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reproductive surgery is used for the treatment of which disorders
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cancer, fibroids, severe endometriosis, chronic PID, abnormal uterine bleeding (AUB) and pelvic relaxation (cystocele and or rectocele due to weakening of the vaginal wall and the bladder or rectum pouch into vagina)
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____ is a symptom complex associated with menstral cycle, starts about a week prior to menstration with leuteal phase
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Premenstrual syndrom (PMS)
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____ the absence of menarche or menstration
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Amenorrhea (as in AMEN no more periods) May be due to primary (never starts) or secondary (occures after menstration starts) or r/t pregnancy
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_____ refers to vaginal bleeding among premenopausal women that is not synchronized with their menstrual period. It is often referred to as spotting.
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Metrorrhagia-May or may not be associate with the post-menopausal period.
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Other than NSAID's, what is the management of dysmenorrhea
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oral contraceptives (prevent ovulation), exercise (walking),rest, heat, nutrition and biofeedback
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Why is dysparenunia a symptom of endometroisis
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painful intercouse because of adheasions, the cervix hurts when moved, normally shouldn't
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Management of PMS
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diet, vit B6, antidepressents
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surgical menopause is removal of ____
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ovaries, not the uterus (hysterectomy)
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Name the two strands for atypical squamous cells (ASC) and what they mean
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ASC-US some cells are abnormal (dysplasia) may be due to infection or HPV. ASC-H is dysplasia - small possibility of precancerous changes
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Tertiary prevention of infertility includes
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resolve (support organization), counseling, adoption, and pregnancy after infertility
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A dysfunctional uterine bleeding (DUB) or abnormal bleeding pattern where bleeding is EXCESSIVE between cycles or IRREGULAR
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Metrorrhagia- Often referred to as spotting
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Cervical cancer used to have a high mortality rate, why has it decreased significantly
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Pap smear - cervical cytology to look for dysplasia (abnormal cells)
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When assessing for infertility, which hormones are reviewed
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FSH, LH and progesterone
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The goal of antibiotic therapy for PID is to prevent ____ of fallopian tubes
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scarring
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etiology of male infertility
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abnormal sperm, obstructed genital tract, abnormal genital tract secretions and ejactulation problems
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female etiology of female infertility
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unfavorable vaginal/cervical environment (natural antibiotics against sperm), lack of endometrial preparation or endometriosis, anovulation, ostuctions b/t cervix, uterus, tubes, ovaries, & PID
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teritary prevention of PID includes what
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completing course of antibiotic therapy, potential for recurring infection, chronic PID and outcome (loss of reproductive capabiity)
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Why are vaginal sprays and douching not recommended
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sprays can cause irritation and douching increases vaginal infections
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What do the three types of hysterectomy (TAV, TVH, and TAH BSO) stand for
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Total abdominal hysterectomy, Total vaginal hysterectomy and Bilateral salpinges ooporectomy (take out the tubes and ovaries)
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How is more severe endometriosis managed
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pseudopregnancy (oral contraceptives) and pseudomenopause (androgenic agents such as Danazol & Lupron) or (GnRHa Leuprolide)
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What percipitates the first pelvic exam & pap smears
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If having sex without monogomus partner (identify STI's/vaginitis) or by age 18
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what are three methods a woman can use to see when she is ovulating
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basal body temp (drops at ovulation then rises), cervical mucus (stretchy), and hormonal assessment kit (FSH & LH)
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when is investigation or referral for infertility suggested
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when the couple as tried unsuccessfully to concieve for 12 months or more
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When is earlier infertility investigation or referral determined
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Woman is over 35, irregular menses, has severe dysmenorrhea or dyspareunia or a medical hx of: mumps in male, repeated miscarriages, ectopic pregnancy, PID or pelvic surgery in female, and serious medical problems in either partner
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symptoms of menopause
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hotflashes, sleep disturbances, emotional (depression and anxiety), vaginal atrophy and drying, weaking of pelvic floor and dyspareunia (painful intercourse)
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What should be ruled out when faced with a dysfunctional uterine bleeding (menorrhagia or metrorrhagia)
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Uterine fibroids, menopause, and endometral cancer
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Management of menopause
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hormone replacement therapy (HRT), and Estrogen replacement therapy (ERT). If have uterus, ERT is bad causes hyperplasia but the heart likes estrogen
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dysplasia can be either low grade (LSIL low grade squamous intraepithelial lesion) or high grade (HSIL high grade squamous intraepithelial lesion) what is the significance of each
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The risk of low grade dysplasia transforming into high grade dysplasia and, eventually, cancer is low. Treatment is usually straightforward. High grade dysplasia represents a more advanced progression towards malignant transformation
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When assessing the male's sperm what is analyzed
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motility, morphology and number
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____ is evaluation of uterine structures and tubal patency
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hysterosalpingogram
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dysmenorrhea (pain), dyspareunia (painful intercourse), pelvic pain, constipation (pain on defecation) and infertility are all symptoms of
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endometriosis
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Why is follow up important for antibiotic therapy for PID
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Symptoms may go away but still have disease. Test for cure in two weeks, may need hospitalization when oral antibiotics don't work and surgery to remove pelvic abscess (can be life threatening)
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____motor symptoms cause hot flashes (flushing and nightsweats) of menopause
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vasomotor symptom
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What is the difference between primary and secondary infertility
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Both are inability to concieve despite unprotected intercourse for one year, but secondary happens whith previous conception
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____ is a normal process, not a disorder where ovaries stop producting estrogen
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menopause - Dx after one year without menstration
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The psychosocial impact of ____ includes an emotional association with cycle, impact on family work and friends and increases incedent over age 30
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PMS
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A dysfunctional uterine bleeding (DUB) or abnormal bleeding pattern where bleeding is excessive at REGULAR intervals
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Menorrhagia
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What two STI cause the majority of pelvic inflammator disease (PID)
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Gonorrhea and Chlamydia
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What is the incidence of infertility
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10-15% of all couples have impared fertility. 1/3 male, 1/3 female and 1/3 both
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What are the surgical interventions for endometriosis
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lacroscopy to remove endometrial foci, hysterectomy, and possible salpingo-oophorectomy
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what is primary and secondary prevention of pelvic inflammatory disease
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primary is screening yearly and education, secondary is early recognition (can be asymptomatic)
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___ implantation of endometrial tissue outside the uterus
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endometriosis - can adhear to organs - stick together and scarring
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What is most common range of beginning of menarche
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12-17 - if not by 17 then healthcare investigation to check hormones
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Differentiate between primary and secondary dysmenorrhea (painful menstration)
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Primary is not related to an underlying condition or pathology where secondary is
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_____ is an abnormally heavy and prolonged menstrual period at regular intervals. Causes may be due to abnormal blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the uterus.
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Menorrhagia Depending upon the cause, it may be associated with abnormally painful periods (dysmenorrhea).
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Etiology of pevic inflammatory disease
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early and multiple sex partners
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When is the best time to do a breast self examination
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After period b/c hormones ar lowest
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sociocultural impact of ____ is missing school or work and the emotional upset this causes
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dysmenorrhea
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____ is a painful menstration occures one day before or at start of mencese and usually have relief by second day
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Dysmenorrhea - there is an increase in prostaglandins so take NSAID, can double the dose
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secondary prevention (tests for infertility) include ovulation, endometrial biopsy and evaluation of what
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cervical factors (spinnbarkeit or stretchy mucus and ferning under microscope)
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