Exam 3 Flashcards
Cysts that are filled with fluid and can be caused by a transient condition in which the dominant follicle fails to rupture or one or more of the nondominant follicles fail to regress.
Follicular cysts
Cyst may normally form by the granulosa cells left behind after ovulation. This cyst is highly vascularized but usually limited in size, and with the normal menstrual cycle it spontaneously regresses.
Corpus luteum cyst
Ovarian teratomas that contain elements of all three germ layers; they are common ovarian neoplasms. These growths may contain mature tissue including skin, hair, sebaceous and sweat glands, muscle fibers, cartilage, and bone–are usually asymptomatic and are found incidentally on pelvic examination. Have malignant potential and need careful evaluation for removal.
Dermoid cysts
A problem with hormones that affects women during their childbearing years–affects a woman’s ovaries, the reproductive organs that produce estrogen and progesterone — hormones that regulate the menstrual cycle. The ovaries also produce a small amount of male hormones called androgens.
It involves cysts in the ovaries, high levels of male hormones, and irregular periods.
Polycystic ovary syndrome (PCOS)
Types of Incontinence
Urge incontinence, Stress incontinence, Overflow incontinence, Mixed incontinence, Functional incontinence
Involuntary loss of urine associated with abrupt and strong desire to void (urgency); often associated with involuntary contractions of detrusor; when associated with neurologic disorder, this is called detrusor hyperreflexia; when no neurologic disorder exists, this is called detrusor instability; may be associated with decreased bladder wall compliance
Urge incontinence
Involuntary loss of urine during coughing, sneezing, laughing, or other physical activity associated with increased abdominal pressure
Stress incontinence
Involuntary loss of urine with overdistention of bladder; associated with neurologic lesions below S1, polyneuropathies, and urethral obstruction (e.g., enlarged prostate)
Overflow incontinence
Combination of both stress and urge incontinence
Mixed incontinence
Involuntary loss of urine attributable to dementia or immobility
Functional incontinence
a group of abnormalities in which the testis fails to descend completely
Cryptorchidism
International criteria for the diagnosis require at least two of these conditions: irregular ovulation, elevated levels of androgens (e.g., testosterone), and appearance of polycystic ovaries on ultrasound.
PCOS
related to a genetic predisposition and an obesity-prone lifestyle related to insulin resistance and an excess of insulin and androgens. A hyperandrogenic state is a cardinal feature in the pathogenesis
PCOS
S/S of PCOS
- Insulin resistance and the resultant compensatory hyperinsulinemia
- overstimulate androgen secretion by the ovarian stroma
- reduce hepatic secretion of serum sex hormone–binding globulin (SHBG).
- The net effect is an increase in free testosterone levels. Excessive androgens affect follicular growth, and insulin affects follicular decline by suppressing apoptosis and enabling the survival of follicles that would normally disintegrate
Clinical manifestations of PCOS
Obesity (41%)
Menstrual disturbance (70% [e.g., dysfunctional uterine bleeding])
Oligomenorrhea (47%)
Amenorrhea (19%)
Regular menstruation (48%)
Hyperandrogenism (69%-74%)
Infertility (73% of anovulatory infertility)
Asymptomatic (20% of those with polycystic ovary syndrome [PCOS])
an acquired narrowing and distal obstruction of the pylorus and a common cause of postprandial (after a meal) vomiting. It is the most common cause of intestinal obstruction in infancy.
Infantile Hypertrophic Pyloric Stenosis
Pathophysiology of Infantile Hypertrophic Pyloric Stenosis
Individual muscle fibers of the longitudinal and circular muscles thicken, so the entire pyloric sphincter becomes enlarged and inflexible. The mucosal lining of the pyloric opening is folded and narrowed by the encroaching muscle. Because of the extra peristaltic effort necessary to force the gastric contents through the narrow opening, the muscle layers of the stomach may become hypertrophied as well.
Upper abdominal distention, visible peristaltic waves, a decrease in the size and frequency of meconium stools, progressive weight loss, persistent vomiting, and dehydration. Congenital obstruction of the duodenum is rare and can be caused by intrinsic malformations, such as atresia (complete blockage), stenosis (partial obstruction or narrowing), or external pressure.
Duodenal obstruction
the most common congenital anomaly of the small intestine.
Intestinal malrotation
a rare congenital malformation characterized by the absence or obstruction of extrahepatic bile ducts resulting in neonatal cholestasis.
biliary atresia
Clinical manifestation of biliary atresia
Jaundice is the primary clinical manifestation of BA, along with hepatomegaly and acholic (clay-colored) stools. Fat absorption is impaired because of the lack of bile salts. Abdominal distention caused by hepatomegaly and ascites may cause anorexia and faltering growth. Fat-soluble vitamin deficiencies (A, D, E, K) require supplementation.
the telescoping of a proximal segment of intestine into a distal segment, causing an obstruction. It is rare but the most common cause of small bowel obstruction in children in the United States.
Intussusception
Pathophysiology in intussusception
- the ileum commonly telescopes into the cecum and part of the ascending colon by collapsing through the ileocecal valve
- Compression of the mesenteric vessels between the two layers of intestinal wall and at the U-shaped angle at either end of the intussusceptum leads within hours to venous stasis, engorgement, edema, exudation, and further vascular compression. Edema and compression obstruct the flow of chyme through the intestine. Unless the intussusception is treated, bleeding, necrosis, and bowel perforation ensue.
a congenital malformation of the GI tract involving all layers of the small intestinal wall; it usually occurs in the ileum.
Meckel diverticulum
a true diverticulum in that it contains all layers of the wall of the intestine, usually the ileum. It is a remnant of the embryonic yolk sac and is the most prevalent congenital abnormality of the small bowel.
Meckel diverticulum
Develops because of obstruction to the outflow of pancreatic digestive enzymes caused by bile and pancreatic duct obstruction (e.g., gallstones). Also results from direct cellular injury from alcohol, drugs, or viral infection.61
Acute pancreatitis
2 main causes of acute pancreatitis
gall stones and high ingestion of etoh
most common causes of chronic pancreatitis
repeated acute pancreatitis, years of etoh abuse, cystic fibrosis–decreased FTR proteins that play a role in the movement of chloride ions that help balance salt&water in epithelial cells causing a decrease in bicarb production and an increase of thick mucous in pancreatic ducts.
ischemic, inflammatory condition that causes bowel necrosis and perforation.
Necrotizing enterocolitis
Factors contributing to the development include infections, abnormal bacterial colonization, intestinal ischemia, immature immune responses, exaggerated inflammatory responses, immature intestinal motility, altered microcirculatory blood flow and barrier function, perinatal stress, effects of medications and feeding practices, and genetic predisposition.
Necrotizing enterocolitis
Defect in copper excretion by liver
Autosomal recessive: defect on chromosome 13 (ATP 7B)
Impaired transport of copper into bile/blood caused by diminished transport protein (ceruloplasmin)
Toxic accumulations of copper in liver, brain, kidney, corneas
Wilson’s disease
Clinical manifestation
High levels of blood galactose
Vomiting
Hypoglycemia
May have failure to thrive
Symptoms of cirrhosis at 2-6 months—jaundice
Intellectual disabilities if not treated
Cataracts if not treated
High levels of blood fructose
Vomiting
Hypoglycemia
May have failure to thrive
Hepatomegaly
Jaundice
Seizures
Intention tremors
Indistinct speech
Dystonia
Greenish yellow rings in cornea
Hepatomegaly
Jaundice
Anorexia
Renal tubular defects
Wilson’s disease
an inflammation of the glomerulus caused by primary glomerular injury and is isolated to the kidney. Secondary glomerular injury is a glomerular injury that occurs as a consequence of systemic diseases, including diabetes mellitus, hypertension, bacterial toxins, systemic lupus erythematosus, congestive heart failure, and HIV-related kidney disease.
Acute glomerulonephritis
Pathophysiology of Glomerulonephritis
The most common type of immune injury is related to the presence of antigen-antibody complexes within the glomerulus.
Immune injury is caused by activation of the inflammatory response (i.e., complement activation, leukocyte recruitment, and release of cytokines from leukocytes). Injury begins after the antigen-antibody complexes have deposited or formed in the glomerulus.
a group of symptoms characterized by severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. The syndrome is more common in children than in adults.
Nephrotic syndrome
a reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin.
Anemia
three factors that cause anemia
(1) impaired erythrocyte production,
(2) blood loss (acute or chronic),
(3) increased erythrocyte destruction, or
(4) a combination of these three factors
irreversible inflammatory, fibrotic liver disease.
Cirrhosis
a chronic inflammatory disease that causes ulceration of the colonic mucosa, most commonly in the rectum and sigmoid colon. The lesions appear in susceptible individuals between 20 and 40 years of age.
Ulcerative colitis
the reflux of acid and pepsin or bile salts from the stomach into the esophagus, causing esophagitis.
GERD
a type of diaphragmatic hernia with protrusion (herniation) of the upper part of the stomach through the diaphragm and into the thorax
Hiatal hernia
the proximal portion of the stomach moves into the thoracic cavity through the esophageal hiatus, an opening in the diaphragm for the esophagus and vagus nerves. A congenitally short esophagus, fibrosis or excessive vagal nerve stimulation, or weakening of the diaphragmatic muscles at the gastroesophageal junction contributes to the hernia.
sliding hiatal hernia
the foreskin cannot be retracted back over the glans
Phimosis
the foreskin is retracted and cannot be moved forward (reduced) to cover the glans
paraphimosis
fibrotic condition that causes lateral curvature of the penis during erection
Peyronie disease
uncommon condition of prolonged penile erection. It is usually painful and is not associated with sexual arousal
Priapism
inflammation of the glans penis (Fig. 36.4) that usually occurs in conjunction with posthitis, an inflammation of the prepuce. (Inflammation of the glans and the prepuce is called balanoposthitis.)
is most commonly seen in men with poorly controlled diabetes and candidiasis.
Balanitis
an infection caused by a sexually transmitted bacterium that infects both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during vaginal, oral or anal sex.
gonorrhea
bleeding from the jejunum, ileum, colon, or rectum, can be caused by polyps, diverticulitis, inflammatory disease, cancer, or hemorrhoids
Lower gastrointestinal bleeding
bleeding in the esophagus, stomach, or duodenum and is characterized by frank, bright red bleeding or dark, grainy digested blood (“coffee grounds”) that has been affected by stomach acids
Upper gastrointestinal bleeding
infection is almost exclusively the cause of cervical cancer.
Human papillomavirus (HPV)
a rare cancer that occurs in your vagina — the muscular tube that connects your uterus with your outer genitals. Vaginal cancer most commonly occurs in the cells that line the surface of your vagina
Vaginal Cancer
n idiopathic inflammatory disorder that affects any part of the GI tract from the mouth to the anus. In a small percentage of cases, is difficult to differentiate from ulcerative colitis (see Table 38.6). Risk factor associated include smoking, low fiber–high carbohydrate diet, medications, such as NSAIDs, and altered intestinal microbiome.
Crohn disease
an autoimmune disease that damages small intestinal villous epithelium when gluten (gliadin), the protein component of cereal grains, is ingested. CD is a common multiorgan disease with a strong genetic predisposition. It is associated with certain human leukocyte antigens (HLAs) and autoantibodies.
Celiac disease
congenital condition in which the urethral meatus is located on the ventral side or undersurface of the penis
Hypospadias
a rare birth defect located at the opening of the urethra. In this condition, the urethra does not develop into a full tube, and the urine exits the body from an abnormal location.
Epispadias
a rare embryonal tumor of the kidney arising from undifferentiated mesoderm. Approximately 500 children are diagnosed each year in the United States, most younger than 5 years of age.
Nephroblastoma (Wilms tumor)
