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alterations of sexual maturation Flashcards

1
Q

percocious puberty

A 
sexual maturation before 
- 6-7 in girls
- 9 in boys 
forms
- isosexual
- heterosexual
- incomplete
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2
Q

delayed pubety

A

no secondary sex characteristics

  • females: by age 13
  • males: by age 14
    etiology:
  • undernutrition
  • athletics
  • HPG defects
  • stress
  • environmental exposures
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3
Q

painful menstruation

A

associated with prostaglandin release in ovulatory cycles

  • r/t duration and amount of menstrual flow.
    tx: NSAIDs and COX inhibitors
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4
Q

dysmenorrhea

A

primary: usually develops 1-2 years after menarche when ovulatory cycles established
secondary: more dull pain, increases with age, associated with pelvic disorders
- endometriosis
- leiomyomoas
- pelvic adhesions

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5
Q

tx for dysmenorhhea

A

primary: focus on phenmenon of prostaglandin-induced enhanced uterine contractility
- prostaglandin inhibitors
secondary: dx therapies
- medical/surgical therapy for underlying condition

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6
Q

primary amenorrhea

A

failure of menarche and the absence of menstruation by age 14; without development of secondary sex characteristics by 16

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7
Q

secondary amenorrhea

A

absence of menstruation for a time equivalent to 3+ cycles or 6 months in women who havve previously menstruated

etiology:
- pregnancy
- dramatic wt loss
- malnutrition
- excessive exercise
- hypothyroidism
- PCOS
- perimenopause
- lactation

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8
Q

tx for amenorrhea

A

directed to correcting interuption in hormone functioning

  • may include hormone supplementation
  • tumor removal
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9
Q

abnormal uterine bleeding (AUB)

A 
bleeding other than monthly cycle
Etiology: 
- hormonal imbalance: menopause
- pregnancy
- polyp/fibroids
- cervical infection
- endometrial cnacer
- hormone replacement therapies
tx: 
- treat cause
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10
Q

dysfunctional uterine bleeding

A

abnormal uterine bleeding not associated with
- tumor, inflammation, pregnancy, trauma, or hormonal effects
Most common around time of menarche and menopause
- adolescents: immature functioning of pituitary and ovary
- menopause: progressive degeneration and failure of the ovary to produce estrogen.

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11
Q

pelvic organ prolaps

A

bladder, urethra, and rectum are supported by the endopelvic facia and perineal muscles

  • loses tone and strength with aging
  • uterine
  • cystocele and rectocele
  • vaginal
  • urethrocele
  • cystourethrocele
  • enterocele
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12
Q

uterine prolapse

A

degrees

  • normal
  • 1st degree: uterine descent within vagina
  • 2nd degree: cervix protrudes through the introitus
  • 3rd degree: vagina is completely everted.
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13
Q

s/s of uterine prolapse

A

sensation of bearing down and discomfort in vagina
discomfort with walking, sitting
difficulty urinating

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14
Q

tx of uterine prolapse

A

hysterectomy

pessary: supportive device holds uterus in place

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15
Q

cystocele and s/s

A 
urinary bladder into anterior vagina
s/s:
- pressure in vagina
- dysuria
- incontinence
- back pain
- fullness at vaginal opening
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16
Q

cystocele tx

A

surgical repair

support bladder

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17
Q

rectocele and s/s

A 
rectum into posterior vagina
s/s:
- difficult bowel elimination 
- constipation: laxative and enema dependent
- pressure
-painful sex
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18
Q

rectocele tx

A

surgical repair

support vaginal wall

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19
Q

PID

A

acute inflammation caused by infection
may involve any organ of reproductive tract
- salpingitis: cervix, oviducts
- oophoritis: uterus, ovaries

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20
Q

PID etiology

A

nml cervical secretions provide protective barrier for reproductive organs
- prevents bacterial agents from ascending into uterus
conditions that alter or destroy cervical mucous
- insertion of IUD
- pelvic surgery
- abortion
- pregnancy
- STI
- pelvic abscess

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21
Q

PID s/s

A
  • abdominal pain and tenderness
  • cervix pain and tenderness
  • increased temp
  • increased WBC
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22
Q

PID Tx

A

antibiotics

drain abscess

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23
Q

vaginitis

A

infection of the vagina
- STI
- candida albicans
Vaginal acidic pH is protective

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24
Q

cervicitis

A

inflammation or infection of the cervix

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25
s/s vaginitis/cervicitis
``` from candidiasis - thick, white discharge - red, edematous mocous membrane - white flecks adhering to vaginal wall - itchaing from other infection - purulent discharge - malodorous - irritation - inflammation - dysuria ```
26
tx of vaginitis/cervicitis
antifungal antibiotics cool compress sitz bath
27
vulvitis
inflammation of external genitalia etiology: - contact with soaps, detergents, lotions, hygienic sprays, shaving, menstrual pads, or titgh-fitting clothing - vaginal infection that spread to the labia
28
bartholinitis
inflammation of one or both docts that lead from the vaginal opening to bartholin glands - narrows the distal ducts - leads to obstruction and stasis of glandular secretions
29
bartholinitis s.s
abscess: bartholin cyst - tenderness, swelling - pus - fever - malaise
30
tx of bartholinitis
antibiotics | abscess drainage
31
endometrial polyps
overgrowth of endometrium | fingerlike growths variable in size that attach to the wall of the uterus
32
endometrial polyps etiology
``` tend to when there is high estrogen risk factors - obesity - tamoxifen - postmenopause - hormone replacement therapy - lynch syndrome or cowden syndrome ```
33
endometrial polyps s/s
menstrual bleeding that is not regular or predictable bleeding between periods bleeding from vagina after menopause trouble getting or staying pregnant
34
endometrial polyps test and tx
exams ans tests: - transvaginal ultrasound - hysteroscopy - endometrial biopsy - hysterosonogram tx: - removal due to possibility of cancer via hysteroscopy or D&C
35
ovarian cyst
fluid filled sac | arrise from normal monthly follicle continuation of growing
36
ovarian cyst s/s
``` dull aching pelvic pain dysparenunia irregular menstruation abnormal uterine bleeding abdominal bloating ```
37
ovarian cyst complications
cyst rupture: sharp abdominal pain, or asymptomatic ovarian torsion: cyst >4cm yield inc. risk of torsion - obstruction and ischemia - infarction may result
38
follicular cyst
maturing follicle fails to release ovum | - continues to enlarge and produce estrogent
39
corpus lutem cyst
corpus luteum fails to degenerate properly | - continues to grow and produce progesterone
40
theca-lutein cyst
bilateral and filled with clear straw colored fluid | - associated with hydatidiform mole, choriocarcinoma, or hormone therapy.
41
cyst tx
recurrent: oral contraceptive | surgery if hemorrhaging
42
endometriosis
endometrial cells attaching to other location of body rather than uterus
43
transportation endometriosis
endometrial tissue backflow through oviducts during menstrual cycle - retrograde menstruation
44
metaplasia endometriosis
inflammation or hormonal change triggers metaplasia
45
induction endometriosis
combo of transportation and metaplasia | - regurgitated endothelium chemically induces mesenchyma to form endometrial endothelium
46
endometriosis s/s
``` dysmenorrhea pain with BM menstrual flow changes - excessive bleeding - anemia and fatigue ```
47
endometriosis tx
``` relieve pain restore/maintain fertility NSAIDs hormonal agents surgical ```
48
leiomyomas
myomal fibroids | in muscle region of uterus
49
leiomyomas s/s
``` abdominal pain/pressure abnormal vaginal bleeding and discharge back pain constipation urinary frequency/urgency prevent pregnancy/ carrying to term difficult ```
50
leiomyoma tx
surgical removal | possible hysterectomy
51
cervical cancer
Viral induced cancer -almost 100% from HPV common site: squamocolumnar junction at exocervix
52
cervical cancer s/s
preinvasive no s/s early: - abnormal vaginal bleeding - vaginal discharge - pain and bleeding after sex later: - s/s appear
53
cervical cancer tx
``` surgery - precancerous -- cryotherapy -- excision -- laster hysterectomy chemo radiation ```
54
endometrial cancer
most common cancer of the female reproductive tract - commonly in postmenopausal women - early sign: involve bleeding
55
endometrial cancer s/s
bleeding between cycles | postmenopausal bleeding
56
endometrial cancer tx
radiation hysterectomy -possible ovaries and oviducts as well
57
ovarian cancer
typically has poor prognosis -r/t later dx woman with BRCA1 mutation have a increased risk
58
ovarian cancer s/s
when occur related to intra-abdominal metastasis - increased abdominal girth - wt loss - abdominal pain - dysuria - urinary frequency - constipation
59
ovarian cancer tx
chemo radiation surgery
60
vaginal cancer
``` squamous cell carcinoma - most common, slow pathogenesis risk factors: - 70+ years diethylstilbestrol DES: hormonal drug given to some women to prevent miscarriage between 1940-1971: multigenerational ```
61
vaginal cancer s/s
vaginal spotting or discharge pain groin masses changes in urinary pattern
62
vaginal cancer tx
radiation surgery try to preserve vaginal function - only possible in early stages
63
vulva cancer
``` rare peak: mid-60's prescence of white plaquelike or ulcerated lesions Predispose factors: - STI - chronic pruritis of vulva with swelling and dryness - obesity - HTN - DM - no pregnancy ```
64
vulva cancer s/s
masses abnormal urination abnormal BM
65
vulva cancer tx
partial excision of vulva

Pathophysiology (80 decks)

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