NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
,MidtermhWomenshgynecologicalhhealth
• MenstrualhCyclehPhysiologyh(fromhChapterh5)
• Menstrualhphaseh-hendometriumhbecomeshveryhthinhd/thlowhestrogenhlevels
- HypophysishsecreteshmorehFSH
- FSHhstimulateshsecretionhofhestrogenhandhestrogenhserveshashproliferationhsignalhtoht
hehendometrialhbasalhlayer
- Follicularhphase
- Follicleshsecretehashtheyhmature,hincreasinghamtshofhestrogenhwhichhthickenshtheh
newhfunctionalhlayerhofhendometriumhinhuterus
-simulateshcryptshinhcervixhtohproducehfertilehcervicalhmucus
-endhofhphase=hovulation
• MenstrualhCyclehPainhandhPremenstrualhConditions
- Dysmenorrhea-horiginateshfromhuterinehcxhduringhmenstrualhphase,htriggers
prostaglandinhproductionhandhrelease.hThishincreaseshcontractionhofhuterus,hreducesh
uterinehbloodhflow,handhcauseshischemia/pain
▪ Riskhfactors-
h ageh<30,hsmoking,hbmih<20,hearlyhmenarche,hhxhpelvichsurgery,hdepr
ession
▪ Primary-h6-12hmonthshafterhmenarche,hcontinuesh8-72hhourshintohcycle
▪ Secondary-
h causedhbyhpelvichpathology,hpainhincreaseshoverhtime,hoccurshbefo
re,hduring,handhafterhmenses
▪ Adenomysis,hIBS,hendometriosis,hleiomyoma,hinterstitialhcystitis
- #1hcausehofhsecondaryhdysmenorrheahishendometriosis-hithcauseshtissuehtohattachhto
surroundinghorganshandhbreakshoffhandhbleeds.hPatientshcanhalsohhavehconstipation,hd
iarrhea,handhbloating.
• Whichhuterinehpositionshishmosthassociatedhwithhdysparenuniahandhdysmenorrhea
- Retrovertedhandhretroflexed
• Posthcoitalhbleeding
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
, - Atrophichvaginitis
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
, • PMShoccurshwithhgreatesthfrequencyhandhseverityhin
- Latehlutealhphase
• Whichhlayerhofhthehovarieshcontainshlymphaticshandhbloodhvessels
- Centralhmedulla
• Ahnursehpractitionerhhashjusthcompletedheducationhwithhahfemalehadolescenthabout
intrauterinehcontraceptivehdevices.hWhichhofhthehfollowinghstatementshbyhthehpatienthwould
hsuggesththathfurtherheducationhishneeded?
• Theyharehonlyhindicatedhforhwomenhwithhstablehmonogamous
relationships.hIthishnothcommonlyhusedhforhnulliparoushwomenhashthereh
arehbetterhoptions.
• Theyharehcontraindicatedhinhwomenhwithhahpasthhistoryhofhpelvichinflammatory
disease.hTheyhmayhbehusedhbyhahwomanhwhohhashhadhahprevioushectopichpregnancy.
• Theyhmayhbehusedhbyhahwomanhwhohhashhadhahprevioushectopichpregnancy.h
Questionh:
• Ahtwenty-four-year-oldhfemalehpresentshtohthehofficehwithhahcomplainthofhvaginalhitchinghin
additionhtohthickhmucoidhdischarge.hShehalsohhashsomehmildhurinaryhdiscomfort.hAhwethmoun
thpreparationhusinghpotassiumhhydroxideh(KOH)hrevealshahnegativehwhiffhtesthandhfewhcluehce
lls.hTherehwerehnohtrichomonadshvisualizedhbuththehWBCshwerehtoohnumeroushtohcount.hWhi
chhofhthehfollowinghwouldhbehthehmosthlikelyhdiagnosishinhthishpatient?
• Bacterial
vaginosish
Herpeshsi
mplexhChl
amydia
• Cystitishwith
cervicitish
Chlamydia
• Ahpostmenopausalhfemalehishtakinghhormonehreplacemenththerapyh(HRT).hWhichhofhthe
followinghriskhfactorshwouldhnothbehahcontraindication?
• Abnormalhvaginal
bleedinghUncontrolledh
hypertensionhChronic
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
h h h h h h h
AMMARY
,MidtermhWomenshgynecologicalhhealth
• MenstrualhCyclehPhysiologyh(fromhChapterh5)
• Menstrualhphaseh-hendometriumhbecomeshveryhthinhd/thlowhestrogenhlevels
- HypophysishsecreteshmorehFSH
- FSHhstimulateshsecretionhofhestrogenhandhestrogenhserveshashproliferationhsignalhtoht
hehendometrialhbasalhlayer
- Follicularhphase
- Follicleshsecretehashtheyhmature,hincreasinghamtshofhestrogenhwhichhthickenshtheh
newhfunctionalhlayerhofhendometriumhinhuterus
-simulateshcryptshinhcervixhtohproducehfertilehcervicalhmucus
-endhofhphase=hovulation
• MenstrualhCyclehPainhandhPremenstrualhConditions
- Dysmenorrhea-horiginateshfromhuterinehcxhduringhmenstrualhphase,htriggers
prostaglandinhproductionhandhrelease.hThishincreaseshcontractionhofhuterus,hreducesh
uterinehbloodhflow,handhcauseshischemia/pain
▪ Riskhfactors-
h ageh<30,hsmoking,hbmih<20,hearlyhmenarche,hhxhpelvichsurgery,hdepr
ession
▪ Primary-h6-12hmonthshafterhmenarche,hcontinuesh8-72hhourshintohcycle
▪ Secondary-
h causedhbyhpelvichpathology,hpainhincreaseshoverhtime,hoccurshbefo
re,hduring,handhafterhmenses
▪ Adenomysis,hIBS,hendometriosis,hleiomyoma,hinterstitialhcystitis
- #1hcausehofhsecondaryhdysmenorrheahishendometriosis-hithcauseshtissuehtohattachhto
surroundinghorganshandhbreakshoffhandhbleeds.hPatientshcanhalsohhavehconstipation,hd
iarrhea,handhbloating.
• Whichhuterinehpositionshishmosthassociatedhwithhdysparenuniahandhdysmenorrhea
- Retrovertedhandhretroflexed
• Posthcoitalhbleeding
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
, - Atrophichvaginitis
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
, • PMShoccurshwithhgreatesthfrequencyhandhseverityhin
- Latehlutealhphase
• Whichhlayerhofhthehovarieshcontainshlymphaticshandhbloodhvessels
- Centralhmedulla
• Ahnursehpractitionerhhashjusthcompletedheducationhwithhahfemalehadolescenthabout
intrauterinehcontraceptivehdevices.hWhichhofhthehfollowinghstatementshbyhthehpatienthwould
hsuggesththathfurtherheducationhishneeded?
• Theyharehonlyhindicatedhforhwomenhwithhstablehmonogamous
relationships.hIthishnothcommonlyhusedhforhnulliparoushwomenhashthereh
arehbetterhoptions.
• Theyharehcontraindicatedhinhwomenhwithhahpasthhistoryhofhpelvichinflammatory
disease.hTheyhmayhbehusedhbyhahwomanhwhohhashhadhahprevioushectopichpregnancy.
• Theyhmayhbehusedhbyhahwomanhwhohhashhadhahprevioushectopichpregnancy.h
Questionh:
• Ahtwenty-four-year-oldhfemalehpresentshtohthehofficehwithhahcomplainthofhvaginalhitchinghin
additionhtohthickhmucoidhdischarge.hShehalsohhashsomehmildhurinaryhdiscomfort.hAhwethmoun
thpreparationhusinghpotassiumhhydroxideh(KOH)hrevealshahnegativehwhiffhtesthandhfewhcluehce
lls.hTherehwerehnohtrichomonadshvisualizedhbuththehWBCshwerehtoohnumeroushtohcount.hWhi
chhofhthehfollowinghwouldhbehthehmosthlikelyhdiagnosishinhthishpatient?
• Bacterial
vaginosish
Herpeshsi
mplexhChl
amydia
• Cystitishwith
cervicitish
Chlamydia
• Ahpostmenopausalhfemalehishtakinghhormonehreplacemenththerapyh(HRT).hWhichhofhthe
followinghriskhfactorshwouldhnothbehahcontraindication?
• Abnormalhvaginal
bleedinghUncontrolledh
hypertensionhChronic
NSG 6430 MIDTERM EXAM Q & AsS
h h h h h h h
AMMARY
