Chart CHAP 31PATHO

Chart CHAP 31PATHO - DISORDE R Premenstrua l Syndrome...

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DISORDE R DEFINITION PATHOGENES IS CLINICAL MANIFESTATIONS EVALUATION AND TREATMENT Premenstrua l Syndrome Cyclic physical, psychological, or behavioral changes that impair interpersonal relationships or interfere with usual activities *3-8% have cyclic dysphoria (exaggerated feeling of depression) known as Premenstrual Dysphoric Disorder: PMDD - symptoms are experienced to some degree by all ovulating people -the presence and severity of symptoms may be inconsistent -menstrual phase for peak symptom severity varies Exact etiology unknown -cause considered to be multifactorial *fluctuating estrogen and progesterone levels may contribute *family history *serotonin levels effect it PMDD is triggered by endocrine changes in late luteal phase -pattern of frequency and severity more important than specific complaints -more than 200 symptoms (physical, emotional and behavioral) can contribute *depression anger irritability in particular - diagnosis based on history and symptoms - treatment symptomatic *if PMDD, medication can be added Pelvic Inflammatory Syndrome -Acute inflammatory disease caused by infection -May involve any organ of the reproductive tract * Salpingitis: inflammation of fallopian tubes * Oophoritis: inflammation of ovaries -Sexually transmitted diseases migrate from the vagina to the upper genital tract -Polymicrobial infection -mediated by a number of defense mechanisms *virulence of organism *size of inoculums *immune status -mostly caused by gonorrhea and Chlamydia (50% get PID) -after one episode of pelvic infection, women develop long term problems like infertility, ectopic pregnancy, pelvic pain, dysarurenia, pelvic adhesions, perihepatitis, and tubovarian abscesses -morality is .29 deaths per 100,000 women -symptoms vary from sudden abdominal pain and fever to no symptoms at all -asymptomatic cervicitis usually present some time before PID develops -pain has gradual onset and symptoms usually worse after or during menstruation *sex, jumping, or walking can worsen symptoms diagnosis *based on history -abdominal tenderness, presence of uterine and cervical movement tenderness upon examination, discharge, white blood cells on gram stain, increased erythrocyte sedimentation rate -test for Chlamydia and gonorrhea to support diagnosis -other conditions excluded Treatment -aggressive -bed rest, avoid sex, antibiotics -25-30% require hospitalization for IV antibiotics and treatment of abscesses Vaginitis Infection of vagina Major causes are sexually transmitted
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Chart CHAP 31PATHO - DISORDE R Premenstrua l Syndrome...

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