33 & 34: Reproductive Alterations Flashcards
1
Q
painful menstruation associated w/ the release of prostaglandins in ovulatory cycles
A
primary dysmenorrhea
2
Q
lack of menstruation
A
amenorrhea
3
Q
most common causes of amenorrhea
A
- hypothalamic dysfunction - PCOS - hyperprolactinemia - ovarian failure
4
Q
increased amount and duration of menstrual flow
A
menorrhagia
5
Q
cycles shorter than 3 weeks
A
polymenorrhea
6
Q
cycles longer than 6-7 weeks
A
oligomenorrhea
7
Q
intermenstrual bleeding or bleeding of light character occurring irregularly between cycles
A
metrorrhagia
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)
9
Q
3 criteria for PCOS
A
- few or anovulatory menstrual cycles - elevated levels of androgens - polycystic ovaries (do not have to be present)
10
Q
leading cause of infertility in the US
A
PCOS
11
Q
syndrome directly related to genetic predisposition, insulin resistance, and excess of insulin and androgens
A
PCOS
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
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
14
Q
clinical manifestations of PCOS
A
- amenorrhea or dysfunctional uterine bleeding - infertility - hirsutism (abnormal hairiness) - acne - HTN - dyslipidemia
15
Q
cause of dysfunctional uterine bleeding
A
progesterone secretion absent while estrogen secretion continues -> endometrium grows and breaks down causing bleeding
16
Q
what can unopposed estrogen lead to?
A
hyperplasia and carcinoma
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)
18
Q
Most common causes of PID?
A
- gonorrhea - chlamydia
19
Q
complications associated w/ PID
A
- infertility - ectopic pregnancy - pelvic pain and dyspareunia - pelvic adhesions - perihepatitis - ovary and fallopian tube abscess
20
Q
Describe the pain associated w/ PID
A
- may start low bilateral ABD - may occur during or post menstruation - increases w/ movement
21
Q
Treatment for PID
A
- bed rest - no intercourse - antibiotics
22
Q
major causes of vaginitis
A
- overgrowth of normal flora - STDs (most common) - vaginal irritation related to low estrogen levels during menopause
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
24
Q
descent of one or more of the following; vaginal wall, uterus, or apex of the vagina
A
pelvic organ prolapse (POP)
25
Risk factors for pelvic organ prolapse?
- direct trauma (ex. childbirth) - heavy lifting - aging - obesity - hysterectomy
26
descent of the cervix or entire uterus into the vaginal canal
uterine prolapse
27
descent of a portion of the posterior bladder wall and trigone into the vaginal canal; usually caused by childbirth
cystocele
28
bulging of the rectum and posterior vaginal wall into the vaginal canal
rectocele
29
herniation of the rectouterine pouch into the rectovaginal septum
enterocele
30
Treatment for pelvic relaxation disorders
- pessary (for uterine prolapse) - Kegel exercies - surgery
31
benign tumors that develop from smooth muscle cells in the myometrium (often in the fundus); can cause ABD pressure and cramping
leiomyoma (aka myoma or uterine fibroids)
32
presence of functioning endometrial tissue or implants outside the uterus (usually ABD and pelvic area); will still respond to hormone fluctuations and can bleed
endometriosis
33
clinical manifestations of endometriosis
- dysmenorrhea - ABD/pelvic pain - dyspareunia - constipation - infertility
34
most common cancer in American women and 2nd most common killer after lung cancer; African Americans more likely to die
breast cancer
35
list 9 risk factors for breast cancer
- 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
4 common metastatic sites for breast cancer
- brain - bone - liver - lung
37
breast cancer manifestations
- painless lump on breast - dimpling of skin - edema - orange peel appearance - nipple discharge
38
group of proliferations limited to breast ducts and lobules without invasion of the basement membrane
ductal carcinoma in situ (DCIS)
39
treatments for breast cancer
depends on stage of cancer - surgery - radiation - chemotherapy - hormone therapy - biologic therapy - BM transplant
40
cancer in men mainly seen after 60 y/o where the tumors resemble carcinomas of breast in women
male breast cancer
41
Risk factors for male breast cancer
- gynecomastia - chest wall irradiation - FHx of Kleinfelters Syndrome - presence of BRCA1 and BRCA 2 mutation - Obesity - Hx of testicular cancer
42
clinical manifestation of male breast cancer
crusting and nipple discharge
43
T/F: ovarian cancer is usually found early
False; usually found in advance stages
44
clinical manifestations of ovarian cancer
GI symptoms usually first: bloating, flatulence, discomfort
45
most significant risk factor for ovarian cancer
family history of ovarian or breast cancer
46
cell surface antigen used to monitor effectiveness of therapy in ovarian cancer if pre-op levels are high; not a good screening tool
CA-125
47
diagnostic test for ovarian cancer
transvaginal US
48
risk factors for endometrial cancer
- obesity - nulliparity - late menopause - HTN - high fat diet
49
most common symptom of endometrial cancer
unusual vaginal bleeding
50
most common cause of cervical cancer
HPV
51
4 other risk factors of cervical cancer (other than HPV)
- smoking - poor nutrition - multiple sex partners - early sexual activity
52
clinical manifestations of cervical cancer
- may be asymptomatic - vaginal bleeding or discharge
53
screening tool for cervical cancer
PAP smear
54
clinical manifestations of prostate cancer
- signs of bladder outlet obstruction (slow urinary stream, hesitancy, incomplete emptying, frequency, nocturia, and dysuria) - progressive and don't remit (unlike BPH)
55
screening for prostate cancer
- digital rectal exam (DRE) - prostate specific antigen (PSA) -\> many false positives
56
4 risk factors for testicular cancer
- abnormal testicle development - family or personal hx of testicular cancer - hx of undescended testicles - Klinefelter syndrome
57
clinical manifestations of testicular cancer
- 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
diagnostic tests of testicular cancer
- testicular self exam (important) - ABD/pelvic CT - blood tests for AFT, b-HCG, and LDH - chest Xray - US of scrotum
59
condition in which the foreskin cannot be retracted back over the glans
phimosis
60
condition in which the foreskin cannot be moved forward (reduced) to cover the glans
paraphimosis
61
condition of prolonged penile erection; usually painful and not associated w/ sexual arousal; urologic emergency
priapism
62
treatment for priapism
- iced saline enemas - ketamine administration - spinal anesthesia - needle aspiration of blood from the corpus
63
inflammation of the glans penis; associated w/ poor hygiene and phimosis
balanitis
64
abnormal dilation of the testicular vein and pampinoform plexus within the scrotum; described as a "bag of worms"
varicocele
65
group of abnormalities in which the testis fails to descend completely
cryptorchidism
66
testis rotates on in vascular pedicle and interrupts blood supply; urologic emergency
testicular torsion
67
enlargement of the prostate gland which compresses the urethra and causes lower urinary tract symptoms; not a form of cancer
BPH
68
clinical manifestations of BPH
- urgency - delay in starting urination - decreased force of stream - long-term urinary retention
69
overdevelopment of breast tissue in males
gynecomastia
70
causes of gynecomastia
imbalance of estrogen/testosterone due to - hypogonadism - Klinefelter syndrome - testicular neoplasms - drugs
71
3 bacterial STIs
- gonorrhea - chlamydia - syphilis
72
2 parasite STIs
- scabies/crabs
73
1 fungal STI
candida albicans
74
2 viral STIs
- HPV - genital herpes
75
2 protozoan STIs
- trichamonisasis (trich) - giardia lamblia (giardiasis)
