CAP 3 Final Review I

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  1. This refers increased vaginal discharge with odor or change in consistency and color.
  2. This type of vaginal infection is thin, white / gray cloudy discharge with fishy odor, which may become stronger after sexual intercourse or during menstrual periods.
    Itching and irritation may also be present.
    Bacterial vaginosis (the balance of bacteria in the vagina is changed)
  3. This type of vaginal infection is usually greenish yellow, frothy smelling discharge, itching, soreness, pain during sexual intercourse or urination.
    Trichomonas vaginitis (infection due to protazoa)
  4. This type of vaginal dicharge is thick, white clumpy discharge (like cottage cheese), moderate to severe itching and burning (but not always), redness and swelling of the genital area.
    Yeast infection (infection due to yeast, Candida)
  5. Leukorrhea is related to ________ and disorder of Dai and CV meridians.  Prolonged leukorrhea consumes body fluids, combined excess-def. syndrome.
    • Dampness
    • Internal: SP dysfunction, LR Qi Stag affecting SP
    • External: prolonged environmental exposure
    • Dysfunciton of KI: fail to store essential fluid and dredge the Chong and CV
    • LR Qi Stag: affecting genital area
  6. Excessive and white leukorrhea without smell, what does this indicate?
    SP Def
  7. Profuse, white, dilute and watery leukorrhea, what does this indicate?
    KI Yang Def
  8. White, dilute or slightly yellowish leukorrhea, and light discharge without odor, what does this indicate?
    KI Yin Def
  9. Profuse white or yellowish, and sticky discharge without odor, what does this indicate?
    LR Qi Stag
  10. Profuse, yellow or brown leukorrhea, sticky with an odor, what does this indicate?
  11. Profuse, yellow, blood-stained or five-color discharge, what does this indicate?
    Heat Toxicity
  12. Heat, dampness, wind are major causes of _________ in general.
  13. This refers to the inability of a couple to achieve a pregnancy after repeated intercourse without contraception for 1 year.
  14. This refers to a couple that has never been able to conceive a pregnancy after a minimum of 1 year.
    Primary Infertility
  15. This refers to the inablitiy to conceive after 1 year where one or both partners had previously conceived children.
    Secondary Infertility
  16. List the types of infertilty, from a Western medical perspective.
    • Problems with:
    • Ovulation
    • Fallopian tubes
    • Mucus in cervix
    • Eggs
    • Unidentified factors
  17. What can you tell me about IUI?  What are factor affecting success?
    • Intrauterine Insemination (IUI)
    • Sperm are separated from fluid and deposited directly into uterine cavity through the cervix
    • Helps those who have: abnormal semen, cervical mucus problems or sexual dysfunction
    • Contraindications: anovulation, blocked fallopian tubes
    • Ovulation  predictors kits seek LH surge, following day IUI is performed
    • Factor affecting: age, sperm count and motility, ovarian function, fallopain tube occlusion or scarring, pelvic adhesions, other
  18. What can you tell me about IVF?  What are factors affecting success?
    • In vitro Fertilization (IVF)
    • in vitro = in glass
    • A fertilized embryo is implanted in to the womans' uterus
    • First successful IVF: 1981
    • Procedure includes: Regulating hormone levels, stimulate ovulation, egg retrieval and transfer, testing at 12-14 days of retrieval, measuring βhCG
    • Factor affecting: age, sperm count and motility, ovarian function, fallopain tube occlusion or scarring, pelvic adhesions, other
  19. What are TCM Pathologies of Female Infertility?
    • KI Essence Def
    • KI Yin Def
    • Weak SP & KI Yang
    • Weak KI and Chong
    • Cold in uterus (which may obstruct Chong and CV)
    • Dampness in Lower Jiao
    • Blood Stasis
    • Blood Heat
    • Qi Stag
  20. What can you tell me about morning sickness?
    • Symptoms may be more severe in the morning but can occur any time throughout the day or night
    • Nausea can be mild or induce actural vomiting, in the extreme cases, vomiting may be severe enough to cause dehydration, weight loss, alkalosis and hypokalemia
    • Approx. 60-80% of pregnant women experience vomiting during pregnancy for average of 35 days
    • Symptoms disappear by the end of the first trimester (12th week)
  21. What are the treatment principles for the four phases of the menstrual cycle?
    • Menstruation: regulate (stop bleeding for heavy, invigorate for scanty)
    • Follicular: Nourish blood (LR) and tonify Yin (KI)
    • Ovulation: Tonify KI, consolidate Chong and CV
    • Luteal: Tonify Yang and move LR Qi
  22. What is the pathogenesis of Morning Sickness?
    • Relative imbalance of Qi and Blood within Chong.  Blood and Essence are relatively deficient; Qi of Chong rebels causing nausea and vomiting.
    • LR Qi Stag: turning to heat, rebellious Qi of Chong cuaseing vomitting
    • Phelgm with rebellious Qi of Chong causing nausea:
  23. What is the main treatment for Morning Sickness?
    • Pacify Chong
    • Subdue Rebellious Qi
    • Harmonize the ST and stop vomiting
    • Additionally:
    • Pacify LR and eliminate stagnation
    • Clear ST Heat
    • Resolve phlegm
  24. This term refers to the loss of a fetus due to natural causes before 20 weeks of pregnancy.
    • Miscarriage (Spontaneous abortion)
    • *may be due to progesterone deficiency
  25. This term refers to women (15-20%) experiencing multiple miscarriages in the first 3 months or 3+ miscarriages, it is refered to a repeated miscarriage or habitual abortion.
    • Recurrent Miscarriage (Habitual Miscarriage)
    • *due to trauma, previous D&C, cervical amputation
  26. What are possible causes of Miscarriage?
    • Chromosomal Defects
    • Structural Abnormalities
    • Infection (i.e. rubella)
    • Hormone imbalance (hypothyroid, low progesterone)
    • Immune Disorder (Rh factor)
    • Poorly controlled Diabetes
    • Drugs
    • Ectopic pregnancy, stillbirth
  27. What are symptoms associated with miscarriage?
    • Spotting or more obvious bleeding and a discharge from the vagina
    • Cramping
    • Death of fetus
    • Dead tissue in the uterus becoming infected (before, during, or after); this is a rare event
  28. What is the pathogenesis of Miscarriage?
    • Fetus: Weak Yuan Qi
    • Mother: Weak KI, Blood Def / Heat / Stasis
  29. Miscarriage before 3 months is due to what syndrome?
    • KI Def:
    • KI Yang Def: history of habitual miscarriage early in pregnancy
    • KI Yin Def: history of repeated miscarriage, usually w/in the first 3 months
  30. Miscarriage after 3 months is due to what syndrome?
    • Sinking of SP Qi
    • LR Blood Stasis (KI Yang Def with cold in uterus leading to Blood Stasis)
    • Blood Heat (LR Fire)
  31. This term refers to pregnant women developing diabetes during pregnancy.  Untreated women can increase the risk of health problems for both the mother and fetus and risk of death for the fetus.
    Gestational Diabetes
  32. The basic pathogenesis of ____ __ is Yin Def as the root and heat-dryness as the branch.
    • Xiao Ke (wasting and thirsting disorder)
    • *the major organs involved are LU, ST, KI
    • LU dryness and LU Yin Def affecting ST & KI Yin
    • ST Heat affecting LU & KI Yin
    • KI Yin Def affecting LU & ST Yin
    • Yang Def (KI)
  33. What are major auricular points used for pain relief during labor?
    • Uterus
    • Shen Men
    • Endocrine
  34. What is the best position and presentation for a baby coming out?
    • Any combination of:
    • Head first
    • Facing Down
    • Face and body angled towards the right or left
    • Neck bent forward
    • Chin tucked in
    • Arms folded across chest
  35. What is the acupuncture points to correct breech presentation?
    • BL-67
    • 15-20 mins (bilateral, moxa)
    • 1-2 times daily till the position is corrected
    • Performed approx 28 weeks
    • 80% success rate
  36. This term refers to the labor that lasts over 18-24 hours due to weak constitution of the uterus, narrow fetal canal and malposition of fetus.
    • Prolonged Labor
    • *due to Qi & Blood Def / Qi & Blood Stag
  37. Retained placenta is caused by maternal exhaustion leading which syndromes?
    • Qi Def
    • Invasion of Cold during Labor leading to Blood Stasis
  38. This term refers to women who have mood swings after having a baby.  They may feel a little depressed, have a hard time concentrating, lose their appetite or can't sleep well even when the baby is asleep.  It is a normal part of early motherhood and usually goes away within 10 days after delivery.
    Baby Blues
  39. This term refers to a moderate to severe depression in a woman after giving birth.  May occur soon after delivery or up to a year later.  Most of the time, it occurs within the first 4 weeks after delivery.
    Postpartum Depression
  40. This term is marked by severely depressed mood, insomnia, irritability and inability to cope.  Anger and loss of libido are often present.  Low energy and no interest in herself, baby or family.
  41. This term is marked by obsessional neurosis or hysteria.  The women feels miserable, tearful and unable to cope with motherhood, and may develop obsessive behavior or phobias.
    Depressive Neurosis
  42. This term is marked by psychotic behavior such as delusion, confusion, hallucinations, disorientation and an aversion to the baby; the woman may become aggressive and may shout and swear at people or laugh uncontrollably.  The patient may also be suicidal.
    Psychotic Depression
  43. What factors can contribute to Postpartum Depression?
    • Family History
    • Decrease in hormone levels
    • Stress of new baby
    • Lack of social support
    • Marital Discord
    • Other (financial, moving, alcohol, drugs)
  44. What are symptoms associated with Postpartum Depression?
    • Frequent crying, mood swings, irritability, extreme sadness
    • Extreme fatigue, difficulty concentrating, sleep problems, anxiety, appetite changes, loss of interest in sex and other activities, less energy and motivation to do things
    • Feeling worthless, hopeless or guilty
    • Unexplained weight loss or gain
    • No interest in her baby
    • Psychosis, depression, combined with suicidal tendencies, hallucinations / bizarre behavior, desire to harm baby
  45. What are the pathologies associated with Postpartum Depression?
    • Blood Def
    • Yin Def / Blood Stasis
    • Blood Stag
    • *depression deals with HT side more than LR side
  46. This term refers to the inability of the mother to produce enough milk to provide adequate nutrition for the growth of her newborn.  Most cases resolve naturally, however, some women are persistently unable to produce enough.
    • Insufficient Lactation
    • *at least 60 ml to show expected weight gain
    • *frequent weighing to precisely diagnose insufficient lactation
  47. What is the pathogenesis of Insufficient Lactation?
    • Blood Def
    • Qi Depletion
    • LR Qi Stag
  48. This term refers to vaginal discharge for the first 2 weeks after childbirth, containing blood, mucus, placental tissue.  Typically continues 4-6 weeks after delivery.
    • Postpartum Lochia
    • Lochia rubra: typically lasts no longer than 3-5 days after birth
    • Lochia serosa: thinned and turned brown or pink in color, lasts till 10th day after delivery; serosa may indicate late postpartum hemorrhaging
    • Lochia alba: white / yellow-white, lasts for 2-6 week after delivery, indicates genital lesion if longer than few weeks
  49. This term refers to the uterus slipping down into or protudes out of the vagina when the pelvic floor muscles and ligmaent weakens, providing inadequate support for uterus.
    • Prolapse of uterus
    • Possible causes:
    • Pregnancy / multiple childbirths with normal delivery through the vagina
    • Weakness in the pelvic muscles with advanced age
    • Weakening and loss of tissue tone after menopause and loss of natural estrogen
    • Conditions leading to increased pressure in the abdomen (chronic cough), straining with constipation or acc of fluids in the abdomen
    • Overweight or obese may put strain on the pelvic muscle
    • Caucasian women more commonly affected
  50. Feeling of fullness or pressure in the pelvis, low back pain, feeling that something is coming out of the vagina, painful sexual intercourse, difficulty with urination or moving the bowels, difficulty walking.
    What are these symptoms of?
    Prolapsed of uterus
  51. How to prevent / treat Prolapse of uterus?
    • Reduce weight
    • Avoid constipation by eating a high-fiber diet
    • Exercises to strengthen the pelvic muscles
    • Avoid weight lifting
    • Estrogen replacement therapy
    • Surgery (repair or hysterectomy)
  52. What is etiology and pathogenesis of Prolapse of uterus?
    • Excessive physical exercise / sports over long period of time: (SP & KI Def)
    • Chronic Illness: (SP & KI Def)
    • Childbirth (prolonged delivery with excessive strain): Injury of SP Qi
    • Prolonged cough (chronic coughing): Excessive descent of Qi
  53. This term refers to the time preceding the end of menstruation and usually occur 2-5 years before true cessation of menstruation.  Hormones decrease and menstruation becomes increasingly irregular, heavy, or scanty.  Follicle stimulating hormone (FSH) levels start to rise, and some of the symptoms associated with menopause begin to appear.
  54. This term refers to the absence of menstruation for a period of 12 months.  Naturally the average age of menopause in the industrialized countries is 51 years old.
    Can be induced artificially by removing ovaries, cancer, chemotherapy, radiation, surgical damage.
    • Menopause
    • *there is no way to predict an individual womans time; can start as early as 30's to as late as 60's, most between 45-55
  55. This term refers to menopause before age of 40
    Premature Ovarian failure
  56. What are pathologies of Menopause?
    • Emotional Stress: Weakened KI (Yin Def); LR Qi Stag leading to stasis and phlegm / damp acc blocking CV and Chong
    • Overwork, too many children too close together: KI Yin / Yang Def
  57. What are auricular points for treating Menopause?
    • Uterus
    • Ovary
    • LR
    • KI
    • SP
    • Endocrine
    • Shen Men
    • Sympathetic
    • Subcortex
  58. Lump that feels distinctly different from other breast tissue or that does not go away, swelling that does not go away, pitting, puckering, dimpling in the skin of the breast, scaly skin around the nipple, changes in the nipple such as turning inward, discharge from nipple, esp if it is bloody.
    • Breast Lumps
    • Possible causes: breast cysts, fibroadenomas, fibrocystic changes
  59. What is pathogenesis of Breast Lumps?
    • HT / LR / LU Qi Stag
    • Qi Stag
    • Phlegm
    • Weakened LR & KI
    • Weakened LR Blood & KI Yin
  60. What is the TCM Diagnosis for a breast lump that is relatively soft, distinct edges, mobile on palpation, whiteness of skin, clear discharge from nipple?
    Phlegm-type breast lump
  61. What is the TCM Diagnosis for a breast lump that is hard, not mobile on palpation, purple skin?
    Blood Stasis-type breast lump
  62. What is the TCM Diagnosis for a breast lump that is hard, indistinct edges, not mobile on palpation, redness of skin, purulent discharge or bloody discharge, yellowish discharge?
    Heat / Fire Toxicity-type breast lump
  63. What is the function of GB-21 for breast lumps?
    Empirical point to benefit the breasts
  64. What is the function of SI-1 for breast lumps?
    Empirical point for breast congestion
Card Set:
CAP 3 Final Review I
2012-12-12 21:50:25

Leukorrhea, Infertility,
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