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68wm6 p2 Dis fem rep
Disorders of the Female Reproductive Tract
Question | Answer |
---|---|
What is Endometriosis? | a female health disorder that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. |
What can endometriosis lead to? | pain, irregular bleeding, and problems getting pregnant. |
What are risk factors for endometriosis? | *Caucasian women between ages of 25 and 35 *Women in higher socioeconomic classes *Postpone childbirth until later years *Never experienced childbirth or lactated *Family history |
When do S/Sx of endometriosis appear and how long do they last? | Signs and symptoms generally appear 5 to 7 days before menses and last 2 to 3 days |
List how endometrial tissue appears in various places in the pelvic cavity - on the ovaries, fallopian tubes, bladder, intestine, rectum, or pelvic wall | *Lymphatic circulation *Menstrual backflow to the fallopian tubes and pelvic cavity *Congenital displacement of endometrial cells |
Why should aspirin NOT be given to a PT with endometriosis? | Aspirin affects the clotting ability of the blood and is contraindicated with bleeding |
What are the types of GYN fistulas? | *Urethrovaginal *Vesicovaginal *Rectovaginal |
What is a Urethrovaginal fistula? | A fistula between the urethra and the vagina |
What is a Vesicovaginal Fistula? | This is a connection established between the bladder and the vagina so that the patient presents with urinary incontinence |
What is a Rectovaginal Fistula? | A fistula or abnormal connection between the rectum and the vagina |
Rectovaginal fistula may be seen as a complication of what? | Ulcerative Colitis |
What are the diagnostic tests for gyn fistulas? | *Physical examination *Methylene blue test *Intravenous pyelogram *Indigo carmine test *Cystoscopy |
What is a Methylene blue test? | Methylene is injected intravenously and is released through urine, turning urine blue and thus can be used to test the urinary tract for leaks or fistulas. |
What is a Indigo carmine test? | Methylene is injected intravenously and is released through urine, coloring the urine and thus can be used to test the urinary tract for leaks or fistulas. |
What is Dyspareunia? | Painful intercourse |
What can cause relaxed pelvic muscles? | *Unrepaired postpartum tears *Childbirth, multiple births *Aging (genital atrophy) *Congenital muscle weakness *Coughing, straining, lifting heavy objects |
List 5 S/Sx of relaxed pelvic muscles | *Back pain *Pelvic pressure or heaviness *A feeling of "something coming down" *Cystitis(if cystocele present) *Stress incontinence *Constipation. (if rectocele present) *Ulceration of the cervix *Fatigue *Dyspareunia |
What is a pessary? | A pessary is a firm rubber doughnut-shaped or ringed device that is inserted into the upper vagina to reposition and give support to the uterus when surgery is not performed. |
How is diagnosis made for uterine displacement? | pelvic examination |
What is Leukorrhea? | A non-bloody vaginal discharge, usually whitish in color |
What is Amenorrhea? | Absence of menstrual flow |
What is Dysmenorrhea? | Painful or difficult menses |
What are Leiomyomas (uterine fibroids)? | Benign tumors |
True or False: An untreated ovarian cyst can result in cancer. | False. DOES NOT BECOME MALIGNANT |
What can cause Amenorrhea? | *Insufficient hormone secretion *Congenital abnormality *Stress *Pregnancy *Menopause |
What is Menorrhagia? | abnormally long or heavy menstrual periods. |
What is done following a negative methylene blue test? | Indigo carmine test |
How often is a pessary removed and cleaned? | Every 3-4 months |
How can a PT with relaxed pelvic muscles be placed to relieve pain and edema? | Low fowlers |
What is anteflexion? | uterus is bent forward at an acute angle |
What is retroversion? | cervix at normal axis, but the body of the uterus is directed toward the sacrum. |
What is retroflexion? | the uterus tilts backward and the fundus is bent backward on the cervix (the opposite of anteflexion |
What surgery is done for a prolapsed uterus? | Vaginal hystorectomy |
When is an abdominal hysterectomy performed? | when there is a need to explore the pelvic cavity or when fallopian tubes and ovaries are to be removed |
What is a salpingectomy? | removal of a fallopian tube |
What is an Oophorectomy? | Removal of an ovary |
What should a PT with a hysterectomy avoid until permitted? | *Heavy lifting (objects over 10 pounds) *Sexual intercourse *Vigorous activity *Douching *Use of tampons. |
What is PO estrogen given for? | *Treatment of moderate to severe vasomotor symptoms of menopause. *Estrogen deficiency states (Female hypogonadism, Ovariectomy, Primary ovarian failure) *Prevention of postmenopausal osteoporosis |
What is vaginal estrogen given for? | *Management of atrophic vaginitis *to decrease the risk of endometrial carcinoma in patients with an intact uterus |
What is IM/IV estrogen given for? | uterine bleeding resulting from hormonal imbalance. |
What is the action of estrogen? | *Promote the growth and development of female sex organs. *Maintenance of secondary sex characteristics in women. *Metabolic effects include reduced blood cholesterol, protein synthesis, and sodium and water retention. |
What are the contraindications of estrogen? | *Thromboembolic disease (e.g. DVT, PE, MI, stroke) *Undiagnosed vaginal bleeding *Liver dysfunction *Pregnancy (may result in harm to the fetus). *Lactation. |
What are the adverse effects of estrogen? | EENT: intolerance to contacts, worsening of myopia/astigmatism CV: MI, THROMBOEMBOLISM Endo: gynecomastia (men). Misc: breast tenderness GU Men: impotence, testicular atrophy. GU Women: amenorrhea, breakthrough bleeding, dysmenorrheal |
What may decrease the effectiveness of estrogen? | Barbiturates or rifampin may ↓effectiveness |
What are the advantages of use of progestins over progesterone? | *Greater potency. *Longer duration. *An effective oral or sublingual dosage form |