{"id":593,"date":"2009-02-09T21:18:54","date_gmt":"2009-02-09T20:18:54","guid":{"rendered":"http:\/\/www.zdravstvena.info\/vsznj\/?p=593"},"modified":"2010-06-15T14:21:52","modified_gmt":"2010-06-15T13:21:52","slug":"ginekologija-in-porodnistvo-dismenoreja-predmenstrualni-sindrom-menarha-puberteta-menopavza-stresna-inkontinenca-rak-dojke-ginekoloski-raki-miom-mijomi-hpv-rak-matericnega-vratu","status":"publish","type":"post","link":"https:\/\/www.zdravstvena.info\/vsznj\/ginekologija-in-porodnistvo-dismenoreja-predmenstrualni-sindrom-menarha-puberteta-menopavza-stresna-inkontinenca-rak-dojke-ginekoloski-raki-miom-mijomi-hpv-rak-matericnega-vratu\/","title":{"rendered":"Ginekologija in porodni\u0161tvo vpra\u0161anja in odgovori 21-50"},"content":{"rendered":"

\"pregledovanje-dojk\"VZROKI HIPOGONADOTROPNE AMENOREJE<\/strong><\/p>\n

Hipotalami\u010dni vzroki (Kasna menarha, psihogeni faktorji)<\/p>\n

Hipofizni vzroki ( tumorji, po\u0161kodbe, vnetja hipofize)<\/p>\n

Hude sistemske bolezni<\/p>\n

<\/p>\n

2. <\/strong>ZNAKI SINDROMA POLICISTI\u010cNIH OVARIJEV <\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Oligo-amenoreja anovulatorni ciklusi<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hiperandrogenizem (pove\u010dana pora\u0161\u010dnost, izpadanje las, mastna ko\u017ea, akne..)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 UZ policisti\u010dni ovariji<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Debelost, pove\u010dan LH, inzulinska rezistenca<\/p>\n

3. <\/strong>KAJ JE DISMENOREJA, KAK\u0160NE POZNAMO?
\n<\/strong><\/p>\n

Tope ali kr\u010devite bole\u010dine v spodnjem delu trebuha in v kri\u017eu<\/p>\n

PRIMARNA DISMENOREJA: Pri mladih dekletih obi\u010dajno izgine (se zmanj\u0161a) s prvim porodom. Terapija: Simptomatska (analgetiki, oralna hormonska kontracepcija…)<\/p>\n

SEKUNDARNA DISMENOREJA: Se pojavi kasneje<\/p>\n

Organski vzroki: Endometrioza, tumorji uterusa, ovarija, stenoza cervikalnega kanala, vnetja notranjih genitalij. Terapija: zdraviti vzrok, simptomatska terapija<\/p>\n

4. <\/strong>PREDMENSTRUALNI SINDROM <\/strong><\/p>\n

7-10 dni pred menstruacijo, 5-10% \u017eensk<\/p>\n

Simptomi: Anksioznost, razdra\u017eljivost, napetost dojk in trebuha, glavobol, utrujenost. Ob nastopu menstruacije ti simptomi izginejo<\/p>\n

5. <\/strong>KAJ POMENIJO IZRAZI: PUBARHE, TELARHE, MENARHE<\/strong><\/p>\n

MENARHE: <\/strong>Prva menstruacija, navadno med 12. in 14. letom<\/p>\n

TELARHE:<\/strong> Prvi znak razvoja dojk (2. Stopnja po Tannerju) ve\u010dinoma prvi znak pubertete – Estrogeni<\/p>\n

PUBARHE:<\/strong> Prvi znak dlak (2. Stopnja po Tannerju). Ve\u010dinoma nekaj mesecev po Telarhi – Androgeni<\/p>\n

6. <\/strong>NEPRAVILNOSTI PUBERTETE <\/strong><\/p>\n

PREZGODNJA PUBERTETA (Pred 8. letom starosti)<\/p>\n

KASNA PUBERTETA – Pri 14. Letih ni Telarhe. V petih letih po telarhe ni menarhe<\/p>\n

Misliti na kriptomenorejo in druge – tudi kromosomske nepravilnosti (npr. Turnerjev sindrom)<\/p>\n

<\/strong><\/p>\n

7. <\/strong>KAJ JE MENOPAVZA in KAK\u0160NE NEPRAVILNOSTI POZNAMO <\/strong><\/p>\n

Menopavza je zadnja menstruacija navadno med 45. in 55. letom<\/p>\n

Prezgodnja menopavza = pred 40. letom<\/p>\n

Prepozna menopavza = po 55 letu<\/p>\n

9. <\/strong>NA\u0160TEJ 5 DEJAVNIKOV ZA NASTANEK OSTEOPOROZE<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zgodnja menopavza, po odstranitvi jaj\u010dnikov<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Drobna, majhna konstitucija<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Svetlopolte \u017eenske<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kajenje, alkohol, premalo kalcija v hrani<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zdravila za \u0161\u010ditnico, kortikosteroidi, astma, artritis…<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Familiarna obremenjenost<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sede\u010d na\u010din \u017eivljenja<\/p>\n

<\/strong>
\n<\/strong><\/p>\n


\n<\/strong><\/p>\n

10. <\/strong>UGOTAVLJANJE OSTEOPOROZE <\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Rentgenolo\u0161ko merjenje gostote kosti – Denzitometrija<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ultrazvo\u010dno – Peta<\/p>\n

11. <\/strong>RAZLO\u017dI POJME<\/strong><\/p>\n

Subtotalni prolaps uterusa:<\/strong> Zdrknjena maternica<\/p>\n

Cistokela:<\/strong> Sprednja stena z mehurjem izbo\u010dena in spu\u0161\u010dena stena no\u017enice.<\/p>\n

Rektokela:<\/strong> Zadnja stena rektumom<\/p>\n

Enterokela:<\/strong> Kila Douglasovega prostora, zadnjega prostora<\/p>\n

12. <\/strong>KAJ JE STRESNA in KAJ URGENTNA INKONTINENCA<\/strong><\/p>\n

STRESNA: Pri ka\u0161ljanju, kihanju, smejanju, dvigovanju, hoja po stopnicah<\/p>\n

URGENTNA: \u010cezmerno aktivni se\u010dni mehur ( OAB – Overactive Bladder )<\/p>\n

13. <\/strong>ZNAKI \u010cEZMERNO AKTIVNEGA SE\u010cNEGA MEHURJA<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nujnost (urgenca)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Pogostnost<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No\u010dna mikcija (nikturija)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Urgentna inkontinenca<\/p>\n

14. <\/strong>NA\u0160TEJ 3 NAJPOGOSTEJ\u0160E INFEKCIJE \u017dENSKEGA SPOLOVILA<\/strong><\/p>\n

BAKTERIJE: Klamidija, gonokok(gonoreja) , Treponema pallidum (sifilis)<\/p>\n

VIRUSI: Genitalni herpes, HPV, AIDS, Hepatitis B<\/p>\n

GLIVICE: Candida, Dermofitije<\/p>\n

PRA\u017dIVALI: Trihomonas<\/p>\n

ZAJEDALCI: Garje (Scabies)<\/p>\n

SRAMNA U\u0160: (Pediculuspubis)<\/p>\n

15. <\/strong>KAJ POVZRO\u010cA CANDIDA ALBICANS, NA\u0160TEJ 4 NAJPOGOSTEJ\u0160E POGOJE ZA NJEN RAZVOJ<\/strong><\/p>\n

Oku\u017ebo. Prisotna povsod.
\n
\nPOGOJI Z NJEN RAZVOJ – SPREMENJENI POGOJI V NO\u017dNICI<\/p>\n

– Antibiotiki – uni\u010dujejo normalno vaginalno floro<\/p>\n

– Nose\u010dnost<\/p>\n

– Jemanje hormonske kontracepcije<\/p>\n

– Sladkorna bolezen<\/p>\n

NO\u017dNICA JE OBLO\u017dENA, gost sirast iztok. Navadno iz no\u017enice na spolovilo – pe\u010de srbi.<\/p>\n

Zdravljenje z antimikotiki lokalno ali per os.<\/p>\n

16. <\/strong>ZNAKI TRIHOMOADNEGA KOLPITISA<\/strong><\/p>\n

Obilen, redek, penast zelenkast izcedek, sluznica vneta, hrapava na dotik in srbi.<\/p>\n

17. <\/strong>KAJ POMENIJO IZRAZI<\/strong><\/p>\n

ENDOMETRITIS: Vnetje sluznice maternice<\/p>\n

SALPINGITIS: Vnetje jajcevodov<\/p>\n

ADNEKSITIS: Vnetje jajcevodov in jaj\u010dnikov<\/p>\n

18. <\/strong>NA\u0160TEJ VSAJ 4 POSLEDICE SALPINGITISA (vnetje jajcevodov)<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Okluzija fimbrij<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Piosalpins, tuboovarijski absces<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Hidrosalpinks, saktosalpinks<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Adhezije – zarastline<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sterilnost<\/p>\n

19. <\/strong>KAJ JE PELVI\u010cNA VNETNA BOLEZEN<\/strong><\/p>\n

Vnetje maternice, jajcevodov ali ovarijev, ki v napredovanju tvori zarastline s sosednjimi tkivi in organi. Lahko povzro\u010da nekroze in tvorbo abscesov.<\/p>\n

<\/strong><\/p>\n


\n<\/strong><\/p>\n

20. <\/strong>NA\u0160TEJ VRSTNI RED POGOSTOSTI GINEKOLO\u0160KIH RAKOV <\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Rak dojke<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Materni\u010dno telo<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Materni\u010dni vrat<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Jaj\u010dnik<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Zunanje spolovilo<\/p>\n

21. <\/strong>ZNA\u010cILNOSTI MALIGNIH TUMORJEV<\/strong><\/p>\n

Karcinomi – iz epitelnega tkiva<\/p>\n

Sarkomi – iz vezivnega tkiva<\/p>\n

22. <\/strong>KAJ SO MIOMI in KJE NAJPOGOSTEJE LE\u017dIJO<\/strong><\/p>\n

[youtube]http:\/\/www.youtube.com\/watch?v=Q8iLUxSJ_K4[\/youtube]<\/strong><\/p>\n

Miomi so ve\u010dinoma benigni tumorji nastali na gladkem mi\u0161i\u010dnem tkivu maternice.
\n<\/strong><\/p>\n

So iz gladkih mi\u0161ic (leiomiom) in veziva (fibromiom) po 35.letu 20% \u017eensk<\/p>\n

Lokalizacija: Subserozni, intramuralni, submukozni, cervikalni<\/p>\n

23. <\/strong>KAJ JE CERVIKALNA INTRAEPITELIJSKA, KAJ JO POVZRO\u010cA in KAKO JO RAZDELIMO<\/strong><\/p>\n

Je premaligna sprememba.<\/p>\n

Povzro\u010da jo Humani Papiloma Virus (HPV): Genotipi 16,18,31,33…<\/p>\n

Neoplasti\u010dne spremembe celic:<\/p>\n

CIN1 – 1\/3 debeline epitela<\/p>\n

CIN2 – 2\/3 debeline epitela<\/p>\n

CIN3 – Ve\u010d kot 2\/3 debeline epitela (je lahko \u017ee intraepitelijski rak)<\/p>\n

24. <\/strong>RAK MATERI\u010cNEGA VRATU, KAKO GA RAZDELIMO in KAJ POVZRO\u010cA, GLEDE NA HISTOLOGIJO in MESTO NASTANKA<\/strong><\/p>\n

Najpogosteje okoli 50. Leta, pa tudi pri zelo mladih dekletih.<\/p>\n

Nastaja na no\u017eni\u010dnem delu materi\u010dnega vratu (porcija) in v vratnem kanalu.<\/p>\n

HPV – preko 90% ( TIP 16, 18, 31, 33..)<\/p>\n

Humani papilomski virus (HPV) je virus iz rodu papilomavirusov, katerega predstavniki povzro\u010dajo pri \u010dloveku lezije, bradavice na sluznici in ko\u017ei, nekateri tipi virusa pa tudi novotvorbe.<\/p>\n

Gre za DNK-viruse. Prena\u0161ajo se stikom ko\u017ee s ko\u017eo. Doslej je poznanih ve\u010d kot 100 razli\u010dnih tipov HPV. 30\u201340 tipov HPV se prena\u0161a zlasti s spolnim odnosom ter povzro\u010da oku\u017ebe genitalno-analne regije.<\/p>\n

Tipa 6 in 11 povzro\u010data genitalne bradavice in papilome grla.<\/p>\n

Persistentna oku\u017eba s tipi 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, in 68 \u2013 torej druga\u010dnimi od tistih, ki povzro\u010dajo bradavice \u2013 lahko vodi do nastanka novotvorb (cervikalna, analna, vulvarna ali penilna intraepitelijska neoplazija).<\/p>\n

Gre za predrakave lezije, ki se lahko razvijejo v invazivno rakavo obolenje.<\/p>\n

Oku\u017eba s HPV je predpogoj za nastanek ve\u010dine primerov raka materni\u010dnega vratu.<\/p>\n

Za odkritje povezave med oku\u017ebo s HPV in rakom materni\u010dnega vratu ter prispevek k razvoju cepiva je leta 2008 nem\u0161ki virolog Harald zur Hausen prejel Nobelovo nagrado.<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Plo\u0161\u010datoceli\u010dni (planocelularni) 90%<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Iz \u017eleznih celic (adenokarcinom) 10%<\/p>\n

25. <\/strong>PREVENTIVA RAKA MATERI\u010cNEGA VRATU<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Prepre\u010devanje infekcije s HPV ( izbira partnerja, kondom…)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Brisi materi\u010dnega vratu<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cepljenje<\/p>\n

26. <\/strong>RIZI\u010cNI FAKTORJI ZA RAK ENDOMETRIJA<\/strong><\/p>\n

Estrogeni, endogeni, debelost, diabetes, niso rodile…<\/p>\n

<\/strong><\/p>\n


\n<\/strong><\/p>\n

27. <\/strong>RAZDELITEV MALIGNIH TUMORJEV JAJ\u010cNIKOV – Splo\u0161no<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nepravi tumorji jaj\u010dnikov<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Benigni<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Maligni<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Maligni epitelijski tumorji ovarija – karcinomi<\/p>\n

28. <\/strong>KAJ JE ENDOMETRIOZA in ADENOMIOZA<\/strong><\/p>\n

ENDOMETRIOZA = Razvoj endometriju podobnega tkiva zunaj materi\u010dne votline – se odziva na hormone<\/p>\n

ADENOMIOZA = Rast endometrialnega tkiva v miometriju<\/p>\n

<\/strong><\/p>\n

<\/strong><\/p>\n


\n<\/strong><\/p>\n

29. <\/strong>DIAGNOZA ENDOMETRIOZE<\/strong><\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Anamneza: bole\u010dina, sterilnost<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ginekolo\u0161ki pregled: slab\u0161e premakljiva maternica, ve\u010dji uterus, mo\u010dne menstruacije ali pa sploh ni\u010d<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 UZ pregled = koristen<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Laparoskopija<\/p>\n

30. <\/strong>KAJ JE NEPLODNOST in KAKO JO RAZDELIMO<\/strong><\/p>\n

PRIMARNA = Nikoli zanosila, nikoli oplodil<\/p>\n

SEKUNDARNA= Je \u017ee zanosila, je \u017ee oplodil<\/p>\n","protected":false},"excerpt":{"rendered":"

VZROKI HIPOGONADOTROPNE AMENOREJE Hipotalami\u010dni vzroki (Kasna menarha, psihogeni faktorji) Hipofizni vzroki ( tumorji, po\u0161kodbe, vnetja hipofize) Hude sistemske bolezni<\/p>\n","protected":false},"author":336,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[636],"tags":[653,663,652,654,650,659,657,649,656,664,662,661,658,651,660,648,655],"class_list":["post-593","post","type-post","status-publish","format-standard","hentry","category-2letnik-ginekologija-in-porodnistvo","tag-candida-albicans","tag-dismenoreja","tag-ginekoloski-raki","tag-infekcije-zenskega-spolovila","tag-maligni-tumorji","tag-menarhe","tag-menopavza","tag-miom","tag-osteoporoza","tag-ovariji","tag-predmenstrualni-sindrom","tag-pubarhe","tag-puberteta","tag-rak-matericnega-vratu","tag-telarhe","tag-tumorji-jajcnikov","tag-urgentna-inkontinenca"],"_links":{"self":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts\/593","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/users\/336"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/comments?post=593"}],"version-history":[{"count":0,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/posts\/593\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/media?parent=593"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/categories?post=593"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.zdravstvena.info\/vsznj\/wp-json\/wp\/v2\/tags?post=593"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}