Ch 33- Alterations in Female Reproductive Systems

Question 1

What is dysmenorrhea?

Answer 1

painful menstruation

Question 2

What is the tx for dysmenorrhea?

Answer 2

NSAIDs

Question 3

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

Answer 3

amount & length

Question 4

What is the cause of pain from dysmenorrhea?

Answer 4

excessive prostaglandin secretion

Question 5

What is endometrial?

Answer 5

layer of tissue that lines uterus

Question 6

What is the result of dysmenorrhea?

Answer 6

ischemia and endometrial shedding

Question 7

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.

Answer 7

1. myometrial
2. vasoconstriction
3. endometrial
4. nerve

Question 8

What are the 2 types of amenorrhea?

Answer 8

Primary and secondary

Question 9

What is the difference between primary and secondary amenorrhea?

Answer 9

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.

Question 10

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

Answer 10

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

Question 11

What is the leading cause of infertility in North America?

Answer 11

PCOS

Question 12

What is the diagnosis for PCOS?

Answer 12

• anovulatory menstrual cycles & elevated levels of androgens.

Question 13

What does anovulatory menstrual cycles mean?

Answer 13

skipped ovulations

Question 14

How does hyper-insulinemia related to PCOS?

Answer 14

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

Question 15

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

Answer 15

1. androgen

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

2. enlarged
3. follicles

Question 16

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

Answer 16

TRUE

Question 17

T or F: PCOS predisposes for obesity

Answer 17

TRUE

Question 18

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

Answer 18

TRUE

Question 19

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

What is the difference of exogenous and endogenous?

Answer 19

1. microorganisms

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

Exogenous – often sexually transmitted

Question 20

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

Answer 20

1. Pelvic inflammatory disease
2. salpingitis
3. Vaginitis
4. cervicitis

Question 21

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

Answer 21

Pelvic inflammatory disease

Question 22

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

Answer 22

uterus, fallopian tube and ovaries

Question 23

What are the risk factors for PID?

Answer 23

untreated STI & multiple sex partners

Question 24

What are the main STI involved in PID?

Answer 24

gonorrhea & chlamydia

Question 25

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.

Answer 25

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

Question 26

What is the inflammation of fallopian tubes?

Answer 26

salpingitis

Question 27

How infection affect people with salpingitis?

Answer 27

changes columnar epithelia of upper reproductive tract

Question 28

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

Answer 28

edema (1) & necrosis (2)

Question 29

What are the consequences of PID?

Answer 29

infertility, tubal obstruction, ectopic pregnancy

Question 30

Salpingitis -- gonorrhea and ____ combined effect.

Answer 30

chalmydia

Question 31

What is the difference between vaginitis and vaginosis?

Answer 31

Vaginitis -- vaginal inflammation WITH increases in WBC Vaginosis -- vaginal irritations WITHOUT WBC

Question 32

What is the cause of vaginitis? (3 pts)

Answer 32

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

Question 33

What is the diagnosis for vaginitis?

Answer 33

marked change in colour & amount of menstrual discharge

Question 34

What are the tx for vaginitis (2pts)

Answer 34

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

Question 35

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

Answer 35

1. pH 2. 4.0-4.5 3. predisposition

Question 36

What is cervicitis?

Answer 36

inflammation of cervix

Question 37

What are the diagnosis for cervicitis? (2pts)

Answer 37

1. purulent discharge (pus) 2. mucopurulent discharge (pus and mucus)

Question 38

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

Answer 38

TRUE

Question 39

What is mucopurulent cervicitis?

Answer 39

infection become red and edematous

Question 40

Where does mucopurulent discharge drain from?

Answer 40

external cervix

Question 41

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

Answer 41

TRUE

Question 42

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

Answer 42

FALSE; Women under 26 yrs old.

Question 43

When does benign ovarian cysts most likely to occur?

Answer 43

puberty and menopause

Question 44

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

Answer 44

TRUE

Question 45

What are the 2 causes of bening ovarian cysts?

Answer 45

1. ovary/follicular cysts 2. corpus luteum cysts

Question 46

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

Answer 46

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

Question 47

What is the location of endometriosis?

Answer 47

ovaries, fallopian tubes & bladder

Question 48

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

Answer 48

TRUE

Question 49

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

Answer 49

120 (1) 1 (2)

Question 50

Endometriosis, is the presence of functional _____ tissue OUTSIDE uterus

Answer 50

endometrial

Question 51

What is the problem with endometriosis?

Answer 51

tissue still responds to menstrual cycle hormonal fluctuations

Question 52

T or F: Endometriosis often causing infertility and pain

Answer 52

TRUE

Question 53

Endometriosis has high levels of _____ (hormone)

Answer 53

estrogen

Question 54

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

Answer 54

1. angiogenesis 2. Stem 3. ectopic

Question 55

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

Answer 55

1. 2nd 2. 8 3. 75 4. 14 5. 240

Question 56

What are the diagnosis for breast cancer?

Answer 56

clinical breast exam, mammograph & biopsy

Question 57

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

Answer 57

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

Question 58

What are the risk factors for breast cancer in women?

Answer 58

- fam history - early period before 12 - late menopause after 55 - nulliparous - oral contraceptives and obesity

Question 59

Protective affect for breast cancer in women?

Answer 59

- early first pregnancy - removal of ovaries and pituitary gland

Question 60

What are the increased risk of breast cancer in women?

Answer 60

- early menarche - late menopause -nulliparous

Question 61

What is Gynecomastia?

Answer 61

overdevelopment of breast tissue in males -- result in hormonal alterations

Question 62

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

Answer 62

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

Question 63

What are axillary nodes?

Answer 63

lymph nodes in armpit that drain lymph from breast area

Question 64

In young males, gynecomastia resolves in __-__ months

Answer 64

4-6

Question 65

What is klinefelter's syndrome?

Answer 65

males have an extra X chromosome

Question 66

What is the tx for men with breast cancer?

Answer 66

modified mastectomy with hormone therapy

Question 67

What is the hormonal imbalance in men with breast cancer?

Answer 67

Estrogen = excessively high Testosterone = excessively low