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1、GYNECOLOGICAL INFECTIONS AND ABNORMALITIES SFC WARD Joint Special Operations Medical Training Center Joint Special Operations Medical Training Center Dysmenorrhea Most common cause of pelvic pain in females. Definition - menstrual pain Etiology - Obstruction and anatomical cervical stenosis, fibroid
2、s, anteflexion of uterus, PID Endocrine - excessive production of prostaglandins which intensify uterine contractions. Joint Special Operations Medical Training Center Dysmenorrhea Management. NSAIDS (nonsteroidal anti inflammatory drugs). Oral contraceptive. Adequate rest and sleep and regular exer
3、cise may be beneficial. Heating-baths, soaks, showers and heating pad. Muscle relaxants-PRN for cramping. Joint Special Operations Medical Training Center Premenstrual syndrome (PMS) premenstrual tension Definition-is a distinct clinical entity characterized by a cluster of physical and psychologica
4、l symptoms that are limited to a week or 10 days, preceding menstruation and are relieved by onset of the menses. Joint Special Operations Medical Training Center Premenstrual syndrome (PMS) premenstrual tension Known precipitating factors include an increase in antidiuretic hormone and aldosterone
5、secretion, as well as estrogen- progesterone imbalance. Joint Special Operations Medical Training Center Premenstrual syndrome (PMS) premenstrual tension PMS increases with age and body weight. Uncommon in women in their teens and twenties. Joint Special Operations Medical Training Center Premenstru
6、al syndrome (PMS) premenstrual tension Symptoms. Physical. Painful and swollen breast. Bloating. Abdominal pain. Headache and back pain. Joint Special Operations Medical Training Center Premenstrual syndrome (PMS) premenstrual tension Psychologically. Depression. Anxiety. Irritability. Behavioral ch
7、anges. Joint Special Operations Medical Training Center 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 ora
8、lly Q 4 6 hrs PRN. Program of regular sleep and exercise. Joint Special Operations Medical Training Center Premenstrual syndrome (PMS) premenstrual tension Treatment. Decrease salt intake to relieve bloating and edema. Drug therapy should be avoided, when possible. Joint Special Operations Medical T
9、raining Center Pelvic Inflammatory Disease Definition-Pelvic Inflammatory Disease (PID) is any acute, subacute, recurrent, or chronic infection of the oviducts, and ovaries, with adjacent involvement. Joint Special Operations Medical Training Center Pelvic Inflammatory Disease Sites - it includes in
10、flammation 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). Joint Special Operations Medical Training Center Pelvic Inflammatory Disease Cervicitis. Defi
11、nition- inflammation of the cervix. Joint Special Operations Medical Training Center Pelvic Inflammatory Disease Causative organisms - gonococcus, streptococcus, staphylococcus, aerobic and anaerobic organisms, herpes virus, and chlamydia. Joint Special Operations Medical Training Center Pelvic Infl
12、ammatory Disease Forms of cervicitis- Acute and Chronic. Joint Special Operations Medical Training Center Pelvic Inflammatory Disease Acute cervicitis. Symptoms. Purulent, foul smelling vaginal discharge. Itching and/or burning sensation. Red, edematous cervix. Pelvic discomfort. Sexual dysfunction
13、infertility. Joint Special Operations Medical Training Center 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 re
14、sults. Joint Special Operations Medical Training Center Pelvic Inflammatory DiseasePelvic Inflammatory Disease Chronic cervicitis. Symptoms. Cervical dystocia-difficult labor. Lacerations or eversion of the cervix. Ulceration vesicular lesions (when cervicitis results from Herpes simplex Joint Speci
15、al Operations Medical Training Center Pelvic Inflammatory DiseasePelvic Inflammatory Disease Assessment. Physical examination. Chronic cervicitis, causative organisms are usually staphylococcus or streptococcus. Joint Special Operations Medical Training Center Pelvic Inflammatory DiseasePelvic Infla
16、mmatory Disease Management - manage by cauterization, cryotherapy, conization (excision of a cone of tissue). Joint Special Operations Medical Training Center Pelvic Inflammatory DiseasePelvic Inflammatory Disease Endometritis. Definition - inflammation of the endometrium. Etiology - produced by bacterial infection most commonly staphylococci, colon bacilli, or gonococci
