Term
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Definition
A synthetic non-steroidal estrogen
It was commonly prescribed to prevent SAB and other pregnancy complications from 1938-1971 |
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Term
True or False:
Women prescribed DES have a decreased risk of Breast CA |
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Definition
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Term
| What is one of the major risks to daughters of women who took DES while pregnant? |
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Definition
Clear cell adenocarcinoma of the vagina and cervix
They are 40X more likely to develop it than those who were never exposed |
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Term
| What are some other potential complications in DES daughters? |
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Definition
1. Reproductive tract structural abnormalities
2. Pregnancy complications
3. Infertility
4. Ectopic pregnancy |
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Term
| DES sons are at an increased risk for non-cancerous ______ ______ |
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Definition
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Term
| Reproductive tract anomalies in DES daughters include: |
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Definition
1. Vaginal epithelial changes
2. Cervical hood/collar
3. Abnormal/absent fornix
4. Transverse or longitudinal vaginal septum
5. Pseudopolyps
6. T-shaped uterus
7. Endometrial bands |
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Term
| Define Toxic Shock Syndrome |
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Definition
| An acute febrile illness produced by a bacterial exotoxin, from certain strains of staph aureus, with a fulminating downhill course involving multiple organ system dysfunction |
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Term
| Four main symptoms of TSS include: |
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Definition
| Fever > 102, rash, desquamation 1 to 2 weeks after rash onset, and hypotension |
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Term
| Which organ systems may be affected by TSS? |
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Definition
1. GI - n/v, diarrhea
2. Muscular - severe myalgia
3. Mucous membranes - vaginal hyperemia
4. Renal - BUN, Creat 2x normal; pyuria
5. Hepatic - bilirubin, ALT, and AST increase
6. Hematologic - Platelts < 100,000
7. CNS - disorientation, changes in LOC |
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Term
True or False:
Consider TSS in any woman with unexplained fever and/or rash during or immediately following menses |
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Definition
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Term
| CDC case definiton of TSS |
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Definition
| Fever >102, rash, desquamation, and hypotension PLUS involvement of 3 other organ systems |
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Term
| Name some recommendations to help prevent TSS |
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Definition
1. Use low-absorbency tampons
2. Change tampons frequently
3. Alternate pad and tampon use
4. Remove barrier contraception within 24 hrs
5. Women who have previously had TSS should not ever use tampons or barrier contraception (i.e. diaphragm) |
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Term
True or false:
Management of TSS should be handled by a physician |
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Definition
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Term
| Treatment for TSS includes: |
|
Definition
1. Fluid resuscitation
2. ATBs - clindamycin (1st choice), PCN
3. General supportive care |
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Term
| Important differentials to r/o when diagnosing TSS |
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Definition
Leptospirosis
and
Rocky mountain spotted fever |
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