NURS 6551 - Primary Care of Women Midterm Exam Study Guide Q & A What is a chancroid caused by? H. ducreyi - gram negative rod - very painful, tender genital ulcer - inguinal adenopathy (... painful inguinal adenitis in 50%) - soft, ragged edges - pus - strong erythema Syphilis chancre sore presentation - hard chancre - firmly indurated, raised edge - mild erythema - painLESS Patient presents w/ multiple painful ulcers with inguinal adenopathy. Negative testing for HSV and syphilis. Most likely diagnosis? Chancroid What condition are Donovan bodies revealed by Wright's or Giemsa's stain? Granuloma Inguinale (Donovanosis) - painless, ulcerative - chronic or recurrent - malodorous discharge - beefy-red granular zone w/ clean, sharp edges Complications -- scarring, introital contraction What does estrogen do to the vagina? - corniness epithelium (follicular phase) What does progesterone do to the vagina? - thickens mucus - epithelium proliferates & infiltrated w/ leukocytes When is the most fertile period? 48 hrs before ovulation What happens when there is an anovulatory cycle? - ovulation fails - no corpus luteum - no progesterone effects on endometrium - estrogen continues to cause growth Common in first 12-18 months of menses and pre-menopause!! PMS: Diagnosis Symptom Documentation required Chart Sx during the month According to ACOG criteria, PMS diagnosed if: - at least 1 affective Sx (depression, angry, etc.) AND - at least 1 somatic Sx (abd bloating, HA, swelling, etc.) - during the 5 days before menses - in each of the 3 prior menstrual cycles - Sx relieved w/in 4 days of the onset of menses, w/o recurrence until at least cycle day 13 AND - reproducible during 2 cycles of prospective recording PMS: Diagnosis General Essentials of Diagnosis Sx include: - mood Sx (irritable, swings, depression, etc.) - cognitive changes (confusion, poor concentration) AND - physical Sx (bloating, insomnia, breast tender, hot flashes, etc.) Must occur in 2nd half of cycle (luteal, pre-mense) Sx-free period of at least 7 days in 1st half of cycle Sx in at least 2 consecutive cycles Sx severe enough to require advice or Tx [Show More]
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