Chapter 33 - Alterations in Male and Female Reproductive Systems Flashcards
1
Q
What is dysmenorrhea?
A
painful menstruation
2
Q
Dysmenorrhea occurs from excess _________ secretion
A
prostaglandin
3
Q
How do prostaglandins affect the myometrium?
A
stimulation and vasoconstriction
4
Q
What is the myometrium?
A
smooth muscle cells of uterine wall superficial to endometrium
5
Q
Prostaglandin induced vasoconstriction results in constriction of __________ tissue and nerve __________ which leads to pain
A
endometrial; hypersensitivity
6
Q
What is the endometrium?
A
layer of tissue that lines uterus
7
Q
Dysmenorrhea results in _________ and endometrial shedding
A
ischemia
8
Q
Pain from dysmenorrhea is directly related to ______ and ______ of menstrual floq
A
length and amount
9
Q
What is the treatment for dysmenorrhea?
A
NSAIDs
10
Q
Primary amenorrhea involves the absence of menstruations by age ____ without the development of secondary characteristics by age ___
A
13; 15
11
Q
Secondary amenorrhea involves the absence of menstruation for ___ cycles in women with previous cycles
A
3
12
Q
Amenorrhea Compartment 1: disorder due to…
A
anatomical defects (absence of vagina and uterus)
13
Q
Amenorrhea Compartment 2: disorders of…
A
ovary or genetic (ie. Turner’s syndrome)
14
Q
Amenorrhea Compartment 3: disorders of the…
A
anterior pituitary gland that results in LH and FSH failure
15
Q
Amenorrhea Compartment 4: disorder due to ____ that prevents release of ______ from the ________
A
CNS; GnRH; hypothalamus
16
Q
______ is the leading cause of infertility in North America
A
PCOS
17
Q
What 2 things diagnose PCOS?
A
-anovulatory menstrual cycles
-elevated androgen levels
18
Q
Anovulatory
A
skipped ovulations
19
Q
PCOS can be due to _______ or an _______-prone lifestyle
A
genetics; obesity
20
Q
PCOS predisposes for _______ while _______ predisposes for PCOS
A
obesity; obesity
21
Q
Why does obesity predispose for PCOS?
A
increased insulin resistance (excess insulin) and androgens
22
Q
Hyper-insulinemia overstimulate ovarian _______ secretion
A
androgen
23
Q
How do androgens contribute to PCOS?
A
increasing follicular growth
24
Q
How does insulin contribute to PCOS?
A
by suppressing follicular apoptosis and allowing follicles to survive
25
PCOS involves ________ ovaries which contain fluid filled _____ (follicles) that surround eggs
enlarged; sacs
26
Genital tract infections can result from _________ or ___________ microorganisms
exogenous or endogenous
27
Exogenous microorganisms are often ________ transmitted
sexually
28
Endogenous microorganisms have ________ residence of...
normal; vagina, bowel, vulva
29
What is pelvic inflammatory disease (PID)?
an infection involving any organ or combination of organs of upper genital tract
30
Female Upper Genital Tract Organs
uterus, fallopian tubes, ovaries
31
What puts one at risk for PID?
-untreated STIs
-multiple sex partners
32
PID develops when pathogens ascent from cervix to _____ _____
fallopian tubes
33
What are the main STIs that cause PID?
gonorrhoea and chlamydia
34
Aerobic bacteria (_______) alter vaginal pH and decrease the integrity of the _______ blocking the cervical canal
gonorrhoea; mucus
35
What is used to treat PID?
broad spectrum antibiotics
36
What is salpingitis?
inflammation of the fallopian tubes
37
Infection changes the _________ epithelia of the upper reproductive treat
columnar
38
Inflammation = _____ and possible ______
edema; necrosis
39
What is the combined effect of gonorrhoea and chlamydia for salpingitis?
Gonorrhoea - secrete a toxin that damages mucosa
Chlamydia - replicates in damaged cells, burst cell membrane, leave scarring
40
What are the 3 consequences of PID?
-infertility
-tubal obstruction
-ectopic pregnancy
41
Ectopic Pregnancy
implantation of fertilized egg outside the uterus
42
Vaginitis
vaginal inflammation with increase in WBCs
43
Vaginosis
vaginal irritation without WBCs
44
What 3 things can cause vaginitis?
-normal flora overgrowth
-STIs
-low estrogen during menopause
45
Vaginitis is related to alterations in vaginal ____
pH
46
What is a normal vaginal pH?
4.0-4.5
47
What 2 factors contribute to vaginal pH?
-cervical secretions
-presence of normal flora that support acidic environment
48
A change in vaginal pH predisposes __________
infection
49
How is vaginitis diagnosed?
change in colour/amount of discharge
50
How is vaginitis treated?
-supporting acidic environment
-probiotics to proliferate normal vaginal flora
51
What is Lactobacillus crispatus?
a probiotic
52
What is cervicitis?
inflammation of the cervix
53
What 2 signs lead to cervicitis diagnosis?
-purulent (pus) discharge
-mucopurulent (mucus and pus) discharge
54
Mucopurulent cervicitis is a red and _______ infection
edematous
55
Cervicitis symptoms:
-mucopurulent discharge
-pelvic pain
-bleeding
56
Mucopurulent cervicitis is a symptom of _____
PID
57
Women under ____ should receive PID treatment while waiting for ______ examination
26; exudate
58
When do benign ovarian cysts occur?
in reproductive years around puberty and menopause
59
Benign ovarian cysts are related to...
hormonal imbalances
60
Benign ovarian cysts male up _____ of gynecological hospital admissions
1/3
61
How many follicles are stimulated during a normal menstrual cycle?
120
62
How many follicles reach ovulation in a normal menstrual cycle?
normally only one
63
Follicular cysts occur when the dominant follicle doesn't __________ normally OR when non-dominant follicles do not ______
rupture; regress
64
Ovary cycts occur when ___ dominant follicle develops and completes the menstruation process
no
65
Corpus luteum cysts can develop from ________ cells left behind after ovulation
granulosa
66
What is endometriosis?
presence of functional endometrial tissue outside the uterus
67
Where can endometriosis affect?
ovaries, fallopian tubes, bladder
68
With endometriosis, the tissue responds to...
menstrual cycle hormonal fluctuations
69
Endometriosis causes high levels of ________
estrogen
70
Endometriosis causes cells to ______ ________ during development
switch fates
71
Endometriosis cells can develop new ______ ______ to support lesions
blood vessels (angiogenisis)
72
_______ cells play a role in the development of endometriosis lesions
stem
73
What is a serious complication of endometriosis?
ectopic pregnancy
74
Breast cancer is the _____ leading cause of death in women
2nd
75
1 in ____ have a chance of developing breast cancer
8
76
___ Canadian women will be diagnosed with breast cancer each day and ___ will die from breast cancer
75; 14
77
In 2022, _____ men will be diagnosed with breast cancer and ____ will likely die
240; 55
78
Breast Cancer Hypothesis 1/4: ovarian androgen (__________) excess
testosterone
79
Breast Cancer Hypothesis 2/4: Blood elevation in both _________ and ____________
estrogen and progesterone
80
Breast Cancer Hypothesis 3/4: "Estrogen-alone hypothesis"
relationship between levels of circulating estrogen and breast cancer in POSTMENOPAUSAL women
81
Breast Cancer Hypothesis 4/4: Local biosynthesis of estrogen in _______ tissue
breast
82
How is breast cancer diagnosed?
-clinical breast exam
-mammogram
-biopsy
83
Breast Cancer Risk Factors:
-gene mutation
-family history
-timing of menstruation and menopause
-nulliparous
-oral contraceptives
-obesity
84
Which gene mutations are associated with breast cancer? What do these genes normally do?
BRCA1 and BRCA2 - normally protect against cancer
85
Menstruation before age ___ or menopause after ___ pose risk for breast cancer
12; 55
86
Nulliparou
no children
87
_______ first pregnancy and removal of _______ and ______ gland are risks for breast cancer ***check
early; ovaries and pituitary gland
88
What is gynecomastia?
overdevelopment of breast tissue in males as a result of hormonal alterations
89
People with Klinefelter's syndrome are at risk for...
Male breast cancer
90
What is Klinefelter's syndrome?
males who have an extra X chromosome (XXY)
91
Breast cancer in males in linked to high ______ or low ________
estrogen; testosterone
92
Gynecomastia resolves in _____ months in younger males
4-6
93
Breast cancer in males older than 60 is linked to _______ and _______ mutations
BCRA1 and BCRA2
94
Gynecomastia in older men involves:
-nipple crusting and discharge
-enlarged axillary nodes
95
Axillary Nodes
lymph nodes in armpit that drain lymph from breast area
96
What is the treatment for gynecomastia in older males?
modified mastectomy with hormone therapy
97
What is urethritis?
inflammation of urethra commonly caused by STIs
98
What bacteria causes gonococcal urethritis?
Neisseria gonorrhoeae
99
Non-infectious urethritis is associated with ingestion of ______ alcohol or _______
wood; turpentine
100
What are the symptoms of urethritis?
-urethral tingling
-itching
-burning
-urine frequency and urgency
-clear mucous-like discharge
101
How is urethritis diagnosed?
-urine nucleic acid detection amplification test to detect N. gonorrhoeae and Chlamydia trachomatis
102
Phimosis
foreskin can't be retracted
103
Paraphimosis
foreskin is retracted but can't be moved forward to cover the gland
104
_________ eliminated the possibility of phimosis or paraphimosis
circumcision
105
What is priapism?
uncommon prolonged penile erection usually painful and not associated with sexual arousal
106
Priapism is a urological _________
emergency
107
What is the treatment for priapism?
needle aspiration of blood from dorsal glans
108
Dorsal glans
artery on top of the penis surface
109
What is varicocele?
abnormal dilation of testicular veins within the scrotum
110
Varicocele aka _______ of ______
bag of worms
111
90% of varicocele occur on the _____ side due to the structure of venous drainage
left
112
Varicocele occurs in ___ to ___% of men
10-15%
113
What is hydrocele?
excessive fluid between tunica vaginalis layers
114
Congenital hydrocele resolves spontaneously in the _____ year of life
first
115
What is spermatoceles?
benign epididymal cysts
116
Spermatocele cysts fill with milky fluid due to ______ involvement
sperm
117
Spermatoeceles cause _____
significant pain
118
What is cryptorchidism?
abnormality where testes don't completely descend
119
Cryptorchidism leaves testes in _______ or inguinal canal
abdomen
120
What 3 things can cause cryptorchidism?
-short spermatic cord
-adhesions
-narrow inguinal canal
121
Cryptorchidism increases the risk of testicular cancer by ___ times
50
122
Cryptorchidism treatment:
-GnRH
-surgery
123
What is orchitis?
acute inflammation of the testes
124
What is the path of infection of orchitis?
urethra, vas deferens, epididymis, testes
125
What is the most common infection cause of orchitis?
mumps
126
What is epididymitis?
inflammation of epididymis
127
Who does epididymitis usually affect?
sexually active young males due to STIs (gonorrhoea or chlamydia)
128
What causes chemical epididymitis?
reflux of sterile urine into ejaculatory ducts
