Women's Health Final Exam
the main three main complications of pregnancy
(miscarriage, ectopic, prematurity).
Effacement
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Organ systems and their functions
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Symptomathermal (natural family planning) how they work, basic effectiveness
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VBAC
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Who are women most likely to be raped by
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afterbirth/placenta
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breech
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cesarean
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clinical trials
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difference between a bacterial, viral, or protozoan STD
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dilation
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emergency birth control how they work, basic effectiveness
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how to calculate mortality rates
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non-hormonal means of menopause management
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risk factors for skin cancer; know their screening and diagnosis!
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the difference between, primary, secondary, and tertiary prevention and be able to identify examples of each
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the differences between an HMO and a PPO
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the important women in healthcare history
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the menstrual cycle, it's stages, and terminology that goes along with it
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the reproductive hormones and where they are produced in the body
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understand the difference between schizophrenia, depression, and multiple personality disorders
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which STDs need to be reported
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which age groups are most affected by STDs
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who are the major perpetrators of elderly abuse
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surgical menopause
...Surgical removal of both ovaries, usually during a hysterectomy
Stages of labor, how many and what are they?
3 Stage I is from the onset of labor to full dilation of the cervix. Stage II of labor begins when the cervix is completely dilated and ends with the birth of the baby. Stage III lasts from the completion of delivery of the baby to completion of delivery of the afterbirth, or placenta.
Stages of breast cancer, how many stages are there?
4, In situ stage breast cancer can be diagnosed by mammogram, but the tumors are usually too small to be felt.
Diaphragm, cervical cap
A diaphragm is a dome-shaped latex cup rimmed with a firm but flexible band or spring. It must be first coated with a spermicidal agent before being inserted into the vagina before intercourse. The spermicidal agent is important because it creates a tighter seal around the cervix and kills sperm on contact. The musculature of the inner vaginal walls holds the diaphragm in place. Because the diaphragm must fit the cervix it is to cover, this contraceptive method requires clinician examination, fitting, and prescription. The cervical cap is in many ways similar to a small, deep diaphragm.
abstinence, how they work, basic effectiveness
Abstinence refers to no penis-in-vagina intercourse and depends on a couple's sustained willpower. Some couples consider oral sex or mutual masturbation, which do not result in pregnancy, a form of abstinence. In theory, abstinence is 100% effective; unfortunately, this method requires considerable sacrifice and has a high rate of failure in practice.
the advantages contraindications to using hormonal contraceptives.
Advantages: Lighter and less painful periods, lower PMS symptoms, improved skin, protect against breast, ovarian, and endometrial cancers and PID, Increased bone density with long-term use
how a woman's age affects the two types of contraceptive failure rates
Age influences the efficacy of the birth control method, with married older women generally being more successful contraceptors than unmarried younger women.
the three support structures found within the pregnant uterus that protect and nourish the growing fetus. Know how they basically function!
Amnion: Fetal Sac that envelops the embryo Amniotic fluid: Provides protection and constant environment for floating embryo Placenta: Supplies fetus with oxygen and nutrients from maternal bloodstream and filters waste back to mother for disposal
osteoporosis
An age-related, debilitating disorder characterized by a general decrease in bone mass and structural deterioration of bone tissue.
both types of IUD's how they work, basic effectiveness
An intrauterine device (IUD) is a small object that is inserted by a clinician into a woman's uterus. It is the most commonly used form of birth control in the world, though it is much less popular in the United States.
the ABCD method of screening for skin cancer
Asymmetry-The shape of one-half of a lesion or mole is different from the other Border Irregularities-The edge may be uneven, ragged, or blotched Color irregularities-different colors may be present in the mole or lesion Diameter-the mole or lesion is usually greater than 6mm
the nutritional needs during pregnancy and breastfeeding
Breast milk is highly nutritious, providing all of the nutrients that a growing baby needs. It is ideal as a baby's sole source of nutrients for the first six months of life. In addition, breast milk contains enzymes to aid in the infant's digestion as well as antibodies to protect against infection. Evidence has shown that breastfed infants have less frequency and severity of diarrhea; fewer cases of upper respiratory, ear, and even urinary infections; and fewer hospitalizations and doctor's visits. Many studies show the possibilities of breast milk protecting against type 1 diabetes (childhood-onset diabetes), Crohn's disease, SIDS, chronic digestive disease, and childhood cancers such as lymphoma and leukemia. Breastfeeding is also believed to bestow cognitive benefits.
the three ways of screening for breast cancer and when they should be done and by whom
Breast self-examination: women over the age of 20 should examine their breasts monthly after menses and at the same time each month Clinical breast examinations: every three years by a woman's health-care provider for women ages 20-39 Mammography: Screenings for women ages 40 or older every one to two years.
lactational amenorrheal, how they work, basic effectiveness
Breastfeeding women may use the lactational amenorrhea method, alone or with other forms of contraception, for the first six months postpartum. For this method to be effective, the woman must be breastfeeding exclusively on demand, be amenorrheic (no vaginal bleeding after eight weeks postpartum), and have an infant younger than six months.
risk factors for cervical cancer know their screening and diagnosis!
Cervical Cancer: Stages 0-IV Screening = Pap Smear Risk Factors: Human papillomavirus (HPV), smoking, immunosuppressant drugs, early sexual intercourse, multiple sex partners, >4 pregnancies Treatment: Cryosurgery, Cone biopsy, laser cone biopsy
who can prescribe contraceptives and which can be bought over the counter.
Clinician for prescription of diaphragm, cervical cap, any hormonal methods, IUD, or sterilization. Other forms of bc do not require a clinicians prescription, but conditions associated with these forms may warrant a clinic visit.
risk factors for colorectal cancer know their screening and diagnosis!
Colorectal cancer: type of disease develops in a gradual progressive manner and may present anywhere in the colon and rectal areas. Screening: digital rectal examination, sigmoidoscopy, fecal occult blood testing, and colonoscopy Risk Factors: Increasing age, an individual with an immediate family memner who has had colorectal cancer. Dietary factors. Diets high in fat and low in fiber or other components of fruits and vegetables.
Condoms
Condoms are the most commonly used barrier form of contraceptive in the United States. They are portable, disposable, and easy to purchase. They may be discreetly carried and are therefore easily available when necessary. Women do not experience any post-intercourse vaginal leaking, and condoms permit the male partner to take an active role in birth control. Latex and polyurethane condoms are also the only methods that effectively prevent sexually transmitted infections, including HIV infection. For couples who want to be especially diligent in their birth control efforts, condom use can supplement other forms of contraception.
contraindications to using hormonal contraceptives.
Contraindications: Past hx of thrombophlebitis (e.g. DVT) CVA or CAD Migraine with focal aura Known or suspected cancer of reproductive system: breast, endometirum, ovary Known or suspected estrogen dependent neoplasia Undiagnosed genital bleeding Cholestatic jaundice of pregnancy Acute or chornic liver disease with abnormal LFTs Hepatic adenomas or carcinomas Known or suspected pregnancy Hypersensitivity Smoking of over the age of 35 years If smoker under the age of 35 years, if not other contraindications- can you pills (select low estrogen pills).
controllable risk factors for breast cancer
Controllable risk factors: Having more then 1 alcoholic drink per day Obesity after menopause Gaining weight as an adult Using oral contraceptives for five years or longer Never having children or having your first child after 30 Current or recent use of HRT Women who are exposed to radiation from frequent spinal x-rays for scoliosis or during the treatment of Hodgkin's disease at a young age
the different methods of delivering contraceptive hormones
Depo-Provera: Injectable progestins every three to four months Ortho Evra: Patch worn on skin for one-week intervals; fourth week is patch-free NuvaRing:Vaginal ring worn for three weeks and removed during week of menstruation
disadvantages to using hormonal contraceptives.
Disadvantages: Mood changes, spotting, weight changes, drug interactions, decreased libido, headaches, fluid retention, health risks for some women
the effects of alcohol consumption on a pregnancy
Drinking alcohol: Alcohol also is detrimental for both the mother and her developing baby. Alcohol consumption during pregnancy is known to cause alcohol-related defects among infants and fetal alcohol syndrome (FAS), which is characterized by growth retardation, facial malformations, and central nervous system dysfunctions, including mental retardation. Alcohol appears to act in concert with several other factors in promoting the development of FAS in infants: Differences in the degree of prenatal exposure to alcohol Maternal drinking patterns Possible genetic susceptibility to FAS Differences in maternal metabolism of alcohol Time of gestation during heavy alcohol consumption Interactions of alcohol use with other drugs and medications Maternal nutritional status The fetus is especially vulnerable during the first trimester of pregnancy, when development of the central nervous system occurs. During this vulnerable period, alcohol-associated effects on the infant may be more closely related to peak blood ethanol levels in the mother than to overall consumption throughout the pregnancy. Because no specific level of alcohol has been identified as causing FAS, women are advised to abstain completely from alcohol consumption throughout pregnancy.
the permanent methods of contraception for both men and women, how they work, failure rates for each, basics of each procedure.
Female and Male Sterilization:Surgical sterilization offers permanent birth control for those individuals who do not wish to have any more children. Female sterilization is second only to oral contraceptives in overall popularity as a method of birth control. One of the most important decisions for a couple is which partner will undergo permanent sterilization. Women have the option of having a tubal ligation (tubes "tied"), and men have the option of a vasectomy. The most common choice is for a tubal ligation, even though it is more difficult, expensive, and invasive than a vasectomy. This may be due to several factors. Many couples don't realize that a vasectomy poses far less risk to men than the risks associated with tubal ligation for women. Men may also be reluctant to have the procedure. A vasectomy is usually performed in a physician's office, whereas a ligation requires a hospital setting.
the benefits of breastfeeding for baby
For baby Breast milk is highly nutritious Breast milk contains enzymes to aid in infant digestion Breast milk contains antibodies to protect against infection Fewer infant episodes of diarrhea Fewer infant cases of upper respiratory, ear, and urinary infections Protects against type 1 diabetes, Crohn's disease, SIDS, chronic digestive disease, childhood cancers
the benefits of breastfeeding for mother
For mother Uterus returns to normal size more quickly Return to prepregnancy weight more quickly Lower risk of ovarian and breast cancer, osteoporosis
what hormone home pregnancy tests are measuring
Home pregnancy tests measure the presence of a pregnancy hormone called human chorionic gonadotropin (hCG) in your urine.
hormonal and non-hormonal means of menopause management
Hormonal replacement therapy: Three types Estrogen alone (ERT) Estrogen + progesterone (HRT) Estrogen + progesterone + testosterone Three types of preparation for HRT Oral preparation Natural estrogen Synthetic Progestin Combination therapy Selective estrogen receptor modulators Natural dietary supplement Vaginal cream Vaginal ring Transdermal patch
which methods of contraception use hormones to prevent pregnancy
Injectables, patches, and vaginal rings. They are all similar in that they provide a steady and predictable dose of contraceptive hormones that prevents ovulation and thickens the cervical mucus.
why menopause is now first being studied as compared to previous decades.
It was not until the twentieth century that the life expectancy of US women reached a point where most women lived much beyond menopause; today most women will live a third or more of their lives postmenopausally.
the health effects of Menopause for long term
Long-Term: Lower HDL ("good" cholesterol) levels and higher LDL ("bad" cholesterol) levels may lead to higher risk of postmenopausal cardiovascular disease Increased risk for osteoporosis or osteopenia Osteoporosis affects >30 million American women and causes approximately 300,000 hip fractures per year Varies by race Increased risk for Alzheimer's disease
how to reduce the chances of a low birth weight baby
Low birthweight is defined as a birthweight of less than 2,500 grams (5.5 pounds), and it and the period of gestation are the most important predictors of an infant's subsequent health and survival. Because of their much greater risk of death, infants born at the lowest birthweights and gestational ages have a large impact on overall U.S. infant mortality. Infants weighing less than 1,000 grams accounted for only 0.8% of births but nearly one-half of all infant deaths in the United States. A similar pattern is seen with infant gestation data. Only 0.8% of births occurred at less than 28 weeks of gestation, but they accounted for nearly one-half of all infant deaths.
the two types of contraceptive failure rates and how a woman's age affects this.
Lowest observed failure rate represents a method's absolute top performance (failure rate with perfect use); also known as "perfect use." Failure rate for typical users is an average rate based on an analysis of studies; it is usually lower than the best observed failure rates; also known as "average use."
the names of early promoters of birth control
Margaret Sanger and Mary Coffin Denett
prenatal tests-when they are done, what they are looking for.
Maternal serum screening tests examine blood for abnormal levels of substances linked with certain birth defects such as Down syndrome and neural tube defects. This group of tests includes maternal serum alpha-fetoprotein screening (MSAFP), which measures a substance produced by the fetal kidneys between the thirteenth and twentieth weeks of pregnancy. Detailed ultrasound exams are usually done after 18 weeks of pregnancy and allow for a more extensive view of the baby's organs and features.
negative effects of HRT
Negative: ERT (without progestin) can increase the risk of endometrial cancer in women with a uterus ERT may increase the risk of breast cancer, but study results are conflicting Progestin diminishes the protection from CVD possibly provided by estrogen Progestin may increase risk of breast cancer
the effects of smoking and alcohol consumption on a pregnancy
Not smoking is essential to a healthy pregnancy and birth. The CDC reports that smoking before and during pregnancy is the single most preventable cause of illness and death among mothers and infants. Women who smoke before pregnancy are twice as likely to experience a delay in conception and have a 30% increased risk of being infertile compared with nonsmoking women. Women who smoke during pregnancy are also twice as likely to experience complications including premature rupture of membranes, early separation of the placenta from the uterus, and blockage of the cervix by the placenta. The CDC also reports that babies born to women who smoke during pregnancy have a 30% increased risk of being born premature or of low birthweight, and are more likely to die of sudden infant death syndrome (SIDS.)
lumpectomy therapy
Often used for early-stage localized tumors when it is possible to remove only the tumor and some surrounding tissue.
risk factors for ovarian cancer know their screening and diagnosis!
Ovarian Cancer: 4 Stages Screening: Pap smear, transvaginal ultrasound, blood test Risk Factors Reproductive tract history, no children, early menstruation, late menopause, pregnancy after age 30, oral contraceptives, previous cancer, long-term use of fertility drug Clomiphene Citrate Treatment Hysterectomy, surgery, radiotherapy, chemotherapy Deadliest of all the reproductive cancers
the advantages, disadvantages, side effects and contraindications to barrier methods of contraception.
Overall safe, condoms offer protection from STIs, Used as backup for pill users, Diaphragm, sponge, and cervical cap: vaginal bacterial infections are possible; small risk of toxic shock syndrome
complete/partial hysterectomy
Partial: Only the uterus is removed Total: both the uterus and the cervix removed
the positive and negative effects of HRT
Positive: ERT provides relief from hot flashes and urogenital changes, while increasing bone density and protecting from bone loss ERT may protect from colorectal cancer and age-related macular (eye) degeneration For some women, testosterone improves libido
the terms for painful menstrual flow
Progestin side effects include bleeding, breast tenderness, mood swings, and bloating Testosterone may increase hair growth and bring negative effects on heart disease
risk factors for breast cancer
Risk factors: Being female Getting older Family history of breast cancer Previous biopsy showing pre-cancerous condition Having your first period before age twelve Having a genetic mutation in the breast cancer genes BRCA 1 or BRCA 2
the health effects of Menopause-both short term
ShortTerm: Hot flashes Depression Sleep disturbances Vaginal dryness Vaginal atrophy Decreased libido Weight changes Hair changes Skin changes Urinary tract infections Urinary incontinence
side effects to using hormonal contraceptives.
Side Effects: Shorter lighter, and more regular menstrual periods. Reduction or elimination of cramps. Mood changes. Reduction or elimination of premenstrual symptoms. Decreased libido. Spotting or bleeding between periods. Weight changes. Acne improvement. Nausea, tender or larger breasts, headaches, and fluid retention.
Spermicides
Spermicidal agents are available as creams, foams, films, suppositories, or gels. The active ingredient in most spermicides, nonoxynol-9 (N-9), inactivates sperm by breaking down the surface of the sperm cells on contact. Spermicidal agents may be used alone or with diaphragms, cervical caps, or condoms. Contraceptive protection is more effective when the agent is used with a barrier method.
which methods of contraception are barrier methods
Spermicides, condoms, female condoms, diaphragm, cervical cap,
Stage 1
Stage I breast cancer remains localized to the breast, generally is smaller than 2 cm in size, and has not spread to the lymph nodes
Stage 1 of labor
Stage I is from the onset of labor to full dilation of the cervix. Before labor begins, the wall of the uterus is thin, the cervix is long and thick, the birth canal is narrow, and the membranes may still be intact. As labor begins, the bands of longitudinal muscle fiber in the upper part of the uterus contract and thus gradually draw up, thin, and open the mouth of the cervix. The cervical canal shortens until the cervix is of the same thickness as the uterine wall. This process, in which the cervix is "taken up" into the uterus, is known as effacement. Once the cervix is effaced, the force of the uterine contractions begins to dilate the cervix, although effacement and dilation may occur simultaneously.
Stage 2
Stage II breast cancer tumors generally are larger-2 to 5 cm in size- have not spread to the lymph nodes. may be smaller than 2 to 5 cm but have spread to nearby lymph nodes
Stage 2 of labor
Stage II of labor begins when the cervix is completely dilated and ends with the birth of the baby. The presentation of the baby—the part of the body positioned to emerge first—is usually by the top of the head, known as a vertex presentation. When the feet or buttocks present first, it is known as a breech presentation. The breech position occurs in about 3% of deliveries. A breech presentation usually results in a longer labor. Because a breech delivery presents greater risks to the mother and baby, a cesarean delivery is often performed.
Stage 3
Stage III Tumors are growth that are larger than 5 cm in size or that have grown into the chest wall, skin, or distant lymph nodes
Stage 3 of labor
Stage III lasts from the completion of delivery of the baby to completion of delivery of the afterbirth, or placenta. In this final stage of labor, the uterus contracts firmly after the delivery of the baby. The placenta separates from the uterine wall and is expelled. If an episiotomy has been performed, it is sutured at this time
Stage 4
Stage IV Tumors are classified as growths that have spread to other parts of the body
the function of amniotic fluid
The amniotic fluid provides protection from shocks and bumps and helps maintain a homeostatic, or constant, environment for the developing embryo. A primitive placenta soon forms.
Female condoms
The female condom is another form of barrier contraception. It is the only female-initiated contraceptive method currently available that can prevent pregnancy and sexually transmitted infections. The condom lines the entire vagina, preventing the penis and semen from coming in direct physical contact with the vagina. It consists of a sheath with a closed ring at one end and an open ring at the other. The female condom covers part of the external genitals, providing extra protection from semen leakage.
metastasis therapy
The process of cancer cell invasion and spreading
radical mastectomy therapy
The removal of the entire affected breast, the underlying chest muscles, and the lymph nodes under the arm. Although once a very common surgery, this procedure is used less often today because of the disfigurement and the side effects it causes
When the Supreme Court struck down a statute that made use of birth control illegal.
This changed in 1965, when the Supreme Court, in Griswold v Connecticut, struck down a state law that criminalized spreading information about the use of birth control and that made birth control illegal
How hormone home pregnancy tests are measuring
This hormone, produced by cells from the placenta, first enters your bloodstream after the fertilized egg (the embryo) implants in the lining of your uterus, shortly after fertilization. The amount of hCG in your body then increases rapidly over the next few weeks, often doubling every two days or so.
adjuvant therapy
Treatments that enhance surgical effectiveness
risk factors for uterine cancer know their screening and diagnosis!
Uterine Cancer: 4 Stages Screening: Pelvic exam, transvaginal ultrasound, endometrial biopsy Risk Factors Age, high levels of estrogen, obesity, diabetes, failure to ovulate, history of infertility, family history, using Tamoxifen Treatment Hysterectomy, surgery, radiotherapy, progesterone
the most commonly use procedure for surgical abortion in the US.
Vacuum curettage is the most widely used abortion technique in the United States. Most legal abortions done in the United States use vacuum curettage. It involves dilating the cervix and then inserting a
withdrawal, how they work, basic effectiveness
Withdrawal, also known as coitus interruptus, refers to interrupting lovemaking before ejaculation of semen. Although it may seem logical that conception requires semen and therefore requires ejaculation, withdrawal often fails as a form of birth control when the man is unable to remove his penis in time or because some sperm are released before ejaculation.
how fertilization takes place in what order
Within 36 hours of fertilization: Cell division of zygote Within 3 to 5 days: Reaches uterus and is known as a blastocyte 1 to 2 days: Blastocyte floats freely before implanting in uterus Terms First 8 weeks: Known as embryo 9 weeks to birth: Known as fetus
gestational diabetes
a disorder in which women who are not diabetic before pregnancy develop diabetes during the pregnancy
hyperglycemia
abnormally high blood sugar usually associated with diabetes
hypoglycemia
abnormally low blood sugar usually resulting from excessive insulin or a poor diet
osteopenia
abnormally low bone density
osteoarthritis
also known as degenerative joint disease. Milder form of arthritis. the surgace layer of cartilage erodes, causing bones under the cartilage to rub together. This friction results in joint pain, swelling, and loss of movement of the joints.
Graves's disease
an autoimmune disorder in which the immune system stimulates the thyroid causes about 80% of hyperthyroid cases.
Alzheimer's disease
an irreversible, progressive brain disorder that evolves gradually and results in memory loss, behavior and personality changes, and a decline in cognitive abilities. It is one of a group of disorders that case dementia.
arthritis
any inflammation of the joints, encompasses more than 100 diseases and conditions that affect joints, the surounding tissues, and other connective tissues.
Hashimoto's disease,
autoimmune condition is caused when the imune system reacts against the thyroid gland.
Type I diabetes mellitus
autoimmune disease, though genetic and environmental factors can also influence its development. The bodys immune system attacks the cells that produce insulin, the hormone that regulates blood glucose. Usually first appears in childhood and adolescence. accounts for about 5% of total cases of diabetes
malignant therapy
capable of spreadint to other tissues and organs and invading adjacent tissue, the difinition of a cancerous growth.
rheumatoid arthritis
chronic inflammatory disease with increasing prevalence among older adults. An autoimmune disease, meaning that the person's immune system attacks the body's own cells. In this condition, the cells inside the joint capsule are attacked, causing inflammation and affecting the cells of the synovial. Abnormal synovial cells eventually invade and destroy cartilage and one within the joint which can lead to severe disability.
two basic types of oral contraceptive pills
combination pills and progestin-only pills
Lupus
disease that is still not fully understood. the immune system forms antibodies that target healthy tissues and organs. can be a mild, moderate, or severe disease. primarliy a disease of young women of childbearing age.
postmenopausal
life after the final menstrual period
Type II diabetes mellitus
most prevealent type of diabetes; occurs when the body cannot use the insulin it makes (receptors have changed so the key/insulin does not work-insulin resistance); can also occur if the insulin produced is not sufficient to decrease the amount of glucose in the blood; can also occure when the liver does not produce enough glucose; gradual onset usually associated with poor eating habits and sedentary lifestyle
the most popular forms of contraception for US women
oral contraceptives, male sterilization, female sterilization, and male condom
which chronic diseases are more common in women.
osteoporosis, arthritis, diabetes mellitus, certain autoimmune diseases, and Alzheimer's disease
hypothyroid
results from an underactive thyroid. can be caused by a lack of iodine in the diet.
premenopausal
stage immediately before menopause where physical changes begin to occur
Menopause
the time of natural cessation of menstruation; also refers to the biological changes a woman experiences as her ability to reproduce declines
hyperthyroid
when the body produces too much thyroid hormone. because the excess of thyroid hormone increases the body's metabolism by as much as 60 to 100%. People often feel symptoms associated with being overstimulated.