study guide 114 Final unit 2

• endometrium (sheds away each month if egg not fertilized)
• Myometrium (middle muscular layer where fibroids develop)
• Perimetrium (outer layer of uterus)

collapsible hollow tube that is vulnerable to pressure from other structures

bottom portion of the uterus

Cervical Cancer

• no intercourse for 24 hours before test
• no vaginal bleeding for best results
• no douching

• Colposcopy
• which is PAP where vinegar is used to accentuate the features of the cervix and then a lighted instrument is used to look for lesions, cancerous area on the cervix
• If any identifiable lesions are found a cervical biopsy is done

should be done when pregnancy is least likely. 2-5 days after menses after bleeding but before ovulation

• 3 small trochars placed into abdomen
• abdomen is distended  with CO2 for visualization

• count
• motility
• shape
• DNA
• ability to swim
• quality of fluid (should be alkaline)

to balance the female vagina is very acidic

• looks for cancer cells
• done either transrectal or transurethral
• needle biopsy with multiple specimens to increase the chance of finding cancer
• Normal PSA is less than 4ng/ml

• 1st stage follicular phase can be any #of days
• Last stage Luteal Phase is always 14 days
• Ovulation triggers Luteal Phase to begin

during luteal phase right after ovulation

• benign breast problem of women approaching menopause
• caused by the thickening of the ducts in subareolar area
• Mass hard with irregular borders
• Greenish Brown Nipple discharge

• Benign occurs women 40-55
• bloody nipple discharge as papilloma grown it causes trauma and erosion in the duct

• Benign adolescence - 30
• Solid, slowly enlarging, round, firm, easily movable, nontender, usually located in the upper outer quadrant

• nodularity of the breast occurs 20-30
• can increase in severity until menopause
• Cyclic in nature
• pain tenderness, cysts in breasts

• less than 1% of all breast cancer is men
• Alcoholism
• Obesity
• Liver Disease
• Hyperparathyroidism
• Androgen Deficiency
• Estrogen Excess

• 1st degree relative
• Obesity
• early menarche, or late menopause
• having no children, or having children late in life
• not breast feeding
• using oral contraceptives
• More estrogen the more likely you are to  have breast cancer each of these thing would stop the estrogen for an amount of time

• Ductal Carcinoma in  Situ:cancerous cells in the mammary ducts. (not dangerous in ducts)
• Usually treated very aggressively because once it leaves ducts it is very dangerous and they cannot predict if or when is will erupt for the ducts

Ductal Carcinoma

• about 10%
• does not always form palpable lump
• harder to see on mamogram
• Only type that may present in both breasts at one time

• Occurs more frequently in older women
• Good Prognosis

• less tha 1%
• very dangerous
• sore, blister or lesion develops on the outer breast
• often mistaken for mastitis
• often metastasized at diagnosis

occurs more frequently in younger wmen

• Poor Prognosis
• Estrogen receptor negative
• Progesterone Receptor Negative
• Does not overexpress HER2NEU gene, less ways to treat because HER2NUE is not making it grow and Estrogen/progesterone are not feeding it
• ONLY Tx IS CHEMO, RAD, & SURGERY
• we don't  know why it is harder to treat and tends to reoccur quickly and is less responsive to chemo and rad

• Tamoxifen
• or other estrogen blocking agent
• give oral pill for 1-5 years

Herceptin (IV treatment)

• removal of the tumor
• always accompanied by Radiation

the lymph nodes are found to have cancer in them

• Increased risk of lymphedema
• lymph nodes draw excess fluid from the body
• doesn't  have good filtering system

• no lab sticks, IV, Blood draws or injections in affected extremity for 25 years
• Keep arm elevated at night when possible
• watch for S/S infection in extremity and report asap

• Chemo (IV Tx for prevention or to slow the growth of DISTANT metastasis)
• Radiation (local external bream Tx to prevent LOCAL RECURRENCE)

• 16 yr old with no menses
• look for S/S of puberty
• Anatomical anomalies
• ask family about family history

• Preg, Menopause, breast feeding, hysterectomy,
• less obvious causes: anorexia, strenuous exercise, some antidepressants, stress and anxiety
• Tx oral contraceptives, treat causes

• involves cognitive, physical and emotional symptoms
• begins with ovulation
• have pt make symptom chart to know what to expect
• may use oral contraceptives or NSAID for relief
• will increase in severity until menopause

• 12 months have passes with no menses
• 45-55
• Hot flashes, Headaches, Anxiety, depression, insomnia, vaginal dryness, stress incontinence, decreased libido

• It increases risk of
• breast cancer
• ovarian cancer
• risk of heart disease and stroke

• growth of endometrial tissue outside of the uterus
• may grow on bowel, ovary, diaphragm
• pain, dyspareunia, constipation, backache, pressure lower abdomen

Laparascopy (has to be visualized to Dx)

• Tx Danocrine, Danozol, Lupron (causes medical menopause)
• only use for 6-8 months
• then allow pt to try conceive symptoms will reappear after childbirth and regress at menopause

• Disease of postmenopausal women
• Good Prognosis if treated early
• ALWAYS follow up on postmenopausal BLEEDING

• Atrophic Vaginitis (due to dry Mucosa)
• Cervical Polyps
• Endometrial Hyperplasia

endometrial layers build up and breaks down intermittently and erratically due to lack of estrogen

painless benign lump on cervix that bleed very easily

• is almost always caused by HPV
• Usually No Symptoms (sometimes painless vaginal bleeding)
• Is a disease of progression, takes years to progress to invasive disease
• vaccine is Gardisil

• is the most deadly GYN cancer
• symptoms are very vague (indigestion, backache, constipation, dyspepsia)
• Biopsy must be done by Laparoscopy because ovaries difficult to reach and not palpable until very large

• still monitored by CDC
• wash hands before and after
• tampons dry out vaginal mucosa and cause fissures and microabrasion. Staph bacteria are rapidly absorbed to blood stream causing sepsis and often death

• 3 grades of uterine prolapse
• uterus drops caused by child birth
• multiple pregnancies
• weakening of pelvis support due to lack of estrogen
• age and gravity

protrusion of bladder through the vaginal wall due to weakened pelvic structures

protrusion of rectum through a weakened vaginal wall

• burning or freezing uterine layer away to destroy it as an alternative to hysterectomy for various gyn problems
• Pt should not get pregnant as supportive endometrium is gone
• If successful not more periods