Term
|
Definition
Black Cohosh
CranBerry
Dong Quai
Fenugreek |
|
|
Term
| What is Black Cohosh for? |
|
Definition
| PMS, Dysmenorrhea, Menopause |
|
|
Term
|
Definition
| Has Phytoestrogen and sm amount salicylic Acid. |
|
|
Term
| What does Phytoestrogen Do? |
|
Definition
| Its Estrogen-Like so it has sterol molecules and SERM (Selective Estrogen Recptors) that help Supress LH. |
|
|
Term
|
Definition
Usual GI. Plus
Headache,
Rash
and Weight Gain
(due to supressing LH). |
|
|
Term
|
Definition
Oral Contraceptives and
Estrogen Replacement Therapy. |
|
|
Term
|
Definition
|
|
Term
| Counseling Patients on Black Cohosh |
|
Definition
Do not use for more than 6 months.
Beware of allergies to Salicylic Acid
Might Cause Hepatotoxicity |
|
|
Term
| What was the Study for Black Cohosh and what did they find? |
|
Definition
HALT Study.
Not effective.
HRT (hormone replacement therapy is though). |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inhibit E.Coli using HIPURRIC Acid. |
|
|
Term
| Adverse Effect of Cranberry |
|
Definition
| No significant. Just usual GI, stomach issue |
|
|
Term
| Drug Interactions of Cranberry |
|
Definition
| Warfarin and small amounts of Salycilic acid in Juice. |
|
|
Term
|
Definition
300-400mg BID or 8-16oz Daily.
*There is more befit with juice than Capsules. |
|
|
Term
| Counseling points for Cranberry |
|
Definition
-The Dried Tablet may Cause Kidney Stones
-beweary of Salicylate Allergy |
|
|
Term
| Any Studies and what found on Cranberry |
|
Definition
| Journal of Anticmicrobial Chemotherapy saw semi positive results. |
|
|
Term
| Dong Quai is also known as |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Phytoestrogen and Serotoinin Effect |
|
|
Term
| Adverse Effects of Dong Quai |
|
Definition
Photosensitivity
Bleeding and Bruising (due to Coumarin ingredients). |
|
|
Term
| Drug IXn's with Dong Quai |
|
Definition
|
|
Term
| So so far, Cranberry and Dong Quai have ixn's with Warfarin. |
|
Definition
| In addition, Both Black Cohosh and Cranberry have salicylic acid. |
|
|
Term
| Counseling points on Dong Quai |
|
Definition
Benificial when in use with other herbals.
Its safe for 24 weeks max.
Beweary of unusual bruising |
|
|
Term
|
Definition
|
|
Term
| What are the Uses for FenguCreek |
|
Definition
Lactation
Decreases Glucose (will cause loss of appetitie).
Usually flavored (maple) |
|
|
Term
|
Definition
| Galactagogue and reduce glucose levels after means. |
|
|
Term
|
Definition
| Don't know. maybe a mamary gland simliar to SWEAT. |
|
|
Term
| Averse Effects of Fengucreek? |
|
Definition
A LOT:
Maybe Syrup urine/sweat
Incraesed sweating
Exacerbate Asthma
Allergic Reactions |
|
|
Term
|
Definition
Antidibetic
and Antiplatelet (warfarin and aspirin) |
|
|
Term
| Counseling points on Fengugreek |
|
Definition
Breast milk has maple smell
Blood glucose is lowered |
|
|
Term
|
Definition
| Yes. Incrased milk production. |
|
|
Term
|
Definition
Panax Ginseng
Sal Palmetto
Yohimbe |
|
|
Term
|
Definition
Male Fertility
Impotence
Premature Ejaculation
Adaptogen = cope with stress |
|
|
Term
| What are the Active Constituents? |
|
Definition
Ginsenosides
and Panaxosides |
|
|
Term
|
Definition
Hypertension/hypotension effects as well as stimulatino/depression.
Will enhance NO.
Relax Penile Muscle (corpus cavernosum) |
|
|
Term
| Adverse for Panax Ginseng |
|
Definition
Insomnia
Hypertension/hypotension
Palpitations
Edema |
|
|
Term
| Drug Ixns' of Panax Ginseng |
|
Definition
Ethanol
Anticoagulant
AntiDiabetic
Caffeine |
|
|
Term
|
Definition
| Use 1 hour before intercourse. |
|
|
Term
| Counseling Tips of Panax Ginseng |
|
Definition
| Red (steam cured = heat = more ginsenosides) vs White. |
|
|
Term
| Do not Use Panax Ginseng for more than... |
|
Definition
|
|
Term
| Clinical Evidence for Panax Ginseng |
|
Definition
| Positive Results!60% on improved libido, duration of action, and patient satisfaction. |
|
|
Term
|
Definition
| Improve Lower Urinary Tract Symptoms (LUTS) |
|
|
Term
|
Definition
Inhibit 5-Alpha-Reductase
Antiestrogenic
Antiinflamatory |
|
|
Term
|
Definition
Headache
Abdominal Pain
and of course, GI. |
|
|
Term
|
Definition
Dutasteride (AvoDart)
Finesteride (Proscar)
Tamsulosin
Alpha Adrenergic Blockers |
|
|
Term
| Counseling tips on Saw Palmetto |
|
Definition
DO NOT use unless Diagnosis confirmed
Use up to 1 year only
Should have 85% standardized fatty acids. |
|
|
Term
| Saw Palmetto's other name |
|
Definition
|
|
Term
| There are no additive benefit when used in conjunction with other Rx therepaies |
|
Definition
|
|
Term
| Evidence for Saw Palmetto |
|
Definition
| Positive and well tolerated. |
|
|
Term
| evidence for Saw Palmetto for Enlarged Prostrates |
|
Definition
|
|
Term
|
Definition
Erectile dysfunction
Sexual Vitality |
|
|
Term
|
Definition
A2 Antagonist
CNS Stimulant
Increase nerve impulses..to genital |
|
|
Term
|
Definition
Excitation
Tremor
Anxiety
Insomnia
Dizzy |
|
|
Term
|
Definition
Antihypertensives (other A2 antagonists)
MAO
Caffeine |
|
|
Term
| Counseling tips on Yohimbe |
|
Definition
Synergistic with L-Argigine
Unsafe for OTC use because of hypotension/hypertension |
|
|
Term
|
Definition
|
|
Term
|
Definition
Safe and more effective than placebo for erectile dysfunction
Use up to 8 weeks. |
|
|
Term
| Section on Vaginal Anatomy and Physiology |
|
Definition
|
|
Term
| What occurs From Puberty to Menopause |
|
Definition
| increase ovarian Estrogen production, |
|
|
Term
| Increaesd Estrogen leads to? |
|
Definition
| Increased stratified squamos epithlial cells on vaginal lining |
|
|
Term
| Increased vaginal lining leads to |
|
Definition
| increased glycogen production |
|
|
Term
| Increased glycogen production leads to |
|
Definition
| increased vaginal flora such as Lactobacillus Acidophilus (bacteria) |
|
|
Term
| Lactobacillus + Glycogen = |
|
Definition
| Lactic Acid and (H2O2) which decreases vagianl pH (4-4.5). |
|
|
Term
| Importance of H202 and Lactic acid |
|
Definition
| Protects vagina from other bacterial phatogen. |
|
|
Term
| Typically where do infections usually occur? |
|
Definition
vulva and vagina, not
cervix or other reproductive organs |
|
|
Term
| What is Leukorrhea? Its characteristics? |
|
Definition
It is a vaginal discharge.
Usually odorless, clear egg white and sticky viscous. |
|
|
Term
| What normally increases Leukorrhea? |
|
Definition
ovulation,
pregnancy,
menses/post-menses
sexual arousal
emotional flares. |
|
|
Term
| What are the common vaginal infections? |
|
Definition
Bacterial Vaginosis,
vulvogavinal Candidiasis,
Trichomonaiasis |
|
|
Term
| The three Vaginal Symptoms, BC, VVC, Trichomonaiasis, account for how much of the abnormal Leukorrhea Vaginal Infections? |
|
Definition
|
|
Term
| Main way of differentiation is based on |
|
Definition
|
|
Term
| BC's Symptoms and Etiology |
|
Definition
Increased Vaginal pH due to decrease in lactobacilli.
Green/Grey Color that's thin/foamy.
Fishy odor
*intensity of irritation,itchy, and dysuria is less prounced than Trichomiasis. |
|
|
Term
| What are risk factors for BV? |
|
Definition
African American,
IUD (better to use Oral Contraceptives)
12% virginal adolescents
New sex partner doing oral.
Douching
Prior pregnacy |
|
|
Term
| What are exclusions to treatment of BV? |
|
Definition
Pregnant
HIV
PID, UTI, Cervictis, Endometriosis |
|
|
Term
|
Definition
No. But we support wearing a condom.
and using oral contraceptives (as opposed to IUD). |
|
|
Term
| PharmaCo treatment for BV |
|
Definition
(RX)Clindamycin, Metronidazole.
Requires compounding - Providine/Iodine. (again. not for pregnant or breastfeeding) |
|
|
Term
| Etiology and Symptoms of VC (Vulvovaginal Candidiasis) |
|
Definition
No change in pH.
Cottage cheese thick white.
No odor.
Very intense erythema,itchy, and vulvar edema.
A fungal yeast infection. |
|
|
Term
| Complications and risk factors for VC |
|
Definition
Systemic Antibiotic use (Diflucan)
Immunosupressants (Diabetes, Aids, HIv, Corticosteroid use).
We can see an increase transmission of other infections. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| We think maybe yogurt, but not really |
|
|
Term
|
Definition
Ask. Are there any exclusions to self care? no Odor? is the Consistency cheesy curd like? Are there lots of itcy, red, and edema? Is normal pH? Irritant?
Then we can give 4 things.
Butoconazole. Clotrimazole.
Micronazole. Iconazole.
*note the AZOLE. |
|
|
Term
| The Main VVC and on infectious vulvovaginal self care exclusions...(6) |
|
Definition
Pregnant.
Less than 12 yeras old
Fever
Meds: Coticosteroids, ABX, Antineoplastics.
Recurrent: More than 3 infections in past year. or Within past 2 months.
HIV or DM |
|
|
Term
| Ticonazole is the the only dosage form that's |
|
Definition
ointment.
The other Azoles are usually cream, though Miconzole can be a suppository. |
|
|
Term
| Generally which dosage form is best? |
|
Definition
| Creams and ointments, especially for siginficiant vulvar symptoms. |
|
|
Term
| What are non curative products for? Examples. |
|
Definition
Hydrocortisone
Bonzocaine
Providine Iodine (no breast feed)
HomeopathicL Pusatilla, C Albicans, C Parapsilosis). |
|
|
Term
| What are two complimentary treatment not to use? |
|
Definition
Douche's
Yogurt kinda sucks too |
|
|
Term
| Beneficial Anti-irritant for Vaginal |
|
Definition
|
|
Term
| Beneficial Antibacterial/Antifungal: |
|
Definition
|
|
Term
|
Definition
| Gentian Violet and Boric Acid |
|
|
Term
| Any risk factors to the complimentary treatments mentioned? |
|
Definition
Tea Tree oil can be allergic reaction.
Boric Acid can be Toxic.Teratogenic |
|
|
Term
| Pros and Cons to OTC pH tests |
|
Definition
Confirms if need treatment and decreases inappropriate self care
Cons: Added cost and Added step. |
|
|
Term
| Trichomoniasis Symptoms and Etiology |
|
Definition
Flagellated Anerobic Protozoan....
Increases vaginal pH
Yellow green discolored
Copious and frothy texture
Very bad odor (just not fishy)
Intensity is more than BV. |
|
|
Term
| Risk Factors and complications of Trichomoniasis |
|
Definition
Mutiple sex partners
STI's
Pregnant, Tubal Infertility,
Hiv |
|
|
Term
|
Definition
|
|
Term
|
Definition
Metronidazole.
Timidazole. |
|
|
Term
| Name two Estrogen Deficiency Disease |
|
Definition
Atrophic Vaginitis and
Dyspareunia. |
|
|
Term
| Symptoms of Atrophic Vaginitis |
|
Definition
Inflamation.
Dysparenia (painful sex)
Leukorrhea: thin, bloody spotting, yellow, malodorous.
Less Vaginal Lube = irritation, dry, burn, itchy. |
|
|
Term
|
Definition
Severe DRYNESS = bleeding
not localized
Personal Lubes don't help |
|
|
Term
| What are the main causes of Dysparunia (aka painful sex) |
|
Definition
Menopause
Anti-Estrogen Meds
Transient Estrogen deficiency = breast feeding or recent childbirth |
|
|
Term
| Treament for Atrophic Vaginitis |
|
Definition
*Water, not oil based..
Glycerin
Propylene Glycol
any methylceullulose
Vit E.
Acacia honey.
Glycol's |
|
|
Term
|
Definition
| Increased Arousal time, More frequent Intercourse. |
|
|
Term
| name three types of OTC douching products |
|
Definition
Water/Vinegar
Antiseptics
Provodine Iodine |
|
|
Term
| Outcome and exclusion to use for Water/Vinegar |
|
Definition
No effect on Lactobacili.
Don't use if pregnant |
|
|
Term
| Outcome and exclusion for Antiseptics |
|
Definition
Inhibits ALL vaginal flora
Don't use if pregnant |
|
|
Term
| Outcome and exclusions for Provodine/Iodine |
|
Definition
Reduce TOTAL vaginal flora = allow pathogenic species to proliferate.
Systemicaly Absorbed
Don't use if pregnant or breast feeding |
|
|
Term
| Name of Brands for Douching |
|
Definition
Massengill
Summer's Eve,
Vagi-Guard. |
|
|
Term
|
Definition
Sit over toilet or Stand in Shower
Insert 3 inches Gently into vagina.
Don't close the lips of vagina. |
|
|
Term
| How to adminster the Bag douche? |
|
Definition
*Can be an enema as well...
Lie down, knees bent. bag 1 foot above.
Fill and hold for 30-60 seconds. |
|
|
Term
| Patient Counseling on Douching. |
|
Definition
Not for birth control
not for vaginal infections
don't do after 6-8 hours after sex.
Dont' use if preg or breast feed
no more than 2x weekly
don't if Dryness/irritation present
Don't w/n 3days of using vaginal antifungal
Don't if 48hrs before gynecologic exam |
|
|
Term
|
Definition
|
|
Term
|
Definition
Stop Using T Computer Graphics
Spyillus
Urethritis
Trichomoniasis
Chylmydia
Gonorrhea |
|
|
Term
| Non Curable Vaccine Preventable |
|
Definition
|
|
Term
| Non Curable but Preventable |
|
Definition
|
|
Term
T/F
The only sti self-care products are condoms |
|
Definition
|
|
Term
| Which group is a great risk for STI |
|
Definition
|
|
Term
| Are women more likely to get STI than men? |
|
Definition
|
|
Term
| 1/4 Teenage girls are infected with STI |
|
Definition
|
|
Term
|
Definition
65 Million have STI
with 15mil infected anually |
|
|
Term
|
Definition
no sex.
monogamous
self exam |
|
|
Term
|
Definition
CONDOMs!!!
Rx Imunize for Hep B and HPV |
|
|
Term
| What was teh results of a Tenofovir Vaginal Gel Clinical Trial? |
|
Definition
| Good. Decreased HIV transmission and Herpes. |
|
|
Term
| What are good Contraceptives |
|
Definition
Latex and Polyurethane
Natural is good only for Bacterial and not Viral.
Sponges might for bacteria, and not for Viral |
|
|
Term
| What are bad Contraceptive ingredients |
|
Definition
Spermicides (can actually increase risk)
Fertility Awareness only helps prevent pregnancy, not STI.
IUD (intrauterine device) increases risk of PID (Pelvic Inflamatoy D)
Horomonal Oral Contraceptives increase risk for Chlaydia |
|
|
Term
| 50% of women with unintended pergnanicies were using a method of contraceptions and of those 50 there were 20% taht had been using it incorrectly |
|
Definition
|
|
Term
| Oil or water based Condom lubriacant should be use? |
|
Definition
|
|
Term
| What are percent of pregnancy using male and female condoms perfectly? not? |
|
Definition
2 to 5 (m to f)
15-21 (m to f) |
|
|
Term
| What causes condom breakage? |
|
Definition
manufacturer defects
bad placement
oil based lubes
reuse
Increased duration of Coitus
Jewelery or nails |
|
|
Term
|
Definition
Use cream or gel spermicides.
not suppositories or films (they have slow dissolution time delay).
Do not Douche. |
|
|
Term
|
Definition
1)Abnormal reflux of gastric into the esophagus...or
2) Heartburn for 2 more days per week |
|
|
Term
|
Definition
1) Regurgitation without nausea
2) Water Brash incident
3) hypersalivation
4) Pyrosis |
|
|
Term
|
Definition
| Compromised LES (lower esophageal sphincter). |
|
|
Term
| Caustic effects of stomach contents are due to 4 things... |
|
Definition
HCL
Pepsin
Bile Acids
Pancreatic Enzymes - Lipases and Proteases. |
|
|
Term
| What is Barrett's Esophagus |
|
Definition
| When squamous epithelial is replaced to specialized columnar epithelial. |
|
|
Term
| Repeated exposure of esophagus to those casutic agents can leads to.... |
|
Definition
Inflamation
Erosion of the squamos epithlial. |
|
|
Term
| Does GERD cause mortality? |
|
Definition
| No, but it can affect the quality of life. |
|
|
Term
|
Definition
| Autonomic Nervous System. |
|
|
Term
| Specifically how does ANS accomplish the LES Tone? |
|
Definition
| Using Non-adrenergic-noncholinger neurons. |
|
|
Term
| What are the Specific Non Adrenergic Non Cholinergic neurons? |
|
Definition
NANC - releases NO
and VIPergic -release VIP (a vasoactive intestinal peptide). |
|
|
Term
| TONE of LES varies by what factors? |
|
Definition
Food
Life-style
Meds
Hormones. |
|
|
Term
| What decreases LES pressure? |
|
Definition
Certain foods like fat, peppermint and choclate.
-Caffeine and coke
-Nicotine
-Ethanol
-Nitrates, Ca Channel Blockers
-Estrogen/progesterone |
|
|
Term
| LES Pressure is increased by |
|
Definition
-Protein
-Prokinetic agents(i.e. metoclopramide
-Adrenergic alpha agonists |
|
|
Term
| Treatment of GERD for Stage 1 |
|
Definition
Life Style changes:
-no smoke, no caffeine, no stress
-high protein meals and no meals in the evening |
|
|
Term
| Treatement of GERD in stage 2 |
|
Definition
Prokinetic agents(MCP and Tegaserod)
Antacids |
|
|
Term
| Treatment of GERD stage 3 |
|
Definition
-H2 antagonists
-proton pump inhibitor |
|
|
Term
|
Definition
Inflammation of the lining of the stomach.
Can be Acute or Chronic. |
|
|
Term
| Gastritis usually involves... |
|
Definition
H-PYLORI
-sometimes with infectious granulomatous, CMV infection, Automimune or Reactive gastropathy. |
|
|
Term
| What is Type A Chronic Gastritis |
|
Definition
Fundal or Autoimmune Gastritis:
-a autoimmune destruction of acid secreting mucosa. |
|
|
Term
| What is one major danger about TYPE A Gastritis? |
|
Definition
| Anti-parietal cells that cause a lack of intrinsc factors and reduces the absorption of vitamin b-12. |
|
|
Term
| What is Type B Gastritis? |
|
Definition
Antral Gastritis which is the most common Chronic Gastritis.
H-pylori is inflamed with mononuclear leucocytes. |
|
|
Term
|
Definition
| Gram negative flagellated corscrew shaped bacteria |
|
|
Term
| What is the distinctive enzymatic marker for H-Pylori? |
|
Definition
|
|
Term
|
Definition
| Converts Urea to CO2 and NH3. |
|
|
Term
| What is Ulcerogenic action of H-Pylori? |
|
Definition
| Neutralized gastric juice of the duodenum incraeses Gastrin production and more acid production by Parietal Cells. |
|
|
Term
|
Definition
| Causes inflammatory response and damages epithelial cells |
|
|
Term
| How test presence of H-Pylori? |
|
Definition
|
|
Term
| What are Peptic Ulcers usually caused from? |
|
Definition
| Proteolytic action of Pepsin on mucosal where can see ischemia, inflamation or infection. |
|
|
Term
| There are three forms of peptic ulcers |
|
Definition
|
|
Term
| Traits of H-pylori Peptic Ulcers |
|
Definition
Chronic,
at duodenum >stomach
Dependent on pH
Epigastric pain
Superficial ulcer depth
mild GI Bleeding |
|
|
Term
|
Definition
Chronic
Stomach>Duodenum
not dep on pH
Asymptomttic
Deep Ulcer Depth
Severe GI bleeding |
|
|
Term
|
Definition
Acute
Stomach> Duodenum
Asymptomiac
not dep on pH
severe gi bleeding |
|
|
Term
| What is the focus of treatment of ulcers? |
|
Definition
| Supress gastric acid production from Parietal Cells. |
|
|
Term
| What percentage of ulcers heal spontaneously? |
|
Definition
|
|
Term
| How is acid production regulated in Parietal cells? |
|
Definition
| Release of HCL is caused by H,K-ATPase (a Proton Pump) enzyme. |
|
|
Term
|
Definition
When the H2CO3 (carbonic acid) is dissoicated to H and bicarbonate (HCo3)
Bicarbonate is exhcnaged with Cl so that Cl comes from Intersitial fluid to the lumen of the gastric gland where it acts as a cotransporter for H back out to the interstitial fluid |
|
|
Term
| Difference between gastric ulcers, duodenum ulcers, and peptic ulcers. |
|
Definition
Gastric has normal levels of HCl but backed up HCL.
Duodnum has increased levels of HCL.
Peptic is caused by Pepsin causing damages |
|
|
Term
| Compare the difference between Gastric and other H/ATPases. |
|
Definition
Gastric:
-only in parietal cells
-2 subunits
-4X10^6 gradient
-Requires K+ions
Other ATPases
-found in every cell
-8-9 Subunits
-100X Gradient
-K not required. |
|
|
Term
| Secretion of HCL by Parietal cells is induced by 3 factors. |
|
Definition
-Histamine
-Gastrin receptors
-Muscarinic (M1/M3) via AcH |
|
|
