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68wm6 p2 Dis fem rep

Disorders of the Female Reproductive Tract

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
Created by: Shanejqb