Female/Male Conditions Flashcards
Some Changes in Pregnancy
• Blood volume increases by 40-50% • Cardiac output increases 30-50% • Red blood cells increases 15-20% ( fall in maternal hematocrit = iron deficiency anemia) • Clotting factors and fibrinogen are increased
- Venous stasis (risk of tromboembolism)
- WBC increases- due to increase in estrogen and cortisol levels
- Higher number of neutrophils
• Less T cells- increased susceptibility to intracellular pathogens : CMV,
herpes simplex virus, varicella and malaria
Do pregnant women with heart murmurs require antibiotic prophylaxis?
NO!!!!!
Increase in blood volume is associated with: tachycardia and heart murmurs WHICH IS PHYSIOLOGICAL! NOT pathologic
However, may unmask glomerulopathies, arterial aneurysm and AV
malformations
Supine hypotensive syndrome- supine position
- Abrupt fall in blood pressure-bradycardia, sweating, nausea, weakness
- Impaired venous return to the heart that results from compression of the inferior vena cava by the gravid uterus
- Decreases blood pressure-reduced cardiac output- loss of consciousness
- Roll the patient over to her left side
- Lifts the uterus off the vena cava
Respiratory function in Pregnancy
Elevation of the diaphragm- decreases the volume of the lungs in resting state- reduce lung capacity
• Tachypnea and dyspnea – worsened by supine position
Developmental Stages in Pregnancy
~40 wks
- First trimester- Organs and systems development
- Second and third trimester- Growth and maturation
• Fetal dentition is susceptible to malformation from toxins (tooth
decoloration)
Gestational Disorders
- Gestational diabetes-
- Preeclampsia- HTN with proteinuria
• Eclampsia- life threatening condition- seizures and come.
Sympathetic overactivity- insulin resistance- renin-angiotensin
system- inflammatory mediators
Complications of Gestational Diabetes
Maternal • Higher risk of CVD • Preeclampsia • Infections • Cesarean section • Future diabetes
Fetal • Macrosomia • Neural tube defects • Hypocalcemia • Hypebilirubinemia • Birth trauma • Childhood/adolescent obesity
Symptoms of Preeclampsia
proteins in urine
rising arterial hypertension
edema (swelling)
“PRE”
Oral complications and manifestations during pregnancy
Gingivitis- exaggerated the inflammatory response to local irritants/estrogens and progesterone
Pyogenic granuloma or pregnancy tumor
Breast diseases
- Inflammatory Disorders
- Benign Epithelial Lesions
- Carcinoma
Breast cancer genetics
• Almost all breast malignancies are adenocarcinomas and based on the expression of estrogen receptor and HER 2
- Identifiable susceptibility gene or genes
- BRCA1, BRCA2, TP53 and CHEK2
• All all tumor suppressor genes that have normal roles in DNA repair and maintenance of genomic integrity
• It is likely that complete loss of function of these proteins creates a mutant phenotype and increased propensity to accumulate genetic
damage and speed cancer development
BRCA1 and BRCA2 carriers
- Higher risk of other epithelial cancers as well as prostate and pancretic carcinomas
- BRCA2- smaller risk to ovarian cancer
MUTATIONS OF:
• BRCA1 ( chromosome 17q21)
• BRCA2 ( chromosome 13q12.3)
Gynecomastia
- Enlargement of the male breast
- Imbalance between estrogens and androgens
- Cirrhosis of the liver (responsible of estrogens)
- Alcohol, marijuana, heroin, antiretroviral therapy and anabolic steroids
- Klinefelter syndrome (XXY karyotype)
Premalignant and Malignant Neoplasms of
the Cervix
- Common cancer in women
- HPV- associated to squamous cell carcinoma tonsil and other oropharyngeal locations
• HPV acts as carcinogen- viral proteins E6 and E7 interfere with the
activity of tumor suppressor proteins that regulate cell growth and survival
• Infects immature cells and replicates in maturing squamous cells
Cervical carcinoma
- Spreads directly to contiguous tissues
- Lymphovascular invasion
- Liver, lungs, bone marrow and other organs
- Vaccination against HPV exists for girls and boys 11-12 and up to 26 yrs
- Nearly complete protection- up to 10 years
