-
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
- genetic
-
what are the medical therapies (nonsurgical) for pelvic relaxation/prolapse that can effect your anesthetic?
- anticholinergics
- beta agonists
- dopamine agonists
- antidepressants
-
Three surgical repairs for pelvic relaxation/prolapse;
- anterior vaginal wall repair
- retropubic suspension
- sling
-
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.
- 20-30
- ovaries
- douglas
- round ligament
- fallopian tubes
- sigmoid
- 10%
- retrograde
-
clinical features of ENDOMETRIOSIS include:
How is this diagnosed?
- dysmenorrhea
- dyspareunia
- infertility
- abnormal bleeding
- pelvic pain
direct visualization
-
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**
- 30
- benign
- hormonally
- estrogen
-
What are the symptoms of LEIOMYOMAS?
Pain, bleeding most common presenting symptom, pressure
-
LEIOMYOMAS dx:
- clinical exam- feel hard mass
- imaging study- ultrasound (others not cost effective)
- Hysteroscopy
-
Cervical cancer has __ _________ presentation but symptoms can include _________. What is the identifiable precursor? Best method of early detection? Other dx method?
- NO clinical
- bleeding
- CIN- cervical intraepithelial neoplasia
- direct biopsy
-
Cervical cancer staging performed under __. TX includes, C__________, L___ _______ __, H____________, R_________ therapy.
- GA
- Cryotherapy
- Loop electrosurgical excision procedure
- hysterectomy (radical)
- radiation
-
Uterine Cancer (Lieomysarcoma) dx by surgical excision, tx is _____________. consider in what women?
- hysterectomy
- 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.
- 25%
- hard to detect
- mortality
-
what can be used to test for pregnancy?
Who gets one?
- HCG levels (more sensitive)
- urine
all women of child bearing age
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