Слайд 2
![Dysmenorrhea Most common cause of pelvic pain in females. Definition](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-1.jpg)
Dysmenorrhea
Most common cause of pelvic pain in females.
Definition - menstrual pain
Etiology
-
Obstruction and anatomical cervical stenosis, fibroids, anteflexion of uterus, PID
Endocrine - excessive production of prostaglandins which intensify uterine contractions.
Слайд 3
![Dysmenorrhea Management. NSAIDS (nonsteroidal anti inflammatory drugs). Oral contraceptive. Adequate](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-2.jpg)
Dysmenorrhea
Management.
NSAIDS (nonsteroidal anti inflammatory drugs).
Oral contraceptive.
Adequate rest and sleep and regular
exercise may be beneficial.
Heating--baths, soaks, showers and heating pad.
Muscle relaxants--PRN for cramping.
Слайд 4
![Premenstrual syndrome (PMS) premenstrual tension Definition--is a distinct clinical entity](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-3.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Definition--is a distinct clinical entity characterized by
a cluster of physical and psychological symptoms that are limited to a week or 10 days, preceding menstruation and are relieved by onset of the menses.
Слайд 5
![Premenstrual syndrome (PMS) premenstrual tension Known precipitating factors include an](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-4.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Known precipitating factors include an increase in
antidiuretic hormone and aldosterone secretion, as well as estrogen-progesterone imbalance.
Слайд 6
![Premenstrual syndrome (PMS) premenstrual tension PMS increases with age and](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-5.jpg)
Premenstrual syndrome (PMS) premenstrual tension
PMS increases with age and body weight.
Uncommon
in women in their teens and twenties.
Слайд 7
![Premenstrual syndrome (PMS) premenstrual tension Symptoms. Physical. Painful and swollen](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-6.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Symptoms.
Physical.
Painful and swollen breast.
Bloating.
Abdominal pain.
Headache and back
pain.
Слайд 8
![Premenstrual syndrome (PMS) premenstrual tension Psychologically. Depression. Anxiety. Irritability. Behavioral changes.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-7.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Psychologically.
Depression.
Anxiety.
Irritability.
Behavioral changes.
Слайд 9
![Premenstrual syndrome (PMS) premenstrual tension Treatment. Past treatment has been](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-8.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Treatment.
Past treatment has been symptomatic.
Diuretics to reduce
fluid retention.
Tranquilizer drugs for mood changes. Diazepam 2 5 mg TID orally.
Analgesics for pain, mild pain ASA 600 mg orally Q 4 6 hrs PRN.
Program of regular sleep and exercise.
Слайд 10
![Premenstrual syndrome (PMS) premenstrual tension Treatment. Decrease salt intake to](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-9.jpg)
Premenstrual syndrome (PMS) premenstrual tension
Treatment.
Decrease salt intake to relieve bloating and
edema.
Drug therapy should be avoided, when possible.
Слайд 11
![Pelvic Inflammatory Disease Definition--Pelvic Inflammatory Disease (PID) is any acute,](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-10.jpg)
Pelvic Inflammatory Disease
Definition--Pelvic Inflammatory Disease (PID) is any acute, subacute, recurrent,
or chronic infection of the oviducts, and ovaries, with adjacent involvement.
Слайд 12
![Pelvic Inflammatory Disease Sites - it includes inflammation of the](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-11.jpg)
Pelvic Inflammatory Disease
Sites - it includes inflammation of the cervix (cervicitis)
uterus (endometritis) fallopian tubes (salpingitis) and ovaries (oophoritis) which can extend to the connective tissue lying between the broad ligaments (parametritis).
Слайд 13
![Pelvic Inflammatory Disease Cervicitis. Definition--inflammation of the cervix.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-12.jpg)
Pelvic Inflammatory Disease
Cervicitis.
Definition--inflammation of the cervix.
Слайд 14
![Pelvic Inflammatory Disease Causative organisms - gonococcus, streptococcus, staphylococcus, aerobic](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-13.jpg)
Pelvic Inflammatory Disease
Causative organisms - gonococcus, streptococcus, staphylococcus, aerobic and anaerobic
organisms, herpes virus, and chlamydia.
Слайд 15
![Pelvic Inflammatory Disease Forms of cervicitis-- Acute and Chronic.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-14.jpg)
Pelvic Inflammatory Disease
Forms of cervicitis--
Acute and Chronic.
Слайд 16
![Pelvic Inflammatory Disease Acute cervicitis. Symptoms. Purulent, foul smelling vaginal](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-15.jpg)
Pelvic Inflammatory Disease
Acute cervicitis.
Symptoms.
Purulent, foul smelling vaginal discharge.
Itching and/or burning sensation.
Red,
edematous cervix.
Pelvic discomfort.
Sexual dysfunction > infertility.
Слайд 17
![Pelvic Inflammatory Disease Acute cervicitis. Assessment. Physical examination. Cultures for](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-16.jpg)
Pelvic Inflammatory Disease
Acute cervicitis.
Assessment.
Physical examination.
Cultures for N. gonorrhea are positive greater
than 90% of the time.
Cytologic smears.
Cervical palpation reveals tenderness.
Management - based on culture results.
Слайд 18
![Pelvic Inflammatory Disease Chronic cervicitis. Symptoms. Cervical dystocia--difficult labor. Lacerations](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-17.jpg)
Pelvic Inflammatory Disease
Chronic cervicitis.
Symptoms.
Cervical dystocia--difficult labor.
Lacerations or eversion of the cervix.
Ulceration
vesicular lesions (when cervicitis results from Herpes simplex
Слайд 19
![Pelvic Inflammatory Disease Assessment. Physical examination. Chronic cervicitis, causative organisms are usually staphylococcus or streptococcus.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-18.jpg)
Pelvic Inflammatory Disease
Assessment.
Physical examination.
Chronic cervicitis, causative organisms are usually staphylococcus or
streptococcus.
Слайд 20
![Pelvic Inflammatory Disease Management - manage by cauterization, cryotherapy, conization (excision of a cone of tissue).](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-19.jpg)
Pelvic Inflammatory Disease
Management - manage by cauterization, cryotherapy, conization (excision of
a cone of tissue).
Слайд 21
![Pelvic Inflammatory Disease Endometritis. Definition - inflammation of the endometrium.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-20.jpg)
Pelvic Inflammatory Disease
Endometritis.
Definition - inflammation of the endometrium.
Etiology - produced by
bacterial infection most commonly staphylococci, colon bacilli, or gonococci, trauma, septic abortion
Слайд 22
![Pelvic Inflammatory Disease Endometritis. Etiology - produced by bacterial infection](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-21.jpg)
Pelvic Inflammatory Disease
Endometritis.
Etiology - produced by bacterial infection most commonly staphylococci,
colon bacilli, or gonococci, trauma, septic abortion.
Sites - uterine ligaments, (uterosacral, broad, round) and ovaries, (extra uterine locations).
Слайд 23
![NOTE Endometriosis - ectopic endometrium located in various sites throughout](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-22.jpg)
NOTE
Endometriosis - ectopic endometrium located in various sites throughout the pelvis
or on the abdominal wall.
Слайд 24
![](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-23.jpg)
Слайд 25
![Pelvic Inflammatory Disease Endometriosis Symptoms. Low back and low abdominal](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-24.jpg)
Pelvic Inflammatory Disease
Endometriosis
Symptoms.
Low back and low abdominal pain.
Dysmenorrhea.
Menorrhagia.
Pain on defecation, constipation.
Sterility.
Слайд 26
![Pelvic Inflammatory Disease Endometriosis Assessment. Physical examination. Vaginal cultures. Management - based upon culture results.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-25.jpg)
Pelvic Inflammatory Disease
Endometriosis
Assessment.
Physical examination.
Vaginal cultures.
Management - based upon culture results.
Слайд 27
![Pelvic Inflammatory Disease Salpingitis and Oophoritis. Definition - infection of](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-26.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis.
Definition - infection of the fallopian tubes
and ovaries.
History - usually recent sexual intercourse, insertion of an IUD, or a recent childbirth or abortion, gonococcus, chlamydia, streptococcus, and anaerobes have been implicated as causative organisms
Слайд 28
![Pelvic Inflammatory Disease Salpingitis and Oophoritis. Signs and symptoms. Lower](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-27.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis.
Signs and symptoms.
Lower abdominal pain sometimes with
signs and symptoms of acute abdomen can be unilateral or bilateral.
Fever.
Severe pain with palpation of the cervix, uterus, and adnexa (Chandelier sign).
Слайд 29
![Pelvic Inflammatory Disease Salpingitis and Oophoritis. Signs and symptoms (cont.) Purulent cervical discharge. Leukocytosis.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-28.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis.
Signs and symptoms (cont.)
Purulent cervical discharge.
Leukocytosis.
Слайд 30
![Pelvic Inflammatory Disease Salpingitis and Oophoritis. Assessment. Physical examination. Gonorrhea culture. Test for chlamydia.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-29.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis.
Assessment.
Physical examination.
Gonorrhea culture.
Test for chlamydia.
Слайд 31
![Pelvic Inflammatory Disease Salpingitis and Oophoritis Complications. Tubal abscess. Infertility--common.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-30.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis
Complications.
Tubal abscess.
Infertility--common.
Слайд 32
![Pelvic Inflammatory Disease Salpingitis and Oophoritis Management. IV fluids to](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-31.jpg)
Pelvic Inflammatory Disease
Salpingitis and Oophoritis
Management.
IV fluids to correct dehydration.
NG suction in
the presence of abdominal distention or ileus.
Manage the associated symptoms.
Bedrest and restrict oral feedings.
Слайд 33
![OTHER GYN ASSOCIATED ABNORMALITIES.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-32.jpg)
OTHER GYN ASSOCIATED ABNORMALITIES.
Слайд 34
![Ovarian Cyst](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-33.jpg)
Слайд 35
![Ovarian Cyst Ovarian cysts are usually nonneoplastic sacs on an](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-34.jpg)
Ovarian Cyst
Ovarian cysts are usually nonneoplastic sacs on an ovary that
contain fluid or semisolid material.
Ovarian cysts are frequently asymptomatic, but the pressure of an abnormal mass may cause discomfort, aching, or heaviness to the pelvic region and on abdominal organs.
Слайд 36
![Ovarian Cyst Sudden or sharp pain may indicate rupture, hemorrhage,](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-35.jpg)
Ovarian Cyst
Sudden or sharp pain may indicate rupture, hemorrhage, or torsion
of cyst.
Fever, leukocytosis or s/s of shock may be present.
Слайд 37
![OTHER GYN ASSOCIATED ABNORMALITIES Leukorrhea - white/yellowish mucoid discharge from cervical canal or vagina.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-36.jpg)
OTHER GYN ASSOCIATED ABNORMALITIES
Leukorrhea - white/yellowish mucoid discharge from cervical canal
or vagina.
Слайд 38
![Leukorrhea Probably most frequently encountered gynecological symptom. Generally associated with](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-37.jpg)
Leukorrhea
Probably most frequently encountered gynecological symptom.
Generally associated with simple infection of
the cervix and vagina.
Слайд 39
![OTHER GYN ASSOCIATED ABNORMALITIES Candidiasis Trichomonas Gardnerella Bartholin’s abscess VAGINITIS - Inflammation of the vagina](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-38.jpg)
OTHER GYN ASSOCIATED ABNORMALITIES
Candidiasis
Trichomonas
Gardnerella
Bartholin’s abscess
VAGINITIS - Inflammation of the vagina
Слайд 40
![Monoliasis or Candidiasis](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-39.jpg)
Monoliasis or Candidiasis
Слайд 41
![Monoliasis or Candidiasis Signs and symptoms. Marked leukorrhea, marked redness](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-40.jpg)
Monoliasis or Candidiasis
Signs and symptoms.
Marked leukorrhea, marked redness of vulva, extreme
pruritus.
White, creamy, cheesy, sweet smelling discharge, thrush patches.
Commonly seen in pregnancy, diabetics, women on BCP or antibiotics (ampicillin).
Слайд 42
![Monoliasis or Candidiasis Assessment - lab KOH wet mount NS](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-41.jpg)
Monoliasis or Candidiasis
Assessment - lab KOH wet mount NS KOH 10%
20% look for (branching Hyphae or Mycelium fungus nails).
Management - Nystatin--intravaginal adult tabs 0.1 to 0.2 million units daily times 7 to 10 days.
Слайд 43
![Trichomonas Vaginitis](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-42.jpg)
Слайд 44
![Trichomonas Vaginitis Signs and symptoms. Leukorrhea, vaginal soreness, burning, pruritus,](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-43.jpg)
Trichomonas Vaginitis
Signs and symptoms.
Leukorrhea, vaginal soreness, burning, pruritus, dyspareunia (pain during
intercourse).
Bubbly, yellowish thick discharge, foul smelling.
Strawberry appearance of cervix.
Слайд 45
![Trichomonas Vaginitis Assessment - lab wet prep, microscopic exam reveals](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-44.jpg)
Trichomonas Vaginitis
Assessment - lab wet prep, microscopic exam reveals pear shaped
parasite with long flagella and undulated (wavy outline in appearance) cell membrane.
Management.
Metronidazole (Flagyl) anti protozoal 250 mg TID to 500 mg BID orally for 5 days.
Patient education of feminine hygiene, douching.
Management based on culture results.
Слайд 46
![Bacterial Vaginitis (Gardnerella vaginitis) Signs and symptoms. Leukorrhea, pruritus, dyspareunia.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-45.jpg)
Bacterial Vaginitis
(Gardnerella vaginitis)
Signs and symptoms.
Leukorrhea, pruritus, dyspareunia.
Turbid, chalky, white/gray or
yellowish discharge; malodorous ("fishy").
Слайд 47
![Bacterial Vaginitis (Gardnerella vaginitis) Assessment. Gram-positive nonmotile coccobacillus that normally](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-46.jpg)
Bacterial Vaginitis
(Gardnerella vaginitis)
Assessment.
Gram-positive nonmotile coccobacillus that normally inhabits the vagina.
Wet
smears of this nonspecific vaginitis yields vaginal desquamated epithelial cells covered with many bacteria.
Слайд 48
![Bacterial Vaginitis (Gardnerella vaginitis) Management. Metronidazole (Flagyl) 250 mg TID](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-47.jpg)
Bacterial Vaginitis
(Gardnerella vaginitis)
Management.
Metronidazole (Flagyl) 250 mg TID to 500 mg
BID orally for 7 10 days.
Ampicillin 500 mg QID x 7 days.
Douching with povidone iodine solution.
About 25% of the patients have recurrence and require treatment in 2 3 months.
Management based on culture results.
Слайд 49
![Perineal pain - Bartholin’s abscess Definition and etiology - acute](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-48.jpg)
Perineal pain -
Bartholin’s abscess
Definition and etiology - acute or chronic infection
of the Bartholin's gland (streptococci, staphylococci, E. coli, anaerobes; may result in infection).
History - recent intercourse, venereal disease, trauma, spontaneous abortion, wiping from rectum to vagina.
Слайд 50
![Perineal pain - Bartholin’s abscess Signs and symptoms. Mass in](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-49.jpg)
Perineal pain -
Bartholin’s abscess
Signs and symptoms.
Mass in perineum that is hot,
tender, and fluctuant.
Pus draining from Bartholin's duct.
Слайд 51
![](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-50.jpg)
Слайд 52
![Perineal pain - Bartholin’s abscess Management. I & D. Sitz](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-51.jpg)
Perineal pain -
Bartholin’s abscess
Management.
I & D.
Sitz bath.
Broad-spectrum antibiotics which cover gram-positive
organisms and some common vaginal gram-negative organisms.
Слайд 53
![BREAST ABNORMALITIES.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-52.jpg)
Слайд 54
![Acute Mastitis Definition - bacterial infection of breast. Time -](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-53.jpg)
Acute Mastitis
Definition - bacterial infection of breast.
Time - confined generally to
the first 2 months of lactation.
Organism - usually staphylococcus, sometimes streptococcus.
RULE - signs and symptoms of mastitis in female; rule out cancer
Слайд 55
![Acute Mastitis Signs and symptoms. Pain in the breast. Withdraw from palpation. Erythema. Induration. Hot.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-54.jpg)
Acute Mastitis
Signs and symptoms.
Pain in the breast.
Withdraw from palpation.
Erythema.
Induration.
Hot.
Слайд 56
![Acute Mastitis Management. Prevention by good hygiene. Preabscess--antibiotics. Abscess I & D.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-55.jpg)
Acute Mastitis
Management.
Prevention by good hygiene.
Preabscess--antibiotics.
Abscess I & D.
Слайд 57
![Chronic Cystic Mastitis Benign pathology - fibrocystic syndrome. Age -](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-56.jpg)
Chronic Cystic Mastitis
Benign pathology - fibrocystic syndrome.
Age - begins in twenties
and increases with age.
Signs and symptoms.
Single or multiple cysts.
Pain/tenderness.
Nodular, well defined cysts.
Smooth, firm, mobile cysts.
Слайд 58
![Chronic Cystic Mastitis Significance - increased incidence of breast cancer](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-57.jpg)
Chronic Cystic Mastitis
Significance - increased incidence of breast cancer 3-5 times.
Management.
Rule
out cancer.
Avoid caffeine and tobacco products, may need referral to rule out cancer; follow-up patient education.
NOTE: In a field environment have patient return for follow up.
Слайд 59
![Malignant Breast Lesions Primary Malignancy Origin--primarily the ducts. Incidence. Major](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-58.jpg)
Malignant Breast Lesions
Primary Malignancy
Origin--primarily the ducts.
Incidence.
Major cancer killer of females.
1
out of 11 females.
130,900 new cases/year.
Mortality--41,300 deaths in 1987.
Слайд 60
![Malignant Breast Lesions Risk factors. Age, over 40. Sex F:M](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-59.jpg)
Malignant Breast Lesions
Risk factors.
Age, over 40.
Sex F:M = 100:1.
Family history of
breast cancer.
Personal history.
Early menarche.
Pregnancy or first child after 30 higher risk.
Слайд 61
![Malignant Breast Lesions Signs and symptoms Persistent lump or thickening,](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-60.jpg)
Malignant Breast Lesions
Signs and symptoms
Persistent lump or thickening, hard irregular mass.
Fixation--tumor
invades surrounding tissue.
Dimpling--shortening of Cooper's ligament.
Nipple retraction, scaliness or discharge.
Слайд 62
![Malignant Breast Lesions Signs and symptoms. Invade skin--ulcer, satellite. Peau](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-61.jpg)
Malignant Breast Lesions
Signs and symptoms.
Invade skin--ulcer, satellite.
Peau d'orange--invasion of lymphatics causes
edema.
Hard, matted, fixed axillary or supraclavicular nodes.
Слайд 63
![Malignant Breast Lesions Signs and symptoms. Bloody nipple discharge. Metastasis--bone](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-62.jpg)
Malignant Breast Lesions
Signs and symptoms.
Bloody nipple discharge.
Metastasis--bone pain, fracture, lung, liver.
Pain
or tenderness.
Слайд 64
![Malignant Breast Lesions Assessment. Physical exam suspicion. Self breast exam](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-63.jpg)
Malignant Breast Lesions
Assessment.
Physical exam suspicion.
Self breast exam suspicion.
Mammogram X ray exam
of the breast.
Needle biopsy--small masses.
Management - surgical; chemotherapy.
Слайд 65
![Malignant Breast Lesions Survival - increases with early diagnosis because](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-64.jpg)
Malignant Breast Lesions
Survival - increases with early diagnosis because size of
lesion is smaller and lymph nodes are not involved.
Metastatic malignancy of the breast - systemic involvement; breast changes during pregnancy with some cancer characteristics (unexplained weight loss).
Слайд 66
![Breast Abnormalities Metastic malignancy of the breast - systemic involvement;](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-65.jpg)
Breast Abnormalities
Metastic malignancy of the breast - systemic involvement; breast changes
during pregnancy with some cancer characteristics (unexplained weight loss).
Слайд 67
![BREAST CHANGES DURING PREGNANCY](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-66.jpg)
BREAST CHANGES DURING PREGNANCY
Слайд 68
![Breasts in Pregnancy Physical Findings - Tenderness. Increase in size](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-67.jpg)
Breasts in Pregnancy
Physical Findings -
Tenderness.
Increase in size and veins.
Nipples increase
in size and pigmentation.
Mammary glands enlarge.
Colostrum--first milk, more protein, more minerals, IgA, less sugar.
Слайд 69
![Breasts in Pregnancy Lactation. Milk letdown in response to suckling](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-68.jpg)
Breasts in Pregnancy
Lactation.
Milk letdown in response to suckling or crying.
Requires adequate
fluids.
Production corresponds to demand.
Encourage maternal bonding and uterine involution.
Breast increase in size, veins, and warmth.
Слайд 70
![Breasts in Pregnancy Lactation. Most drugs ingested are secreted. Engorgement--manage](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-69.jpg)
Breasts in Pregnancy
Lactation.
Most drugs ingested are secreted.
Engorgement--manage with binder, ice, codeine.
Suppression--ice,
binder, analgesics, Parlodel.
Fissures--manage with nipple shield and topical meds, pump.
Слайд 71
![Lactation Agalactia - complete lack of milk, very rare. Polygalactia - excess milk.](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-70.jpg)
Lactation
Agalactia - complete lack of milk, very rare.
Polygalactia - excess milk.
Слайд 72
![SUMMARY Evaluation and management of gynecologic infections and abnormalities require](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-71.jpg)
SUMMARY
Evaluation and management of gynecologic infections and abnormalities require the ability
to recognize normal structures and physiology.
Слайд 73
![SUMMARY From that point, one must be able to categorize](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-72.jpg)
SUMMARY
From that point, one must be able to categorize the problem
into an anatomical, traumatic malignancy, or infection problems.
Слайд 74
![SUMMARY Knowing the key signs and symptoms for each of](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-73.jpg)
SUMMARY
Knowing the key signs and symptoms for each of these categories
will ensure your ability to reach the best assessment without the common hospital aid at your disposal in the field environment.
Слайд 75
![QUESTIONS???](/_ipx/f_webp&q_80&fit_contain&s_1440x1080/imagesDir/jpg/312705/slide-74.jpg)