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Pathophysiology > 33 & 34: Reproductive Alterations > Flashcards

33 & 34: Reproductive Alterations Flashcards

1
Q

painful menstruation associated w/ the release of prostaglandins in ovulatory cycles

A

primary dysmenorrhea

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2
Q

lack of menstruation

A

amenorrhea

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3
Q

most common causes of amenorrhea

A
  • hypothalamic dysfunction - PCOS - hyperprolactinemia - ovarian failure
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4
Q

increased amount and duration of menstrual flow

A

menorrhagia

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5
Q

cycles shorter than 3 weeks

A

polymenorrhea

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6
Q

cycles longer than 6-7 weeks

A

oligomenorrhea

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7
Q

intermenstrual bleeding or bleeding of light character occurring irregularly between cycles

A

metrorrhagia

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8
Q

heavy or irregular bleeding in the absence of organic disease; accounts for most hysterectomies and almost all endometrial ablations

A

dysfunctional uterine bleeding (DUB)

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9
Q

3 criteria for PCOS

A
  • few or anovulatory menstrual cycles - elevated levels of androgens - polycystic ovaries (do not have to be present)
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10
Q

leading cause of infertility in the US

A

PCOS

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11
Q

syndrome directly related to genetic predisposition, insulin resistance, and excess of insulin and androgens

A

PCOS

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12
Q

how does insulin resistance and hyperinsulinemia lead to PCOS

A
  • insulin resistance overstimulates androgen secretion and reduces hepatic secretion of sex hormone binding globulin - increased free testosterone levels - leads to disordered LH/FSH release - anovulation and hyperandrogenism -> PCOS
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13
Q

Why are HTN, dyslipidemia, and hyperinsulinemia commonly present w/ PCOS?

A
  • insulin resistance -> more insulin production - high insulin levels -> increased triglycerides and BP
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14
Q

clinical manifestations of PCOS

A
  • amenorrhea or dysfunctional uterine bleeding - infertility - hirsutism (abnormal hairiness) - acne - HTN - dyslipidemia
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15
Q

cause of dysfunctional uterine bleeding

A

progesterone secretion absent while estrogen secretion continues -> endometrium grows and breaks down causing bleeding

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16
Q

what can unopposed estrogen lead to?

A

hyperplasia and carcinoma

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17
Q

acute inflammatory process caused by infection of the organs of upper genital tract; usually caused by STIs and often polymicrobial

A

pelvic inflammatory disease (PID)

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18
Q

Most common causes of PID?

A
  • gonorrhea - chlamydia
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19
Q

complications associated w/ PID

A
  • infertility - ectopic pregnancy - pelvic pain and dyspareunia - pelvic adhesions - perihepatitis - ovary and fallopian tube abscess
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20
Q

Describe the pain associated w/ PID

A
  • may start low bilateral ABD - may occur during or post menstruation - increases w/ movement
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21
Q

Treatment for PID

A
  • bed rest - no intercourse - antibiotics
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22
Q

major causes of vaginitis

A
  • overgrowth of normal flora - STDs (most common) - vaginal irritation related to low estrogen levels during menopause
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23
Q

acute inflammation of one or both of the ducts that lead from the vaginal opening to the Bartholin/greater vestibular glands; usually cyst or abscess

A

bartholinitis or bartholin cyst

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24
Q

descent of one or more of the following; vaginal wall, uterus, or apex of the vagina

A

pelvic organ prolapse (POP)

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25
Q

Risk factors for pelvic organ prolapse?

A
  • direct trauma (ex. childbirth) - heavy lifting - aging - obesity - hysterectomy
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26
Q

descent of the cervix or entire uterus into the vaginal canal

A

uterine prolapse

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27
Q

descent of a portion of the posterior bladder wall and trigone into the vaginal canal; usually caused by childbirth

A

cystocele

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28
Q

bulging of the rectum and posterior vaginal wall into the vaginal canal

A

rectocele

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29
Q

herniation of the rectouterine pouch into the rectovaginal septum

A

enterocele

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30
Q

Treatment for pelvic relaxation disorders

A
  • pessary (for uterine prolapse) - Kegel exercies - surgery
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31
Q

benign tumors that develop from smooth muscle cells in the myometrium (often in the fundus); can cause ABD pressure and cramping

A

leiomyoma (aka myoma or uterine fibroids)

32
Q

presence of functioning endometrial tissue or implants outside the uterus (usually ABD and pelvic area); will still respond to hormone fluctuations and can bleed

A

endometriosis

33
Q

clinical manifestations of endometriosis

A
  • dysmenorrhea - ABD/pelvic pain - dyspareunia - constipation - infertility
34
Q

most common cancer in American women and 2nd most common killer after lung cancer; African Americans more likely to die

A

breast cancer

35
Q

list 9 risk factors for breast cancer

A
  • increasing age - family hx - genetic predisposition (BRCA 1/2) - early menarche/late menopause - no full-term pregnancies - obesity - sedentary lifestyle - smoking/alcohol - oral contraceptive use or HRT
36
Q

4 common metastatic sites for breast cancer

A
  • brain - bone - liver - lung
37
Q

breast cancer manifestations

A
  • painless lump on breast - dimpling of skin - edema - orange peel appearance - nipple discharge
38
Q

group of proliferations limited to breast ducts and lobules without invasion of the basement membrane

A

ductal carcinoma in situ (DCIS)

39
Q

treatments for breast cancer

A

depends on stage of cancer - surgery - radiation - chemotherapy - hormone therapy - biologic therapy - BM transplant

40
Q

cancer in men mainly seen after 60 y/o where the tumors resemble carcinomas of breast in women

A

male breast cancer

41
Q

Risk factors for male breast cancer

A
  • gynecomastia - chest wall irradiation - FHx of Kleinfelters Syndrome - presence of BRCA1 and BRCA 2 mutation - Obesity - Hx of testicular cancer
42
Q

clinical manifestation of male breast cancer

A

crusting and nipple discharge

43
Q

T/F: ovarian cancer is usually found early

A

False; usually found in advance stages

44
Q

clinical manifestations of ovarian cancer

A

GI symptoms usually first: bloating, flatulence, discomfort

45
Q

most significant risk factor for ovarian cancer

A

family history of ovarian or breast cancer

46
Q

cell surface antigen used to monitor effectiveness of therapy in ovarian cancer if pre-op levels are high; not a good screening tool

A

CA-125

47
Q

diagnostic test for ovarian cancer

A

transvaginal US

48
Q

risk factors for endometrial cancer

A
  • obesity - nulliparity - late menopause - HTN - high fat diet
49
Q

most common symptom of endometrial cancer

A

unusual vaginal bleeding

50
Q

most common cause of cervical cancer

A

HPV

51
Q

4 other risk factors of cervical cancer (other than HPV)

A
  • smoking - poor nutrition - multiple sex partners - early sexual activity
52
Q

clinical manifestations of cervical cancer

A
  • may be asymptomatic - vaginal bleeding or discharge
53
Q

screening tool for cervical cancer

A

PAP smear

54
Q

clinical manifestations of prostate cancer

A
  • signs of bladder outlet obstruction (slow urinary stream, hesitancy, incomplete emptying, frequency, nocturia, and dysuria) - progressive and don’t remit (unlike BPH)
55
Q

screening for prostate cancer

A
  • digital rectal exam (DRE) - prostate specific antigen (PSA) -> many false positives
56
Q

4 risk factors for testicular cancer

A
  • abnormal testicle development - family or personal hx of testicular cancer - hx of undescended testicles - Klinefelter syndrome
57
Q

clinical manifestations of testicular cancer

A
  • discomfort or pain in the testicle - feeling of scrotal heaviness - dull ache in lower back or ABD - enlargement of a testicle or change in how it feels - lump or swelling in either testicle
58
Q

diagnostic tests of testicular cancer

A
  • testicular self exam (important) - ABD/pelvic CT - blood tests for AFT, b-HCG, and LDH - chest Xray - US of scrotum
59
Q

condition in which the foreskin cannot be retracted back over the glans

A

phimosis

60
Q

condition in which the foreskin cannot be moved forward (reduced) to cover the glans

A

paraphimosis

61
Q

condition of prolonged penile erection; usually painful and not associated w/ sexual arousal; urologic emergency

A

priapism

62
Q

treatment for priapism

A
  • iced saline enemas - ketamine administration - spinal anesthesia - needle aspiration of blood from the corpus
63
Q

inflammation of the glans penis; associated w/ poor hygiene and phimosis

A

balanitis

64
Q

abnormal dilation of the testicular vein and pampinoform plexus within the scrotum; described as a “bag of worms”

A

varicocele

65
Q

group of abnormalities in which the testis fails to descend completely

A

cryptorchidism

66
Q

testis rotates on in vascular pedicle and interrupts blood supply; urologic emergency

A

testicular torsion

67
Q

enlargement of the prostate gland which compresses the urethra and causes lower urinary tract symptoms; not a form of cancer

A

BPH

68
Q

clinical manifestations of BPH

A
  • urgency - delay in starting urination - decreased force of stream - long-term urinary retention
69
Q

overdevelopment of breast tissue in males

A

gynecomastia

70
Q

causes of gynecomastia

A

imbalance of estrogen/testosterone due to - hypogonadism - Klinefelter syndrome - testicular neoplasms - drugs

71
Q

3 bacterial STIs

A
  • gonorrhea - chlamydia - syphilis
72
Q

2 parasite STIs

A
  • scabies/crabs
73
Q

1 fungal STI

A

candida albicans

74
Q

2 viral STIs

A
  • HPV - genital herpes
75
Q

2 protozoan STIs

A
  • trichamonisasis (trich) - giardia lamblia (giardiasis)

Pathophysiology (20 decks)

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