AANP - Walden (Women's Health & Pregnancy)/ AANP - Walden (Women's Health & Pregnancy), Walden University. Questions and Correct Answers. Updated 2024.

AANP - Walden (Women's Health & Pregnancy)/ AANP - Walden (Women's Health & Pregnancy), Walden University. Questions and Correct Answers. Updated 2024. For post menopausal bleeding: DO ULTRASOUND FIRST OR REFER FOR ENDOMETREAL BIOPSY Dominant breast/breast cancer: characteristics and diagnostics mass one side feels hard, irregular, immobile, located tail of spence, skin color peu d orange (resembles orange peel), dimpling retraction, painless, bloody nipple discharge DX: order mammogram, refer to breast surgeon Paget's disease of the breast characteristics: chronic red scaly rash resembling eczema starts on nipple and spreads to areola, itching, pain, burning sensation, skin lesion enlarges includes crusting, ulceration and bleeding at the nipple Inflammatory breast cancer characteristics: recent or acute onset red swollen warm area in breast of younger woman, mimics mastitis, no lump, may pit, turn orange, appear bruised, rare but aggressive breast cancer Fibrocystic breast: characteristics, diagnostics & treatment engorged and painful breasts symptoms 2 weeks before menses and at worst before cycle, resolves after menses DX: multiple, mobile rubbery cystic masses on both breasts TX: stop caffeine, take vitamin E, IS IT "NORMAL IN AGING/ELDERLY BRCA1/2 associated hereditary breast/ovarian Cancer: define & treatment family history is high risk, Men are higher risk TX: patient positive with BRCA mutation should be referred to breast specialist, MRI and mammogram, high risk in Jews, refer to counseling and mutation testing Ovarian cancer: define, risk factors, diagnostics & treatment palpate ovary in 1-year post-menopausal woman, risk factors: include family history, Jewish descent, BRCA1/2 mutation, lynch syndrome, breast cancer, 55 age, endometriosis, first child at age 30, nulliparity(never completed pregnancy past 20 weeks) DX: pelvic exam, transvaginal US, biopsy, intravaginal US, CA124 TX: chemotherapy, referral surgical oncology eval and treatmen Pap testing begins at 21 and every three years til 30 then every 5 years if co-testing for HPV. UPSTF recommends: recommends at age 30 with HPV testing to every 5 years, HIV positive women can screen before 21 years of age, stop PAP screening at 65 Loop electrosurgical excision procedure (LEEP): gynecologic procedure that uses a thin, low-voltage electrified wire loop to cut out abnormal tissue in the cervix is a device used like a scalpel cut thru cervix to treat cervical cancer Potassium hydroxide slide: KOH aids in diagnosing fungal infections hair, nails and skin KOH works by causing lysis of the squamous cell which makes it easier to see the hyphae and spores, vaginal specimens do not require KOH The whiff test can be used to detect _____. BV test for BV, fish odor is released after dropping KOH on slide Polycystic ovarian syndrome endocrine disorder associated with chronic anovulation hormone abnormality marked by anovulation, infertility excessive androgen production and insulin resistance, high risk for type 2 diabetes, dyslipidemia, metabolic syndrome, endometrial hyperplasia, obesity and cancer, infertility, sleep apnea, hirsutism, acne, amenorrhea, Post menopause with bleed/PCOS- high risk for endometrial cance Polycystic ovarian syndrome diagnostics & treatment: DX: transvaginal US, testosterone, FSH, fasting glucose TX: low dose contraceptives, spiraladactone for hirsutism, metformin Osteoporosis A condition in which the body's bones become weak and break easily. -2.5 Osteopenia thinner than average bone density; decreased calcification -1.5 to -2.4 Persistent vaginal or urinary tract infection should be screen for ________. diabetes Prostaglandins are responsible for inflammation dysmenorrhea Immunizations in pregnancy hepA, Hep B, influenza inactivated), meningococcal, polio, tetanus Tdap (only in 3rd trimester) Contraindicated Immunizations in pregnancy oral polio, HPV, flu mist (influenza), MMR (no pregnancy attempt after 28 days of rubella vaccine), Varicella zoster 3 months Safe Abx in pregnancy -PCN (amoxicillin and ampicillin), cephalosporins, erithro, and azitho penicillin's, cephalosporins, macrolides, and nitrofurantoin (not on patients with glucose 6 phosphate deficiency) Medications not 100 % safe in pregnancy ARBS, ACEI, Fluoroquinolone, tetracyclines NSAIDS, Sulfa drugs Estimated delivery date with ______. Naegles rule: minus 3 months from date of last period, add 1 year and add 7 days Preeclampsia characteristics primigravida in third trimester, multipara, 35 years old, sudden onset recurrent headaches, blurred vision, pitting edema, weight gain, RUQ pain, shoulder pain, lower back pain, hyperreflexia, decrease in urine output, BP elevated, N/V, occurs after 20 weeks pregnancy induced hypertensive condition, resolves after pregnancy Preeclampsia: diagnostics & treatment DX: HTN, proteinuria, and edema TX: hospitalization, antihypertensive medications- methyldopa/aldomet, CCB, labetalol, bedrest, laying on left side recumbent position off of vena cava, seizure precautions, balance diet high intake of protein low salt, antihypertensive, education, only CURE deliver fetus, refer to OB Eclampsia most serious form of toxemia during pregnancy seizures or coma in patient with previous preeclampsia Ectopic pregnancy: defines, causes/risk factors A pregnancy outside of the womb, usually in a fallopian tube caused by idiopathic, PID, IUD, estrogen/progesterone, high risk- 50% no known risk factor, 35 years of age, nonwhite females, PID, endometriosis, previous ectopic pregnancy, IUD, pelvic or tubal surgery, cigarette smoking, infertility, invitro fertilization, leading cause of death for women in first trimester Threatened abortion bleeding with the threat of miscarriage vaginal bleeding, cramping without cervical dilation Inevitable abortion Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open. vaginal bleeding, cramping with cervical dilation Incomplete abortion abortion without expulsion of all of the products of conception moderate to diffuse bleeding, passage of tissue, uterine contractions Hcg in urine pregnancy test is produced by______? produced by placenta Alpha feta proteins are produced by _______? produced by fetal liver Oral contraceptives: are___ effective. Side effects and contraindications. 91% effective estrogen/progestrin disadvantages- pill daily, SE: thrombophlebitis/embolism, liver adenomas, stroke, gall bladder disease, no std protection, NO smoking may result in cardiovascular side effect Contraindicated in: 6- week post-partum, breast cance Contraceptive patch -suppresses ovulation, decrease sperm motility, thickens cervical mucus -change q/wk; patch applied to fatty areas 91% effective, estrogen/progestrin, disadvantages same as above, patch may fall off and must be reapplied, patch once a week Contraceptive Vaginal Ring (Nuvaring) contains etonogestrel and ethanol estradiol that is delivered at continuous levels vaginally 91% effective estrogen/progastrin, insert day after menses, disadvantages- uncomfortable inserting, ring falls out for less than 3 hours, rinse off and reinsert Progestin oral 91% effective, disadvantages taken daily, chance of ectopic pregnancy Deprovera increase risk of bone loss 94% effective, injectable progestin for 13 weeks, disadvantage is bone loss, fertility may not return for 1 year Etonogestrel implant (nexpalon) 99% effective, placed subcutaneously in upper arm and releases hormones for 3 years, quick return to fertility, bleeding is side effect Intrauterine device (IUD) small, T-shaped device inserted by a physician inside the uterus to prevent pregnancy Mirena, progesterone, 99.8% effective, disadvantages expel intrauterine device, sepsis, cervical infection, ectopic pregnancy, infertility Diaphragm