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Reproductive Mind Map - Coggle Diagram
Reproductive Mind Map
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Leiomyoma of Uterus: A benign, smooth-muscle tumor within the uterine muscle wall.
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Diagnosis:
- ultrasonography, laparoscopy, and hysteroscopy can visualize leiomyomas
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Treatment:
- surgical excision of tumor. Uterine artery embolization to diminish circulation to the tumor.
Dysfunctional Uterine Bleeding: Abnormal uterine bleeding caused by a disturbance of the menstrual cycle.
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diagnosis:
- Hysteroscopy can visualize if there are any lesions inside the uterus that could cause irregular menses.
- FSH, LH, estrogen, and progesterone levels may be drawn to assess the hormonal cycle.
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treatment:
- Progesterone or HRT is the most common treatment that resets the regularity of the menstrual cycle.
Premature Ovarian Insufficiency: Dysfunction of the hypothalamic–pituitary–ovarian axis. Lack of development of follicles for ovulation.
physical assessment:
- May or may not have physical examination findings.
Depends on etiology of disorder.
Diagnosis:
- FSH will be elevated because of a lack of ovarian production of estrogen, which feeds back to pituitary-stimulating FSH.
- Other hormones may be abnormal, depending on the etiology of POI.
signs and symptoms:
- Amenorrhea
- infertility
- May have other endocrine or congenital disorder such as Turner’s syndrome (45,XO), hypothyroidism, or Addison’s disease.
- Turner’s syndrome symptoms are webbed neck, short stature, and shield-like chest.
treatment:
- Hormone treatment to stimulate ovulation.
Uterine Prolapse: Protrusion of the uterus into the vaginal canal that occurs when supportive ligaments of the perineum are stretched and there is loss of pelvic muscle strength.
physical assessment: on pelvic examination, visualization of a protrusion of the uterus into the vaginal canal.
Diagnosis: laparoscopy an visualize uterus, bladder, or rectum displacement
Signs and Symptoms:
- may feel back pain or pressure in vaginal canal or on bladder or toward rectum.
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Ectopic pregnancy: This is growth of an embryo outside the uterus, most commonly in the fallopian tube.
Physical Assessment findings:
Abdominal tenderness, abdominal rigidity, abdominal mass palpation possible.
Diagnosis:
- Laboratory test: b-HCG.
- Transvaginal or pelvic ultrasound is the best test to visualize an ectopic pregnancy.
- Laparoscopy may be necessary if ultrasound does not show the ectopic pregnancy.
Signs and Symptoms: Acute abdominal pain, nausea, vomiting.
treatment:
- methotrexate
- surgical excision
- removal of the fallopian tube common.
Vaginitis: An infection of the vaginal canal with Candida, Trichomonas, or bacterial vaginosis.
Physical Assessment:
- vaginal erythema and discharge
Diagnosis:
Potassium hydroxide wet mount, whiff test, vaginal pH.
Signs and Symptoms:
- Itching and vaginal discharge.
- Can be a white, thick discharge or fishy odor of discharge.
Treatment:
- Antibiotic, metronidazole for Trichomonas or antifungal agent for Candida treatment.
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Benign Ovarian Cyst: Growth composed of the remains of a Graafian follicle that has not ejected the ovum, or remains of the corpus luteum that did not degenerate.
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diagnosis:
- Transvaginal or pelvic ultrasound is the best test to visualize an ovarian cyst.
- Laparoscopy may be necessary.
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Teratoma of the ovary: ovary develops large cystic growth containing embryonic tissue that forms hair, teeth, and other kinds of tissue.
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Diagnosis: Transvaginal or pelvic ultrasound can visualize the growth. Laparoscopy also can visualize growth.
signs and symptoms: abdominal and pelvic pain, back pain
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Fibrocystic Breasts: This is not a pathological condition; breasts have multiple, mobile, tender cysts that change in size with menstrual cycle.
physical assessment: Clinical breast examination reveals multiple, movable, compressible cysts throughout breast tissue bilaterally.
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treatment:
- no treatment
- advise decreased coffee, tea, chocolate, or cola
- supportive bra
Torsion of the Ovary: A twisting of the ovary that obstructs arterial flow. Usually occurs only if the ovary is enlarged or if a large cyst is present.
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diagnosis:
- Transvaginal or pelvic ultrasound is the best test to visualize an ovarian cyst.
- Laparoscopy may be necessary.
signs and symptoms: Intense abdominal pain, nausea, vomiting.
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Polycystic Ovary Syndrome: A hormonal imbalance of androgen and estrogen that causes amenorrhea and infertility. Ova can develop and come to the ovary’s surface but are not released. Multiple ova under the surface resemble multiple cysts.
physical assessment:
- Patient commonly has metabolic syndrome; hypertension,
glucose intolerance, hyperlipidemia, and central obesity.
Diagnosis:
- Laparoscopy to visualize ovaries and hormone levels; androgens, FSH, LH, estrogen, and progesterone are performed.
- Patient has high androgens and an imbalance of other hormones.
Signs and Symptoms:
- amenorrhea
- infertility
- hirsutism
- obesity
treatment:
- Insulin sensitizers are recommended to decrease the insulin resistance and prevent diabetes and heart disease. Progesterone therapy is recommended to oppose estrogen’s effects on the endometrium.
Fibroadenoma of Breast: A singular mass that develops within the breast tissue, which is usually benign.
physical assessment: Discrete, movable, rubbery mass on clinical breast examination.
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Signs and Symptoms: discrete, movable, rubbery mass
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Mastitis: Infection of the breast caused by Staphylococcus or Streptococcus ascending from the skin to the duct and glands.
physical assessment:
- Tender, erythematous nipple area in a breastfeeding mother.
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signs and symptoms:
- Tender, erythematous nipple area, usually during breastfeeding.
treatment:
- analgesics
- antibiotics
- hot or cold compresses
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BPH: Increased cellular growth and size of prostate gland with urethral obstruction; this is a normal physiological change of aging.
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diagnosis:
- DRE; clinician palpates enlarged prostate
- PSA blood tests
- CT scan shows enlarged prostate
signs and symptoms: Urinary frequency, urgency, hesitancy, straining to urinate, weak stream, nocturia, susceptibility to urinary tract infection.
treatment:
- Alpha-adrenergic blocker medications, 5-alpha-reductase inhibitors, TURP, TUNA, or radical resection of prostate.
Testicular Cancer: Most common cancer type is germ cell seminoma; neoplastic growth of the seminiferous tubule cells.
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diagnosis:
- biopsy
- elevated AFP and beta-HCG
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treatment:
- surgery
- radiation
- chemotherapy
Hydrocele, Hematocele, Varicocele: Hydrocele is fluid in the scrotal sac, causing swelling of the scrotum. Hematocele is a collection of blood in the scrotal sac. Varicocele is a condition of distended veins and lack of blood drainage of the testes.
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Bacterial Vaginosis: Change in the vaginal bacterial flora from Lactobacillus to a mixture of gram-negative and anaerobic bacterial organisms (largely Gardnerella vaginalis) that cause breakdown of vaginal peptides.
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Diagnosis: Characteristic clue cells found in vaginal secretions. Positive whiff-amine test and Gram stain.
signs and symptoms: Vulvar and vaginal pruritus. Thin, off-white vaginal discharge that has a “fishy odor.”
Treatment: Metronidazole or clindamycin. Treatment of female sex partners. Testing for other STIs advisable.
Chlamydia: An obligate, intracellular microorganism that reproduces in the cells of the host. Chlamydia can protect itself from the host’s immune system by converting into a sporelike inclusion body.
physical assessment:
females: pelvic examination shows friable cervix and discharge.
male: painful urination and discharge from meatus
Diagnosis:
- culture in special medium
- characteristic inclusion body found in cervical cells.
Signs and symptoms: often asymptomatic in both males and females.
females: possible vaginal bleeding/discharge
males: possible urethritis
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Gonorrhea: Gonococcus is a gram-negative, diplococcal microorganism that invades mucosal epithelium. It is highly virulent because of pili that attach to mucosa. Organism has a high mutation ability.
Diagnosis:
- culture on special medium
- gram stain slide on microscope
- PCR testing can identify organism DNA.
physical assessment: if symptomatic purulent discharge.
- female: inflamed cervix
- male: painful urination, discharge from penile meatus
signs and symptoms: often asymptomatic in males and females
- females: purulent vaginal discharge can occur
- males: urethritis can occur.
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Mycoplasma Genitalium: Mycoplasma bacterial organism that causes non-gonoccocal urethritis in men and cervicitis and PID in women.
signs and symptoms: Women often have asymptomatic cervicitis, whereas men usually present with dysuria, urethral discharge, pruritus, and inflammation of the glans penis.
diagnosis: Diagnosis involves NAAT of the urethral discharge, first-void urine, or vaginal discharge.
physical assessment: Pelvic examination shows cervicitis; male urethritis, discharge.
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Syphilis: A bacterial spirochete, T. pallidum, that can infect the body and remain dormant for decades. It invades mucous membranes or can be transferred to the fetus through the placenta. It forms granulomas called gummas that disrupt body organs.
Physical assessment:
- Painless, ulcerated lesion at site of inoculation.
- Maculopapular rash all over body, including palms of hands and soles of feet.
- Late stages cause neurological problems such as ataxia, stroke, and dementia.
Diagnosis:
- Dark-field microscope (observe spirochetes).
- VDRL: positive.
- RPR: positive.
- Fluorescent treponemal antibodies: absorbed.
Signs and symptoms:
- Primary stage: painless chancre on the external genitalia often not readily apparent.
- Secondary stage: rash appears on body, palms, and soles of feet.
- Tertiary stage: neurological and cardiovascular complications become apparent.
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LGV, Chancroid, Granuloma Inguinale: LGV is caused by C. trachomatis; chancroid is caused by H. ducreyi; and granuloma inguinale by K. granulomatis. Granuloma inguinale is also called donovanosis.
physical assessment:
- Ulcer at site of inoculation.
- Enlarged inguinal lymph nodes called buboes.
Diagnosis:
- Microorganisms are found via culture. Scraping the lesion and examining scraped cells under microscope; stained bacteria are observed and identified.
- Nucleic acid amplification and PCR testing used. Donovan bodies in granuloma inguinale.
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Treatment:
- Antibiotics are curative. Other laboratory tests should be done: VDRL, RPR, PCR assays for H. ducreyi and HSV2 and HIV antibodies.
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Herpes Simplex Virus (viral): enital herpes can be caused by HSV1 or HSV2. Viruses invade skin and remain dormant in neurological tissue. Remissions and exacerbations of lesions can occur.
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HPV: These genital warts can increase the risk of cervical cancer. HPV infection can occur in other areas predisposing to cancer: anal, rectal, oropharyngeal, or laryngeal cancer.
physical assessment: Painless, fleshy papules in and around genitalia or anal region.
Diagnosis:
- Clinical evaluation.
- HPV: Pap smears to identify types.
Signs and Symptoms: Fleshy, warty growths, usually in pelvic area.
Treatment:
- Podophyllin, laser ablation.
- Trichloroacetic acid application.
- Not curative but can decrease appearance of warts.
PID: Most common causes are N. gonorrhoeae and C. trachomatis. The microorganisms ascend from the vagina into the uterus, fallopian tubes, and ovaries.
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