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Gender Healthcare Comprehensive Final Exam

Terms in this set (156)

What condition is menstrual periods that are accompanied by either sharp intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen?
Dysmenorrhea
What term is when excessive heavy blood loss occurs?
Menorrhagia
What percent of menstruating women are affected by Dysmenorrhea?
50%
What percent of women affected by Dysmenorrhea are incapacitated for up to 3 days?
10%
Incidence of Dysmenorrhea is greatest in the late _____ and _____, then declines with age.
Late Teens and 20s
Some Dysmenorrhea patients experience menstrual pain in late ____ and ____ as endocrine system prepares for menopause
Late 30s and 40s
What type of dysmenorrhea is described as: Menstrual pain that occurs in otherwise healthy women and this pain is not related to any specific problems with uterus or other pelvic organs?
Primary Dysmennorhea
What type of dysmenorrhea is described as: menstrual pain attributed to underlying disease process or structural abnormality either within or outside the uterus and examples include endometriosis, pelvic inflammatory disease, adhesions, adenomyosis, retroverted uterus?
Secondary Dysmenorrhea
What are the 3 risk factors for primary Dysmenorrhea?
1. Obesity
2. Cigarette Smoking
3. Positive Family History
What are the 3 risk factors for secondary dysmenorrhea?
1. Pelvic Infection
2. STD
3. Endometriosis
What substance is a major factor in the pathophysiology of primary dysmenorrhea?
Prostaglandin F2a
Increased levels of Prostaglandin F2a in primary dysmenorrhea leads to an increase in what 3 things?
1. Uterine Contractions
2. Ischemia
3. Pain
Prostaglandin F2a is a potent stimulator of the smooth muscle of the GI tract leading to what 3 symptoms?
1. Nausea
2. Vomiting
3. Diarrhea
What are the 2 symptoms for Primary Dysmenorrhea?
1. Cramping before bleeding begins
2. Pain located in suprapubic area radiating through back
To decrease discomfort of primary dysmenorrhea, a patient can do what?
Lay in fetal position and use heating pad or hot water bottle
What are normal menstruation uterine contraction levels?
50-80 mmHg
What is the normal menstruation uterine contraction duration?
15-30 seconds
What is the normal menstruation uterine contraction frequency?
1-4/10 minutes
What is the normal menstruation uterine contraction resting pressure?
5-15 mmHg
What are Primary Dysmenorrhea contraction levels?
400 mmHg
What is the Primary Dysmenorrhea contraction duration?
Greater than 90 seconds
What is the Primary Dysmenorrhea contraction frequency?
Every 15 seconds
What is the Primary Dysmenorrhea contraction resting pressure?
80-100 mmHg
What are the 5 treatments for Primary Dysmenorrhea?
1. Drugs to inhibit prostaglandin production
2. Oral Contraceptives
3. Zinc Dosage
4. Physical Therapy
5. TENS
What type of drugs are taken to inhibit prostaglandin production for patients with primary dysmenorrhea?
NSAIDS (Naproxen, Ibuprofen)
How do oral contraceptives help treat primary dysmenorrhea?
Supresses ovulation causing shorter, lighter, and less cramping during menstruation
What dosage of zinc should be taken for patients with primary dysmenorrhea?
30 mg, 1-3 times per day
What 4 PT interventions should be performed for patients with primary dysmenorrhea?
1. Stretching
2. Jogging
3. Pelvic Floor Strengthening
4. Diaphragmatic Breathing
What are the 3 electrode placement options for TENS usage for Dysmenorrhea?
1. Crossed pattern over abdomen
2. Crossed pattern over low back
3. One pair on abdomen and one pair on back
What are the 6 possible intrauterine causes of Secondary Dysmenorrhea?
1. Adenomyosis
2. Myomas (uterine fibroid)
3 Polyps
4. Intrauterine contraceptive device
5. Infection
6. Benign disease of vagina and cervix
What are the 7 possible extrauterine causes of Secondary Dysmenorrhea?
1. Endometriosis
2. Tumors
3. Inflammation
4. Adhesions
5. Psychogenic
6. "Pelvic congestive syndrome"
7. Non-gynecological cause
What are 4 drugs that may be useful for patients with Secondary Dysmenorrhea?
1. NSAIDs
2. Hormonal Contraception
3. Progestional Agents
4. GnRH agonists
What are the 2 functions of the testicles?
1. Produce sperm
2. Secrete several male hormones
____% of testicular tumors develop in germ cells.
90%
What is the average age of diagnosis of testicular cancer?
33 years old
Testicular cancer affects 1 of every ______ males.
1 of every 263
1 in ________ will die of testicular cancer.
5000
What are the 2 major types of tumors that develop in germ cells?
1. Seminoma
2. Non-Seminoma
What are the 6 risk factors for developing Testicular Cancer?
1. Age
2. Undescended or late-descended testes
3. Family history
4. HIV infection
5. Cancer in other testicle
6. Race and ethnicity
What are the 8 signs/symptoms of testicular cancer?
1. Small, painless lump in a testicle
2. Change in size of testicle
3. Feeling of heaviness in the testicle or groin
4. Pain in the testicle
5. Pain in the low back, abdomen or groin
6. A change in the way the testicle feels
7. Enlarged male breasts and nipples
8. Blood or fluid suddenly accumulating in the scrotum
What is the relative survival rate for Stage 1 of Testicular Cancer?
99%
What is the relative survival rate for Stage 2 of Testicular Cancer?
96%
What is the relative survival rate for Stage 3 of Testicular Cancer?
73%
What are the 6 methods for testicular cancer diagnosis?
1. Self-examination
2. History & Physical
3. Ultrasound
4. Blood test
5. Surgery
6. CT and/or MRI
What does the acronym TNMS stand for in the staging of testicular cancer?
T: If primary TUMOR has spread to tissue next to testicle
N: If cancer has spread to lymph NODES nearby
M: Whether cancer has METASTASIZED
S: SERUM blood levels of tumor marks
What are the 4 treatments of Testicular Cancer?
1. Surgery
2. Surveillance
3. Chemotherapy
4. Radiation Therapy
T/F: It is abnormal for one testicle to be a little bit bigger than the other testicle.
False, this is normal
Testicular Self-Examinations should be performed monthly for any male _____ years old or older.
15 years old or older
T/F: The US Preventative Task Force recommends against screening for testicular cancer in adolescent or adult males.
True
The Female Athlete Triad consists of what 3 disorders?
1. Disordered Eating
2. Menstrual Dysfunction
3. Osteoporosis
What are the 2 conditions of disordered eating in the female athlete triad?
1. Anorexia
2. Bulimia
What are the 2 conditions of menstrual dysfunction in the female athlete triad?
1. Delayed Menarche
2. Absence of Menstrual Cycle
What are 3 risk factors for the Female Athlete Triad?
1. Dieting at young age
2. Pressure to excel at sport
3. Achieving "ideal" body weight/composition
What are the 9 warning signs of Disordered Eating?
1. Dramatic loss of weight
2. Preoccupation with food
3. Baggy clothing
4. Excessive exercise
5. Mood swings
6. Avoiding food related activity or refusing to eat with other people
7. Frequent comments about weight
8. Criticism of others eating habits
9. Highly self critical
What are the 4 side effects to disordered eating?
1. Morbidity due to fluid/electrolyte losses
2. Chronic health problems
3. Psychological problems
4. Death
What are the 4 possible reasons for eating disorders?
1. Fear of fatness
2. Peer or social pressure
3. Concern with performance
4. Athletes think disordered eating patterns are harmless
What term is the onset of menses?
Menarche
What term is normal menses, typically 28-30 days?
Eumenorrhea
What term is irregular or infrequent menses, less than 6 menses per year?
Oligomenorrhea
What term is the absence of menses?
Amenorrhea
_____________ Amenorrhea occurs when the female's menses has not begun by age 16.
Primary Amenorrhea
_____________________ Amenorrhea occurs when the female's menses begins, but then ceases.
Secondary Amenorrhea
What are the two types of Amenorrhea?
1. Anatomic Amenorrhea
2. Hypothalamic Amenorrhea
What type of Amenorrhea is caused by trauma, pathologies, or surgery?
Anatomic Amenorrhea
What type of Amenorrhea is caused by functional abnormalities in the neural mechanisms regulating secretion of GnRH and is reversible?
Hypothalamic Amenorrhea
Amenorrhea is defined by more than ____ months since last menstrual period, less than _____ menstrual periods per year, and no more than 1 menstrual period during the previous _____ months.
6 months; 3 periods; 10 months
T/F: Menstruation stops when body fat is optimal.
False
T/F: Amenorrhea is a form of birth control.
False
T/F: Amenorrhea is a normal consequence of training
False
What are the 3 side-effects of Amenorrhea?
1. Low Estrogen
2. Infertility
3. Loss of Bone Density
T/F: Amenorrhea causes increased cholesterol and triglycerides.
True
Estrogen is ____________ for immune function and cortisol is ___________ for immune function
Positive; Negative;
Estrogen _____________ the rate of resorption of bone.
Decreases
Chronically low levels of ___________ & ________________ will result in bone loss.
Estrogen & Progesterone
What is the treatment for disordered eating?
Individualized, long-term, multidisciplinary approach
What is the treatment for Amenorrhea?
1. Reduce training to reduce energy expenditure
2. Increase caloric intake
What are the 2 treatments for Osteoporosis?
1. Oral Contraceptives
2. Hormone Replacement Therapy
What are the 3 functions of the pelvis?
1. Holds the contents of the pelvis
2. Allows weight transfer from the trunk to the lower extremities
3. Protection of the female reproductive organs and fetus
What 5 anatomic structures are contained in the female pelvis?
1. Bladder
2. Urethra
3. Uterus
4. Vagina
5. Rectum
What 4 anatomic structures are contained in the male pelvis?
1. Bladder
2. Urethra
3. Prostate
4. Rectum
The length of the male urethra is ___-___ cm.
15-20 cm
The length of the female urethra is ___cm.
4 cm
The internal sphincter of the rectum is made up of _______________ muscle.
Smooth muscle
The external sphincter of the rectum is made up of _______________ muscle.
Striated muscle
The pelvic diaphragm technically only consists of what 2 muscles?
1. Levator Ani
2. Coccygeus
The Levator Ani contains what 3 muscles?
1. Pubococcygeus
2. Puborectalis
3. Iliococcygeus
What are the 3 functions of the pelvic floor?
1. Support
2. Sphincteric Control
3. Sexuality
If the pelvic floor is too mobile, what can occur?
Prolapse
If the pelvic floor is too fixated or stable, what can occur?
Pain
What organ is located below the bladder and in front of the rectum, and produces fluid that makes up part of semen?
Prostate Gland
What is the name for non-cancerous abnormal enlargement of the prostate gland?
Benign Prostatic Hyperplasia
_____% of men 50 years or older experience symptoms of BPH.
75%
An estimated 1 in _____ will require treatment by age ____ for BPH.
1 in 4; age 80
What are the 5 symptoms of Obstructive BPH?
1. Slow start of the stream
2. Straining
3. Decreased force of urine stream
4. Urinary retention
5. Dribbling after urinating
What are the 7 symptoms of Irritative BPH?
1. Nocturia
2. Frequency
3. Urgency
4. Sensation of incomplete voiding
5. Strong and sudden urge
6. Urinary Incontinence
7. Hematuria or Hemaspermia
What are the 5 diagnostic tools for diagnosing Benign Prostate Hyperplasia?
1. Digital rectal exam
2. Prostate-Specific Antigen (PSA)
3. Post-void residual volume test
4. Cystoscopy
5. Ultrasound
What are the 4 treatment options for BPH?
1. Behavioral Therapy
2. Medications
3. Minimally Invasive Procedures
4. Surgery
1 in _____ men die of prostate cancer.
1 in 39
1 in _____ men will be diagnosed with prostate cancer in their lifetime.
1 in 7
The average age of prostate cancer diagnosis is _____ years old.
66 years old
What are the 5 risk factors of Prostate Cancer?
1. Age
2. Race
3. Diet
4. Smoking
5. Family History
What ethnicity has the highest incidence of prostate cancer?
African American
What 2 ethnicities have the lowest incidence of prostate cancer?
Asian and Native American
What is the 5 year survival rate for prostate cancer?
100%
What is the 10 year survival rate for prostate cancer?
98%
What is the 15 year survival rate for prostate cancer?
95%
What is the survival rate for Stages I-III prostate cancer?
Nearly 100%
What is the survival rate for Stage IV prostate cancer?
28%
What are the 3 diagnostic tools for prostate cancer?
1. Digital Rectal Exam (DRE)
2. Prostate-specific Antigen
3. Biopsy
Chronic pelvic pain accounts for ____% of all out-patient gynecologic visits.
10%
A Gleason prostate cancer biopsy score of 2-4 means what?
Low chance of spreading
A Gleason prostate cancer biopsy score of 5-6 means what?
Intermediate chance of spreading
A Gleason prostate cancer biopsy score of 7-10 means what?
High chance of spreading
What are the 5 pain characteristics of pelvic pain?
1. Burning
2. Stabbing
3. Cramping
4. Aching
5. Pressure
Both men and women complain of what 3 issues in chronic pelvic pain?
1. Bladder
2. Bowel
3. Sexual
What pelvic condition presents as pain, pressure or discomfort in the rectum, sacrum and coccyx and may have pain in the gluteal region and thighs?
Levator Ani Syndrome
What pelvic condition presents with pain in the absence of organic disease localized to the vagina or lower pelvis with penetration or thrusting?
Dyspareunia
What pelvic condition is the inability to penetrate the vagina - patient reports, "something blocking the entrance" or "tight spot"?
Vaginismus
What muscle is often in spasm with Vaginismus?
Bulbocavernosus
What pelvic condition presents as vulvar discomfort characterized by burning, stinging, irritation or rawness lasting longer than 6 months with no infection or skin disease?
Vulvodynia
What pelvic condition is the hypertonicity of the pelvic floor that affects women in their childbearing years and causes pain on palpation of the vulvar tissue or vaginal entry?
Vulvar Vestibulitis
What pelvic condition is a painful spasm of the external anal sphincter and is a sharp fleeting rectal pain that last from seconds to 20-30 minutes?
Proctalgia Fugax
What pelvic condition is a sharp knife-like pain in the coccyx region when sitting or rising from a chair and occurs in patients with history of trauma?
Coccydynia
What pelvic condition is the constant unprovoked burning, itching, dryness, dyspareunia, and feels "Vice-like"?
Pudendal Neuralgia
What pelvic condition is the chronic and severe inflammation of the bladder wall?
Interstitial Cystitis (Painful Bladder Syndrome)
What are the 7 possible physical therapy treatments for pelvic pain?
1. Joint Alignment
2. Muscular Re-Education
3. Functional Training
4. Modalities
5. Soft Tissue Mobilization
6. Visceral Mobilization
7. Trigger Point Therapy
What are the 7 effects chronic illness/disabilities has on sexuality?
1. Changes in self-image and self-concept
2. Changes in roles and relationships
3. Feelings of sadness, anger or frustration
4. Decreased sexual desire
5. Decreased interest in sex
6. Decreased opportunities for sexual contact and relationships
7. Societal views
What are the 6 female myocardial infarction symptoms?
1. Pain under sternum
2. Abdominal pain
3. Indigestion
4. Difficulty breathing
5. Nausea
6. Unexplained fatigue
What disease is the #1 killer of women?
Heart Disease
What ethnicity of women develop heart disease 10 years earlier than Caucasian women?
Hispanic Women
What ethnicity is heart disease the leading cause of death?
African American Women
T/F: Both men and women have the same size hearts and arteries.
False, women have both smaller hearts and arteries
T/F: Heart disease diagnostic procedures are not accurate in women.
True
What type of drugs tend to be more effective in women than men for heart disease?
Clot-Busting Drugs
What are the 6 heart disease prevention steps?
1. Exercise 30-60 minutes/day
2. Maintain healthy weight
3. Quit Smoking
4. Diet Low in Saturated Fat, Cholesterol, and Salt
5. Closely manage BP, cholesterol levels, and diabetes
6. Consume Omega-3 Fatty Acids
What condition is the 2nd most common ailment affecting the musculoskeletal system?
Fibromyalgia
What are the 5 possible causes of fibromyalgia?
1. Genetics
2. Physical or emotional trauma
3. Abnormal pain response
4. Sleep disturbances
5. Infectious microbe
What are the diagnosis criteria for fibromyalgia?
3 month history of pain in 11 of 18 sites on right/left side and above/below waist
What are the 6 pain symptoms of fibromyalgia?
1. Tender points in neck, shoulders, sternum, low back, hips, shins, elbows, and knees
2. Deep-aching, radiating, gnawing, shooting or burning
3. Ranges from mild to severe
4. Achiness around joints
5. Wake up with body aches and stiffness
6. Pain can increase with activity, cold or damp weather, anxiety, and stress
What is the prognosis for fibromyalgia?
Chronic, symptoms may improve but other times, can get worse for months or years
What are 6 possible treatments for fibromyalgia?
1. Physical Therapy
2. Cognitive-Behavioral Therapy
3. Support Groups
4. Dietary Changes
5. Medications
6. Alternative Medicine
What term is the cessation of menstruation as the result of the loss of ovarian function and 12 months of amenorrhea elapses?
Menopause
What is the average age of menopause occurring in women of the Western World?
51.5 years old; Range: 40-58 years old
What factors affect the onset of menopause?
1. What age did your mom experience menopause?
2. Do you smoke?
3. Have you ever had chemo?
4. Have you had ovarian surgery?
5. What is your ethnicity?
What stage of menopause refers to the reproductive years?
Premenopause
What stage of menopause occurs about or around menopause?
Perimenopause
What stage of menopause lasts around 4 years at the average age of 47.5 y.o. and variation in menstrual cycle length occurs?
Menopausal Transition
What stage of menopause is the permanent change in hormones and rapid bone loss occurring over the first 4 year time span?
Postmenopause
What are the 6 signs and symptoms of menopause?
1. Severe Vasomotor Instability
2. Emotional Changes
3. Sleep Disturbances
4. Urogenital Atrophy/Atrophic Vaginitis
5. Recurring Vaginal/Urinary Infections
6. Osteoporosis
What term is the benign, distal urethral lesions occurring near the external urethral opening?
Urethral Caruncle
What are the 4 benefits of Hormone Replacement Therapy in Menopausal women?
1. Maintain bone density
2. Maintain size and flexibility of the vagina and urogenital tract
3. Controls menopausal symptoms
4. Reduce risk of Alzheimer's Disease
What term is the pattern of violence and/or coercive behaviors used by one person to maintain power and control over another person?
Intimate Partner Violence
What are the 9 risk factors for Intimate Partner Violence?
1. Young age
2. Low income
3. Low academic achievement
4. Involvement in delinquent adolescent behavior
5. Witnessing mother's abuse or being abused as a child
6. Growing up in an impoverished family
7. Excessive alcohol use
8. Personality factors
9. Cultural
For intimate partner violence, the guidelines for ER physicians acronym RADAR stands for what?
R: Routinely screen all females aged 14 and older
A: Ask direct, kind, nonjudgmental questions
D: Document findings
A: Assess patient's safety
R: Review options and provide referrals
For intimate partner violence, the validated screening tool acronym HITS stands for what?
H: Hurt?
I: Insulted?
T: Threatened?
S: Screamed At?
When documenting intimate partner violence, what word should you never use?
Alleged--> Allegation-->Alleges
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