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<s>[INST] How to prepare for Colposcopic biopsy? [/INST] There is no special preparation. You may be more comfortable if you empty your bladder and bowel before the procedure.
You should not douche, place any products into the vagina, or have sexual intercourse for 24 hours before the exam. You should not be menstruating heavily. However, if you are at the very end or beginning of your regular period or you are having abnormal bleeding, you should still keep your appointment.
You may be able to take ibuprofen or acetaminophen (Tylenol) before the colposcopy. Ask your doctor if this is okay, and when and how much you should take.
Tell your doctor before the test if you are pregnant or could be pregnant. </s> |
<s>[INST] What do I experience during the procedure? [/INST] The placement of the instrument (speculum) to better see the cervix may be more uncomfortable than for a regular Pap smear.
Some women feel a slight sting from the vinegar or Lugol's solution.
The biopsy or curettage may feel like a pinch or cramp each time a tissue sample is taken. You may have some cramping or slight bleeding after the biopsy. Heavy bleeding is unusual; if you have bleeding that soaks a pad in an hour, call your doctor. Do not use tampons or put anything in the vagina for several days after a biopsy.
It is typical for women to hold their breath during pelvic procedures because they expect pain. Concentrating on slow, regular breathing will help you relax and relieve pain. Ask your doctor or nurse about bringing a support person with you if that will help. </s> |
<s>[INST] When to seek urgent medical care when I have Colposcopic biopsy ? [/INST] After biopsy, call your health care provider if:
Bleeding is very heavy or lasts for longer than 2 weeks. You have pain in your belly or in the pelvic area. You notice any signs of infection (fever, foul odor, or discharge). </s> |
<s>[INST] Where to find centers that perform Colposcopic biopsy? [/INST] Directions to Hospitals Performing Colposcopic biopsy </s> |
<s>[INST] What to expect if I have Colposcopic biopsy (Outlook/Prognosis)? [/INST] After the biopsy, you may have some bleeding for up to a week. You may have mild cramping, your vagina may feel sore, and you may have a dark discharge for 1 - 3 days.
A colposcopy and biopsy will not make it more difficult for you to become pregnant, or cause problems during pregnancy.
You may have some bleeding after the biopsy for up to 1 week.
You should not douche, place tampons or creams into the vagina, or have sex for up to a week afterward. Ask your doctor or nurse how long you should wait. You can use sanitary pads.
If the colposcopy or biopsy does not show why the Pap smear was abnormal, your health care provider may suggest that you have a more extensive biopsy. </s> |
<s>[INST] What are the symptoms of Cystocele? [/INST] A bladder that has dropped from its normal position may cause two kinds of problems-unwanted urine leakage and incomplete emptying of the bladder. In some women, a fallen bladder stretches the opening into the urethra, causing urine leakage when the woman coughs, sneezes, laughs, or moves in any way that puts pressure on the bladder. </s> |
<s>[INST] What causes Cystocele? [/INST] A cystocele may result from muscle straining while giving birth. Other kinds of straining-such as heavy lifting or repeated straining during bowel movements-may also cause the bladder to fall. The hormone estrogen helps keep the muscles around the vagina strong. When women go through menopause-that is, when they stop having menstrual periods-their bodies stop making estrogen, so the muscles around the vagina and bladder may grow weak.
A cystocele is mild-grade 1-when the bladder droops only a short way into the vagina. With a more severe-grade 2-cystocele, the bladder sinks far enough to reach the opening of the vagina. The most advanced-grade 3-cystocele occurs when the bladder bulges out through the opening of the vagina. </s> |
<s>[INST] Who is at highest risk for Cystocele ? [/INST] Following factors increases the risk for developing cyslocele:
Vaginal delivery of a child Risk increases with age and is seen more frequently in postmenopausal women. Hysterectomy - surgical removal of uterus Connective tissue disorders which occur in genetically predisposed women. </s> |
<s>[INST] When to seek urgent medical care when I have Cystocele ? [/INST] Consult your health care provider if you experience the above mentioned symptoms. </s> |
<s>[INST] How is the Dilation and curettage done? [/INST] D and C, also called uterine scraping, may be performed in the hospital or in a clinic while you are under general or local anesthesia.
The health care provider will insert an instrument called a speculum into the vagina. This holds open the vaginal canal. Numbing medicine may be applied to the opening to the uterus (cervix).
The cervical canal is widened using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is passed through the opening into the uterus cavity. The doctor gently scrapes the inner layer of tissue, called the endometrium. The tissue is collected for examination. </s> |
<s>[INST] Who needs Dilation and curettage? [/INST] This procedure may be done to:
Diagnose conditions such as uterine cancer Remove tissue after a miscarriage Treat heavy menstrual bleeding or irregular periods Perform a therapeutic or elective abortion
Your doctor may also recommend a D and C if you have:
Abnormal bleeding while on hormone replacement therapy An embedded intrauterine device (IUD) Bleeding after menopause Endometrial polyps Thickening of the uterus
This list may not be all-inclusive. </s> |
<s>[INST] Where to find centers that perform Dilation and curettage? [/INST] Directions to Hospitals Performing Dilation and curettage </s> |
<s>[INST] What to expect if I have Dilation and curettage (Outlook/Prognosis)? [/INST] You may return to normal activities as soon as you feel better, possibly even the same day. There may be vaginal bleeding, as well as pelvic cramps and back pain for a few days after the procedure.
You can usually manage pain well with medications. Tampon use and sexual intercourse are not recommended for 1 - 2 weeks after this procedure. </s> |
<s>[INST] What causes Dyspareunia? [/INST] A diaphragm that does not fit properly Endometriosis Genital irritation from soaps, detergents, douches, or feminine hygiene products Hemorrhoids Herpes sores, genital warts, or other sexually transmitted infections (STIs) Intercourse too soon after surgery or childbirth Menopause Ovarian cysts Prostatitis (inflammation of the prostate) Reaction to the latex of a diaphragm or condom Sexual abuse or rape Urinary tract infections Use of certain medications Vaginal dryness Vaginal infection Vaginismus </s> |
<s>[INST] When to seek urgent medical care when I have Dyspareunia ? [/INST] Call your doctor if:
Home remedies are not working. You have other symptoms with painful intercourse, like bleeding, genital lesions, irregular periods, discharge from penis or vagina, or involuntary vaginal muscle contraction.
If you have been sexually assaulted, report the crime to the police and go to the emergency room immediately. Get a trusted friend to accompany you. Do NOT change, bathe, shower or even wash your hands before the ER evaluation. The temptation to do so will be great, but it is important to not lose any evidence in order to help find, charge, and convict the suspect. </s> |
<s>[INST] How is the Endometrial biopsy done? [/INST] This procedure may be done with or without anesthesia. You will lie on your back with your feet in stirrups.
The health care provider will do a pelvic examination, and will insert an instrument (speculum) into the vagina to hold it open and see the cervix.
The cervix is cleaned with an antiseptic liquid and then grasped with an instrument (tenaculum) to hold the uterus steady. A device called a cervical dilator may be needed to stretch the cervical canal if there is tightness (stenosis). Then a small, hollow plastic tube is gently passed into the uterine cavity.
Gentle suction removes a sample of the lining. The tissue sample and instruments are removed. A specialist called a pathologist examines the sample under a microscope. </s> |
<s>[INST] Who needs Endometrial biopsy? [/INST] The test is done to find the cause of:
Abnormal menstrual periods (heavy, prolonged, or irregular bleeding) Bleeding after menopause Bleeding from taking hormone therapy medications Thickened uterine lining seen on ultrasound The test is usually done in women over age 35.
This test can also be used to test for endometrial cancer. Sometimes, it is used as part of the diagnosis in women who have been unable to become pregnant (see infertility). </s> |
<s>[INST] How to prepare for Endometrial biopsy? [/INST] There is no special preparation for the biopsy. You may want to take ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol) 1 hour before the procedure to reduce cramping. </s> |
<s>[INST] What do I experience during the procedure? [/INST] The instruments may feel cold. You may feel some pain when the cervix is grasped. You may have some cramping as the instruments enter the uterus and the sample is collected. </s> |
<s>[INST] Where to find centers that perform Endometrial biopsy? [/INST] Directions to Hospitals Performing Endometrial biopsy </s> |
<s>[INST] What are the symptoms of Germ cell tumor? [/INST] The symptoms of germ cell tumor depend on the location of the cancer. Early cancer does not have any symptoms. As the tumor grows larger, patients may feel the following symptoms.
Pain in the affected area
Constipation
Urinary retention
Cough and/or difficulty breathing
Headache
Vaginal bleeding
Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible. </s> |
<s>[INST] Who is at highest risk for Germ cell tumor ? [/INST] At present, the risk factors for the development of a germ cell tumor are not known. </s> |
<s>[INST] When to seek urgent medical care when I have Germ cell tumor ? [/INST] Call your health care provider if symptoms of germ cell tumor develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
Severe pain
Severe constipation
Urinary retention
Severe difficulty breathing
Severe headache
Large vaginal bleeding </s> |
<s>[INST] What to expect if I have Germ cell tumor (Outlook/Prognosis)? [/INST] The prognosis of germ cell tumor depends on the following:
Whether the tumor is benign or cancerous
Whether or not the tumor can be removed by surgery
The stage of the cancer: the size and location of the tumor, whether the cancer has spread outside the tumor
Whether the cancer has just been diagnosed or has recurred
The patient’s general health </s> |
<s>[INST] What are the Symptoms of Gonadoblastoma? [/INST] Gonadoblastoma has no specific signs and symptoms. It is a tumor usually arising from a maldeveloped gonad and it can manifest with non-specific symptoms such as:
Excess hair overgrowth Delayed onset of menstrual bleeding Abnormal shape of genitalia
It may also present as a lower abdominal mass in women or growing mass in the testicles causing discomfort in men. </s> |
<s>[INST] What Causes gonadoblastoma? [/INST] The exact cause of gonadoblastoma is not clear, but it usually arises in the setting of maldeveloped sex organs. There is also a hypothesis regarding the presence of a putative gene called TSPY gene. Although the exact mechanism of its role in the pathogenesis of the disease is not clear, it has been observed that the product of this gene increased in the gonadoblastoma. </s> |
<s>[INST] Who is at highest risk for Gonadoblastoma ? [/INST] Individuals with sex organ maldevelopment disorders are at highest risk of developing gonadoblastoma. Sex organ maldevelopment disorders are referred to disorders manifesting with an abnormal shape of genitalia during infancy or sexual organ developmental disorders during puberty such as delayed onset of menstruation, excess hair overgrowth. </s> |
<s>[INST] When to seek urgent medical care when I have Gonadoblastoma ? [/INST] Individuals with a known diagnosis of sexual maldevelopment disorders such as:
Androgen insensitivity syndrome Swyer syndrome Turner syndrome Frasier syndrome Denys-Drash syndrome 9p partial monosomy
should be screened for the presence of gonadoblastoma. </s> |
<s>[INST] Where to find Medical Care for Gonadoblastoma? [/INST] Medical care for gonadoblastoma can be found here. </s> |
<s>[INST] What to expect if I have Gonadoblastoma (Outlook/Prognosis)? [/INST] Gonadoblastoma prognosis is excellent after the surgical removal of the tumor. In the case of a coexisting malignant tumor, the prognosis depends on the staging of that tumor. </s> |
<s>[INST] What are the symptoms of Granulosa cell tumour? [/INST] Ovarian cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.
You should see your doctor if you have the following symptoms on a daily basis for more than a few weeks:
Bloating Difficulty eating or feeling full quickly Pelvic or abdominal pain
Other symptoms are also seen with ovarian cancer. However, these symptoms are also common in women who do not have cancer:
Abnormal menstrual cycles Digestive symptoms: Constipation Increased gas Indigestion Lack of appetite Nausea and vomiting Sense of pelvic heaviness Swollen abdomen or belly Unexplained back pain that worsens over time Vaginal bleeding Vague lower abdominal discomfort Weight gain or loss
Other symptoms that can occur with this disease:
Excessive hair growth Increased urinary frequency or urgency </s> |
<s>[INST] What causes Granulosa cell tumour? [/INST] Ovarian cancer is the fifth most common cancer among women, and it causes more deaths than any other type of female reproductive cancer.
The cause is unknown. </s> |
<s>[INST] Who is at highest risk for Granulosa cell tumour ? [/INST] The risk for developing ovarian cancer appears to be affected by several factors. The more children a woman has and the earlier in life she gives birth, the lower her risk for ovarian cancer. Certain genes defects (BRCA1 and BRCA2) are responsible for a small number of ovarian cancer cases. Women with a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk for ovarian cancer.
Women who take estrogen replacement only (not with progesterone) for 5 years or more seem to have a higher risk of ovarian cancer. Birth control pills, however, decrease the risk of ovarian cancer.
Studies suggest that fertility drugs do not increase the risk for ovarian cancer.
Older women are at highest risk for developing ovarian cancer. Most deaths from ovarian cancer occur in women age 55 and older. </s> |
<s>[INST] When to seek urgent medical care when I have Granulosa cell tumour ? [/INST] Call for an appointment with your health care provider if you are a woman over 40 years old who has not recently had a pelvic examination. Routine pelvic examinations are recommended for all women over 20 years old.
Call for an appointment with your provider if you have symptoms of ovarian cancer. </s> |
<s>[INST] What to expect if I have Granulosa cell tumour (Outlook/Prognosis)? [/INST] Ovarian cancer is rarely diagnosed in its early stages. It is usually quite advanced by the time diagnosis is made
About 3 out of 4 women with ovarian cancer survive 1 year after diagnosis. Nearly half of women live longer than 5 years after diagnosis. If diagnosis is made early in the disease and treatment is received before the cancer spreads outside the ovary, the 5-year survival rate is very high </s> |
<s>[INST] What Causes Hirsutism? [/INST] All women normally produce low levels of male hormones (androgens). Unwanted hair growth (hirsutism) in women may occur when the body makes too much male hormones.
In most cases, the exact cause is never identified. It tends to run in families. In general, hirsutism is a harmless condition. But many women find it bothersome, or even embarrassing.
A common cause is polycystic ovarian syndrome (PCOS). Women with PCOS and other hormonal conditions that cause unwanted hair growth may also have acne, problems with menstrual periods, trouble losing weight, a deeper voice similar to that of men, and diabetes. If these symptoms start suddenly, there may be a tumor that releases male hormones.
The following other causes of unwanted hair growth are rare:
Tumor or cancer of the adrenal gland Tumor or cancer of the ovary Cushing's syndrome Congenital adrenal hyperplasia Hyperthecosis (a condition in which the ovaries produce too much male hormones) Medications (testosterone, danazol, anabolic steroids, glucocorticoids, cyclosporine, minoxidil, phenytoin)
Rarely, a woman with hirsutism will have normal levels of male hormones, and the specific cause of the unwanted hair growth cannot be identified. </s> |
<s>[INST] When To Seek Urgent Medical Care? [/INST] Call your doctor if:
The hair grows rapidly. The hair growth is associated with male features such as acne, deepening of voice, increased muscle mass, and decreased breast size. You are concerned that a medication may be worsening unwanted hair growth. </s> |
<s>[INST] Where To Find Medical Care For Hirsutism? [/INST] Directions to Hospitals Treating Hirsutism) </s> |
<s>[INST] When to seek urgent medical care when I have Hormone replacement therapy for menopause ? [/INST] It is important to have regular checkups with your health care provider when taking hormone therapy.
If you have vaginal bleeding or other unusual symptoms during hormone therapy, call your health care provider. </s> |
<s>[INST] What diseases are caused by HPV? [/INST] HPV is a common virus that is spread through sexual contact. There are many different types of HPV, and many do not cause problems. However, certain types of HPV can lead to:
Cervical cancer in women Genital warts in men and women Cancer of the penis or anus in men </s> |
<s>[INST] Who needs HPV vaccine? [/INST] Gardasil is approved for:
Females ages 9-26 to protect against cervical cancer and to prevent genital warts Males ages 9 - 26 to prevent genital warts
Cervarix is approved for:
Females age 10 - 26 to help protect against cervical cancer
Girls ages 11 and 12 should receive the HPV vaccine series:
The vaccine is given in three shots over a 6-month period. (The second and third doses are given 2 and 6 months after the first dose.) One brand of vaccine can be substituted for another in the 3-dose series. The HPV vaccine can be given at the same time as other vaccines. Girls as young as age 9 can receive the vaccine if their doctor recommends it.
Girls and women ages 13 - 26:
Those who have not received the HPV vaccine in the past should get a series of three vaccines. Those who have not completed the full vaccine series should catch up on missed doses. (Note: Some experts do not recommend that women between ages 19 and 26 receive catch-up doses of this vaccine. Talk with your provider if you are in this age group.)
Boys and men ages 9 - 26:
May receive Gardasil to reduce the chance of becoming infected with genital and anal warts. The vaccine is not yet being recommended for all boys and men up to age 26. The vaccine can prevent genital warts in men and decrease the risk for cancer of the penis and anus.
Pregnant women should not receive this vaccine. However, there have been no problems found in women who received the vaccine during pregnancy, before they knew they were pregnant. </s> |
<s>[INST] When to seek urgent medical care when I have HPV vaccine ? [/INST] You aren't sure whether you or your child should receive the HPV vaccine You or your child develops complications or severe symptoms after getting an HPV vaccine You have other questions or concerns about the HPV vaccine </s> |
<s>[INST] What to expect if I have HPV vaccine (Outlook/Prognosis)? [/INST] The HPV vaccine does not protect against all types of HPV that lead to cervical cancer. Girls and women should still receive regular screening (Pap tests) to look for any early signs of cervical cancer.
The HPV vaccine does not protect against other infections that can be spread during sexual contact. </s> |
<s>[INST] What diseases are caused by HPV? [/INST] HPV is a common virus that is spread through sexual contact. There are many different types of HPV, and many do not cause problems. However, certain types of HPV can lead to:
Cervical cancer in women Genital warts in men and women Cancer of the penis or anus in men </s> |
<s>[INST] Who needs HPV vaccine? [/INST] Gardasil is approved for:
Females ages 9-26 to protect against cervical cancer and to prevent genital warts Males ages 9 - 26 to prevent genital warts
Cervarix is approved for:
Females age 10 - 26 to help protect against cervical cancer
Girls ages 11 and 12 should receive the HPV vaccine series:
The vaccine is given in three shots over a 6-month period. (The second and third doses are given 2 and 6 months after the first dose.) One brand of vaccine can be substituted for another in the 3-dose series. The HPV vaccine can be given at the same time as other vaccines. Girls as young as age 9 can receive the vaccine if their doctor recommends it.
Girls and women ages 13 - 26:
Those who have not received the HPV vaccine in the past should get a series of three vaccines. Those who have not completed the full vaccine series should catch up on missed doses. (Note: Some experts do not recommend that women between ages 19 and 26 receive catch-up doses of this vaccine. Talk with your provider if you are in this age group.)
Boys and men ages 9 - 26:
May receive Gardasil to reduce the chance of becoming infected with genital and anal warts. The vaccine is not yet being recommended for all boys and men up to age 26. The vaccine can prevent genital warts in men and decrease the risk for cancer of the penis and anus.
Pregnant women should not receive this vaccine. However, there have been no problems found in women who received the vaccine during pregnancy, before they knew they were pregnant. </s> |
<s>[INST] When to seek urgent medical care when I have Human papillomavirus quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant ? [/INST] You aren't sure whether you or your child should receive the HPV vaccine You or your child develops complications or severe symptoms after getting an HPV vaccine You have other questions or concerns about the HPV vaccine </s> |
<s>[INST] What to expect if I have Human papillomavirus quadrivalent (types 6, 11, 16, and 18) vaccine, recombinant (Outlook/Prognosis)? [/INST] The HPV vaccine does not protect against all types of HPV that lead to cervical cancer. Girls and women should still receive regular screening (Pap tests) to look for any early signs of cervical cancer.
The HPV vaccine does not protect against other infections that can be spread during sexual contact. </s> |
<s>[INST] How is the Hysterectomy done? [/INST] During a hysterectomy, your doctor may remove the entire uterus or just part of it. The fallopian tubes (the tubes that connect the ovaries to the uterus) and ovaries may also be removed.
Types of hysterectomy:
Partial (or supracervical) hysterectomy: The upper part of the uterus is removed. The cervix is left in place. Total hysterectomy: The entire uterus and cervix are removed. Radical hysterectomy: The uterus, upper part of the vagina, and tissue on both sides of the cervix are removed. This is most often done if you have cancer.
There are many different ways to perform a hysterectomy. It may be done through a surgical cut in either the belly (abdomen) or vagina.
Your doctor will help you decide which type of hysterectomy is best for you. The specific procedure depends on your medical history and reason for the surgery. </s> |
<s>[INST] Who needs Hysterectomy? [/INST] There are many reasons a woman may need a hysterectomy. The procedure may be recommended if you have:
Cancer of the uterus, most often endometrial cancer Cancer of the cervix or a precancerous condition of the cervix called cervical dysplasia Cancer of the ovary Childbirth complications, such as uncontrolled bleeding Long-term (chronic) pelvic pain Severe endometriosis that does not get better with other treatments Severe, long-term vaginal bleeding that cannot be controlled by medicines or other surgeries Slipping of the uterus into the vagina (uterine prolapse) Tumors in the uterus, such as uterine fibroids Adenomyosis, which causes heavy, painful periods
Hysterectomy is a major surgery. It is possible that your condition may be treated without this major surgery. Talk with your doctor about all your treatment options. Less invasive procedures include:
Uterine artery embolization Pelvic laparoscopy Endometrial ablation </s> |
<s>[INST] Where to find centers that perform Hysterectomy? [/INST] Directions to Hospitals Performing Hysterectomy </s> |
<s>[INST] What to expect if I have Hysterectomy (Outlook/Prognosis)? [/INST] How long it takes you to recover depends on the type of hysterectomy. Recovery may take anywhere from 2 to 6 weeks. Average recovery times are:
Abdominal hysterectomy: 4 - 6 weeks Vaginal hysterectomy: 3 - 4 weeks Robot-assisted hysterectomy: 2 - 4 weeks
A hysterectomy will cause menopause if you also have your ovaries removed. Removal of the ovaries can also lead to a decreased sex drive. Your doctor may recommend estrogen replacement therapy. </s> |
<s>[INST] What causes Mastalgia? [/INST] Some amount of breast tenderness is normal. The discomfort may be caused by hormone changes from:
Menopause (unless a woman is taking hormone replacement therapy) Menstruation and premenstrual syndrome (PMS) Pregnancy -- breast tenderness tends to be more common during the first trimester and in women who become pregnant at a young age Puberty in both girls and boys
Soon after having a baby, a woman's breasts may become swollen with milk. This can be very painful. If you also have an area of redness, call your health care provider.
Breastfeeding itself may also cause breast pain.
Fibrocystic breast changes are a common cause of breast pain. Fibrocystic breast tissue contains lumps that tend to be more tender just before your menstrual period.
Certain medications may also cause breast pain, including:
Anadrol Chlorpromazine Diuretics Digitalis preparations Methyldopa (Aldomet) Spironolactone (Aldactone)
Shingles can lead to pain in the breast if the painful blistering rash appears on the skin over one of your breasts. </s> |
<s>[INST] When to seek urgent medical care when I have Mastalgia ? [/INST] Call your health care provider if you have:
Bloody or clear discharge from your nipple Given birth within the last week and your breasts are swollen or hard Noticed a new lump with the pain that does not go away after your menstrual period Persistent, unexplained breast pain Signs of a breast infection, including local redness, pus, or fever </s> |
<s>[INST] What are the symptoms of Miscarriage? [/INST] Low back pain or abdominal pain that is dull, sharp, or cramping Tissue or clot-like material that passes from the vagina Vaginal bleeding, with or without abdominal cramps </s> |
<s>[INST] What causes Miscarriage? [/INST] Most miscarriages are caused by chromosome problems that make it impossible for the baby to develop. Usually, these problems are unrelated to the mother or father's genes.
Other possible causes for miscarriage include:
Drug and alcohol abuse Exposure to environmental toxins Hormone problems Infection Obesity Physical problems with the mother's reproductive organs Problem with the body's immune response Serious body-wide (systemic) diseases in the mother (such as uncontrolled diabetes) Smoking
It is estimated that up to half of all fertilized eggs die and are lost (aborted) spontaneously, usually before the woman knows she is pregnant.
Among those women who know they are pregnant, the miscarriage rate is about 15-20%. Most miscarriages occur during the first 7 weeks of pregnancy. The rate of miscarriage drops after the baby's heart beat is detected. </s> |
<s>[INST] Who is at highest risk for Miscarriage ? [/INST] The risk for miscarriage is higher in women:
Older age, with increases beginning by 30, becoming greater between 35 and 40, and highest after 40 Who have had previous miscarriages? </s> |
<s>[INST] When to seek urgent medical care when I have Miscarriage ? [/INST] Call your health care provider if vaginal bleeding with or without cramping occurs during pregnancy.
Call your health care provider if you are pregnant and notice tissue or clot-like material passed vaginally (any such material should be collected and brought in for examination). </s> |
<s>[INST] How is the Pap smear done? [/INST] You will lie on a table and place your feet in stirrups. The health care provider will insert an instrument (called a speculum) into the vagina and open it slightly to see inside the vaginal canal. Cells are gently scraped from the cervix area, and sent to a lab for examination. </s> |
<s>[INST] Who needs Pap smear? [/INST] The Pap smear is a screening test for cervical cancer. Most cervical cancers can be detected early if women has routine Pap smears and pelvic examinations.
Screening should start at age 21. After the first test:
Woman should have a Pap smear ever 2 years to check for cervical cancer. If you are over age 30 or your Pap smears have been negative for 3 times in a row, your doctor may tell you that you only need a Pap smear every 3 years. If you or your sexual partner have other new partners, then you should have a Pap smear every 2 years. After age 65-70, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years. If you have a new sexual partner after age 65, you should begin having Pap smear screening again.
You may not need to have a Pap smear if you have had a total hysterectomy (uterus and cervix removed) and do not have a history of cervical dysplasia (abnormal cells), cervical cancer, or other pelvic cancer. </s> |
<s>[INST] How to prepare for Pap smear? [/INST] Tell your health care provider if you:
Are taking any medications or birth control pills Have had an abnormal Pap smear Might be pregnant
Avoid the following for 24 hours before the test:
Douching Having intercourse Taking a bath Using tampons
Avoid scheduling your Pap smear while you have your period (are menstruating), because it may affect the accuracy of the Pap smear. If you are having abnormal bleeding, your doctor may still recommend you have the test done.
Empty your bladder just before the test. </s> |
<s>[INST] What do I experience during the procedure? [/INST] A Pap smear may cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam.
You may bleed a little bit after the test. </s> |
<s>[INST] Where to find centers that perform Pap smear? [/INST] Directions to Hospitals Performing Pap smear </s> |
<s>[INST] What to expect if I have Pap smear (Outlook/Prognosis)? [/INST] The Pap smear test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Fortunately, cervical cancer develops very slowly in most women and follow-up Pap smears should identify worrisome changes in time for treatment.
Make sure your doctor knows about all the medicines you are taking. Some, including estrogen and progestins, may affect the result of your Pap smear. </s> |
<s>[INST] What are the symptoms of Uterine prolapse? [/INST] A feeling as if sitting on a small ball Difficult or painful sexual intercourse Frequent urination or a sudden, urgent need to empty the bladder Low backache Pain during intercourse Protruding of the uterus and cervix through the vaginal opening Repeated bladder infections Sensation of heaviness or pulling in the pelvis Vaginal bleeding or increased vaginal discharge
Many of the symptoms are worse when standing or sitting for long periods of time. </s> |
<s>[INST] What causes Uterine prolapse? [/INST] The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue,. The uterus drops into the vaginal canal (prolapses) when these muscles and connective tissues weaken. </s> |
<s>[INST] Who is at highest risk for Uterine prolapse ? [/INST] Uterine prolapse usually happens in women who have had one or more vaginal births. Normal aging and lack of estrogen hormone after menopause may also cause uterine prolapse Chronic cough and obesity increase the pressure on the pelvic floor and may contribute to the prolapse. Uterine prolapse can also be caused by a pelvic tumor, although this is rare. Chronic constipation and the pushing associated with it can worsen uterine prolapse. </s> |
<s>[INST] When to seek urgent medical care when I have Uterine prolapse ? [/INST] Call for an appointment with your health care provider if you have symptoms of uterine prolapse. </s> |
<s>[INST] What to expect if I have Uterine prolapse (Outlook/Prognosis)? [/INST] Most women with mild uterine prolapse do not have bothersome symptoms and don't need treatment.
Vaginal pessaries can be effective for many women with uterine prolapse.
Surgery usually provides excellent results, however, some women may require treatment again in the future. </s> |
<s>[INST] What are the symptoms of Vaginal cysts? [/INST] Vaginal cysts usually do not cause symptoms, although there may be a soft lump felt in the vaginal wall or protruding from the vagina. Some women with vaginal cysts may have discomfort during sexual intercourse or difficulty inserting tampons. </s> |
<s>[INST] What causes Vaginal cysts? [/INST] There are several types of vaginal cysts, which can range in size from the size of a pea to that of an orange. Vaginal inclusion cysts are the most common. These may form as a result of trauma sustained by the vaginal walls or following an obstetric or gynecologic procedure, when the lining of the vagina doesn't heal to its normal smoothness.
Gartner's duct cysts develop in the space occupied by the Gartner's duct, usually on the side walls of the vagina. This duct is active during fetal development but ordinarily disappears after birth. In some cases, however, portions of the duct may collect fluid and develop into a vaginal wall cyst later in life.
Benign tumors of the vagina are uncommon and are usually made up of cysts. </s> |
<s>[INST] When to seek urgent medical care when I have Vaginal cysts ? [/INST] Call your health care provider if a lump is felt inside the vagina or protruding from the vagina. </s> |
<s>[INST] What to expect if I have Vaginal cysts (Outlook/Prognosis)? [/INST] The outcome is generally good. Frequently cysts remain small and require no treatment. When surgically removed, the cysts usually do not return. </s> |
<s>[INST] What causes Vaginal discharge? [/INST] The following situations can increase the amount of normal vaginal discharge:
Emotional stress Ovulation (the production and release of an egg from your ovary in the middle of your menstrual cycle) Pregnancy Sexual excitement
Abnormal vaginal discharge may be due to:
Atrophic vaginitis: seen in women who have gone through menopause and have low estrogen levels Bacterial vaginosis (BV): Bacteria that normally live in the vagina overgrow, causing a grey discharge and fishy odor that worsen after sexual intercourse. BV is usually not sexually transmitted. Cervical or vaginal cancer: rarely a cause of excess discharge Chlamydia Desquamative vaginitis and lichen planus Forgotten tampon or foreign body Gonorrhea Other infections and sexually transmitted diseases Trichomoniasis Vaginal yeast infection </s> |
<s>[INST] When to seek urgent medical care when I have Vaginal discharge ? [/INST] Call your doctor right away if:
Your discharge is associated with fever or pain in your pelvis or abdomen. You have been exposed to a sexual partner with gonorrhea, chlamydia, or other sexually transmitted disease. You have increased thirst or appetite, unexplained weight loss, increased urinary frequency, or fatigue: these may be signs of diabetes.
Also call if:
A child who has not reached puberty has vaginal discharge. You think that your discharge may be related to a medication. You are concerned that you may have a sexually transmitted disease or you are unsure of possible exposure. Your symptoms worsen or last longer than 1 week despite home care measures. You have blisters or other lesions on your vagina or vulva (exterior genitalia). You have burning with urination or other urinary symptoms. You may have a urinary tract infection. </s> |
<s>[INST] Who Is The Editor In Chief For The Entire Wikidoc Site? [/INST] Dr. C Michael Gibson, M.S., M.D. a Professor of Medicine at Harvard Medical School is the Founder and Editor-in-Chief of the WikiDoc site. </s> |
<s>[INST] Do You Need To Be An Editor In Chief To Edit Content? [/INST] No. You need to be logged in, but you do not need to be an Editor-in-Chief to edit content. </s> |
<s>[INST] What Are The Qualifications To Be An "Expert"? [/INST] Criteria would include publications of textbooks and manuscripts relevant to the topic. Priority would be given to original, peer-reviewed publications. Clinical experts with an extensive list of review articles would qualify as well. </s> |
<s>[INST] Why Use the Formatting Below Including "Equal Signs" to Create Sections, Subsections, and Sub Sub Sections? [/INST] So that WikiDoc can automatically generate a table of contents for you. If you just use bold, an automatic table of contents will not be created.
What it looks like What you type Start your sections as follows: New section Subsection Sub-subsection Start with a second-level heading (==); don't use first-level headings (=). Don't skip levels (for example, second-level followed by fourth-level). A Table of Contents will automatically be added to an article that has four or more sections. If appropriate, place subsections in an appropriate order. If listing countries, place them in alphabetical order rather than, say, relative to population of OECD countries, or some random order. ==New section== ===Subsection=== ====Sub-subsection==== A single newline generally has no effect on the layout. These can be used to separate sentences within a paragraph. Some editors find that this aids editing and improves the function diff (used internally to compare different versions of a page). But an empty line starts a new paragraph. When used in a list, a newline does affect the layout (see below). A single newline generally has no effect on the layout. These can be used to separate sentences within a paragraph. Some editors find that this aids editing and improves the function''diff'' (used internally to compare different versions of a page). But an empty line starts a new paragraph. You can break lines without starting a new paragraph. Please use this sparingly. Close markup between lines, do not start a link or italics or bold on one line and close it on the next. You can break lines<br> without starting a new paragraph. It's easy to create a list: Start every line with a star (asterisk). More stars means deeper levels. A newline in a list marks the end of a list item. An empty line starts a new list. * It's easy to create a list: ** Start every line with a star. *** More stars means deeper levels. **** A newline in a list marks the end of a list item. * An empty line starts a new list. Numbered lists are also good very organized easy to follow easier still # Numbered lists are also good ## very organized ## easy to follow ### easier still Definition list list of definitions item the item's definition another item the other item's definition Begin with a semicolon. One item per line; a newline can appear before the colon, but using a space before the colon improves parsing.; Definition list: list of definitions; item: the item's definition; another item: the other item's definition You can even create mixed lists and nest them like this can I mix definition list as well? yes how? it's easy as a b c * You can even create mixed lists *# and nest them *#* like this *#*; can I mix definition list as well? *#*: yes *#*; how? *#*: it's easy as *#*:* a *#*:* b *#*:* c A colon indents a line or paragraph. A manual newline starts a new paragraph. This is primarily for displayed material, but is also used for discussion on Talk pages.: A colon indents a line or paragraph. A manual newline starts a new paragraph. When there is a need for separating a block of text the blockquote command will indent both margins when needed instead of the left margin only as the colon does. This is useful for (as the name says) inserting blocks of quoted (and cited) text. <blockquote> The'''blockquote''' command will indent both margins when needed instead of the left margin only as the colon does. </blockquote> (See formula on right): This is useful for: pasting preformatted text; algorithm descriptions; program source code; ASCII art; chemical structures; WARNING: If you make it wide, you force the whole page to be wide and hence less readable, especially for people who use lower resolutions. Never start ordinary lines with spaces. IF a line starts with a space THEN it will be formatted exactly as typed; in a fixed-width font; lines will not wrap; ENDIF Centered text. Please note the American spelling of "center." <center>Centered text.</center> A horizontal dividing line: this is above it and this is below it. Mainly useful for disambiguation - but to be used sparsely, only when separating completely different, unrelated (groups of) meanings separating threads on Talk pages. A horizontal dividing line: this is above it ---- and this is below it.
This page is for assisting in basic formatting of text on wiki pages. </s> |
<s>[INST] Who Is The Editor In Chief For The Entire Wikidoc Site? [/INST] Dr. C Michael Gibson, M.S., M.D. a Professor of Medicine at Harvard Medical School is the Founder and Editor-in-Chief of the WikiDoc site. </s> |
<s>[INST] Do You Need To Be An Editor In Chief To Edit Content? [/INST] No. You need to be logged in, but you do not need to be an Editor-in-Chief to edit content. </s> |
<s>[INST] What Are The Qualifications To Be An "Expert"? [/INST] Criteria would include publications of textbooks and manuscripts relevant to the topic. Priority would be given to original, peer-reviewed publications. Clinical experts with an extensive list of review articles would qualify as well. </s> |
<s>[INST] How Can WikiDoc Meet Those Needs? [/INST] WikiDoc scholars board review project has several goals, and some of those are:
Provide a robust resource for medical students and graduates preparing for the boards Provide opportunities for WikiDoc scholars on campus to exchange knowledge, strategies and test-taking skills </s> |
<s>[INST] How Can You Help WikiDoc Meet Those Needs? [/INST] WikiDoc encourages medical students, interns, residents, fellows, and attending level faculty members to submit board review questions. The WikiDoc Board Review Team meets every Monday at 10:30 AM in the Longwood Medical Area. The meeting is led by Will Gibson, an M.D., Ph.D. candidate from Harvard Medical School. For more details, you can send an email to [email protected].
Template:WH Template:WS </s> |
<s>[INST] What are the symptoms of Bronchiolitis obliterans? [/INST] Bronchiolitis obliterans usually causes a dry cough and shortness of breath, especially on exertion, two to eight weeks after toxic fume exposure or a respiratory illness. It may be several months or years until it presents itself after a transplant.
Fatigue and wheezing in the absence of a cold or asthma are other symptoms of this lung disease. </s> |
<s>[INST] What causes Bronchiolitis obliterans? [/INST] The disease can be caused by breathing in irritant fumes, such as chlorine, ammonia, oxides of nitrogen or sulfur dioxide. Diacetyl, a chemical used to provide butter flavor in many foods, has also been suspected of causing bronchiolitis obliterans in workers who manufacture it or mix it into foods, such as butter-flavored popcorn. Bronchiolitis obliterans also can result from respiratory infections, a connective tissue disorder such as rheumatoid arthritis, a medication reaction, and after a bone marrow, lung or heart-lung transplant. Also, the disease may be idiopathic (without a known cause).
Another similarly named disease, bronchiolitis obliterans organizing pneumonia, is a completely different disease. </s> |
<s>[INST] How Can WikiDoc Meet These Needs? [/INST] The WikiDoc team has come up with the'calculator project' intended to solve these problems. The calculator project is focused on creating calculators for the risk assessment tools. With the use of calculators, a health care provider can rapidly determine the prognosis and treatment goals of a specific medical condition and institute appropriate actions based on the interpretation. This project is intended for interns, residents, attending physicians, hospitalists, specialists, nurses, nurse practitioners, and physician assistants to contribute their knowledge and clinical experience. This project aims at improving the quality of making diagnoses and treating medical conditions, reducing the variability in treatment, and to improve the overall quality of patient care. WikiDoc welcomes your involvement in contributing to this project. </s> |
<s>[INST] How Can You Help WikiDoc Meet These Needs? [/INST] Your participation as an Assistant Editor-in-Chief in this project is very important to us at WikiDoc. You are welcome to apply if you are an intern, resident, attending physician, specialist, nurse or a nurse practitioner. It is required of you to have a strong grasp of medical knowledge, and preferably, a prior residency training and experience in order to apply. </s> |
<s>[INST] Why put an article in a category? [/INST] At some point it becomes useful to classify the information according to categories. For instance, you might want to add an article on acute MI to the category of cardiology. Acute MI would then be included with all the other articles related to the subject of cardiology in this category. All the articles in a category can come together to forming a living textbook of a given topic. Categories are also used to list all the articles that need work for instance, like the addition of an overview statement. </s> |
<s>[INST] Where do I type in the references? [/INST] Usually you would type a number in the text like this (1) or this 1 which refers to a reference you would like to cite. You would then type in the reference at the end of the article. This is not the preferred method in WikiDoc.
WikiDoc features an automated reference manager. The advantages of this reference manager are that:
The references are numbered automatically! When you move the text, the reference moves with it! You can click on the reference and go directly to the article!
Unlike the usual format where you type in the references at the end of the article, when you use the WikiDoc reference manager, you insert code for the reference right after the material you want to add a reference to. You use a software program to add in the references. The next section describes how to use the software program. </s> |
<s>[INST] What if I don't want to use the reference manager? What if I just want to type the references in myself? [/INST] You are not required to use the reference manager. You can do the following:
Step 1: Place a <ref>... </ref> immediately after the sentence where you want a footnote number to appear.
Step 2: Type the text of the note between the ref tags. For example if I typed this
It would appear as this
Note: If you intend on using the same manual reference more than once, you will need to assign a name to the reference. You can do this by writing <ref name="anythingyouwanthere">... </ref>. Your name can be anything you want. Without a name, every manual reference will be viewed as a unique reference. This means that a reference used multiple times will show up as multiple references instead of just the one. </s> |
<s>[INST] How do I make the references appear at the bottom of the article? [/INST] Put the following code in:
This will generate your references in small font, in two columns, with links to the original article and abstract. It will return text that looks like this: </s> |
<s>[INST] What are the symptoms of cyanotic congenital heart disease? [/INST] Some heart defects cause major problems right after birth. Others cause few, if any, problems until adulthood.
One symptom is cyanosis, which usually seen as a bluish color of the lips, fingers, and toes. It may occur while the child is resting, or only when the child is active.
Some children have breathing problems (dyspnea). They may get into a squatting position after physical activity to relieve breathlessness.
Others have spells, in which their bodies are suddenly starved of oxygen. During these spells, symptoms may include:
Anxiety Breathing too quickly (hyperventilation) Sudden increase in bluish color to the skin
Infants may get tired or sweat while feeding and may not gain as much weight as they should.
Fainting (syncope) and chest pain may occur.
Other symptoms depend on the type of cyanotic heart disease, and may include:
Feeding problems or reduced appetite, leading to poor growth Grayish skin Puffy eyes or face Tiredness all the time </s> |
<s>[INST] What causes cyanotic congenital heart disease? [/INST] Normally, blood returns from the body and flows through the heart and lungs
Blood that is low in oxygen (blue blood) returns from the body to the right side of the heart. The right side of the heart then pumps the blood to the lungs, where it picks up more oxygen and becomes red. The oxygen-rich blood returns from the lungs to the left side of the heart. From there, it is pumped to the rest of the body.
Heart defects that children are born with can change the way blood flows through the heart and lungs. This abnormal blood flow is called shunting.
The blood that is pumped out to the body is lower in oxygen. Less oxygen delivered to the body can make the skin look blue (cyanosis)
Many of these heart defects involve the heart valves. Heart valves are found between the heart and the large blood vessels that bring blood to and from the heart. These valves open up enough for blood to flow through. Then they close, keeping blood from flowing backward.
Heart valve defects that can cause cyanosis include:
Tricuspid valve (the valve between the two chambers on the right side of the heart) may be absent or unable to open wide enough. Pulmonary valve (the valve between the heart and the lungs) may be absent or unable to open wide enough. Aortic valve (the valve between the heart and the blood vessel to the rest of the body) is unable to open wide enough.
Other heart defects that may cause cyanosis include:
Coarctation or complete interruption of the aorta Ebstein's anomaly Hypoplastic left heart syndrome Tetralogy of Fallot Total anomalous pulmonary venous connection Transposition of the great arteries Truncus arteriosus
Cyanotic heart diseases may be caused by:
Chemical exposure Genetic and chromosomal syndromes, such as Down syndrome, trisomy 13, Turner syndrome, Marfan syndrome, and Noonan syndrome Infections (such as rubella) during pregnancy Poorly controlled blood sugar levels in women who have diabetes during pregnancy Medications prescribed by your doctor or bought on your own and used during pregnancy Street drugs used during pregnancy </s> |
<s>[INST] When to seek urgent medical care when I have Congenital heart disease cyanotic ? [/INST] Call your health care provider if your baby has:
Bluish skin (cyanosis) or grayish skin Breathing difficulty Chest pain or other pain Dizziness, fainting, or heart palpitations Feeding problems or reduced appetite Fever, nausea, or vomiting Puffy eyes or face Tiredness all the time </s> |
<s>[INST] What to expect if I have Congenital heart disease cyanotic (Outlook/Prognosis)? [/INST] The outlook depends on the specific disorder. </s> |
<s>[INST] How Can WikiDoc Meet These Needs? [/INST] The WikiDoc team has come up with the'critical pathways project' intended to solve these problems. The critical pathways project is focused on creating standardized treatment protocols for the management of medical conditions by applying evidence-based medical approaches to patient care. With the use of critical pathways, a health care provider can rapidly determine the treatment goals of a specific medical condition and institute appropriate actions in a chronological sequence with optimal efficiency. This project is intended for interns, residents, attending physicians, hospitalists, specialists, nurses, nurse practitioners, and physician assistants to contribute their knowledge and clinical experience. This project aims at improving the quality of making diagnoses and treating medical conditions, reducing the variability in treatment, and to improve the overall quality of patient care. WikiDoc welcomes your involvement in contributing to this project. </s> |
<s>[INST] How Can You Help WikiDoc Meet These Needs? [/INST] Your participation as an Assistant Editor-in-Chief in this project is very important to us at WikiDoc. You are welcome to apply if you are an intern, resident, attending physician, specialist, nurse or a nurse practitioner. It is required of you to have a strong grasp of medical knowledge, and preferably, a prior residency training and experience in order to apply. </s> |
<s>[INST] Who Is The Editor In Chief For The Entire Wikidoc Site? [/INST] Dr. C Michael Gibson, M.S., M.D. a Professor of Medicine at Harvard Medical School is the Founder and Editor-in-Chief of the WikiDoc site. </s> |
<s>[INST] Do You Need To Be An Editor In Chief To Edit Content? [/INST] No. You need to be logged in, but you do not need to be an Editor-in-Chief to edit content. </s> |
<s>[INST] What Are The Qualifications To Be An "Expert"? [/INST] Criteria would include publications of textbooks and manuscripts relevant to the topic. Priority would be given to original, peer-reviewed publications. Clinical experts with an extensive list of review articles would qualify as well. </s> |
Subsets and Splits