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Pathophysiology > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

Testes job

A

Spermatogenesis

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2
Q

Epidiymis job

A

Maturation of sperm

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3
Q

Vas deferens job

A

Transport of sperm or urethra

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4
Q

Seminal vesicles

A

Secretion to nourish sperm

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5
Q

Prostate gland

A

Secretions to balance pH

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6
Q

Cowper glands (bulbourethral)

A

Secretes alkaline mucus

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7
Q

Penis

A

Ejeculation of semen

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8
Q

Male hormones: follicle-stimulating hormone (FSH)

A

Initiates speratogenesis

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9
Q

Male hormones: luteinizing hormone (LH)

A

Stimulates testosterone testosterone

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10
Q

Male hormones: testosterone

A

Maturation of sperm, sex characteristics, protein metabolism, muscle development

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11
Q

Congenital Abnormalities of the Penis: epispadias

A

Urethral opening on ventral or upper surface of the penis

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12
Q

Congenital Abnormalities of the Penis: hypospadias

A

Urethral opening on dorsal surface (underside) of the penis

— either condition may result in incontinence or infection

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13
Q

Treatment of epispadias and hypospadias

A

Surgical reconstruction

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14
Q

Cryptorchidism

A

Testis fail to descend into scrotum properly

- reason not totally understood

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15
Q

Ectopic testis

A

Testis positioned outside of scrotum

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16
Q

Ectopic testis increased risk of what

A

Testicular cancer if not fixed by age 5

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17
Q

Ectopic testis can cause what

A

Degeneration of seminiferous tubules and spermatogenesis

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18
Q

Hydrocele

A

Occurs when excessive fluid collects in space between layers of the tunica vaginalis of the scrotum

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19
Q

Hydrocele may result from what

A

Congenital defect

Injury, infection, tumor

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20
Q

Hydrocele effects

A

Compromise blood supple or lymph drainage in testes

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21
Q

Spermatocele

A

Cyst containing fluid and sperm that develops between the testis and epididymis

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22
Q

Spermatocele may be related to what

A

Developmental abnormality

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23
Q

Spermatocele treatment

A

Surgical remove all

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24
Q

Varicocele

A

Dilated vein in the spermatic cord

- lack of valves allows back flow in veins; leads to increased pressure and dilation

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25
Q

Varicocele causes what

A

Impaired blood flow to testes and decreased spermatogenesis

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26
Q

Varicocele requires what

A

Surgery

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27
Q

Torsion of testes

A

Testes route on spermatic cord, compressing arteries and veins

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28
Q

Torsion of testes leads to what

A

Ischemia, scrotum swells

Infaction of testes if torsion not reduced

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29
Q

Torsion of testes: cause

A

Spontaneous or follows trauma

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30
Q

Torsion of testes treatment

A

Manually and surgically

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31
Q

Prostatitis

A

Infection or inflammation of the prostate gland, most often caused by E. Coli

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32
Q

Prostatitis: Acute bacteria

A

Gland is tender and swollen, urine and secretions contain bacteria

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33
Q

Prostatitis: chronic bacterial

A

Gland only slightly enlarged, dysuria, frequency, urgency

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34
Q

Prostatitis: non bacterial

A

Urine and secretions contain large number of leukocytes

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35
Q

Prostatitis: asymtptomatic and inflammatory

A

Look up

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36
Q

Prostatitis usually what

A

Ascending infection

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37
Q

Prostatitis: occurs in who

A 
Young men with UTIs
Older men with prostatic hypertrophy 
STDs
Instrumentation (catheterization)
Through bacteremia
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38
Q

Prostatitis: treatment

A

Antibiotics (acute or chronic bacterial infection)

Anti inflammatory drugs and prophylactic antibacterial agents

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39
Q

Prostatitis: symptoms

A

Pretty expected but go look on slide 11

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40
Q

Balanitis

A

Fungal infection of the glans penis

- sexually transmitted

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41
Q

Balanitis: cause

A

Candida albicans

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42
Q

Balanitis: patho

A

Vesicles develop into patches; severe burning

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43
Q

Balanitis: treatment

A

Topical antifungal medication

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44
Q

Benign Prostatic Hypertrophy: what

A

Hyperplasia of prostatic tissue

  • compression of urethra and urinary obstruction
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45
Q

Benign Prostatic Hypertrophy: related to what

A

Estrogen-testosterone imbalance

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46
Q

Benign Prostatic Hypertrophy: how can you discover it

A

Enlarged gland palpated on digital rectal examination

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47
Q

Benign Prostatic Hypertrophy: leads to what

A

Frequent infections

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48
Q

Benign Prostatic Hypertrophy: continues obstruction causes what

A

Distended bladder, dilated ureters, hydronephrosis, renal failure

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49
Q

Benign Prostatic Hypertrophy: s/s

A 
Obstructed urinary flow / hesitancy starting urine flow
Dribbling 
Decreased flow strength
Increased frequency and urgency
Nocturia
Dysuria occurs if infection is present
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50
Q

Benign Prostatic Hypertrophy: treatment

A

Drugs to slow enlargement
Tamulosin (smooth muscle relaxer)
Surgery

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51
Q

Prostate cancer: causes

A

High androgen levels, increased insulin-like growth factor, history of recurrent prostatitis

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52
Q

Prostate cancer: s/s

A 
Hard nodule felt on periphery of gland
Hesitancy in urination
Decreased stream
Frequent urination
Recurrent UTI
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53
Q

Prostate cancer: diagnosis

A

Serum markers

  • prostate-specific antigen (PSA)
  • prostatic acid phosphate

Ultrasonography

  • biopsy
  • bone scans to detect metasteses
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54
Q

Prostate cancer: treatment

A

Surgery
Radiation
If androgen sensitive, then orchiectomy is effective, as well as antitestosterone drugs
New chemos are in clinical trials

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55
Q

What is the most common solid tumor in young men

A

Cancer of testes

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56
Q

Cancer of testes originates from what

A

One type of cell or mixed cells from various sources

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57
Q

Teratoma

A

Tumor consisting of mixture of different germ cells

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58
Q

Some malignant tumors secrete what? How is this helpful?

A

HcG or AFT, which serve as useful markers for diagnosis

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59
Q

Cancer of testes: typical spreading pattern

A
  1. Appear in common iliac and para-aortic lymph nodes
  2. Then to the mediastinal and supraclavicular lymph nodes
  3. Then though the blood to the lungs, liver, bone and brain
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60
Q

Cancer of the testes: causes

A

Genetics (chromosome 12)
Predisposing factor (cryptorchidism)
Exposure to herbicides and other environmental agents

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61
Q

Cancer of testes: s/s

A 
Hard, painless, unilateral tumor
Enlarged / heavy testes
Aching scrotum and pelvis
Hydrocele or epididymus May develop
Gynecomastia if tumor of hormone secreting
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62
Q

Cancer of testes: diagnosistic tests

A 
Biopsy
Tumor markers
Ultrasound
CT
Lymphangiography
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63
Q

Cancer of testes: treatment

A

Combination of surgery, radiation, chemo

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64
Q

Vulva consists of what

A

Mons pubis and labia majora/minors

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65
Q

Mons pubis

A

Adipose tissue and hair covering the symphysis pubis

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66
Q

Labia majora and minora

A

Outer and inner thin folds of skin extending back and down from the mons pubis

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67
Q

Clitoris

A

Erectile tissue anterior to urethra

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68
Q

Vagina

A

Muscular, distensible canal extending upward from the Vulva to the cervix

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69
Q

Uterus

A

Muscular organ within which fertilized ovum may implant and develop

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70
Q

Cervix

A

Opening into uterus and neck of the uterus

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71
Q

Cervix: external os

A

Opening from vagina filled with thick mucus

Prevents vaginal flora from ascending into the uterus

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72
Q

Cervix is composed of what

A

Internal and external os

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73
Q

Fallopian tubes (oviducts)

A

Tubes from ovaries to uterus

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74
Q

Ovaries

A

Produce ova and estrogen and progesterone hormones

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75
Q

Breasts

A

Glands produce colostrum and milk for newborn

Adipose tissue

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76
Q

Cycle is how many days

A

May be from 21 to 45 days

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77
Q

Hormones and the men trial cycle: cycle consists of

A

Menstruation (days 1-5)
Endometrial proliferation and production of estrogen (days vary)
Maturation of ovarian follicle
Release of LH, causing ovulation

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78
Q

Process of the menstrual cycle

A
  1. Follicle becomes the corpus luteum, produced progesterone
  2. Vascularization of endometrium is preparation for implantation
    º12 to 14 days prior to onset of next menstruation
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79
Q

What happens is implantation does not occur?

A
  1. Corpus luteum atrophies
  2. Uterine muscle contracts - ischemia
  3. Endometrium degeneration
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80
Q

Normal position of uterus

A

Slightly anteverted and anteflexed

Cervix downward and posterior

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81
Q

Structural abnormalities: Retroflexion of uterus

A

Uterus tipped posteriorly
May be excessively curved or bent
Marked retro version may cause back pain, dysmenorrhea, dyspareunia
In some cases, infertility may occur

82
Q

Uterine displacement or prolapse: first degree

A

When cervix drops into vagina

83
Q

Uterine displacement or prolapse: second degree

A

When cervix lies at opening to the vagina

- body of uterus is in the vagina

84
Q

Uterine displacement or prolapse: third degree

A

If uterus and cervix protrude through the vaginal orifice

  • early stages of prolapse may be asymptomatic
  • advanced stages cause discomfort, infection, and decreased mobility
85
Q

Rectocele

A

Protrusion of the rectum into the posterior vagina

- may cause constitution and pain

86
Q

Cystocele

A

Protrusion of bladder into the anterior vagina

May cause UTIs

87
Q

Rectocele and Cystocele treatment

A

If severe, conditions are treated surgically to increase the support of the pelvic ligaments

88
Q

Amenorrhea

A

Absence of menstruation

  • may be primary or secondary
  • primary = genetic
  • secondary from hormonal balance
89
Q

Dysmenorrhea

A

Painful menstruation caused by excessive release of prostaglandins as a result of endometrial ischemia

Usually begins a few days prior to menses lasts a few days after onset

NSAIDs for release

90
Q

Premenstrual syndrome

A

Starts about 1 week before onset of menses; not exactly sure why this happens

Breast tenderness, weight gain, abdominal distention, bloating, irritability, emotional liability, sleep disturbances, depression, headache, fatigue

91
Q

Premenstrual syndrome treatment

A

Individualized and may include exercise, limiting salt intake, use of oral contraceptives, diuretics, or antidepressant drugs

92
Q

Abnormal menstrual bleeding cause

A

Usual cause is lack of ovulation, but a hormonal imbalances in the pituitary-ovarian axis may be a favor

93
Q

Menorrhagia

A

Increased amount and duration of flow

94
Q

Metrorrhagia

A

Bleeding between cycles

95
Q

Polymenorrhea

A

Short cycles of less than 3 weeks

96
Q

Oligomenorrhea

A

Long cycles of more than 6 weeks

97
Q

Endometriosis

A

Endometrial tissue occurs outside the uterus

  • responds to cyclical hormone changes
  • bleeding leads to inflammation and pain
  • fibrous tissue May cause adhesions and obstructions of the involved structures
98
Q

Endometriosis cause

A

Unknown but thought to be linked to congenital in some cases

99
Q

Endometriosis treatment

A

Hormonal suppression

Surgical removal of ectopic tissue

100
Q

Candidiasis

A

Form of vaginitis that is not sexually transmitted

Cause: candida albicana

101
Q

Candidiasis: opportunistic infection - how

A

Antibiotics
Pregnancy
Diabetes
Reduced host defenses

102
Q

Candidiasis s/s

A

Red and swollen, intensely pruritic mucous membranes and a thick, white, curd like discharge

103
Q

Candidiasis treatment

A

Antifungal meds

104
Q

Candidiasis may extend where

A

Vulvar tissues

105
Q

Pelvic Inflammatory Disease (PID): what

A

Infection of uterus, Fallopian tubes, and/or ovaries

- may be acute or chronic

106
Q

Pelvic Inflammatory Disease (PID): originates as what

A

As an ascending infection from lower reproductive tract

107
Q

Pelvic Inflammatory Disease (PID): may occur because of what

A

Bacteremia
STD
Non-sterile abortion
Childbirth

108
Q

Pelvic Inflammatory Disease (PID): scarring of tubes increases what

A

Risk of infertility and ectopic pregnancy

109
Q

Pelvic Inflammatory Disease (PID): potential acute complications

A

Peritonitis
Pelvic abscesses
Septic shock

110
Q

Pelvic Inflammatory Disease (PID): first sign.

A

Pelvic pain

  • increased temp
  • guarding
  • nausea
  • leukocytosis
  • purulent discharge may be present
111
Q

Pelvic Inflammatory Disease (PID): treatmetn

A

Aggressive antibiotic therapy in hospital

112
Q

Leiomyoma (Fibroids): what

A

Benign tumor of the myometrium

- usually multiple, well-defined, unencapsulated masses

113
Q

Leiomyoma (Fibroids): common what

A

Reproductive years

114
Q

Leiomyoma (Fibroids): s/s

A

Abnormal bleeding
May interfere with implantation
Often asymptomatic until large

115
Q

Leiomyoma (Fibroids): treatment

A

Hormonal therapy or surgery

116
Q

Leiomyoma (Fibroids): classification

A

By location

117
Q

Ovarian cyst

A

Usually multiple, small, fluid-filled sacs (variety of types)
Physiological type lasts about 8-12 weeks and disappears without complications

118
Q

When are ovarian cysts serious

A

When bleeding occurs, inflammation occurs

119
Q

Ovarian cyst treatment

A

Surgical intervention

120
Q

Ovarian cyst diagnosis

A

Ultrasound or laparoscopy

121
Q

Polycystic Ovarian Disease: what

A

Fibrous capsule thickens around follicles of ovary

122
Q

Polycystic Ovarian Disease: s/s

A

Absence of ovulation and infertility
Hormonal imbalance
Amenorrhea
Hirsutism

123
Q

Polycystic Ovarian Disease: treatment

A

May be surgical wedge resection or drugs

124
Q

Fibrotic breast disease: what

A

Broad range of breast changes and increased density of breast tissue

125
Q

Fibrotic breast disease: patho

A

Cyclic occurrence of nodules or masses in breast tissue

126
Q

Fibrotic breast disease: increased risk of what

A

Increase risk of breast cancer is atypical cells are present

127
Q

Fibrotic breast disease: increased density does what to breasts

A

Makes breast self-examination difficult

128
Q

Increased risk of cystic masses with what lifestyle habit

A

Caffeine intake

129
Q

Carcinoma of the breast: most arise from what

A

Most arise from ductal epithelial cells

130
Q

Carcinoma of breast: metastasize

A

Metastasis occurs via lymph nodes early in course of disease

131
Q

Carcinoma of breast: most tumors are what

A

Unilateral

132
Q

Carcinoma of breast: what influences treatment

A

Presence of estrogen and progesterone receptors on tumor cells

133
Q

Carcinoma of breast: earlier onset associated with what

A

More aggressive growth

134
Q

Carcinoma of breast: incidence

A

Incidence increases after 20 years old

Most cases in women between 50 and 69 years

135
Q

Carcinoma of breast: predisposing factor s

A 
First-degree relative with the disease
Genetics
Longer and higher exposure to estrogen 
Nulliparous or late first pregnancy
Lack of exercise
Smoking
High fat diet
Radiation therapy to chest
Cancer of uterus, ovaries or pancreas
136
Q

Carcinoma of breast: initial sign

A

Single, small, hard, painless nodule

137
Q

Carcinoma of breast: later signs

A

Distortion of breast tissue, dimpled skin, discharge of nipple

138
Q

Carcinoma of breast: diagnosis

A

Mammogram
Ultrasound
Needle biopsy

139
Q

Carcinoma of breast: treatment

A 
Surgery
Lymph node removal
Radiation
Chemo 
Hormone blocking agents
Estrogen receptor blockers
Drugs inhibiting estrogen production
140
Q

Different breast cancer treatment drugs

A

Slide 37

141
Q

Carcinoma of breast: how big is tumor when metestasis occurs

A

By the time tumor is 1-2cm in diameter

142
Q

Carcinoma of breast: lymph node often involved

A

Axillary lymph node

143
Q

Carcinoma of breast: secondary tumors

A

Bone
Lung
Brain
Liver

144
Q

Carcinoma of cervix: cause

A

HPV

- vaccines now exist against the causative stains of HPV

145
Q

Carcinoma of cervix: prevention

A

Pap smears of cervical cells

- start by age 20 or when sexually active (at intervals)

146
Q

Pathophysiology of carcinoma of the cervix

A

Slide 40

147
Q

Carcinoma of cervix: risk factors

A 
Age < 40 
HPV
Multiple partners
Early sexual intercourse 
Smoking
Hx STD
148
Q

Most common cancer in post menopausal women

A

Carcinoma of uterus

149
Q

Carcinoma of Uterus: early indicator

A

Painless vaginal bleeding or spotting

150
Q

Carcinoma of Uterus: risk factors

A

Age > 50
High dose estrogen hormone treatment without progesterone
Obesity
Diabetes

151
Q

Carcinoma of Uterus: what cells

A

Arises from glandular epithelium

152
Q

Carcinoma of Uterus: characteristics

A

Slow-growing but invasive

Staging based on degree of localization

153
Q

Carcinoma of Uterus: treatment

A

Surgery and radiation

154
Q

Carcinoma of Uterus: what does NOT detect this cancer

A

Pap smear

155
Q

Ovarian cancer: diagnosis

A

No reliable screening available

  • large mass detected by pelvic examination
  • transnational ultrasound
156
Q

Ovarian cancer: why is it considered a silent killer?

A

Few diagnosed in early stage

157
Q

Ovarian cancer: risk factors

A 
Obesity
BRCA1 gene
Early menarche 
Nulliparous or late first pregnancy 
Use of fertility drugs
158
Q

Ovarian cancer: what may protect

A

Oral contraceptives containing progesterone are someone protective

159
Q

Ovarian cancer: treatment

A

Surgery and chemo

160
Q

Infertility

A

Male and females

161
Q

Infertility risk factors

A 
Hormonal imbalances 
Age of parents
Structural abnormalities
Infections 
Chemo
Workplace toxins
Environmental factors
Idiopathic
162
Q

Sexually Transmitted Diseases: bacterial infections

A

Chlamydial infection
Gonorrhea
Syphilis

163
Q

Sexually Transmitted Diseases: viral infections

A 
Genital herpes 
Condylomata acuminata (genital warts)
164
Q

Sexually Transmitted Diseases: protozoan infections

A

Trichomoniasis

165
Q

Chlamydial infections: cause

A

Chlamydia trachomatis

166
Q

Chlamydial infections: what’s effected in males

A

Urethritis and epididymitis

167
Q

Chlamydial infections: s/s in males

A

Dysuria, itching, white discharge from penis (urethritis symptoms)

Painful swollen scrotum, usually unilateral, fever (epididymitis); inguinal lymph nodes swollen

168
Q

Chlamydial infections: females

A

Often asymptomatic until PID or infertility develops

Newborns may be infected during birth

169
Q

Gonorrhea: cause

A

Neisseria gonorrhea

Many strains have become resistant to penicillin and tetracycline

170
Q

Gonorrhea: males

A

Most common site is urethra, which is inflamed

Some males asymptomatic

171
Q

Gonorrhea: females

A

Frequently asymptomatic

PID and infertility are serious complications

172
Q

Gonorrhea: newborns

A

May infect eyes of newborn, causing irreversible damage and blindness

173
Q

Gonorrhea: spread

A

May spread systemically to cause septic arthritis

174
Q

Syphilis: cause

A

Treponema pallidum (a spirochete)

175
Q

Syphilis: primary stage

A 
Presence of chancre at site of infection
- genital region
- anus
- oral cavity 
Painless, firm, ulcerated nodule
176
Q

Syphilis: s/s occur when

A

About 3 weeks after exposure

177
Q

Syphilis: primary treatment

A

Lesion heals spontaneously but patient is still contagious

178
Q

Syphilis: secondary stage

A

If untreated, flu-like illness with symmetrical rash (self limited but client remains contagious)

179
Q

Syphilis: latent stage

A

May persist for years

Transmission may occur

180
Q

Tertiary syphilis

A

Irreversible changes

  • gummas in organs and major bv
  • dementia, blindness or motor disabilities
181
Q

Tertiary Syphilis: transmission

A

Can be transmitted in utero

182
Q

Tertiary Syphilis: baby born with it

A

Changes are not reversible

183
Q

Tertiary Syphilis: treatment

A

Antimicrobial drugs

184
Q

Syphilis: treatment cautions

A

Increase in antibiotic resistant strains causing an increase in prevalence

185
Q

Herpes: cause

A

HSV-1 or HSV-2

186
Q

HSV-1: transmission

A

Can be oral sex

187
Q

Genital herpes: s/s

A

Recurrent outbreaks of blister-like vesicles on genitalia

  • preceded by tingling or itching sensation
  • lesions are extremely painful
188
Q

Genital herpes: what happens after acute

A

Virus migrates back to dorsal root ganglion

189
Q

Genital herpes: infection greater when

A

When symptoms are present

190
Q

Genital herpes: reactivating is common and may be associated with what

A
  • stress
  • illness
  • menstruation
191
Q

Genital herpes: treatment

A

Antiviral drugs

192
Q

Genital herpes: infection is considered what

A

Lifelong

193
Q

Condylomata acuminata (Genital warts): cause

A

HPV

194
Q

Condylomata acuminata (Genital warts): incubation period

A

Up to 6 months

195
Q

Condylomata acuminata (Genital warts): symptoms

A

May be asymptomatic

  • vary in appearance
  • appear wherever contact with virus has occurred
196
Q

Condylomata acuminata (Genital warts): can predispose to what

A

Cervial or vulvar cancer

197
Q

Condylomata acuminata (Genital warts): treatment

A

Can be removed by different methods

198
Q

Trichomoniasis: cause

A

Trichomonas vaginalis - a protozoan parasite

- localized infection

199
Q

Trichomoniasis: men

A

Usually asymptomatic

200
Q

Trichomoniasis: women

A

May be sub clinical
Flares up when microbial balance in vagina shift
Causes intense itching

201
Q

Trichomoniasis: treatment

A

Systemic treatment necessary for both partners

Pathophysiology (11 decks)

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