NURS660 Exam 1 - Correct Answers Rated A+ How many months does p...

NURS660 Exam 1 Exam Update Latest Questions and Correct Answers Rated A+

How many months does pelvic pain need to be present to be considered chronic? -ANSWER->6 months

What is the most common missed contributor to pelvic pain? -

ANSWER-IBS

What is some important education for an endometriosis patient who is interested in pre-sacral neuroectomy? -ANSWER-This procedure only works well for midline pain, not pain over the ovaries which is where many endometriosis patients have pain

What is a potential side effect from adhesiolysis surgery? -ANSWER- may increase scar tissue and therefore worsen adhesions, having opposite effect

• key symptoms of endometriosis -ANSWER-Pain with sex

Pain with defecation Pain with menses

What is the pathophysiology of endometriosis? -ANSWER-unknown etiology but it occurs when there is endometrial tissue outside of the uterus that acts the same as the tissue inside the uterus, so it sheds and creates pain during cycles

What is required for a true endometriosis diagnosis? -ANSWER- visualization of tissue via laproscopy

What is the number 1 theory of what causes endometriosis? - ANSWER-Retrograde menstruation --> shed uterine tissue exits through os but some backflows via tubes into pelvic cavity

What is the rating system for endometriosis like? -ANSWER-Rated from stage 1 which is minimal to stage IV which is severe

What is adenomyosis? -ANSWER-Endometriosis tissue inside of the uterine wall Can change the shape of uterus, causes pain with palpation

What is the only definitive treatment for endometriosis? -ANSWER- Removal of all reproductive organs

What is a goal of pharmacologic treatment for endometriosis? - ANSWER-decrease cycles less cycles --> less pain for woman

Danazol is used for what? What are some side effects? -ANSWER- Suppresses LH and FSH which can in turn stop periods Essentially a weak androgen Can have side effects like weight gain, masculinizations, vocal changes (can be permanent)

When choosing an OCP for a patient with endometriosis, what do you want to consider regarding estrogen content? -ANSWER-Choose OCPs with the least estrogenic effects with maximum endrogenic effects This will minimize the building of the lining

Describes the uses and side effects of progestins for endometriosis. - ANSWER-Can be taken long term for pain control unlike GnRH-A and are relatively inexpensive BUT can cause AUB, weight gain, amenorrhea (Which is not always the goal)

How do GNRH-A work for endometriosis? How long can you use?What is "add back therapy"? -ANSWER-GnRH-A initially stimulate FSH/LH release and down-regulates GnRH receptors to cause a pseudomenopause (so much stimulation that the anterior pituitary 'ignores' GnRH) Add back therapy is taking estrogen with it as well which can lengthen the amount of time patients can be on it. Should be a low dose estrogen

Without add back: 6 months

With add back: 1 year

What is the main factor to consider when deciding how long someone

can be on Orlissa? -ANSWER-Pain with sex: 6 months max

No pain with sex: 24 months

Reason: if pain with sex, higher dosage (BID)

A patient with endometriosis is having new, sharp pain over her RLQ.What might you suspect? -ANSWER-Appendicitis Very common as tissue often lands on appendix and causes inflammation

The core cause of PCOS is what body system? -ANSWER-endocrine, not gynecological

Stein-Leventhal syndrome includes what triad of symptoms - ANSWER-Amenorrhea, obesity, hirsutism

Name the 4 requirements for PCOS diagnosis -ANSWER-1.Ovarian/menstrual dysfunction

• Clinical/biochemical evidence of increased androgens
• Ultrasound showing polycystic ovaries
• Insulin resistance/metabolic syndrome

What assessments in a teen with delayed onset or irregular menses would make you suspicious for PCOS? -ANSWER-This as well as significant acne, hirsutism, other signs of masculinity

Which hormone is more of the issue with PCOS? FSH or LH? -

ANSWER-LH

They typically do not have issues with folicles being stimulated (will see several developed on US) but do not have a strong enough LH surge to trigger ovulation however, their LH will be high because it's trying to get something to happen

What number of periods per year would be suspicious for PCOS? - ANSWER-<8/year

Describe the lab work you would see in a PCOS patient most likely for these values Testosterone, glucose, insulin, FSH, LH -ANSWER-Increased T Increased glu (can also be low, really anything altered would be expected) Increased insulin normal FSH Increased LH

In regards to PCOS, does BMI/obesity matter regarding insulin resistance? -ANSWER-No