MDC3 Exam 1 Review
ABCs
• A - airway
• B - breathing
• C – circulation
Uterine Leiomyoma
• Benign, slow growing solid tumors of the muscle layer of the uterus
(fibroids)
• Excessive local growth of smooth muscle tissues
o Growth may be stimulated by estrogen, progesterone,
and growth hormone
Assessment: asymptomatic or symptomatic (heavy prolonged vaginal
bleeding)**
• Assess pelvic pressure, elimination pattern, abdomen size,
dyspareunia, infertility
• Painful menses
• Elimination patterns (due to enlarged fibroid pressing on organs)
• Ask how many pads/tampons used in a day
S/S: Heavy periods or periods that last a long time & abd distention,
urinary frequency
Psychosocial assessment:
• Quality of life from dyspareunia
• Fear that symptoms could be cancerous
• Anxiety
• Significance of loss of uterus for patient and partner if want to
conceive
Diagnostic assessment:
• CBC – iron deficiency anemia from heavy bleeding
• WBC would be normal
• HGB and HCT – low
• Pregnancy test to rule out uterine enlargement
• Transvaginal US – able to see if fibroid is protruding into uterine cavity
• Biopsy: gold standard
Pelvic exam
Planning and Implementation
• Manage bleeding
o Non-surgical management: oral contraceptive**
o Surgical management:
▪ MRI focused ultrasound-heat to tumor
▪ Uterine artery embolization – starves tumor of
circulation allowing it to shrink
, ▪ Myomectomy- laser removal
▪ Hysterectomy
Erectile Dysfunction: causes & treatment
• Common as one ages: reduced blood flow to penis
Causes
Medical causes: change in blood
pressure Non-organic: increased
stressor, illnesses Treatment
• Medications that increase perfusion to penis (PDE- 5 inhibitors)
• Vacuum pump
• Pineal implant
• Managing stress
Education related to treatment for HPV/Cervical Cancer
• Caused by HPV
s/s of cervical cancer:
o heavy bleeding in later stages
o bleeding after sex
o Most of the time
asymptomatic Bleeding
between periods
Preventive screening: PAP smear, surgical biopsy (gold standard) to
determine staging
Treatment:
• Early- ablation, laser
• Late- chemotherapy/radiation
Education:
• No sticking anything up the vagina (tampons, douches)
• May have bleeding
• No sexual intercourse
• No tub baths
Breast cancer- preventative screenings, risk factors, diagnostic tests
Preventative screenings
• Mammography
o Recommended to start screening at 45
o Women over 55 may switch to every 2 years
• Breast self-awareness/self-examinations
o >90% detected by patient
• Clinical breast clinical
, o At least every 3 years for women in their 20s and 30s and
every year for asymptomatic women at least 40 years old
Risk
Factors
• Increased age
• Family history
• Early menarche, late menopause
• Lack of breastfeeding
• Postmenopausal obesity
• Alcohol consumption
• Mutations in BRCA1 or BRCA2
Diagnostic tests
• Lab assessment: study of breast mass tissue and lymph nodes, liver
enzymes, calcium, and alkaline phosphatase
• Imaging assessment:
o Mammogram
o Ultrasound
o MRI
o Chest x-ray, CT for metastasis
o Breast biopsy*
Endometrial cancer- symptoms, risk factors, diagnostic testing
• Most common gynecologic malignancy
• Cancer of inner uterine lining
• Grows slowly but vaginal bleeding usually leads to prompt
evaluation and treatment = good prognosis
• Most commonly associated with prolonged exposure to estrogen
without its protective effects of progesterone
Risk Factors:
• Women in reproductive years
• Family History
• Diabetes Mellitus
• HTN
• Obesity
• Uterine polyps
• Late menopause
• Nulliparity (no childbirths)
• Smoking
• Tamoxifen – given for breast cancer
Symptoms:
ABCs
• A - airway
• B - breathing
• C – circulation
Uterine Leiomyoma
• Benign, slow growing solid tumors of the muscle layer of the uterus
(fibroids)
• Excessive local growth of smooth muscle tissues
o Growth may be stimulated by estrogen, progesterone,
and growth hormone
Assessment: asymptomatic or symptomatic (heavy prolonged vaginal
bleeding)**
• Assess pelvic pressure, elimination pattern, abdomen size,
dyspareunia, infertility
• Painful menses
• Elimination patterns (due to enlarged fibroid pressing on organs)
• Ask how many pads/tampons used in a day
S/S: Heavy periods or periods that last a long time & abd distention,
urinary frequency
Psychosocial assessment:
• Quality of life from dyspareunia
• Fear that symptoms could be cancerous
• Anxiety
• Significance of loss of uterus for patient and partner if want to
conceive
Diagnostic assessment:
• CBC – iron deficiency anemia from heavy bleeding
• WBC would be normal
• HGB and HCT – low
• Pregnancy test to rule out uterine enlargement
• Transvaginal US – able to see if fibroid is protruding into uterine cavity
• Biopsy: gold standard
Pelvic exam
Planning and Implementation
• Manage bleeding
o Non-surgical management: oral contraceptive**
o Surgical management:
▪ MRI focused ultrasound-heat to tumor
▪ Uterine artery embolization – starves tumor of
circulation allowing it to shrink
, ▪ Myomectomy- laser removal
▪ Hysterectomy
Erectile Dysfunction: causes & treatment
• Common as one ages: reduced blood flow to penis
Causes
Medical causes: change in blood
pressure Non-organic: increased
stressor, illnesses Treatment
• Medications that increase perfusion to penis (PDE- 5 inhibitors)
• Vacuum pump
• Pineal implant
• Managing stress
Education related to treatment for HPV/Cervical Cancer
• Caused by HPV
s/s of cervical cancer:
o heavy bleeding in later stages
o bleeding after sex
o Most of the time
asymptomatic Bleeding
between periods
Preventive screening: PAP smear, surgical biopsy (gold standard) to
determine staging
Treatment:
• Early- ablation, laser
• Late- chemotherapy/radiation
Education:
• No sticking anything up the vagina (tampons, douches)
• May have bleeding
• No sexual intercourse
• No tub baths
Breast cancer- preventative screenings, risk factors, diagnostic tests
Preventative screenings
• Mammography
o Recommended to start screening at 45
o Women over 55 may switch to every 2 years
• Breast self-awareness/self-examinations
o >90% detected by patient
• Clinical breast clinical
, o At least every 3 years for women in their 20s and 30s and
every year for asymptomatic women at least 40 years old
Risk
Factors
• Increased age
• Family history
• Early menarche, late menopause
• Lack of breastfeeding
• Postmenopausal obesity
• Alcohol consumption
• Mutations in BRCA1 or BRCA2
Diagnostic tests
• Lab assessment: study of breast mass tissue and lymph nodes, liver
enzymes, calcium, and alkaline phosphatase
• Imaging assessment:
o Mammogram
o Ultrasound
o MRI
o Chest x-ray, CT for metastasis
o Breast biopsy*
Endometrial cancer- symptoms, risk factors, diagnostic testing
• Most common gynecologic malignancy
• Cancer of inner uterine lining
• Grows slowly but vaginal bleeding usually leads to prompt
evaluation and treatment = good prognosis
• Most commonly associated with prolonged exposure to estrogen
without its protective effects of progesterone
Risk Factors:
• Women in reproductive years
• Family History
• Diabetes Mellitus
• HTN
• Obesity
• Uterine polyps
• Late menopause
• Nulliparity (no childbirths)
• Smoking
• Tamoxifen – given for breast cancer
Symptoms:
