Chiamaka Shared "B6 Path 2 " - 31 Picmonics

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B6 Path 2

Dysfunctional Uterine Bleeding
Assessment
Bimodal Age Distribution
Painless Vaginal Bleeding
Amenorrhea
Menorrhagia (Heavy Menstrual Bleeding)
Metrorrhagia (Bleeding Between Menses)
Interventions
Balloon Thermotherapy
Hormone Medications
Dilation and Curettage (DandC)
Considerations
Monitor for Anemia
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3 mins
Pelvic Inflammatory Disease (PID)
Mechanism
Neisseria gonorrhoeae
Chlamydia Trachomatis
Symptoms
Cervical Motion Tenderness
Chandelier Sign
Salpingitis
Tubo-ovarian abscess
Hydrosalpinx
Complications
Ectopic Pregnancy
Infertility
Adhesions
Fitz-Hugh-Curtis Syndrome
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2 mins
Pelvic Inflammatory Disease (PID) Interventions
Antibiotics
No Intercourse for 3 Weeks
Semi-Fowler's Position
Analgesics
Monitor Temperature
Treat Partners
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2 mins
Endometriosis Characteristics
Endometrial Tissue Outside of Uterus
Glands and Stroma
Most Common in Ovary, Pelvis, Peritoneum and Bowels
"Chocolate Cyst" in Ovary
Adenomyosis
Theories
Retrograde Flow
Metaplastic Transformation
Mullerianosis
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1 min
Endometriosis Symptoms and Treatment
Symptoms
Dysmenorrhea
Cyclic Pelvic Pain
Dyschezia
Dysuria
Dyspareunia
30-40% are Infertile
Treatment
Surgery
NSAIDs
OCPs
Progesterone (Progestins)
GnRH Agonists
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1 min
Polycystic Ovarian Syndrome (PCOS) Mechanism
Mechanism
Hyperinsulinemia Increases GnRH Pulse Frequency
Large Increase in LH
Small Decrease in FSH
Increased Androgen Production From Theca-Lutein Cells
Decreased Steroid Hormone-Binding-Globulin (SHBG) Causes Increased Free Testosterone
Obese Patients Have Increased Estrogen
Increased Risk of Endometrial Cancer
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2 mins
Polycystic Ovarian Syndrome (PCOS) Symptoms and Diagnosis
Symptoms
Most Common Cause of Infertility in Women
Amenorrhea
Acne
Hirsutism
Obesity
Diagnosis
Enlarged, Cystic Ovaries
LH:FSH Ratio of 3:1
"String of Pearls" on Ultrasound
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1 min
Polycystic Ovarian Syndrome (PCOS) Treatment
Weight Loss
Oral Contraceptives
Clomiphene Citrate
Anti-androgens
Cyclic Progesterone for Endometrial Protection
Metformin
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1 min
Menopause Symptoms
Symptoms
HAVOCS Mnemonic
Hot Flashes
Atrophy of Vagina
Osteoporosis
Coronary Artery Disease (CAD)
Sleep disturbances
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50 secs
Menopause Lab Findings
Decreased Estrogen
Lack of Negative Feedback
Increased FSH
Increased LH
Increased GnRH
Small Amount of Estrogen From Androgen Conversion
Increased Androgens = Hirsutism
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1 min
Cervical Cancer Screening
Women aged 21-65 years old
Pap smear every 3 years
Women aged 30-65 years old
Can opt for Co-testing (Pap Smear + HPV testing) every 5 years
Identify lesions
High grade lesions
Cryotherapy
Loop Excision
Cold knife Conization
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2 mins
Cervical Cancer Assessment
Cause/Mechanism
Human Papillomavirus (HPV)
Assessment
Metrorrhagia
Leukorrhea
Pain
Abnormal Pap Test
May Be Asymptomatic
Considerations
HPV Vaccine
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2 mins
Leiomyoma
Most common GU tumor
Most common tumor in women
Increased incidence in African Americans
Age is a common risk factor, with a lifetime risk of women over 45 being 60%
Can be subserosal, intramural, submucosal
Higher association of AUB with submucosal lesions compared to intramural and subserosal myomas
Well circumscribed, non-encapsulated, benign smooth muscle tumors of the myometrium
Estrogen and progesterone important to growth
Each fibroid is monoclonal, made up of cell from a single progenitor cell
Tumor is active during pregnancy and obesity (high estrogen states), but not menopause (low estrogen state)
Symptoms: bulk
pelvic pressure
urinary frequency (extrinsic compression)
infertility and/or recurrent pregnancy loss
Abnormal uterine bleeding
heavy menstrual bleeding
intermenstrual bleeding
Dysmenorrhea
Cigar-shaped nuclei
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Fibroadenoma
Most Common Benign Breast Tumor
Stromal Tumor
Presentation
Women under 40
Small, firm mass
Sharp Edges
Increased tenderness and size with Estrogen
Management
Biopsy
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1 min
Intraductal Papilloma
Presentation
Bloody nipple discharge
Women 20-40 years old
Mechanism
Small tumor in lactiferous ducts
Occurs Centrally
Occurs Peripherally
Increased malignancy
Diagnosis
Too Small to Palpate
Galactogram biopsy
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1 min
Phyllodes Tumor
Presentation
Common in 40's
Large Palpable Mass
Mechanism
Benign
Rarely Malignant
Low-Grade Tumor
Leaf-Like
Stromal Tumor
Treatment
Wide Resection
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2 mins
Breast Cancer Diagnosis
Mammography
Ultrasound
MRI for High Risk Patients
Confirmed with Biopsy
Considerations
Lymph Node Involvement
Receptor Positivity
Estrogen and Progesterone Receptors
HER-2
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2 mins
Breast Cancer Interventions
Radiation or Chemotherapy
Hormonal Therapy
Tamoxifen
Lumpectomy
Mastectomy
Avoid BP and Injections Affected Arm
Hand Exercises
Considerations
Grief Related to Body Image
Prosthetics
Reconstruction
Lymphedema
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3 mins
Fibromas
Non-germ cell tumor
Meigs Syndrome
Thecoma
Pulling sensation in groin
Spindle-shaped fibroblasts
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44 secs
Hydatidiform Mole (Molar Pregnancy)
Cause/Mechanism
Abnormal Fertilization
Assessment
Symptoms of Pregnancy
Elevated hCG
Vaginal Bleeding
Inappropriate Uterine Growth
No Fetal Heart Rate (FHR)
Interventions
Dilation and Curettage (D&C)
Emotional Support
Considerations
No Pregnancy 1 Year
Hysterectomy
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3 mins

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