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Patho > Female Repro > Flashcards

Female Repro Flashcards

1
Q

Amenorrhea

A

absence of menstruation

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2
Q

Hypomenorrhea

A

with each menstrual cycle, only a little bit of bleeding aka scantly bleeding

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3
Q

Oligomenorrhea

A

periods more than 35 days apart

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4
Q

Polymenorrhea

A

periods less than 21 days apart

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5
Q

Menorrhagia

A

heavy bleeding at time of menses

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6
Q

Metrorrhagia

A

bleeding in between periods

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7
Q

Metromenorrhagia

A

heavy bleeding at irregular intervals

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8
Q

Primary Amenorrhea

A

the failure to menstruate by age 15-16 OR absence of secondary sex characteristics by age 13.
(women hasn’t gotten her menses in the time she has expected)

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9
Q

Secondary amenorrhea

A

failure to menstruate for at least 3-6 months after having established normal menstruation
(had established menstrual cycle and now doesn’t)

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10
Q

What are causes of primary amenorrhea

A

Gonadal dysgenesis
Congenital Mullerian agenesis
Ambiguous genitalia
HPO axis disorders
usually a young, thin athlete

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11
Q

What is the most common cause of secondary amenorrhea?

A

pregnancy

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12
Q

What are other possible causes of secondary amenorrhea?

A
  1. Pharmacologic suppression of menstruation
  2. HPO axis dysfunction (anovulatory cycles)
    –(Low body weight)
  3. Intrauterine adhesions
  4. Infection (reproductive or systemic)
  5. Pituitary tumor (hyperprolactinemia)
  6. Hyperthyroidism
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13
Q

What is abnormal uterine bleeding?

A

Uterine bleeding that occurs outside the normal menstrual cycle
-Irregular
-May be excessive or painful but not necessarily

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14
Q

Abnormal uterine bleeding may be a primary disorder of the _______ or ______ secondary to non-gyn etiology

A

uterus, ovaries

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15
Q

What are hormonal causes for abnormal uterine bleeding?

A

HPO stimulation
Weight change
Endocrine or metabolic disturbances
Thyroid disturbances
Most common cause: anovulatory cycle(s).
-May be related to progesterone and/or estrogen imbalance

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16
Q

What is the most common cause of abnormal uterine bleeding?

A

anovulatory cycles

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17
Q

What are nonhormonal causes for abnormal uterine bleeding?

A

Endometrial polyps
Uterine fibroid
Bleeding disorder (such as VWB disease)
Endometrial dysplasia or cancer

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18
Q

What is premenstrual syndrome (PMS)

A

The cyclical presence of symptoms related directly to the menstrual cycle.
Symptoms may be present from 1 to 14 days but must resolve with menstruation.

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19
Q

What are symptoms of PMS

A

mood swings, fluid retention, headache, cramps and anxiety.

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20
Q

What is the cause of PMS?

A

Exact cause is unknown but thought to be related to changing progesterone levels.

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21
Q

What is the difference between PMS and PMDD?

A

PMS is life affecting but women can still function in PMDD, these women have significant impact in their life (significant sadness)

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22
Q

Dysmenorrhea

A

“cramping”
Painful menstruation
Often described as suprapubic cramping with radiation to the low back and may be accompanied by HA, N/V/D

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23
Q

Primary Dysmenorrhea

A

“idiopathic” type
Excessive prostaglandins causing smooth muscle overreaction

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24
Q

What is secondary Dysmenorrhea?

A

often more severe, lasts longer
Endometriosis
Fibroids
PID
IUD
Adenomyosis
Pelvic adhesions

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25
Q

What is Endometriosis?

A

The presence of endometrial tissue outside of the uterine cavity (ovaries, fallopian tubes, vagina, perineum, intestines, other distant sites)

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26
Q

Which population does endometriosis typically affect?

A

younger females (esp those of child bearing age and havent gone through pregnancy)

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27
Q

What are the theories for the causes of Endometriosis?

A

Retrograde menstruation
Lymphatic metastasis
Embryonic metaplasia(most likely)

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28
Q

What are the risks for developing endometriosis?

A

early menarche, short intervals between cycles, longer duration of menses, heavy flow, FHx
Patients present with severe dysmenorrhea, chocolate cysts, bowel or bladder complaints, and infertility

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29
Q

What is the major risk for developing Endometriosis?

A

infertility

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30
Q

Leiomyomas are commonly called __________ and are completely ___________

A

fibroids, bengin

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31
Q

What are the three locations of Leiomyomas ?

A
  1. Submucosal: replace normal endometrium and more like to bleed
  2. Intramural: in myometrium
  3. Subserosal: irregular projections on uterine surface
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32
Q

What are symptoms of Leiomyomas ?

A

asymptomatic, excessive or irregular bleeding, urinary or rectal pressure, abdominal distention

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33
Q

Do Leiomyomas require therapy?

A

require no therapy and will typically resolve after menopause

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34
Q

Adenomyosis

A

Endometrial tissue found deeper in myometrium

35
Q

Which population is Adenomyosis most common in?

A

More common in middle aged women

36
Q

In Adenomyosis, there will be a relationship with repeated ____________

A

pregnancies

37
Q

What are the symptoms of Adenomyosis?

A

heavy menses, dyspareunia
May coexist with fibroids and uterine hyperplasia

38
Q

Adenomyosis resolves with ____________________

A

menopause

39
Q

_____________ is the Most common female reproductive tract cancer

A

Endometrial Cancer

40
Q

What is the precursor to Endometrial Cancer?

A

endometrial hyperplasia

41
Q

Endometrial Cancer occurs most often in __________ women, peaks at _____________

A

postmenopausal women, 55-65

42
Q

Which two factors does endometrial cancer increase with?

A

obestiy and nulliparity (never had a baby)

43
Q

What is the most common presenting symptoms in endometrial cancer?

A

is abnormal painless bleeding

44
Q

Functional cysts

A

thin walled, typically holds fluid and found on surface of ovary

45
Q

Follicular cysts

A

(very common follicle doesn’t release egg, it continues to grow.)
related to occlusion of follicle’s duct therefore dominant follicle doesn’t release egg, but rather continues to grow

46
Q

Luteal cysts

A

(also very common) failure of corpus luteum to regress

47
Q

S/S of ovarian cyts

A

asymptomatic, however may have dull ache > severe pain

48
Q

What are the complications of ovarian cycsts?

A

ovarian torsion
Rupture
hemorrhage

49
Q

Dermoid tumors

A

primordial germ cell tumors, may contain hair, sebum, teeth, etc

50
Q

Granulosa tumors

A

excrete excess estrogen, cause increased bleeding

51
Q

Sertoli-Leydig tumors

A

secrete androgen, cause hirsutism and virilism

52
Q

What are the three types of ovarian cancers?

A

Epithelial (90%, most common)
Germ cell
Gonadal stromal

53
Q

There is increased incidence with age _____________ with ovarian cancer

A

(40-65)

54
Q

What are the risks for ovarian cancer?

A

Increased ovulatory age
BRCA 1 or 2 + status (20-60% by age 70)

55
Q

What are the symptoms of ovarian cancer?

A

vague, early asymptomatic, later see abdominal distention, early satiety, bloating, and pelvic pain

56
Q

External genitalia infections

A
  1. HPV-
  2. HSV-
57
Q

Internal lower genitalia infections

A
  1. Vaginosis- change in normal floral not classified as infection more an alteration in balance of natural flora.
  2. Vaginitis- inflammation caused by infection
  3. Cervicitis- infection has gone into the cervix
58
Q

What is the most common sexually transmitted infection

A

HPV (Human Papillomavirus)

59
Q

In HPV, Approximately ________of those who are sexually active will acquire a strain of HPV, usually within the first few years of sexual debut

A

75%

60
Q

In HPV, Prevalence is greatest in ___________aged __________; in 2007 half of those newly infected will be from this age group

A

women, 15-24

61
Q

HPV can be implicated in

A

genital warts, cervical cancer, as well as penile, anal, and head and neck cancers

62
Q

Herpes Simplex Virus (HSV)

A

Recurrent, lifelong viral infection
Sexually and orally transmitted
Most infected are asymptomatic but shed virus intermittently in the vaginal tract
HSV I and II: 95% recurring genital lesions are HSV II

63
Q

How is Herpes Simplex Virus (HSV) spread?

A

Spread by direct mucocutaneous contact
Prodrome of itching/burning
Painful vesicular lesions
Can be spread to infant during delivery if active infection at time
Spread by direct mucocutaneous contact

64
Q

Most vulvar malignancies are ______________

A

squamous cell carcinomas (90%)

65
Q

slide 28

A
66
Q

Most often vulvar atypias present with:

A

pruritus/itching and/or
an area of discoloration of skin
an area of discoloration of skin

67
Q
A
68
Q

What is chlamydia?

A

Bacterial Infection due to Chlamydia trachomatis (CT)
Sexually transmitted
Steadily increasing over the years
Usually asymptomatic
ASYMPTOMATIC

69
Q

CMT slid

A

wiggle finer, and woman wants to go off o
go up to uterus and PID

70
Q

Gonorrhea

A

Bacterial infection due to Neisseria gonorrhea
2005= first increase, ? due to microbial resistance
Sexually transmitted to genitals or throat
Often asymptomatic
May present with endocervical discharge
Dysuria
Complications can include Bartholin gland abscess
and PID may be seen
If (+), give prophylactic tx for chlamydia if not r/o yet

71
Q

Bacterial Vaginosis (BV)

A

Vaginosis = condition of vagina
Can be associated with alterations in normal flora and overgrowth
Thin milky discharge
Dysuria
Fishy odor, especially if exposed to KOH (amine odor = (+) whiff test)
Vaginal secretions will show clue cells
Can be associated with PID

72
Q

Candidiasis

A

Fungal infection aka “yeast infection”
Increased risk in diabetics
White/yellow, thick/curdy discharge
“yeasty” or no odor noted
Swelling of labia or vaginal canal can be seen, especially after sex
Vaginal secretions will show hyphae or rods noted
Can cause significant vaginal erosions and dermatitis

73
Q

What is the classic symptom for candidiasis?

A

pruritus

74
Q

Trichomonas Vaginalis

A

Usually sexually transmitted
Classic symptom: yellow/green, frothy discharge
Usually copious, pooled in fornix
Vaginal mucosa tends to be “beefy” red, causing easy friability of mucosa and dyspareunia
Strawberry cervix
Vaginal culture: Trichomonads

75
Q

Endometritis is an infection of the ________, ____________ or both

A

endo/myometrium

76
Q

Endometritis is seen after

A

Delivery
Instrumentation
Abortion

77
Q

What are the s/s of upper pelvic infections

A

vaginal bleeding, uterine tenderness, fever, purulent discharge

78
Q

What organisms can cause Pelvic Inflammatory Disease (PID)

A

PID polymicrobial, STIs, anaerobes, strep, H. flu, rarely TB, organisms that cause BV

79
Q

In PID, infection ascends up the reproductive tract and an affect which structures?

A

uterus, fallopian tubes, and ovaries

80
Q

Risk for developing PID in adolescents and young women and increases with _______ and in women who do not have __________

A

multiple sexual partners, children

81
Q

Acute PID

A

the pt can die from it

82
Q

Chronic PID

A

doesnt get beyond the pelivc sturctures

83
Q

What are S/S of PID?

A

Lower abdominal pain, dyspareunia, vaginal/cervical discharge, cervical motion tenderness, and fever

84
Q

What are complications with PID?

A

infertility, Fitz-Hugh-Curtis (liver involvement, RUQ Pain)

Patho (16 decks)

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