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Pathophysiology > alterations of sexual maturation > Flashcards

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
Q

s/s vaginitis/cervicitis

A 
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
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26
Q

tx of vaginitis/cervicitis

A

antifungal
antibiotics
cool compress
sitz bath

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27
Q

vulvitis

A

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
Q

bartholinitis

A

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
Q

bartholinitis s.s

A

abscess: bartholin cyst
- tenderness, swelling
- pus
- fever
- malaise

30
Q

tx of bartholinitis

A

antibiotics

abscess drainage

31
Q

endometrial polyps

A

overgrowth of endometrium

fingerlike growths variable in size that attach to the wall of the uterus

32
Q

endometrial polyps etiology

A 
tend to when there is high estrogen
risk factors
- obesity
- tamoxifen
- postmenopause
- hormone replacement therapy 
- lynch syndrome or cowden syndrome
33
Q

endometrial polyps s/s

A

menstrual bleeding that is not regular or predictable
bleeding between periods
bleeding from vagina after menopause
trouble getting or staying pregnant

34
Q

endometrial polyps test and tx

A

exams ans tests:

  • transvaginal ultrasound
  • hysteroscopy
  • endometrial biopsy
  • hysterosonogram
    tx:
  • removal due to possibility of cancer via hysteroscopy or D&C
35
Q

ovarian cyst

A

fluid filled sac

arrise from normal monthly follicle continuation of growing

36
Q

ovarian cyst s/s

A 
dull aching pelvic pain
dysparenunia 
irregular menstruation
abnormal uterine bleeding 
abdominal bloating
37
Q

ovarian cyst complications

A

cyst rupture: sharp abdominal pain, or asymptomatic
ovarian torsion: cyst >4cm yield inc. risk of torsion
- obstruction and ischemia
- infarction may result

38
Q

follicular cyst

A

maturing follicle fails to release ovum

- continues to enlarge and produce estrogent

39
Q

corpus lutem cyst

A

corpus luteum fails to degenerate properly

- continues to grow and produce progesterone

40
Q

theca-lutein cyst

A

bilateral and filled with clear straw colored fluid

- associated with hydatidiform mole, choriocarcinoma, or hormone therapy.

41
Q

cyst tx

A

recurrent: oral contraceptive

surgery if hemorrhaging

42
Q

endometriosis

A

endometrial cells attaching to other location of body rather than uterus

43
Q

transportation endometriosis

A

endometrial tissue backflow through oviducts during menstrual cycle
- retrograde menstruation

44
Q

metaplasia endometriosis

A

inflammation or hormonal change triggers metaplasia

45
Q

induction endometriosis

A

combo of transportation and metaplasia

- regurgitated endothelium chemically induces mesenchyma to form endometrial endothelium

46
Q

endometriosis s/s

A 
dysmenorrhea
pain with BM 
menstrual flow changes
- excessive bleeding
- anemia and fatigue
47
Q

endometriosis tx

A 
relieve pain
restore/maintain fertility
NSAIDs 
hormonal agents
surgical
48
Q

leiomyomas

A

myomal fibroids

in muscle region of uterus

49
Q

leiomyomas s/s

A 
abdominal pain/pressure
abnormal vaginal bleeding and discharge
back pain
constipation
urinary frequency/urgency
prevent pregnancy/ carrying to term difficult
50
Q

leiomyoma tx

A

surgical removal

possible hysterectomy

51
Q

cervical cancer

A

Viral induced cancer
-almost 100% from HPV
common site: squamocolumnar junction at exocervix

52
Q

cervical cancer s/s

A

preinvasive no s/s

early:
- abnormal vaginal bleeding
- vaginal discharge
- pain and bleeding after sex
later:
- s/s appear

53
Q

cervical cancer tx

A 
surgery
- precancerous
-- cryotherapy
-- excision
-- laster
hysterectomy 
chemo 
radiation
54
Q

endometrial cancer

A

most common cancer of the female reproductive tract

  • commonly in postmenopausal women
  • early sign: involve bleeding
55
Q

endometrial cancer s/s

A

bleeding between cycles

postmenopausal bleeding

56
Q

endometrial cancer tx

A

radiation
hysterectomy
-possible ovaries and oviducts as well

57
Q

ovarian cancer

A

typically has poor prognosis
-r/t later dx
woman with BRCA1 mutation have a increased risk

58
Q

ovarian cancer s/s

A

when occur related to intra-abdominal metastasis

  • increased abdominal girth
  • wt loss
  • abdominal pain
  • dysuria
  • urinary frequency
  • constipation
59
Q

ovarian cancer tx

A

chemo
radiation
surgery

60
Q

vaginal cancer

A 
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
Q

vaginal cancer s/s

A

vaginal spotting or discharge
pain
groin masses
changes in urinary pattern

62
Q

vaginal cancer tx

A

radiation
surgery
try to preserve vaginal function
- only possible in early stages

63
Q

vulva cancer

A 
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
Q

vulva cancer s/s

A

masses
abnormal urination
abnormal BM

65
Q

vulva cancer tx

A

partial excision of vulva

Pathophysiology (80 decks)

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