Ch 33- Alterations in Female Reproductive Systems Flashcards
What is dysmenorrhea?
painful menstruation
What is the tx for dysmenorrhea?
NSAIDs
The pain from dysmenorrhea is directly related to ____(1) & ____ (2) of mentrual flow.
amount & length
What is the cause of pain from dysmenorrhea?
excessive prostaglandin secretion
What is endometrial?
layer of tissue that lines uterus
What is the result of dysmenorrhea?
ischemia and endometrial shedding
Dysmenorrhea Pathophysio:
Prostaglandin result in ____ (1)(smooth muscle cells of uterine wall) stimulation & _____ (2)
Result:
pain is due to constriction of ____ (3) tissue and ____ (4) hypersensitivity.
- myometrial
- vasoconstriction
- endometrial
- nerve
What are the 2 types of amenorrhea?
Primary and secondary
What is the difference between primary and secondary amenorrhea?
primary - absence of mens by 13 yrs old w/o dev of sec characteristics by 15 yrs old
secondary - absence of mens for 3 cycles in women with previous cycles.
What are the 4 types of compartmentalization to understand the pathophysiology of amenorrhea?
Compartment:
1 - disorder due to anatomical defects: absence of vagina & uterus
2 – disorders of ovary/ genetic (e.g., Turner’s Syndrome)
3 – disorders of anterior pituitary gland –> failure of FSH & LH to properly signal ovaries.
4– disorder due to CNS that prevents release of hypothalamic GnRH
What is the leading cause of infertility in North America?
PCOS
What is the diagnosis for PCOS?
- anovulatory menstrual cycles & elevated levels of androgens.
What does anovulatory menstrual cycles mean?
skipped ovulations
How does hyper-insulinemia related to PCOS?
PCOS related to obseity-prone lifestyle. This lifestyle increased isulin resistance and excess insulin and androgens
Hyper-insulineamia = overstimulates ovarian _____ (1) secretion.
What are the effects of hyper-insulinemia? (2 pts)
Result of being hyper-insulinemia?
Ovaries become ______(2) and contain fluid filled sacs (____ (3)) that surround eggs
- androgen
Effects:
- increased in free androgen and follicular growth
- increased insulin which suppresses follicular apoptosis
- enlarged
- follicles
T or F: PCOS is related to GENETIC predisposition and OBESITY-PRONE lifestyle.
TRUE
T or F: PCOS predisposes for obesity
TRUE
T or F: Pre-existing obesity predisposes to PCOS.
TRUE
Infections of genital tract result from EXOgenous and ENDOgenous _____ (1)
What is the difference of exogenous and endogenous?
- microorganisms
Endogenous – microorganisms that have NORMAL RESIDENCE of vagina, bowel and vulva
Exogenous – often sexually transmitted
What are 4 infections of genital tract are going to be covered?
- Pelvic inflammatory disease
- salpingitis
- Vaginitis
- cervicitis
Which infections of genital tract is associated with infections involving any organ or combination of organs of UPPER genital tract?
Pelvic inflammatory disease
What are the upper genital tract involved in Pelvic Inflammatory Disease?
uterus, fallopian tube and ovaries
What are the risk factors for PID?
untreated STI & multiple sex partners
What are the main STI involved in PID?
gonorrhea & chlamydia
PID develops when pathogens ascend from an infected cervix to infect _____ _____ (1)
______ (2) bacteria (gonorrhea) alter vaginal ___ (3) = decrease integrity of mucus blocking cervical canal.
fallopian tubes (1)
aerobic (2)
pH (3)
What is the inflammation of fallopian tubes?
salpingitis
How infection affect people with salpingitis?
changes columnar epithelia of upper reproductive tract
Inflammation caused by bacterial infection of people with salpingitis caused localized _____ (1) & possible _____ (2)
edema (1) & necrosis (2)
What are the consequences of PID?
infertility, tubal obstruction, ectopic pregnancy
Salpingitis – gonorrhea and ____ combined effect.
chalmydia
What is the difference between vaginitis and vaginosis?
Vaginitis – vaginal inflammation WITH increases in WBC
Vaginosis – vaginal irritations WITHOUT WBC
What is the cause of vaginitis? (3 pts)
overgrowth of normal flora; STIs; low ESTROGEN levels during menopause
What is the diagnosis for vaginitis?
marked change in colour & amount of menstrual discharge
What are the tx for vaginitis (2pts)
supporting acidic environment & probiotics (esp Lactobacillus crispatus) encourages proliferation of normal vaginal flora
Pathophysiology of Vaginitis:
- Related to alterations in vaginal ____ (1)
- Normal vaginal pH is ___-___ (2) depends on cervical secretions and presence of normal flora that supports acidic environment
- Changes in pH = _____ (3) to infection
- pH
- 4.0-4.5
- predisposition
What is cervicitis?
inflammation of cervix
What are the diagnosis for cervicitis? (2pts)
- purulent discharge (pus)
- mucopurulent discharge (pus and mucus)
T or F: Mucopurulent cervicitis is a symptom of PID.
TRUE
What is mucopurulent cervicitis?
infection become red and edematous
Where does mucopurulent discharge drain from?
external cervix
T or F: When a woman has mucopurulent cervicitis, pelvic pain and bleeding may be present.
TRUE
T or F: Women above 26 yrs old who have mucopurulent cervicitis should receive tx for PID while waiting for exudate examination.
FALSE; Women under 26 yrs old.
When does benign ovarian cysts most likely to occur?
puberty and menopause
T or F: Benign ovarian cysts is related to hormone imbalances
TRUE
What are the 2 causes of bening ovarian cysts?
- ovary/follicular cysts
- corpus luteum cysts
What is the difference between follicular cysts, ovary cysts & corpus luteum cysts
FC - dominant follicle doesn’t rupture normally or non-dominant follicles do not regress = cysts develop
OC - dev occurs when NO dominant follicle develops and completes maturation process
CLC - may form from granulosa cells left behind after ovulation
What is the location of endometriosis?
ovaries, fallopian tubes & bladder
T or F: Benign Ovarian Cysts is 1/3 of gynecological hospital admissions.
TRUE
During normal menstrual cycle __ (1) follicles are stimulated and only ___ (2) reaches ovulation
120 (1)
1 (2)
Endometriosis, is the presence of functional _____ tissue OUTSIDE uterus
endometrial
What is the problem with endometriosis?
tissue still responds to menstrual cycle hormonal fluctuations
T or F: Endometriosis often causing infertility and pain
TRUE
Endometriosis has high levels of _____ (hormone)
estrogen
Causes of endometriosis:
Dev of new blood vessels to support lesions – _____ (1)
___(2) cells play a role in dev of lesions
Serious complication of endometriosis: _____(3) pregnancy
- angiogenesis
- Stem
- ectopic
Breast cancer in Canada:
__nd (1) leading caue of death in women.
1 in ___ (2) change of dev breast cancer.
On average, __(3) Canadian women/day will be diagnosed with BC/ __ (4) will die from cancer.
In 2022, ___ (5) men will be diagnosed with breast cancer; 55 will likely die from breast cancer
- 2nd
- 8
- 75
- 14
- 240
What are the diagnosis for breast cancer?
clinical breast exam, mammograph & biopsy
What are the gene mutations for women with BC? Which chromosomes are these invovled?
BRCA1 (Chromosome 17) & BRCA 2 (Chromosome 13)
What are the risk factors for breast cancer in women?
- fam history
- early period before 12
- late menopause after 55
- nulliparous
- oral contraceptives and obesity
Protective affect for breast cancer in women?
- early first pregnancy
- removal of ovaries and pituitary gland
What are the increased risk of breast cancer in women?
- early menarche
- late menopause
-nulliparous
What is Gynecomastia?
overdevelopment of breast tissue in males – result in hormonal alterations
What is cause of breast cancer in men? Who are at risk?
idiopathic; at risk: Klinefelter’s syndrome, men >60 yrs old, nipple crusting & discharge, enlarged axillary nodes
What are axillary nodes?
lymph nodes in armpit that drain lymph from breast area
In young males, gynecomastia resolves in __-__ months
4-6
What is klinefelter’s syndrome?
males have an extra X chromosome
What is the tx for men with breast cancer?
modified mastectomy with hormone therapy
What is the hormonal imbalance in men with breast cancer?
Estrogen = excessively high
Testosterone = excessively low
