NSG 6330 WOMEN'S HEALTH STUDY GUIDE LATEST 2020 (Kaplan)

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 What are the geners directly associated with Breast CA? BRCA 1 and BRCA 2 What puts women at a higher risk for developing breast CA? Nulliparity, early menarche, late menopause, HRT Breast CA increases your risk of developing what other kind of CA? Endometrial CA What is the MC type of breast CA? Infiltrating Ductal Carcinoma How do you Tx a women who has estrogen receptive breast CA, or who is post menopausal? Tamoxifen Contraception *Add info* What conditions does the term PID include? Acute salpingitis, UID related pelvic cellulitis, Tubo-ovarian abscess, and pelvic abscess What are teh complications of PID? Infertility and ectopic pregnancy A young female presents with bilateral lower abdominal and pelvic pain. She has also been feeling nauseous, but has not vomited. She is afebrile. During the exam, you note positive chandelier's sign, and purulent vaginal discharge. No adnexal masses are noted. Dx? Tx? PID Mild: PO abx Severe: Hospitalization with IV abx and possible surgery. What testing should ALWAYS be done in a women that has confirmed PID? STD testing --- more specifically Gonorrhea and Chlamydia Abortion is the termination of a pregnancy before what gestational age? 20 weeks Name the condition: Spontaneous and premature expulsion of the products of conception Spontaneous abortion When is the MC time for a spontaneous abortion to occur? The first trimester A women comes in for her 20 week pregnancy visit. When you perform the exam, you note that the fundus does read at 20 cm, but instead is only present around 15cm. You also note the fundus feels boggy, adn is tender to palpation. What should you be suspicious of? Spontaneous abortion How soon after conception can serum bHCG be detected? Urine? 5 days 14 days Uterus softening at 6 weeks gestation Ladin's sign Uterine isthmus softening at 6-8 weeks gestation Hegar's sign Cervix softening 4-5 weeks gestation Goodell's sign Cervix and vulva bluish color at 8-12 weeks gestation Chadwick's sign When are fetal heart tones first heard? What is the normal rate? 10-12 weeks 120-160 bpm When can you first detect a fetus on PELVIC ultrasound? 5-6 weeks gestation