NSG 6330 WOMEN'S HEALTH
STUDY GUIDE LATEST 2020
What is the typical onset of
Dysmenorrhea? Within 2 years of
menarche
Painful menstruation caused by excess prostaglandin and leukotriene levels
Primary dysmenorrhea
What Sx occur with primary dysmenorrhea?
Uterine contraction, N/V, and Diarrhea
Painful menstruation caused by an identifiable condition, normally of the uterus or pelvic
Secondary dysmenorrhea
What are some conditions that cause secondary dysmenorrhea?
Endometriosis, Adenomyosis, Fibroids, PID, and IUDs
What is the MC population that suffers from Secondary Dysmenorrhea?
Women >25 yo
What is the MC population that suffers from Primary
Dysmenorrhea? Late teens and early 20's
An 18 yo female presents to your clinic with complaints of cramps that radiate to her lower
back and diarrhea. She says that it started when her period started, but has continues for 3
days now. You preform a PE, and note that everything is normal. Her labs also come back as
normal.
Dx?
Tx?
Primary dysmenorrhea
NSAIDS --> start 2 days prior to start of menses and continue for 1-3 days
A 27 yo female comes in with complaints of cramps that radiate to her lower back, bloating,
and
pain with sex. She states that it does not necessarily occur with the first day of her cycle. You
note in her chart that she had an IUD placed ~6 months ago. You preform a PE and draw labs.
PE
,is normal, and labs are all normal.
Dx?
Tx?
Secondary Dysmenorrhea
Treat underlying cause if possible, NSAIDS, if severe in this case, remove
IUD What is the average length of time that perimenopause lasts?
3-5 years
By definition, what is
menopause? The last menses
What is the average age of
menopause? 51.5 years old
What is the average age range most women enter Menopause
in? 44-55 yo
What is associated directly with early onset menopause?
Smoking
Premature menopause occurs before the age of
what? 40 yo
Which type of estrogen is the predominant circulating estrogen during Menopause?
Estrone
What is the MC Vasomotor Sx that menopausal women experience?
When do they most commonly occur (time of day)?
How long does it take for them to
cease? Hot flashes
At night
2-3 years
What level of FSH is diagnostic of Menopause?
>30
,What lifestyle change has been directly associated with relieving Menopause Sx?
Increasing exercise
HRT for Menopause increases the women's chance of developing what?
Cardiovascular probs, Breast CA, and Cognitive decline
What are the absolute CI's to HRT in a menopausal women?
Undiagnosed vaginal bleeding, acute vascular thrombosis, liver probs, and Hx of
endometrial/ovarian CA
Name that condition:
Abnormal uterine bleeding in the absence of an anatomical lesion
DUB
What is the MC origin of DUB?
Hypothalamic-pituatary-ovarian hormonal axis
What are the MC times for DUB to occur?
Shortly after Menarche and during Perimenopause
How can you Tx DUB?
1. Conservative Tx
2. OCPs
3. Progestin trial
4. D&C
5. Hysterectomy
Which virus is directly linked to Cervical
CA? HPV strains 16, 18, 31, and 33
Which HPV strains are strongly linked to Condylomata Acuminata?
HPV strains 6 and 11
What is the MC age group that suffers from CIN?
MC age group for CIS?
MC age group for Cervical CA?
Women in their
20's Women 25-35
Women >40 yo
, If a women has an abnormal Pap smear, what is teh most appropriate technique, moving
forward, for evaluation of the patient?
Colposcopy with Bx
How do you Tx pre-invasive cervical
lesions? Electrocautery, conization, LEEP
procedure
When is Conization a better option than the LEEP procedure?
When is LEEP favored in general?
Conization is a better option for larger areas of concern
LEEP is generally favored overall because it has a lower risk for causing an incompetent cervix
What is the Tx for CIS?
Hysterectomy and RADs
Which imaging modality helps to differentiate between solid and cystic breast
masses? US
What is the MC benign condition of the breast?
What is the second MC?
Fibrocystic breast
disease Fibroadenomas
What procedure is BOTH diagnostic and therapeutic in fibrocystic breast disease?
FNA
**Contain straw colored fluid
What is the MC population that experiences
Fibroadenomas? AA women <25 yo
How do you manage/Tx a Fibroadenoma?
Bx all masses. Surgical excision or conservative management based on the patient's Sx
What is the MC CA in females?
Breast CA
What is the 2nd MC COD from CA in
females? Breast CA
STUDY GUIDE LATEST 2020
What is the typical onset of
Dysmenorrhea? Within 2 years of
menarche
Painful menstruation caused by excess prostaglandin and leukotriene levels
Primary dysmenorrhea
What Sx occur with primary dysmenorrhea?
Uterine contraction, N/V, and Diarrhea
Painful menstruation caused by an identifiable condition, normally of the uterus or pelvic
Secondary dysmenorrhea
What are some conditions that cause secondary dysmenorrhea?
Endometriosis, Adenomyosis, Fibroids, PID, and IUDs
What is the MC population that suffers from Secondary Dysmenorrhea?
Women >25 yo
What is the MC population that suffers from Primary
Dysmenorrhea? Late teens and early 20's
An 18 yo female presents to your clinic with complaints of cramps that radiate to her lower
back and diarrhea. She says that it started when her period started, but has continues for 3
days now. You preform a PE, and note that everything is normal. Her labs also come back as
normal.
Dx?
Tx?
Primary dysmenorrhea
NSAIDS --> start 2 days prior to start of menses and continue for 1-3 days
A 27 yo female comes in with complaints of cramps that radiate to her lower back, bloating,
and
pain with sex. She states that it does not necessarily occur with the first day of her cycle. You
note in her chart that she had an IUD placed ~6 months ago. You preform a PE and draw labs.
PE
,is normal, and labs are all normal.
Dx?
Tx?
Secondary Dysmenorrhea
Treat underlying cause if possible, NSAIDS, if severe in this case, remove
IUD What is the average length of time that perimenopause lasts?
3-5 years
By definition, what is
menopause? The last menses
What is the average age of
menopause? 51.5 years old
What is the average age range most women enter Menopause
in? 44-55 yo
What is associated directly with early onset menopause?
Smoking
Premature menopause occurs before the age of
what? 40 yo
Which type of estrogen is the predominant circulating estrogen during Menopause?
Estrone
What is the MC Vasomotor Sx that menopausal women experience?
When do they most commonly occur (time of day)?
How long does it take for them to
cease? Hot flashes
At night
2-3 years
What level of FSH is diagnostic of Menopause?
>30
,What lifestyle change has been directly associated with relieving Menopause Sx?
Increasing exercise
HRT for Menopause increases the women's chance of developing what?
Cardiovascular probs, Breast CA, and Cognitive decline
What are the absolute CI's to HRT in a menopausal women?
Undiagnosed vaginal bleeding, acute vascular thrombosis, liver probs, and Hx of
endometrial/ovarian CA
Name that condition:
Abnormal uterine bleeding in the absence of an anatomical lesion
DUB
What is the MC origin of DUB?
Hypothalamic-pituatary-ovarian hormonal axis
What are the MC times for DUB to occur?
Shortly after Menarche and during Perimenopause
How can you Tx DUB?
1. Conservative Tx
2. OCPs
3. Progestin trial
4. D&C
5. Hysterectomy
Which virus is directly linked to Cervical
CA? HPV strains 16, 18, 31, and 33
Which HPV strains are strongly linked to Condylomata Acuminata?
HPV strains 6 and 11
What is the MC age group that suffers from CIN?
MC age group for CIS?
MC age group for Cervical CA?
Women in their
20's Women 25-35
Women >40 yo
, If a women has an abnormal Pap smear, what is teh most appropriate technique, moving
forward, for evaluation of the patient?
Colposcopy with Bx
How do you Tx pre-invasive cervical
lesions? Electrocautery, conization, LEEP
procedure
When is Conization a better option than the LEEP procedure?
When is LEEP favored in general?
Conization is a better option for larger areas of concern
LEEP is generally favored overall because it has a lower risk for causing an incompetent cervix
What is the Tx for CIS?
Hysterectomy and RADs
Which imaging modality helps to differentiate between solid and cystic breast
masses? US
What is the MC benign condition of the breast?
What is the second MC?
Fibrocystic breast
disease Fibroadenomas
What procedure is BOTH diagnostic and therapeutic in fibrocystic breast disease?
FNA
**Contain straw colored fluid
What is the MC population that experiences
Fibroadenomas? AA women <25 yo
How do you manage/Tx a Fibroadenoma?
Bx all masses. Surgical excision or conservative management based on the patient's Sx
What is the MC CA in females?
Breast CA
What is the 2nd MC COD from CA in
females? Breast CA
