nsg_6430_midterm exam Womens gynecological health

nsg_6430_midterm exam Womens gynecological health Midterm Womens gynecological health • Menstrual Cycle Physiology (from Chapter 5) • Menstrual phase - endometrium becomes very thin d/t low estrogen levels - Hypophysis secretes more FSH - FSH stimulates secretion of estrogen and estrogen serves as proliferation signal to the endometrial basal layer - Follicular phase - Follicles secrete as they mature, increasing amts of estrogen which thickens the new functional layer of endometrium in uterus -simulates crypts in cervix to produce fertile cervical mucus -end of phase= ovulation • Menstrual Cycle Pain and Premenstrual Conditions - Dysmenorrhea- originates from uterine cx during menstrual phase, triggers prostaglandin production and release. This increases contraction of uterus, reduces uterine blood flow, and causes ischemia/pain ▪ Risk factors- age 30, smoking, bmi 20, early menarche, hx pelvic surgery, depression ▪ Primary- 6-12 months after menarche, continues 8-72 hours into cycle ▪ Secondary- caused by pelvic pathology, pain increases over time, occurs before, during, and after menses ▪ Adenomysis, IBS, endometriosis, leiomyoma, interstitial cystitis - #1 cause of secondary dysmenorrhea is endometriosis- it causes tissue to attach to surrounding organs and breaks off and bleeds. Patients can also have constipation, diarrhea, and bloating. 1. Which uterine positions is most associated with dysparenunia and dysmenorrhea - Retroverted and retroflexed 2. Post coital bleeding - Atrophic vaginitis 3. PMS occurs with greatest frequency and severity in - Late luteal phase 4. Which layer of the ovaries contains lymphatics and blood vessels - Central medulla • Normal and Abnormal Uterine Bleeding - Structural ▪ P- Polyps- deep bright red growths, bleed easily ▪ A- Adenomyosis- occurs in multiparous, over age 40, occurs with tamoxifen use ▪ L- Leiomyoma- fibroids- leading indication for hysterectomy ▪ M- Malignancy- hyperplasia - Non-structural ▪ C- Coagulopathy- von willebrands disease (easy bruising, bleeds heavy) ▪ O- Ovulatory dysfunction- anovulation (occurs with pregnancy, bmi18, lactation, excessive exercise, perimenopause, pcos, thyroid/pituitary issues) ▪ E- Endometrial- predictive, cyclic manner, can also be caused by chlamydia/gonorrhea ▪ I- Iatrogenic- example- mirena, skyla, SSRIs ▪ N- Not yet classified • Women’s Health from a Feminist Perspective - Characteristics of a feminist perspective in