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Name 4 preop considerations:
- psychological impact of condition
- mestrual cycle
- potential for bleeding
- positioning required
what are the causes pelvic organ prolapse?
- loss of support- birth, chronic intra abdominal pressure, collagen weakness, atrophy due to age or estrogen loss
what are the medical therapies (nonsurgical) for pelvic relaxation/prolapse that can effect your anesthetic?
- beta agonists
- dopamine agonists
Three surgical repairs for pelvic relaxation/prolapse;
- anterior vaginal wall repair
- retropubic suspension
Endometriosis is most commonly seen in women who are __-__. common locations include 60% in the _______, pouch of _______, ____ _______, f________ tubes, _______ colon. __% of infertility is due to this. Caused by _________ menstruation.
- round ligament
- fallopian tubes
clinical features of ENDOMETRIOSIS include:
How is this diagnosed?
- abnormal bleeding
- pelvic pain
what are the medical and surgical tx's for ENDOMETRIOSIS?
- med- oral contraceptives, progestin alone, DANZOL, GRH-agonist
- surgical- conservative= excision or ablation of lesions. definitive= TAH
LEIOMYOMA: __% of women have these ______ tumors. They are _________ responsive and growth is related to ________ production. new tx's involve GnRH analogs**
What are the symptoms of LEIOMYOMAS?
Pain, bleeding most common presenting symptom, pressure
- clinical exam- feel hard mass
- imaging study- ultrasound (others not cost effective)
Cervical cancer has __ _________ presentation but symptoms can include _________. What is the identifiable precursor? Best method of early detection? Other dx method?
- NO clinical
- CIN- cervical intraepithelial neoplasia
- direct biopsy
Cervical cancer staging performed under __. TX includes, C__________, L___ _______ __, H____________, R_________ therapy.
- Loop electrosurgical excision procedure
- hysterectomy (radical)
Uterine Cancer (Lieomysarcoma) dx by surgical excision, tx is _____________. consider in what women?
- post-menopausal with uterine enlargement
What is the 2nd most common GYN cancer? What is the tx?
Ovarian cancerare malignant postmenopausal __% of the time. It is ____ __ _______, and has the highest _________ rate.
- hard to detect
what can be used to test for pregnancy?
Who gets one?
- HCG levels (more sensitive)
all women of child bearing age