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Understanding Human Disease > Exam 2 (ch. 17 &20) > Flashcards

Exam 2 (ch. 17 &20) Flashcards

1
Q

What are the phases of a normal menstrual cycle?

A

Follicular phase then luteal phase

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2
Q

What hormones are produced during a normal menstrual cycle?

A

estrogen and progesterone

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3
Q

During a normal menstrual cycle, if no pregnancy occurs, what happens?

A
  • corpus luteum degrades
  • secretory endometrium shed with blood
  • new cycle begins
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4
Q

Ovaries are the site of?

A
  1. gametogenesis

2. hormone production

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5
Q

Fallopian tubes

A

Pathways from ovaries to the uterus;

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6
Q

where is the site of fertilization?

A

fallopian tubes

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7
Q

Cervix

A

opening of the uterus

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8
Q

uterus

A

houses and protects developing fetus

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9
Q

Menorrhagia

A

heavy menstrual bleeding

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10
Q

Metorrhagia

A

uterine bleeding at irregular intervals

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11
Q

Dysmenorrhea

A

painful periods

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12
Q

Vaginal discharge can be associated with what?

A

superficial infections (STI)

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13
Q

What do you look at when you look at menstrual history?

A
  • length of cycle
  • duration
  • amount (heavy or light)
  • regularity (often)
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14
Q

What occurs during a pelvic examination

A
  • direct inspection of the vulva, vagina and cervix

- bimanual examination (fingers in vagina and tap abdomen)

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15
Q

Pap test can detect what?

A

HPV and neoplastic lesions

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16
Q

What is a cone biospy

A

removal of a cone of tissue for histologic exam

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17
Q

Infections of the reproductive tract: types

A
  1. STI
    a. chlamydia
    b. gonorrhea
    c. syphilis
    d. HPV
  2. Fungus
    a. yeast
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18
Q

STIs and fungal infections of the female reproductive tract can lead to what?

A
  1. Vaginitis: inflammation of vagina
  2. Cervicitis: inflammation of cervix
  3. Salpingitis: inflammation of fallopian tubes
  4. PID: pelvic inflammation disease
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19
Q

Cervical Polyps

A

Benign tumors on the surface of the cervical canal

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20
Q

Symptoms of Cervical Polyps

A

Many are asymptomatic, but can lead to irregular menstrual bleeding

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21
Q

Treatment of Cervical Polyps

A

removal

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22
Q

Cervical Dysplasia

A

Abnormal growth of cervical squamous epithelium

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23
Q

Describe how Cervical Dysplasia ranges from mild to severe

A
  1. Mild = may regress

2. Severe = pre-cancerous

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24
Q

How do you test to see if a female has Cervical Dysplasia?

A

Screening –> pap smear

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25
Q

What are risk factors for Cervical Dysplasia?

A
  • HPV infection
  • multiple sex partners
  • certain HLA genotypes
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26
Q

Describe the progression of cervical cancer

A

a. Cervical dysplasia (CIN)
b. Cervical carcinoma in situ (not yet invaded BM)
c. invasive carcinoma of cervix

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27
Q

Risk factors for cervical cancer?

A

HPV & many sex partners

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28
Q

Types of vaginal cancer

A
  1. Squamous cell

2. Adenocarcinoma

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29
Q

Signs and symptoms of vaginal cancer

A

Typically asymptomatic

- often found in routine gynecological exam

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30
Q

Risk factors for vaginal cancer

A

HPV

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31
Q

Endometrium

A

Innermost lining of the uterus; part that is shed during period

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32
Q

Myometrium

A

Smooth outer muscle of uterus; helps with delivery

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33
Q

Disorders of the uterus

A
  • irregular bleeding
  • endometriosis
  • leiomyomas
  • cancer
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34
Q

Leading cause of irregular uterine bleeding

A
  1. . Follicle fails to mature and no corpus luteum is formed (anovulatory cycle)
    a. no corpus luteum = no progesterone
  2. Endometrial and cervical polyps
  3. uterine leiomyomas
  4. uterine carcinoma
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35
Q

Anovulatory bleeding

A

Uterus is subjected to continuous estrogen stimulation and responds by shedding and bleeding in an irregular manner instead of shedding all at once

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36
Q

Endometriosis

A

Presence of functioning endometrial tissue outside of uterus

  • ectopic
  • responds to hormone fluctuations
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37
Q

Possible causes of Endometriosis

A

a. Retrograde menstruation (sheds up instead of down)
b. spread through vascular or lymphatic systems
c. genetic predispositions

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38
Q

Symptoms of Endometriosis

A
  • pelvic pain
  • infertility
  • bleeding of ectopic endometrium, causing pooling of blood
  • adhesions of internal organs
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39
Q

Diagnosis of Endometriosis

A

laparoscopy or biopsy

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40
Q

Treatment of Endometriosis

A

a. Surgical removal of ectopic endometrium
b. Oral contraceptives
c. Medication to inhibit pituitary release of gonadotropins
d. Medication to suppress production of gonadotropin-releading hormone
e. complete hysterectomy

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41
Q

gonadotropins

A

FSH and LH

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42
Q

gonadotropin-releading hormone

A

controls the release of FSH and LH

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43
Q

Uterine Leiomyoma

A

“Fibroids”

- benign tumors of myometrium

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44
Q

Etiology of Uterine Leiomyoma

A
  • unknown
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45
Q

Risk factors of Uterine Leiomyoma

A
  • age of at least 30
  • obesity
  • family history of fibroid
  • African Caribbean decent
  • not having had children
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46
Q

Signs and symptoms of Uterine Leiomyoma (uterine fibroid)

A
  • abdominal fullness
  • change in menstruation
  • bleeding at times other than menstruation
  • dysmenorrhea
  • pain
  • some symptoms are related to the location
    • bladder region: urinary frequency and dysuria
    • Rectal region: anal-sphincter spasm
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47
Q

Treatment of Uterine Leiomyoma (uterine fibroid)

A
  • no treatment if small
  • oral contraceptives
  • removal
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48
Q

Amenorrhea

A

not having period for 3 consecutive months

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49
Q

Etiology of Amenorrhea

A
  1. Hypothalamic, pituitary, or endocrine dysfunction
  2. Congenital or acquired abnormalities of reproductive tract
  3. extreme weighloss
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50
Q

Consequences of Amenorrhea

A

infertility, osteoporosis because loss of estrogen

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51
Q

Treatment of Amenorrhea

A

oral contraceptive pills

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52
Q

Dysmenorrhea

A
  • painful menstruation
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53
Q

Types of Dysmenorrhea

A
  1. Primary
    - pelvic organs are normal but painful menstruation
  2. Secondary
    - pelvic organ disease (endometriosis)
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54
Q

Etiology of Dysmenorrhea

A
  1. Prostaglandins
    - synthesized in uterus under progesterone
    - menstruation leads to release
    - causes cramping of myometrium to hell shed blood of endometrium
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55
Q

Endometrial Carcinoma

A

Most common cancer of female reproductive tract; cancer of endometrium…account for almost all cancers in uterus

56
Q

Endometrial Carcinoma Symptoms

A

abnormal uterine bleeding

57
Q

Risks of Endometrial Carcinoma

A

obesity, excessive estrogen exposure

58
Q

Treatment of Endometrial Carcinoma

A

Hysterectomy, good prognosis

59
Q

Ovarian Cyst

A

Fluid filled sac on ovary

60
Q

Etiology of ovarian cyst

A
  • unknown
  • hypothyroidism
  • early age of menarche
61
Q

Signs and Symptoms of ovarian cyst

A
  • most asymptomatic
  • abdominal fullness
  • low back pain
  • nausea and vomiting
  • abnormal uterine bleeding
62
Q

Diagnosis on ovarian cyst

A

ultrasound

63
Q

Treatment of ovarian cyst

A
  • oral contraceptives

- laparoscopic procedure to drain or remove cyst

64
Q

Polycystic Ovary Syndrome (PCOS)

A

One of the most common female endocrine disorders,

a. follicles develop, but they do not ovulate after the LH surge
b. high LH levels persist
c. LH stimulates androgen production (male pattern hair growth which interferes with ovulation evenmore)

65
Q

Polycystic Ovary Syndrome (PCOS) is associated with…?

A
  • insulin resistance
  • hypertension
  • dyslipidemia
66
Q

Treatment of Polycystic Ovary Syndrome (PCOS)

A
  • no cure
  • based on whether you want to get pregnant or not (yes, birth control pills…no, fertility medication)
  • diabetes modifications
67
Q

Ovarian cancer

A

Leading cause of death among gynecological malignancies

68
Q

Ovarian cancer mortality has been ____, whereas cervical and uterine cancer mortality rates have been _____.

A

Rising, falling

69
Q

What is the prognosis for ovarian cancer

A

The prognosis is generally poor for ovarian cancer patients of whom only ~25% survive for >5 years

70
Q

Symptoms of ovarian cancer

A
  • abdominal fullness
  • weight gain
  • not a ton of symptoms
71
Q

Ovarian cancer risk factors

A
  1. Heredity
    a. 10% of ovarian cancer are hereditary
    b. 90% of the hereditary cases are linked to breast-ovarian cancer genes 1 and 2
    c. with BRCA the lifetime risk varies between 15% and 66%
  2. Childbirth and Pregnancy
    a. women who had children about half the risk as do women who haven’t
    b. increasing number of children appears to reduce risk a further 15% each
    c. miscarriage or abortions provide smaller risk reductions
72
Q

What are three factors that reduce the chances of developing ovarian cancer and why?

A
  1. Lactation
    a. reduces the risk for ovarian cancer (as it does for breast cancer)
  2. Oral contraceptives
    a. Ever-users have about half the risk as do never-users
    b. Long term use seems to further enhance the protection against ovarian cancer
  3. Having kids
    * these all reduce the risk for developing ovarian cancer because the women does not ovulate*
73
Q

Hormone replacement therapy, does it increase or decrease the risk of ovarian cancer?

A

Appears to increase the risk for ovarian cancer, particularly long term use

74
Q

Pelvic Inflammation Disease (PID)

A

Infection of women’s reproductive organs

75
Q

Etiology of Pelvic Inflammation Disease (PID)

A

untreated STDs

76
Q

Symptoms of Pelvic Inflammation Disease (PID)

A
  • pain in lower abdomen
  • fever
  • unusual discharge
77
Q

Complications of Pelvic Inflammation Disease (PID)

A
  • scar tissue
  • infertility
  • ectopic pregnancy
78
Q

Menopause or Climacteric

A

Decrease in ovary function

  • around 51 years
  • low estrogen
  • less inhibition of pituitary gland
79
Q

low estrogen is a risk factor for what?

A

osteoporosis and atherosclerosis

80
Q

Less inhibition of pituitary gland leads to what?

A

increased FSH and LH, which contributes to hot flashes

81
Q

Why is hormone replacement therapy no longer the standard care for menopause?

A
  • increased risk for ovary/breast cancer

- increased risk for stroke

82
Q

Contraception: Natural Family Planning

A

Avoidance of intercourse at time of ovulation (day 9-14)

83
Q

Contraception: Artificial Contraception

A
  1. Barrier Method
    a. diaphragms and condoms; effective, no side effects, keep sperm away from egg
  2. Oral Contraceptive
    a. suppress ovulation
    b. side effects –> increased tendency for thromboembolic complications, especially among smokers; hypertension
  3. IUD
    a. prevent implantation
    b. increased incidence of tubal infections and tubal pregnancies
    c. fertilization can still happen but not implantation
84
Q

Emergency contraception

A

Prevent pregnancy following unprotected intercourse or sexual assault

85
Q

Explain how emergency contraception works

A

a. sperm can survive as long as 6 days in genital tract and can still fertilize an ovum, thus…
b. it prevents pregnancy by interfering with ovulation; tubal transport of ovum; and implantation within endometrium

86
Q

Explain the effectiveness of emergency contraception

A

a. If taken within 12 hours, risk of pregnancy <1% and 3% if taken within 72 hours
b. Some protection is still provided for as long as 5 days

87
Q

Infertility

A

The inability to get pregnant after trying for 1 year

88
Q

Etiology of infertility for females

A
  • hormonal imbalances
  • structural problems
  • eating/nutritional disorders
89
Q

Etiology of infertility: general lifestyle factors

A
  • emotional stress
  • obesity
  • malnutrition
  • alcohol
  • tobacco or drug misuse
  • cancer and cancer treatment
  • age
90
Q

Male primary sex organs

A

testis –> produce sperm and testosterone

91
Q

Male accessory sex organs

A

seminal vesicles, vas deferens, penis, prostate

92
Q

Common signs and symptoms of male reproductive system diseases and disorders

A

Urinary complaints

  • frequency, urgency, incontinence, dysuria, nocturia
  • pain in any reproductive organ or unusual discharge
  • swelling or enlargement of any reproductive organs
  • any sexual disorder or concern
93
Q

What is the prostate gland

A

The prostate secretes fluid that nourishes and protects sperm; size of walnut

94
Q

Disorders of prostate

A
  • prostatitis
  • benign prostatic hyperplasia (BPH)
  • carcinoma of the prostate
95
Q

Prostatitis

A

Inflammation of the prostate gland

96
Q

Acute Prostatitis

A

Spread of infection from bladder to urethra into prostate

97
Q

Chronic Prostatitis

A

mild inflammation. common, few symptoms

98
Q

Signs and symptoms of Prostatitis

A
  • fever and chills
  • urethral discharge
  • dysuria
  • malaise
  • tender, enlarged, prostate gland
99
Q

Treatment of Prostatitis

A
  • extended course of antibiotics

- opiate analgesics

100
Q

analgesics

A

manage pain

101
Q

Benign Prostatic Hyperplasia (BPH)

A

Enlargement of the prostate gland

102
Q

Symptoms of Benign Prostatic Hyperplasia (BPH)

A
  • obstructs flow of urine
  • urinary hesitancy
  • frequent urination
  • nocturia
103
Q

Benign Prostatic Hyperplasia (BPH): the hyperplasia is due to what?

A

Hyperplasia is due to dihydrostestosterone (DHT) hormone in prostate
–> testosterone is converted to DHT by 5-alpha reductase and binds to androgen receptor

104
Q

Who does Benign Prostatic Hyperplasia (BPH) target?

A

men in their 7th decade of life –> affects 75% of them

105
Q

Complications of Benign Prostatic Hyperplasia (BPH)

A

Inflammation of bladder/kidneys, UTI, kidney stones

106
Q

Treatment of Benign Prostatic Hyperplasia (BPH)

A
  1. 5-alpha reductase inhibitors
  2. heat
  3. resection
107
Q

Carcinoma of the prostate

A

Most common cancer of internal organs in males

- >100,000 new cases per year

108
Q

What is the most common cause of death from cancer in men over age of 75?

A

Carcinoma of the prostate

109
Q

What accounts for 29% of all cancers in males?

A

Cancer of the prostate

110
Q

2nd leading cause of cancer deaths in males

A

cancer of the prostate

111
Q

Describe the symptoms of prostate cancer

A
  • asymptomatic until it’s advanced stages

- symptoms are similar to BPH

112
Q

Risk factors for cancer of the prostate

A
  • dietary
  • hormones
  • vasectomy
  • chronic inflammation
  • family factors
  • ethnicity
113
Q

Diagnostic procedures for prostatic cancer

A
  1. Digital rectal exam
  2. Biopsy
  3. CT scan or ultrasonography
  4. PSA blood test
114
Q

PSA blood test

A

can not solely use for the diagnosis of prostate cancer, but it helps aid as a tool in diagnosing it

115
Q

BPH vs Prostate cancer

A
  1. identical symptoms
  2. both in prostate
  3. BPH cannot spread (benign)
  4. PSA can be high in both
116
Q

Tumor of Testis

A
  1. Rare but important; most common in men 25-45 years old
  2. Majority germ cell tumors
  3. Usually malignant but can be successfully treated by surgery & chemo or radiation
117
Q

What is the cure rate for tumor of the testis

A

high cure rate; >90% of patients survive

118
Q

Signs and symptoms for tumor of the testis

A
  • lump on testis / scrotum

- pain in scrotum/lower abdomen

119
Q

Cryptorchidism

A

Testes do not descend normally

- absence of one or both testes from scrotum

120
Q

Testes normally descend to aid in what?

A

sperm production

121
Q

Treatment of Cryptorchidism

A
  1. Time –> most will descend on own

2. surgery

122
Q

Complications of Cryptorchidism

A
  • testicular cancer
  • fertility issues
  • testicular torsion
  • inguinal hernia
123
Q

Testicular Torsion

A

Twisting of spermatic cord due to rotation of testicles

  • reduces blood flow
  • more common in boys 12-16 because active
124
Q

Symptoms of testicular torsion

A
  • acute onset testicular pain

- swelling of involved testis

125
Q

Complications of testicular torsion

A

medical emergency –> death of testis within 6-12 hours

126
Q

Orchitis

A

Inflammation of testis

127
Q

Etiology of Orchitis

A
  • mumps virus infection

- STIs

128
Q

Signs and Symptoms of Orchitis

A
  • testicular pain and inflammation
  • edema
  • fever
  • malaise
  • urethral discharge
129
Q

Diagnosis of Orchitis

A
  • recent history of mumps infection
  • presenting signs and symptoms
  • culture of urethral discharge
  • ultrasound
130
Q

Treatment of Orchitis

A
  • antibiotics
  • analgesics
  • cold compress
  • scrotal support
131
Q

Hydrocele

A

Scrotal abnormality

  • excess fluid accumulates
  • treated by aspiration
132
Q

Varicocele

A

Scrotal abnormality

  • varicose veins in spermatic cord
  • usually involves left side of scrotum
  • may impair fertility
  • treatment required only is varicocele causes discomfort or impairs infertility
133
Q

Erectile Dysfunction (ED)

A

Difficulty developing and maintaining full erection throughout intercourse
- age related

134
Q

Causes of ED

A
  • Stress, emotional factors
  • chronic disease
  • renal failure
  • diabetes mellitus
  • penile diseases/trauma
135
Q

Treatment of ED

A

Phosphodiesterase inhibitors

136
Q

What is the neural control of a penile erection

A
  1. Parasympathetic nerves release acetylcholine and nitric oxide (NO)
  2. NO produces vasodilation
  3. cGMP is inactivated by PDE-5 mediated conversion to GMP
137
Q

Etiology of infertility in males

A
  • sperm deficiencies
  • congenital abnormalities
  • endocrine imbalances
  • surgical intervention
  • infection or chronic inflammation of the testes, epididymis, vas deferens

Understanding Human Disease (4 decks)

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