MDC3 dExam d1 dReview dWITH dNCLEX dQUESTIONS d& dEXTRA dNOTES
ABCs
• A d- dairway
• B d- dbreathing
• C d– dcirculation
Uterine dLeiomyoma
• Benign, dslow dgrowing dsolid dtumors dof dthe dmuscle dlayer dof dthe
duterus d(fibroids)
• Excessive dlocal dgrowth dof dsmooth dmuscle dtissues
o d Growth dmay dbe dstimulated dby destrogen, dprogesterone, dand
dgrowth d hormone
Assessment: dasymptomatic dor dsymptomatic d(heavy dprolonged dvaginal
dbleeding)**
• Assess dpelvic dpressure, delimination dpattern, dabdomen dsize,
ddyspareunia, d infertility
• Painful dmenses
• Elimination dpatterns d(due dto denlarged dfibroid dpressing don dorgans)
• Ask dhow dmany dpads/tampons dused din da dday
S/S: dHeavy dperiods dor dperiods dthat dlast da dlong dtime d& dabd
ddistention, durinary d dfrequency
Psychosocial dassessment:
• Quality dof dlife dfrom ddyspareunia
• Fear dthat dsymptoms dcould dbe dcancerous
• Anxiety
• Significance dof dloss dof duterus dfor dpatient dand dpartner dif dwant
dto dconceive
Diagnostic dassessment:
• CBC d– diron ddeficiency danemia dfrom dheavy dbleeding
• WBC dwould dbe dnormal
• HGB dand dHCT d– dlow
• Pregnancy dtest dto drule dout duterine denlargement
• Transvaginal dUS d– dable dto dsee dif dfibroid dis dprotruding dinto duterine
dcavity
• Biopsy: dgold dstandard
Pelvic dexam
Planning dand dImplementation
• Manage dbleeding
o Non-surgical dmanagement: doral dcontraceptive**
o Surgical dmanagement:
MRI dfocused dultrasound-heat dto dtumor
Uterine dartery dembolization d– dstarves dtumor dof
dcirculation d allowing dit dto dshrink
, Myomectomy- dlaser dremoval
Hysterectomy
Erectile dDysfunction: dcauses d& dtreatment
• Common das done dages: dreduced dblood dflow dto dpenis
Causes
Medical dcauses: dchange din dblood
dpressure d Non-organic: dincreased
dstressor, dillnesses d Treatment
• Medications dthat dincrease dperfusion dto dpenis d(PDE- d5 dinhibitors)
• Vacuum dpump
• Pineal dimplant
• Managing dstress
Education drelated dto dtreatment dfor dHPV/Cervical dCancer
• Caused dby dHPV
s/s dof dcervical dcancer:
o heavy dbleeding din dlater dstages
o bleeding dafter dsex
o Most dof dthe dtime
dasymptomatic d Bleeding
dbetween dperiods
Preventive dscreening: dPAP dsmear, dsurgical dbiopsy d(gold dstandard) dto
ddetermine d staging
Treatment:
• Early- dablation, dlaser
• Late- dchemotherapy/radiation
Education:
• No dsticking danything dup dthe dvagina d(tampons,
ddouches)
• May dhave dbleeding
• No dsexual dintercourse
• No dtub dbaths
Breast dcancer- dpreventative dscreenings, drisk dfactors, ddiagnostic dtests
Preventative dscreenings
• Mammography
o Recommended dto dstart dscreening dat d45
o Women dover d55 dmay dswitch dto devery d2 dyears
• Breast dself-awareness/self-examinations
o d>90% ddetected dby dpatient
• Clinical dbreast dclinical
, o At dleast devery d3 dyears dfor dwomen din dtheir d20s dand d30s
dand devery dyear dfor d asymptomatic dwomen dat dleast d40 dyears
Risk dold
dFactors
• Increased dage
• Family dhistory
• Early dmenarche, dlate dmenopause
• Lack dof dbreastfeeding
• Postmenopausal dobesity
• Alcohol dconsumption
• Mutations din dBRCA1 dor dBRCA2
Diagnostic dtests
• Lab dassessment: dstudy dof dbreast dmass dtissue dand dlymph dnodes,
dliver denzymes, d calcium, dand dalkaline dphosphatase
• Imaging dassessment:
o Mammogram
d o dUltrasound
d d o dMRI
o Chest dx-ray, dCT dfor dmetastasis
o Breast dbiopsy*
Endometrial dcancer- dsymptoms, drisk dfactors, ddiagnostic dtesting
• Most dcommon dgynecologic dmalignancy
• Cancer dof dinner duterine dlining
• Grows dslowly dbut dvaginal dbleeding dusually dleads dto dprompt
devaluation dand d dtreatment d= dgood dprognosis
• Most dcommonly dassociated dwith dprolonged dexposure dto destrogen
dwithout dits d protective deffects dof dprogesterone
Risk dFactors:
• Women din dreproductive dyears
• Family dHistory
• Diabetes dMellitus
• HTN
• Obesity
• Uterine dpolyps
• Late dmenopause
• Nulliparity d(no dchildbirths)
• Smoking
• Tamoxifen d– dgiven dfor dbreast dcancer
Symptoms:
ABCs
• A d- dairway
• B d- dbreathing
• C d– dcirculation
Uterine dLeiomyoma
• Benign, dslow dgrowing dsolid dtumors dof dthe dmuscle dlayer dof dthe
duterus d(fibroids)
• Excessive dlocal dgrowth dof dsmooth dmuscle dtissues
o d Growth dmay dbe dstimulated dby destrogen, dprogesterone, dand
dgrowth d hormone
Assessment: dasymptomatic dor dsymptomatic d(heavy dprolonged dvaginal
dbleeding)**
• Assess dpelvic dpressure, delimination dpattern, dabdomen dsize,
ddyspareunia, d infertility
• Painful dmenses
• Elimination dpatterns d(due dto denlarged dfibroid dpressing don dorgans)
• Ask dhow dmany dpads/tampons dused din da dday
S/S: dHeavy dperiods dor dperiods dthat dlast da dlong dtime d& dabd
ddistention, durinary d dfrequency
Psychosocial dassessment:
• Quality dof dlife dfrom ddyspareunia
• Fear dthat dsymptoms dcould dbe dcancerous
• Anxiety
• Significance dof dloss dof duterus dfor dpatient dand dpartner dif dwant
dto dconceive
Diagnostic dassessment:
• CBC d– diron ddeficiency danemia dfrom dheavy dbleeding
• WBC dwould dbe dnormal
• HGB dand dHCT d– dlow
• Pregnancy dtest dto drule dout duterine denlargement
• Transvaginal dUS d– dable dto dsee dif dfibroid dis dprotruding dinto duterine
dcavity
• Biopsy: dgold dstandard
Pelvic dexam
Planning dand dImplementation
• Manage dbleeding
o Non-surgical dmanagement: doral dcontraceptive**
o Surgical dmanagement:
MRI dfocused dultrasound-heat dto dtumor
Uterine dartery dembolization d– dstarves dtumor dof
dcirculation d allowing dit dto dshrink
, Myomectomy- dlaser dremoval
Hysterectomy
Erectile dDysfunction: dcauses d& dtreatment
• Common das done dages: dreduced dblood dflow dto dpenis
Causes
Medical dcauses: dchange din dblood
dpressure d Non-organic: dincreased
dstressor, dillnesses d Treatment
• Medications dthat dincrease dperfusion dto dpenis d(PDE- d5 dinhibitors)
• Vacuum dpump
• Pineal dimplant
• Managing dstress
Education drelated dto dtreatment dfor dHPV/Cervical dCancer
• Caused dby dHPV
s/s dof dcervical dcancer:
o heavy dbleeding din dlater dstages
o bleeding dafter dsex
o Most dof dthe dtime
dasymptomatic d Bleeding
dbetween dperiods
Preventive dscreening: dPAP dsmear, dsurgical dbiopsy d(gold dstandard) dto
ddetermine d staging
Treatment:
• Early- dablation, dlaser
• Late- dchemotherapy/radiation
Education:
• No dsticking danything dup dthe dvagina d(tampons,
ddouches)
• May dhave dbleeding
• No dsexual dintercourse
• No dtub dbaths
Breast dcancer- dpreventative dscreenings, drisk dfactors, ddiagnostic dtests
Preventative dscreenings
• Mammography
o Recommended dto dstart dscreening dat d45
o Women dover d55 dmay dswitch dto devery d2 dyears
• Breast dself-awareness/self-examinations
o d>90% ddetected dby dpatient
• Clinical dbreast dclinical
, o At dleast devery d3 dyears dfor dwomen din dtheir d20s dand d30s
dand devery dyear dfor d asymptomatic dwomen dat dleast d40 dyears
Risk dold
dFactors
• Increased dage
• Family dhistory
• Early dmenarche, dlate dmenopause
• Lack dof dbreastfeeding
• Postmenopausal dobesity
• Alcohol dconsumption
• Mutations din dBRCA1 dor dBRCA2
Diagnostic dtests
• Lab dassessment: dstudy dof dbreast dmass dtissue dand dlymph dnodes,
dliver denzymes, d calcium, dand dalkaline dphosphatase
• Imaging dassessment:
o Mammogram
d o dUltrasound
d d o dMRI
o Chest dx-ray, dCT dfor dmetastasis
o Breast dbiopsy*
Endometrial dcancer- dsymptoms, drisk dfactors, ddiagnostic dtesting
• Most dcommon dgynecologic dmalignancy
• Cancer dof dinner duterine dlining
• Grows dslowly dbut dvaginal dbleeding dusually dleads dto dprompt
devaluation dand d dtreatment d= dgood dprognosis
• Most dcommonly dassociated dwith dprolonged dexposure dto destrogen
dwithout dits d protective deffects dof dprogesterone
Risk dFactors:
• Women din dreproductive dyears
• Family dHistory
• Diabetes dMellitus
• HTN
• Obesity
• Uterine dpolyps
• Late dmenopause
• Nulliparity d(no dchildbirths)
• Smoking
• Tamoxifen d– dgiven dfor dbreast dcancer
Symptoms:
