Obstetric Emergencies, Gynecologic Cancers, Intimate Partner Violence, and Breast Disorders

Comprehensive vocabulary flashcards covering shoulder dystocia management, cancers of the female reproductive tract, intimate partner violence assessment, and benign/malignant breast disorders.

Shoulder Dystocia

An obstetric emergency where the fetal shoulder (typically the anterior shoulder) fails to deliver following the emergence of the head, occurring in $0.6\%-1.4\%$ of vaginal deliveries with a $16\%$ recurrence risk.

HELPERR Mnemonic

A clinical mnemonic for shoulder dystocia management: Help, Episiotomy, Legs (McRoberts), Pressure (suprapubic), Enter (rotational maneuvers), Remove posterior arm, Roll (hands and knees).

McRoberts Maneuver

A position for shoulder dystocia management involving hyperflexion and abduction of the maternal legs toward the chest.

Suprapubic Pressure

Downward and lateral pressure applied by an assistant above the pubic bone to dislodge an anterior shoulder in shoulder dystocia.

Rubin's Maneuver

A rotational maneuver for shoulder dystocia performed by placing a hand behind the anterior shoulder and rotating toward the midline (toward the infant's nose) with suprapubic pressure.

Modified Woods Screw Maneuver

A rotational maneuver for shoulder dystocia performed by placing a hand behind the posterior shoulder and rotating toward the midline to release the anterior shoulder.

Delivery of Posterior Shoulder

A maneuver for shoulder dystocia executed by placing a hand along the posterior elbow and sweeping to the midline to deliver the hand and arm.

Gaskins Maneuver

A position change for shoulder dystocia management where the patient is rolled into a hands-and-knees (all-fours) position.

Symphysiotomy

A surgical intervention for refractory shoulder dystocia where local anesthetic is injected and the upper-to-middle and upper third of the pubic ligament are incised to expand the pelvis.

Zavanelli Maneuver

A rescue procedure for failed shoulder dystocia maneuvers involving replacement of the fetal head back into the uterus followed by emergent cesarean section.

Ovarian Cancer

A gynecologic malignancy known as an overlooked disease and silent killer because it is often diagnosed late due to vague early symptoms, after metastasis.

BRCA1 / BRCA2 Mutations

Genetic mutations that increase the risk of developing breast cancer ($80\%$) and ovarian cancer ($40\%$).

CA-125

A serum tumor marker that is elevated in ovarian cancer and other malignancies.

Total Abdominal Hysterectomy (TAH)

Surgical removal of the uterus and cervix.

Bilateral Salpingo-Oophorectomy (BSO)

Surgical removal of both fallopian tubes and both ovaries.

Endometrial Cancer

The most common gynecologic cancer in the U.S., usually diagnosed early, where postmenopausal bleeding serves as a key red flag.

Transvaginal Ultrasound

A diagnostic imaging technique for endometrial cancer where an endometrial thickness measurement of $<4\,\text{mm}$ indicates low risk.

Cervical Cancer

A highly preventable gynecologic cancer caused primarily by HPV types 16 and 18, presenting key symptoms like abnormal post-coital vaginal bleeding, and screened via Pap smear starting at age 21.

Gardasil 9

An HPV vaccine used for the primary prevention of cervical cancer and other HPV-related lesions.

Vaginal Cancer

A rare gynecologic cancer ($1\%-2\%$ of gynecologic malignancies) that is usually metastatic, most commonly squamous cell carcinoma, and linked to HPV in $\sim 75\%$ of cases.

Vulvar Cancer

A rare but aggressive gynecologic malignancy often presenting as a visible lesion with persistent pruritus, lump, bleeding, or pain.

Intimate Partner Violence (IPV)

Threatened or actual physical or sexual violence, or psychological/emotional abuse between intimate partners, occurring across all demographics.

Cycle of Violence

A pattern of intimate partner violence consisting of four repeating phases: Tension Building, Physically Abusive incident, Reconciliation, and Period of Calm.

Trauma-Informed Care (TIC)

An approach to nursing care for patients with abuse histories that includes asking permission before touching, explaining each step, keeping the patient clothed until needed, and moving at the patient's pace.

Fibrocystic Breast Changes

A benign noncancerous breast condition causing cyclic pain, tenderness, and lumpy breast tissue that worsens prior to menses.

Fibroadenoma

A benign, hormone-sensitive breast tumor that is smooth, firm, rubbery, mobile, non-cyclic, and increases in size during pregnancy.

Invasive Ductal Carcinoma (IDC)

The most common type of malignant breast cancer, originating in the milk ducts, which may metastasize.

Tamoxifen

A hormonal therapy medication for breast cancer that carries elevated risks of endometrial cancer and deep vein thrombosis (DVT).

Aromatase Inhibitors

A class of hormonal therapy drugs used in breast cancer treatment whose adverse risk includes osteoporosis.