
  48. Vaginal cancer
    • Rare
    • Treatment with common cancer treatments
  49. Fallopian tube cancer
    • rarest of all gynecologic cancers
    • most common symptoms - postmenopausal bleeding, increased abdominal pain, water vaginal discharge, leukorrhea
    • treatment - total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy