Reproductive Health Issues

fibrocystic breast changes

thickening of normal breast tissue

etiology of fibrocystic breast changes

imbalance in estrogen and progesterone

s/s fibrocystic breast changes

cyclic pain, tenderness, swelling before period

diagnosis of fibrocystic breast changes

mammography MRI, fine needle aspiration

treatment for fibrocystic breast changes

limit caffeine, decrease sodium, use oral contraceptives

endometriosis

endometrial tissue outside of uterine cavity

endometriosis etiology

unknown, maybe backflow of flow, inflammation, immune defect

endometriosis s/s

pelvic pain usually at period time

diagnosis of endometriosis

laparoscopy

treatment of endometriosis

surgical removal, NSAIDS, oral contraceptives

polycystic ovarian syndrome

ovaries enlarged and contain numerous small cysts along outer edge of ovaries

polycystic ovarian syndrome etiology

unknown

s/s polycystic ovarian syndrome

irregular to absent menses, elevated testosterone and adrogen, obesity, insulin resistance, infertility

diagnosis of polycystic ovarian syndrome

h&p, labs, vaginal US for cysts

treatment of polycystic ovarian syndrome

oral contraceptives, glucophage and spironolactone

toxic shock syndrome

disease of women in reproductive years around menses or postpartum

toxic shock syndrome etiology

toxin released by Staph A

s/s toxic shock syndrome

fever, rash on trunk that resembles sunburn, vomiting, hypotension, inflamed mucus membranes

diagnosis of toxic shock syndrome

elevated BUN, AST, ALT, bili, low platelets

treatment of toxic shock syndrome

hospitalization, IVF for BP, abx

bacterial vaginosis

decrease in normal vaginal flora

bacterial vaginosis etiology

overgrowth of bacteria, douching, sex

s/s bacterial vaginosis

thin, watery, whitish/great fluid with fishy smell

diagnosis of bacterial vaginosis

vaginal pH >4.5, slide prep

treatment of bacterial vaginosis

flagyl, clindamycin cream

vaginal candidiasis

yeast infection

vaginal candidiasis etiology

abx, oral contraceptives, immunosuppressants, diabetes

s/s vaginal candidiasis

thick, curdy vaginal discharge, itching, rash

diagnosis of vaginal candidiasis

vaginal discharge show spores under microscope

treatment of vaginal candidiasis

diflucan, nystatin

trichomoniasis

most common nonviral STI

trichomoniasis etiology

trichomoniasis vaginalis

s/s trichomoniasis

yellow/green discharge, inflammation, itching, dysuria

diagnosis of trichomoniasis

organism on microscope slide

treatment of trichomoniasis

flagyl or no treatment bc risk for preterm labor

trichomoniasis in pregnant women

increase risk for PROM, premature labor, low birth weight

chlamydial infection

most common bacterial STD

chlamydial infection etiology

chlamydia trachomatis

s/s chlamydial infection

thin, purulent discharge, dysuria, low abd pain

diagnosis of chlamydial infection

lab culture

treatment of chlamydial infection

azithromycin

chlamydial infection in pregnant women

can lead to blindness and pneumonia in newborn if not treated (neonatal conjunctivitis)

gonorrhea

STD increasing risk for pelvic inflammatory disease

gonorrhea etiology

bacteria neisseria gonorrhoeae

s/s gonorrhea

purulent, green/yellow discharge, dysuria, vulva swelling

diagnosis of gonorrhea

lab culture

treatment of gonorrhea

rocephin + azithromycin

gonococcal ophthalmia neonatorum

untreated mom leads to blindness in baby

herpes genitalis

HSV1- cold sores

HSV2- genital infection

herpes genitalis etiology

herpes simplex virus

s/s herpes genitalis

single, blister-like vesicle in genital area

diagnosis of herpes genitalis

culture lesion

treatment of herpes genitalis

no cure, acyclovir keeps dormant

pregnant women with active herpes lesion

should not deliver vaginally bc risk of systemic illness and death in baby

syphilis

chronic infection from contact with open wound or congenitally

syphilis etiology

spirochete treponema pallidum

s/s syphilis

chancre then later wart plaque on vulva, fever, weight loss, malaise

diagnosis of syphilis

blood test VDRL or RPR

treatment for syphilis

penicillin

women diagnosed with syphilis while pregnant

baby risk for intra-uterine growth restriction, preterm birth, still birth

human papillomavirus

sexually transmitted, causes cervical cancer

s/s human papillomavirus

genital warts

diagnosis of human papillomavirus

biopsy lesion

treatment for human papillomavirus

cryotherapy, shave excision, acid removal

pelvic inflammatory disease

inflammatory disorder of upper female genitalia, can cause tubal damage and infertility

pelvic inflammatory disease etiology

women w multiple partners, use of IUD, untreated gonorrhea and chlamydia

s/s pelvic inflammatory disease

bilateral, sharp cramping pain, fever, chills, purulent vaginal drainage

diagnosis of pelvic inflammatory disease

cultures, CBC, VDRL, RPR

treatment of pelvic inflammatory disease

multiple abx

lower UTI etiology

E. coli, staph

s/s lower UTI

low grade temp, hematuria, painful urination

upper UTI etiology

proceeded by lower infection

s/s upper UTI

high temp, chills, flank pain

diagnosis of UTI

urine specimen, labs

treatment for UTI

abx, IVF