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Pathophysiology 4 > Class 7 (2/18/21) Part 3 > Flashcards

Class 7 (2/18/21) Part 3 Flashcards

1
Q

Symptoms of PID (pelvic inflammatory disease)

A

Fever, lower abdominal pain, vaginal discharge

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2
Q

Treatment of PID (pelvic inflammatory disease)?

A

Antibiotic

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3
Q

Candida vaginitis sx?

A

Thick, white and odorless discharge

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4
Q

Trichomonas vaginitis symptoms

A
  • Profuse, malodorous, yellow green discharge
  • Can be treated with antibiotics:
    Metronidazole and Flagyl
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5
Q

Bacterial vaginosis

A

Gray, fishy smelling discharge

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6
Q

Routing screening for breast cancer includes

A

Breast self-examination (BSE)
Clinical breast examination (CBE)
Mammography

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7
Q

Breast self-examination (BSE)

A
  • With pads of three middle fingers, self-palpation of the outer margins toward the nipple, BSE performed during a shower, lying down and while standing before a mirror
  • How often an BSE is performed?
  • > > Every month, one week after menses begin
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8
Q

What confirms diagnosis of breast cancer?

A

Biopsy

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9
Q

High risk factor for breast cancer?

A

Family history of breast cancer

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10
Q

Breast cancer

A

Painless lump which is irregular and fixed (attached firmly to surrounding tissue)

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11
Q

Breast cancer treatment

A

Mastectomy
Radiotherapy
Chemotherapy
***But not hormone therapy. Remember hormone therapy can cause breast cancer

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12
Q

Fibroadenoma

A
  • Fine, round, mobile, non tender lump
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13
Q

Fibrocystic lesions in breast may become larger and more tender …

A

Just prior to menstruation

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14
Q

Cyst in breast

A

Soft to firm, round, mobile, often tender

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15
Q

Heavy menstrual bleeding can be indicative of …

A

Fibroid

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16
Q

Symptoms of endometriosis

A

Pain
Pelvic pain
Pain during menses (dysmenorrhea)
Pain during intercourse (Dyspareunia)

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17
Q

Endometriosis can be confirmed by …

A

Laparoscopy with biopsy

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18
Q

Hormone replacement therapy (HRT) side effects:

A

Heart disease, blood clots, stroke, etc.

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19
Q

Hormone replacement therapy (HRT) decrease …

A

Osteoporosis

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20
Q

Preeclampsia vs Eclampsia

A
  • Preeclampsia is a condition that can develop during pregnancy characterized by high blood pressure (hypertension) and protein in the urine (proteinuria).
  • If not properly recognized and managed, preeclampsia can progress to eclampsia, which involves the development of seizures in a woman
    with preeclampsia.
    Preeclampsia -> Clampsia (+seizure)
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21
Q

Preeclampsia symptoms

A
  • Edema, excess weight gain, new onset hypertension, proteinuria
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22
Q

Prostate cancer diagnosis

A
  • DRE: digital rectal exam
  • Increased PSA (prostate specific antigen) in blood
  • Biopsy
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23
Q

Females cycle has two phases:

A
  • Follicular phase (just one follicle will mature and release the oocyte at the end of this phase)
  • Luteal phase (the mature follicle that released the oocyte will be dead and the dead follicle will be transformed to corpus luteum)
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24
Q

A cycle is __ days

A

28 days

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25
Q

How many egg will be released each month?

A

1 egg

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26
Q

The egg (oocyte) will be released from …?

A

Mature follicle

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27
Q

All the hormones (LH, FSH, estrogen) peak in the middle of the cycle except …

A

Progesterone

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28
Q

Estrogen is released in ___ phase

A

Follicular phase (first phase)

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29
Q

Progesterone is released in the ___ phase

A

Luteal phase (second phase)

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30
Q

Oocyte will be released …

A

In the middle of cycle (ovulation)

31
Q

Gonadotropin releasing hormone is secreted from …

A

Hypothalamus

32
Q

LH and FSH are released from …

A

Anterior pituitary

33
Q

Progesterone function?

A

Increases thickness of endometrial lining.

34
Q

Follicle produces …

A

Estrogen

35
Q

Follicular phase: release of FSH from …

A

Pituitary

36
Q

How does ovulation happen?

A

At mid-cycle, approx. day 14 there is a spike in LH levels, in response to the estrogen surge which stimulates ovulation.

37
Q

After ___ the luteal phase begins

A

Ovulation

38
Q

Remnants of the follicle left behind in the ovary develop into the ___ which is responsible for the secretion of ___

A

corpus luteum, progesterone

39
Q

Progesterone function

A

Maintains the endometrial lining in preparation for receiving the fertilized egg.

40
Q

If no fertilization …

A

Corpus luteum degenerates -> progesterone levels decline -> endometrial lining is sloughed off
= menstruation.

41
Q

Pregnancy has 3 trimesters:

A
  • 1st trimester (lasts until 12 weeks)
  • 2nd trimester (lasts from 12-14 to 24-28 weeks)
  • 3rd trimester (lasts from 24-28 weeks until delivery)
42
Q

Gravidity (G)

A

Number of times woman has been pregnant

43
Q

Parity (P)

A

The number of pregnancies that led to a birth at or beyond 20 weeks of gestational age.

44
Q

Ectopic pregnancy:

A
  • Any pregnancy which is outside of uterine, for example in fallopian tubes
  • Sx: unilateral abdominal pain, positive BHCG urine pregnancy test
45
Q

Screening tests during pregnancy

A
  • Amniocentesis

- Chorionic-villus sampling

46
Q

Amniocentesis vs Chorionic-villus sampling

A
  • Amniocentesis: the sample is from amniotic fluid

- Chorionic-villus sampling: the sample is from placenta

47
Q

Infertility

A
  • Need to evaluate both man and woman as potential sources of problem
  • 3-6 mL of ejaculation, 30-50 million sperm per mL, therefore 300-400 million sperm in healthy ejaculation
  • Need at least 30-60 million sperm for good probability of fertilization
  • In evaluating sperm you look at activity / motility, numbers, and health of sperm
48
Q

In vitro fertilization = IVF

A
  • it is done outside the body, then egg is introduced into uterus manually.
  • with hope that it will remain and implant
49
Q

PCOS

A
  • This is a common cause of why women don’t ovulate regularly, there are cysts forming but with no egg.
  • Because of higher levels of androgens, PCOS is associated with hirsutism, acne, increased levels of testosterone in women, and an irregular menstrual cycle.
50
Q

PCOS treatment?

A

Drug clomiphene

51
Q

Intrauterine Devices (IUDs)

A

Mirena – progestin releasing device, good for 5 years after insertion, after time may reduce periods to scant flow.
Copper-T – good for 10 years after insertion, associated with heavier cramping and heavier flow
**Mirena is hormonal, but copper doesn’t have any hormone
**If the patient has dysmenorrhea, Mirena is better. Because copper IUD increase cramping

52
Q

Depot – Provera

A
  • Injectable progesterone only formulation suppress ovulation
53
Q

OCPs

A
  • Hormonal contraception
  • OCPs are 99% effective at preventing pregnancy.
  • OCPs can affect mood, can also cause decreases in libido.
54
Q

Condoms

A
  • Have a 15% failure rate.

- Condoms with spermicide have a 98% success rate.

55
Q

Both male and Female condom protect from …

A

STD

56
Q

Diaphragm with spermicide is __% effective. But,

has to stay some hours after the act.

A

95%,

57
Q

Nuva ring

A
  • Sits around cervix
  • Releases hormones
  • Gets changed once a month.
  • Reduced number of dosing times, increases compliance, therefore increases success rate.
58
Q

Tubal ligation and vasectomy has ___% effectiveness for

preventing pregnancy.

A

100%

59
Q

Dysmenorrhea

A
  • Painful periods in a regular cycle the monthly spike in prostaglandins increase cramping and contractions
  • Getting a 24-36 hour jump on the start of cycle and pre-treating with Advil is enough to alleviate symptoms.
60
Q

Amenorrhea

A
  • No period for months to years
  • Etiologies:
    • Premature ovarian failure
    • Increased prolactin -> increased breast milk production, also will shut down period
  • Pituitary adenomas (prolactin producing tumors)
61
Q

Unusual heavy menstrual bleeding can be ____

A

Fibroid (benign tumor of the uterus)

62
Q

Menopause

A

Hot flashes, insomnia, vagina dryness, vaginal mucosal tissue thinning, perimenopause marked by increasingly irregular periods, osteoporosis (increased risk for broken bones, hip-fractures, vertebral compression, kyphosis).

63
Q

Treatment of menopause

A
  • HRT (hormone replacement therapy)
  • For vaginal dryness can give estrogen creams for local topical application, vaginal dryness can lead to dyspareunia.
  • For osteoporosis can give Calcium, Vit-D 2000 IU a day, Also bisphosphonates (Fosamax) reduce reabsorption of bone
  • Exercise help maintain bone density.
64
Q

Ovarian cancer

A

For ovarian cancer the early warning signs are not there as with endometrial or cervical cancer. Usually by the time signs and symptoms appear the cancer is already serious. Therefore, mortality rate for ovarian cancer is quite high.

65
Q

Ovarian cancer diagnosis

A

Ultra sound diagnostics can reveal enlarged ovaries – CA-125 is a blood marker that can help screen for ovarian cancer.

66
Q

Cervical dysplasia most often caused by ____

A

HPV, main screening are PAP smears which are good screening for cancer.

67
Q

Screening for cervical dysplasia

A

PAP smears

68
Q

Most common of STDs is

A

HPV, the human papilloma virus

69
Q

HPV associated with cancer

A

HPVs 16, 18

70
Q

Syphilis STD

A

Can affect joints, also can affect CNS and cause dementia and etc.

71
Q

Herpes simplex

A

HSV-1, HSV-2 are most common types associated with “cold sores” (HSV-1) and genital herpes (HSV-2).
There may be many small fluid filled papules, that then can burst
Tx: acyclovir

72
Q

_____ is more common in post-menopausal women

A

Uterine cancer

73
Q

Post-menopausal bleeding is a common presentation of _______

A

Uterine cancer

Pathophysiology 4 (15 decks)

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