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Pathophysiology > Chapter 33 - Alterations In Female Reproductive Systems > Flashcards

Chapter 33 - Alterations In Female Reproductive Systems Flashcards

1
Q

Dysmenorrhea

A

Painful menstruation

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2
Q

Dysmenorrhea results from

A

Excessive prostaglandin secretion

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3
Q

Prostaglandin results in

A

Myometrial (smooth muscle cells of uterine wall) stimulation and vasoconstriction

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4
Q

Dysmenorrhea result:

A

Constriction of endometrial tissue, and nerve hypersensitivity = PAIN

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5
Q

Dysmenorrhea: pain is directly related to

A

Length and amount of menstrual flow

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6
Q

TX Dysmenorrhea

A

NSAIDs

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7
Q

Layers of uterus inner to outer

A
  1. Endometrium
  2. Myometrium
  3. Uterus
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8
Q

Primary amenorrhea

A

Absence of menstruations by 13 yoa without development of secondary characteristics by 15 yoa

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9
Q

Secondary amenorrhea

A

Absence of menstruation for 3 cycles in women with previous cycles

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10
Q

Important for amenorrhea is to understand

A

Compartmentalizations

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11
Q

amenorrhea compartment 1:

A

Disorder due to anatomical defects
-absence of vagina and uterus

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12
Q

amenorrhea compartment 2:

A

Disorder of ovary/genetic disorders
-Turner’s syndrome

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13
Q

amenorrhea compartment 3:

A

disorder of anterior pituitary gland
-results in failure of FSH and LH to properly signal ovaries s

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14
Q

Amenorrhea compartment 4:

A

Disorder due to CNS that prevents release of hypothalamic GnRH

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15
Q

What is the leading cause of infertility in NA?

A

PCOS

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16
Q

Diagnosis of PCOS

A

Anovulatory (skipped ovulations) and menstrual cycles
-elevated levels of androgen

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17
Q

PCOS is related to

A

Genetics and obesity prone lifestyle

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18
Q

Obesity and PCOS

A

-PCOS predisposes for obesity
-obesity predisposes to PCOS

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19
Q

Obesity prone lifestyle =

A

Inc insulin resistance and excess of insulin + androgens
-hyperinsulinemia = overstimulation of ovarian androgen secretion

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20
Q

Overstimulation of ovarian androgen secretion causes

A

-inc free androgen which inc follicular growth
-inc insulin suppresses follicular apoptosis = survival of follicles that would normally disintegrate

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21
Q

Result of PCOS

A

Ovaries become enlarged and contain fluid filled sacs (follicles) that surround eggs

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22
Q

Exogenous

A

Most often sexually transmitted

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23
Q

Endogenous

A

Microorganism that have normal residence of vagina, bowel and vulva

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24
Q

Pelvic inflammatory disease affects

A

Upper gentian tract (uterus, fallopian tubes, ovaries)

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25
Q

Risk factors for pelvic inflammatory disease

A

Earlier untreated sexually transmitted disease, or having multiple sex partners

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26
Q

pelvic inflammatory disease develops when

A

Pathogens ascend from an infected cervix to infect fallopian tubes

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27
Q

Main sexually transmitted infections

A

Gonorrhoea and chlamydia

28
Q

Aerobic bacteria alter vaginal pH =

A

Decrease integrity of mucus blocking cervical canal

29
Q

TX pelvic inflammatory disease

A

Broad spectrum antibiotics to ensure all causative agents are eliminated

30
Q

Salpingitis

A

Inflammation of fallopian tubes
-changes columnar epithelia of upper reproductive tract

31
Q

Salpingitis causes

A

Local edema and possibly necrosis

32
Q

Gonorrhoea and chlamydia in Salpingitis

A

G: attach to fallopian tubes and secrete a toxin that damages mucosa

C: enters damaged cells and replicates = pathogens burst cell membrane causing scarring

33
Q

Chronic consequences of PID

A

Infertility, tubul obstruction, ectopic pregnancy

34
Q

Vaginitis

A

Vaginal inflammation with inc of WBC

35
Q

Vaginosis

A

Vaginal irritations without WBC

36
Q

Causes of vaginitis

A

Overgrowth of normal flora
-STI
-low estrogen levels during menopause

37
Q

vaginitis is related to alterations in

A

Vaginal pH
-normal levels of 4 to 4.5 depending on cervical secretions and presence of normal flora
-changes in pH = predisposition to infection

38
Q

Diagnosis of vaginitis

A

Change in colour and amount of menstrual discharge

39
Q

TX for vaginitis

A

Support acidic environment
-probiotics encourage proliferation of normal vaginal flora

40
Q

Cervicitis

A

Inflammation of cervix

41
Q

Diagnosis fo Cervicitis

A
  1. Purulent discharge (pus)
  2. Mucopurulent discharge (pus and mucus)
42
Q

Mucopurulent Cervicitis

A

Infection becomes red and edematous (related to or affected by edema)
-drains from external cervix
-pelvic pain
-bleeding may be present

43
Q

Mucopurulent Cervicitis is a symptom of

A

Pelvic inflammatory disease

44
Q

Women under 26 yoa should receive

A

TX for PID while waiting for exudate examination

45
Q

Benign ovarian cysts occur in

A

Reproductive years around puberty and menopause

46
Q

Benign ovarian cysts are related to

A

Hormone imbalances
-reason for 1/3 gynaecological hospital admissions

47
Q

Two causes for Benign ovarian cysts

A

Ovary/follicular cysts and corpus luteum cysts

48
Q

During normal menstrual cycle ___ follicles are stimulates

A

120
-but only one reaches ovulation

49
Q

Follicular cyst

A

Dominant follicle does not rupture normally, or non dominant follicles do not regress

50
Q

Ovary cysts

A

Development occurs when no dominant follicle develops and completes maturation process

51
Q

Corpus luteum cysts

A

May form from granulosa cells left behind after ovulation

52
Q

Endometriosis

A

Presence of functional endometrial tissue outside uterus
-ovaries, fallopian tubes, bladder

53
Q

Problem with functional endometrial tissue outside uterus

A

Tissue still responds to menstrual cycle hormonal fluctuations
-causing infertility and pain

54
Q

Endometriosis causes

A

-high levels of estrogen
-cells switching fates during development
-new bv to support lesions (angiogenesis)
-stem cells play role
-ectopic pregnancy

55
Q

Second leading cause of death in women, with an 1 in 8 chance of development

A

Breast cancer

56
Q

On average per day, __ canadian women will be diagnosed with breast cancer and ___ will die from the cancer

A

75, 14

57
Q

In 2022 ___ men will be diagnosed with breast cancer, and __ will likely die from breast cancer

A

240, 55

58
Q

Four hypothesis for breast cancer

A
  1. Ovarian androgen (testosterone) excess
  2. Blood elevation in both estrogen and progesterone
  3. Estrogen alone : estrogen circulating in breast cancer in post menopausal women
  4. Local biosynthesis of estrogen in breast tissue
59
Q

Diagnosis of breast cancer

A

Clinical breast exam, mammography, biopsy

60
Q

Risk factors for breast cancer in women

A

BRCA1 and BRCA2 gene mutation
-normally these protect against cancer but mutations lead to cancer

Family history
Menstruation before 12 yoa
Menopause after 55 yoa
Nulliparou (no children)
Oral contraceptives
Obesity

61
Q

Hormonal factors of breast cancer in women

A

-progesterone affects early first pregnancy or removal of ovaries and pituitary gland
-inc risk associated with early menarche, late menopause, nulliparity

62
Q

Gynecomastia

A

Overdevelopment of breast tissue in males
-results in hormonal alterations

63
Q

Who is at risk for Gynecomastia

A

Klinefelters syndrome
-males with an extra X chromosome

64
Q

Hormonal imbalance in Gynecomastia

A

Estrogen is very low or testosterone is very low

65
Q

In young males Gynecomastia resolves in

A

4-6 months

66
Q

Males > 60 yoa risks/Gynecomastia

A

-BRCA1 and BRCA2 mutations
-nipple crusting and discharge
-enlarged auxiliary nodes

67
Q

TX for Gynecomastia

A

Modified mastectomy with hormone therapy

Pathophysiology (20 decks)

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