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Pathophysiology > Ch 33- Alterations in Female Reproductive Systems > Flashcards

Ch 33- Alterations in Female Reproductive Systems Flashcards

1
Q

What is dysmenorrhea?

A

painful menstruation

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2
Q

What is the tx for dysmenorrhea?

A

NSAIDs

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3
Q

The pain from dysmenorrhea is directly related to ____(1) & ____ (2) of mentrual flow.

A

amount & length

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4
Q

What is the cause of pain from dysmenorrhea?

A

excessive prostaglandin secretion

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5
Q

What is endometrial?

A

layer of tissue that lines uterus

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6
Q

What is the result of dysmenorrhea?

A

ischemia and endometrial shedding

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7
Q

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.

A
  1. myometrial
  2. vasoconstriction
  3. endometrial
  4. nerve
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8
Q

What are the 2 types of amenorrhea?

A

Primary and secondary

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9
Q

What is the difference between primary and secondary amenorrhea?

A

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.

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10
Q

What are the 4 types of compartmentalization to understand the pathophysiology of amenorrhea?

A

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

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11
Q

What is the leading cause of infertility in North America?

A

PCOS

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12
Q

What is the diagnosis for PCOS?

A
  • anovulatory menstrual cycles & elevated levels of androgens.
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13
Q

What does anovulatory menstrual cycles mean?

A

skipped ovulations

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14
Q

How does hyper-insulinemia related to PCOS?

A

PCOS related to obseity-prone lifestyle. This lifestyle increased isulin resistance and excess insulin and androgens

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15
Q

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

A
  1. androgen

Effects:
- increased in free androgen and follicular growth
- increased insulin which suppresses follicular apoptosis

  1. enlarged
  2. follicles
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16
Q

T or F: PCOS is related to GENETIC predisposition and OBESITY-PRONE lifestyle.

A

TRUE

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17
Q

T or F: PCOS predisposes for obesity

A

TRUE

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18
Q

T or F: Pre-existing obesity predisposes to PCOS.

A

TRUE

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19
Q

Infections of genital tract result from EXOgenous and ENDOgenous _____ (1)

What is the difference of exogenous and endogenous?

A
  1. microorganisms

Endogenous – microorganisms that have NORMAL RESIDENCE of vagina, bowel and vulva

Exogenous – often sexually transmitted

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20
Q

What are 4 infections of genital tract are going to be covered?

A
  1. Pelvic inflammatory disease
  2. salpingitis
  3. Vaginitis
  4. cervicitis
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21
Q

Which infections of genital tract is associated with infections involving any organ or combination of organs of UPPER genital tract?

A

Pelvic inflammatory disease

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22
Q

What are the upper genital tract involved in Pelvic Inflammatory Disease?

A

uterus, fallopian tube and ovaries

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23
Q

What are the risk factors for PID?

A

untreated STI & multiple sex partners

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24
Q

What are the main STI involved in PID?

A

gonorrhea & chlamydia

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25
Q

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.

A

fallopian tubes (1)
aerobic (2)
pH (3)

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26
Q

What is the inflammation of fallopian tubes?

A

salpingitis

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27
Q

How infection affect people with salpingitis?

A

changes columnar epithelia of upper reproductive tract

28
Q

Inflammation caused by bacterial infection of people with salpingitis caused localized _____ (1) & possible _____ (2)

A

edema (1) & necrosis (2)

29
Q

What are the consequences of PID?

A

infertility, tubal obstruction, ectopic pregnancy

30
Q

Salpingitis – gonorrhea and ____ combined effect.

A

chalmydia

31
Q

What is the difference between vaginitis and vaginosis?

A

Vaginitis – vaginal inflammation WITH increases in WBC

Vaginosis – vaginal irritations WITHOUT WBC

32
Q

What is the cause of vaginitis? (3 pts)

A

overgrowth of normal flora; STIs; low ESTROGEN levels during menopause

33
Q

What is the diagnosis for vaginitis?

A

marked change in colour & amount of menstrual discharge

34
Q

What are the tx for vaginitis (2pts)

A

supporting acidic environment & probiotics (esp Lactobacillus crispatus) encourages proliferation of normal vaginal flora

35
Q

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
A
  1. pH
  2. 4.0-4.5
  3. predisposition
36
Q

What is cervicitis?

A

inflammation of cervix

37
Q

What are the diagnosis for cervicitis? (2pts)

A
  1. purulent discharge (pus)
  2. mucopurulent discharge (pus and mucus)
38
Q

T or F: Mucopurulent cervicitis is a symptom of PID.

A

TRUE

39
Q

What is mucopurulent cervicitis?

A

infection become red and edematous

40
Q

Where does mucopurulent discharge drain from?

A

external cervix

41
Q

T or F: When a woman has mucopurulent cervicitis, pelvic pain and bleeding may be present.

A

TRUE

42
Q

T or F: Women above 26 yrs old who have mucopurulent cervicitis should receive tx for PID while waiting for exudate examination.

A

FALSE; Women under 26 yrs old.

43
Q

When does benign ovarian cysts most likely to occur?

A

puberty and menopause

44
Q

T or F: Benign ovarian cysts is related to hormone imbalances

A

TRUE

45
Q

What are the 2 causes of bening ovarian cysts?

A
  1. ovary/follicular cysts
  2. corpus luteum cysts
46
Q

What is the difference between follicular cysts, ovary cysts & corpus luteum cysts

A

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

47
Q

What is the location of endometriosis?

A

ovaries, fallopian tubes & bladder

48
Q

T or F: Benign Ovarian Cysts is 1/3 of gynecological hospital admissions.

A

TRUE

49
Q

During normal menstrual cycle __ (1) follicles are stimulated and only ___ (2) reaches ovulation

A

120 (1)
1 (2)

50
Q

Endometriosis, is the presence of functional _____ tissue OUTSIDE uterus

A

endometrial

51
Q

What is the problem with endometriosis?

A

tissue still responds to menstrual cycle hormonal fluctuations

52
Q

T or F: Endometriosis often causing infertility and pain

A

TRUE

53
Q

Endometriosis has high levels of _____ (hormone)

A

estrogen

54
Q

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

A
  1. angiogenesis
  2. Stem
  3. ectopic
55
Q

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

A
  1. 2nd
  2. 8
  3. 75
  4. 14
  5. 240
56
Q

What are the diagnosis for breast cancer?

A

clinical breast exam, mammograph & biopsy

57
Q

What are the gene mutations for women with BC? Which chromosomes are these invovled?

A

BRCA1 (Chromosome 17) & BRCA 2 (Chromosome 13)

58
Q

What are the risk factors for breast cancer in women?

A
  • fam history
  • early period before 12
  • late menopause after 55
  • nulliparous
  • oral contraceptives and obesity
59
Q

Protective affect for breast cancer in women?

A
  • early first pregnancy
  • removal of ovaries and pituitary gland
60
Q

What are the increased risk of breast cancer in women?

A
  • early menarche
  • late menopause
    -nulliparous
61
Q

What is Gynecomastia?

A

overdevelopment of breast tissue in males – result in hormonal alterations

62
Q

What is cause of breast cancer in men? Who are at risk?

A

idiopathic; at risk: Klinefelter’s syndrome, men >60 yrs old, nipple crusting & discharge, enlarged axillary nodes

63
Q

What are axillary nodes?

A

lymph nodes in armpit that drain lymph from breast area

64
Q

In young males, gynecomastia resolves in __-__ months

A

4-6

65
Q

What is klinefelter’s syndrome?

A

males have an extra X chromosome

66
Q

What is the tx for men with breast cancer?

A

modified mastectomy with hormone therapy

67
Q

What is the hormonal imbalance in men with breast cancer?

A

Estrogen = excessively high
Testosterone = excessively low

Pathophysiology (20 decks)

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