female Flashcards
cervical cancer can spread to the
volon and the bladder as there is only a thin endothelial cell in between them
FSH- NOT ON exam
GOES TO THE OVARY -> estrogen-> endometrium -> proliferation of glands (primed for implantation
LH- NOT ON EXAM
goes to ovary-> progesterone-> endometrium-> prepares endometrium for implantation
hypothalamus release NOT ON EXAM
GnRH -> anterior pituitRY -> fsh and LH
Vaginal bleeding
hormonal disorder
- dysfunctional uterine bleeding (DUB)
Genital Neoplasia
- fibroids
= endometrial disease
-cervical disease
Uterine Fibroids
Leiomyoma of Uterus
Benign tumors of smooth muscle cells of myometrium
Almost all benign
Most common uterine tumor (20% of women have them)
Clinical Features: Small tumors – asymptomatic Larger tumors “mass effect” (compression of rectum & bladder) Abdominal heaviness Constipation Menstrual irregularities & bleeding
Dysfunctional Uterine Bleeding (DUB)
Abnormal bleeding in the absence of a well –defined organic lesion in the uterus.
1. Failure of ovulation (anovulation)
Endometrial Hyperplasia
Excess of estrogen (unopposed estrogen) for prolonged periods of time
Causes:
Anovulatory cycles around menopause
Exogenous estrogen
Polycystic ovarian disease( just grows and grows (proliferates
Types:
Simple
Complex
Complex with atypia
Precursor to endometrioid carcinoma (20-25% risk)
need to remove the uterus
Endometrial Carcinoma- if hyperplaisa continues
Two Types:
1. Endometrioid Carcinoma:
arises in a background of hyperplasia.
Estrogen dependent
2. Serous carcinoma: Estrogen independent. Arises in a background of atrophic endometrium. P53 mutation. High grade
Epidemiology
Age 55-65
Risk Factors: Obesity Diabetes Hypertension Infertility
- Serous carcinoma:
Estrogen independent. Arises in a background of atrophic endometrium. P53 mutation. High grade usually older in age (70)
- Endometrioid Carcinoma:
arises in a background of hyperplasia.
Estrogen dependent
(age 55)
5 stages of cancer growth: Staging
– Limited to Mucosa
Stage 1 – Invasive confined to Cx
Stage 2 – Beyond Cx, not reaching pelvic wall
Stage 3 – Reaching Pelvic Wall
Stage 4 – Beyond Pelvis ± Metastases
one it reaches the cervix 50% survival\ once it leaves to bladder-20%
Carcinoma of Cervix
20% of malignant tumors of female reproductive tract
Mortality reduced by early detection: (Papanicolaou “Pap” Smear)
Etiology and pathogenesis- cervical cancer
Human Papillomavirus: (most common) Types 16 and 18
Risk Factors Sexual Intercourse at Early age Multiple Sexual Partners Evidence of HP Virus Infection Persistent infection by High risk HPV
type of cells: Squamous Cell (lines the vaginal cervic surface)Carcinoma
Originate in Transformation Zone !!!!!(where Endocervix meets Exocervix)(scaumous meets the ___ cells)
Zone of intense cell proliferation (Proliferating cells are susceptible to Viral Infection)
Progresses from low to high grade dysplasia to invasive carcinoma
Clinical Features cervicalcancer
Median Age 50 years Age At Dx of CIN 35 years Early on Post-coital Bleeding Vaginal Discharge
Most common cause of abnormal uterine/vaginal bleeding is:
A. dysfunctional uterine bleeding
inflammations
Vulvitis Vaginitis (the first 2- vulvovaginitis) Cervicitis Endometritis (PID pelvic inflammatory disease) Salpingitis Oophoritis
abnormal implantation, infertility,
Pathogenesis of vulvovaginitis
Ascending (More Common) Sexual Contact Vagina Uterus Fallopian Tubes Descending Hematogenous or Lymphatic Spread from other organs (eg Tb)
Etiology- vulvovaginitis
Protozoa: Trichomonas vaginalis Chlamydial Chlamydia trachomatis Cervicitis Urethritis PID Fungal Candida albicans(fungal infection) (Monilia) Vulvovaginitis
Common Infections
genital herpes and herpes simplex
HPV
Infectious vaginitis - trichomonas, gardnerell, candida
Clinical Features
All may be associated with systemic symptoms Fever Malaise General Uneasiness Local Symptoms Viruses Blisters or Warts Vaginitis Copious discharge Chlamydia Vulvitis, Urethritis, Dysuria Vaginal Discharge Local Symptoms Gonorrhea Urethritis (Dysuria) Proctitis PID Septicemia Arthritis
Pelvic Inflammatory Disease (PID)
Salpingitis Red Swollen Filled with Pus Tubo-ovarian Abscess Lower Abdominal Pain -> Peritonitis
Fibrocystic Change- the duct gets blocked - forms a cyst
Consequence of an exaggerated and distortion of the cyclic breast changes that occur normally in the menstrual cycle.
Fibrosis & Cystic Degeneration reactive to Hormonal changes
50% of women show Histologic changes
10 - 15% of women show Clinical Signs
sni- etiny??
make the milk
