E4: female repro.

Question 1

patho chain of menstural cycle

Answer 1

the hypot. is stimulated when estrogen blood levels decrease–> FSH, gonadotrophins and LS are released from ant. pit.–> FSH starts follicular maturation in ovary–>LH completes follicular maturation–>as follicle matures it secretes increased estrogen–>follicle (carpus leutem) secretes progesterone after ovulation (supports pregnancy)—>estrogen and progesterone circulates through blood to uterus–>estrogen supports proliferation of endometrial growth—>progesterone causes lush growth of endometrium—> if fertilized, implanted they nourish ovum until placenta grows

Question 2

endometriosis

Answer 2

Presence of live endometrium implanted outside of uterine cavity - e.g. lung, ovary, brain, bowel - cells act the same as in the uterus - pain, bleeding.

Question 3

cause of endometriosis

Answer 3

Unsure of actual cause - theories:

1. Viable fragments of endometrium regurgitated through fallopian tubes - ? Caused by intercourse or pelvic exam during menses.
2. Lymphatic dissemination
3. Abnormal cell migration during embryonic life

Question 4

the clinical mani of endometriosis depends on

Answer 4

where the implants are

Question 5

clinical mani of endometriosis

Answer 5

1. Perimenstrual pain
2. Dyspareunia - painful intercourse
3. Dyschezia - painful stooling
4. Spotting hypermenorrhea - spotting between periods
5. Dysuria - difficulty urinating
6. Infertility - altered ovum transport

Question 6

Inadequate corpus luteum - if corpus luteum dies within first 12 weeks of pregnancy, so does the pregnancy

Answer 6

if corpus luteum dies within first 12 weeks of pregnancy, so does the pregnancy

Question 7

what does the corpus luteum normally do

Answer 7

maintains pregnancy for 12 weeks, until placenta can take over

Question 8

Ectopic pregnancy

Answer 8

• ovum gets implanted in fallopian tube instead of uterus, pregnancy usually ends within 6 weeks.

Question 9

cause of ectopic pregnancy

Answer 9

• anything that interferes with ovum transport to the uterus - scars, abnormal fallopian tube peristalsis

Question 10

Uterine abnormalities

Answer 10

• if anything interferes with the size or shape of the uterine cavity, pregnancy may not occur or may terminate

Question 11

anovulation

Answer 11

no ovulation

Question 12

what causes anovulation

Answer 12

• failed FSH & LH; stress, CNS infections

* ovarian failure; ovary not receptive to FSH & LH, radiation

Question 13

hostile environment mucus implantation usually secondary to

Answer 13

infection

• vaginal
• cervical

Question 14

cervical mucus needs to be….

Answer 14

be slippery at time of ovulation to facilitate sperm movement

Question 15

obstruction

Answer 15

anywhere :
• uterus, cervix,
• vas differens

Question 16

Combined causes - male & female

Answer 16

• 40% of time - problem is female
• 40% of time - problem is male
• 20% of time - both have a problem

Question 17

Abnormal spermatogenesis -

Answer 17

abnormal sperm - shape, motility

Question 18

what causes abnormal spermatogenesis

Answer 18

• LH & FSH are necessary for testosterone production in men, testosterone necessary for sperm production in testicle
• infection can cause
• alcohol can make semen abnormal

Question 19

Adenocarcinoma - ,

Answer 19

arises from glandular tissue, most reproductive cancers are adenocarcinoma

Question 20

most common sites for adrenocarcinoma

Answer 20

upper outer quadrant and under nipple

Question 21

risk factors for breast cancer

Answer 21

–increasing age (highest risk after age 50)
–high fat diet - obesity
–Alcohol intake
–nulliparas - never pregnant
–first child after age 30
–early menarche - early menstration
–late menopause
–affected relative - mother, sister; usually first degree relative
–hormone replacement therapy - recently have been implicated with breast cancer
–male breast cancer occurs more often in families with a hereditary risk of breast cancer
–obesity at age 30 (not consistently found in research) - males
• Risk Factors do not seem to be additive.

Question 22

cervical cancer risk factors

Answer 22

1. young age at first time sex - most important risk factor
2. high number of sexual partners
3. sexually transmitted diseases (STDs) - human papilloma virus
4. frequent intercourse with men whose previous sexual partners had cervical cancer
5. oral contraceptives - because tend to have more sexual partners
6. smoking

Question 23

clincial mani of cervical cancer

Answer 23

1. asymptomatic - early

2. bloody, watery discharge - late sign

Question 24

progression stages of cervical cancer

Answer 24

1. cervical intraepithelial neoplasia
2. cervical carcinoma in situ - localized
3. invasive carcinoma - metastasized - pelvis, etc.

Question 25

risk factors for ovarian cancer

Answer 25

1. nulliparity , never pregnant
2. Estrogen Replacement Therapy (ERT) after menopause
3. smoking
4. asbestos and/or talc exposure - talc - used to be in baby powder - travels up vagina to ovaries

Question 26

decreased risk for ovarian cancer in those who

Answer 26

1. women who have used oral contraceptives for years,

2. women exposed prior to age 12 to mumps, measles and rubella viruses

Question 27

types of ovarian cancer

Answer 27

1. epithelial ovarian neoplasms - can be benign or malignant
2. germ cell neoplasms - can be benign or malignant. If malignant, rapid growing

Question 28

clinical mani of ovarian cancer

Answer 28

1. pain
2. abdominal swelling
3. dyspepsia (generalized abdominal discomfort)
4. vomiting
5. bleeding