Term
|
Definition
supresses LH surge (necessary for ovulations)
thickens mucus (barrier to sperm penetrations)
thinning of the lining of the uterus (prevents implantation) |
|
|
Term
|
Definition
| Irregular uterine bleding, insertion complications, possible weight gain, ovarian cysts, headaches, loss of libido, vaginal dryness, clinician dependency, increased risk of thromboembolic conditions, relatively new method |
|
|
Term
|
Definition
| High efficacy, easy to use, discrete, no adverse effect on acne, relief of dysmenorrhea, relief of endometriosis symptoms, reduced risk of ectopic, no estrogen, reversible, |
|
|
Term
|
Definition
Single flexible rod, 4cm long,
made up of ethylene vinyl acetate,
containing 68mg of etonogestrel
(3-keto-desogestrel) |
|
|
Term
| How much hormone is released by Implanon? |
|
Definition
67ug/day for the first 2 years,
then 30ug/day |
|
|
Term
| How soon after placement is Implanon effective? |
|
Definition
| Concentrations that inhibit ovulation are reached within 8 hours. A steady state is reached after 4 months |
|
|
Term
| How long is Implanon effective? |
|
Definition
3 years;
can inhibit ovulation for 2.5 years |
|
|
Term
| When should Implanon be inserted? |
|
Definition
Insert day 1-5;
if inserted after day 7, use a back up method |
|
|
Term
| Contraindications of Implanon |
|
Definition
Active thrombophlebitis, or thromboembolic disease, undiagnosed genital bleeding, acute liver disease, benign or malignant liver tumors, known or suspected breast cancer
Heavy smoker, hx ectopic pregnancy, DM, high cholesterol, HTN, heart disease, gallbladde disease, immunocompromised |
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|
Term
| Where is Implanon inserted? |
|
Definition
Placed subdermally in the upper inner arm;
crease between the biceps and triceps |
|
|
Term
| How effective is Implanon? |
|
Definition
Just as effective as IUDs and sterlization;
failure rate 0.01% |
|
|
Term
|
Definition
Insertion $400-$800;
removal $100-300 |
|
|
Term
|
Definition
| Can't have estrogen (breastfeeding), want to delay pregnancy 2-3 yrs, difficulty using other forms of contraception, not yet ready fo sterilization, hx of heavy bleeding, have chronic illnesses and health will be threatened by pregnancy |
|
|
Term
What is the cause of genital warts
(condyloma acuminta)? |
|
Definition
HPV
90% caused by types 6 and 11 |
|
|
Term
| Symptoms of genital warts |
|
Definition
| May be asymptomatic or cause anogenital pruitus, burning, dyspareunia |
|
|
Term
| Physical findings of genital warts |
|
Definition
cauliflower-lilke, flat, papular, keratotic with a thick horny layer, fond-like
found in the vulvular, perineal, and perianal areas as well as vaginal walls, the cervix, in the urethra, anus, and mouth |
|
|
Term
| Diagnosis/labs of genital warts |
|
Definition
visual inspection and history
biopsy-if diagnosis unclear, getting worse, recurrent, or immunocompromised patient
colposcopy-for flat warts that are difficult to see (not recommended by varney)
screen for other STIs |
|
|
Term
| Treatment of genital warts |
|
Definition
Time- may resolve on own
Patient applied:podofilox gel, imiquimod cream, sinecatechins ointment
Provider-administered: cryotherapy w/ liquid nitrogen or cryoprobe, TCA (trichloric acid), BCA (bichloroacetic acid), podophyllin resin, surgical removal |
|
|
Term
| Prevention of genital warts |
|
Definition
Gardasil
protects against 6, 11, 16, 18 |
|
|
Term
| Patient education-genital warts |
|
Definition
| use condoms, abstain from sex during treatment, annual paps, stop smoking-will reduce risk of HPV neoplasia |
|
|
Term
| Implications for pregnancy-genital warts |
|
Definition
usually incease in size and number (due to decreased immune system), regress after pregnancy, excessive growth may cause a difficult labor, excessive bleeding-may require c-section
imiquimod, siecagechins, podophyllin, and podofilox should not be used in pregnancy |
|
|
Term
| What strands of HPV does Gardasil protect against? |
|
Definition
6, 11: 90% of warts
16, 18: 70% of cervical cancers |
|
|
Term
| At what age should the gardisil vaccine be administered |
|
Definition
|
|
Term
| Can the gardisil vaccine be adminstered with a history of cervical cancer or genital warts? |
|
Definition
|
|
Term
| How is gardisil adminstered? |
|
Definition
Intramuscularly, 3-series injection at 0, 2, and 6 months
minimum of 4 weeks between 1 and 2, minimum of 12 weeks between 2 and 3, do not restart if interrupted |
|
|
Term
| Do patients need to continue getting regular paps if they have aleady recieved the gardisil vaccine? |
|
Definition
| Yes, they may have been infected before administration, and the vaccine does not protect against 30% of cervical cancers |
|
|
Term
| Is gardisil recommended during pregnancy? |
|
Definition
| No, it is a pregnancy B category but not recommended |
|
|
Term
| Can gardisil be given to lactating women? |
|
Definition
|
|
Term
|
Definition
Only effective against HPV types 16 and 18
which cause cervical cancer
no protection against genital warts
not tested or licensed for use in males |
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