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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
What is Endometriosis?
The presence of endometrial tissue outside of the uterine cavity (ovaries, fallopian tubes, vagina, perineum, intestines, other distant sites)
26
Which population does endometriosis typically affect?
younger females (esp those of child bearing age and havent gone through pregnancy)
27
What are the theories for the causes of Endometriosis?
Retrograde menstruation Lymphatic metastasis Embryonic metaplasia(most likely)
28
What are the risks for developing endometriosis?
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
29
What is the major risk for developing Endometriosis?
infertility
30
Leiomyomas are commonly called __________ and are completely ___________
fibroids, bengin
31
What are the three locations of Leiomyomas ?
1. Submucosal: replace normal endometrium and more like to bleed 2. Intramural: in myometrium 3. Subserosal: irregular projections on uterine surface
32
What are symptoms of Leiomyomas ?
asymptomatic, excessive or irregular bleeding, urinary or rectal pressure, abdominal distention
33
Do Leiomyomas require therapy?
require no therapy and will typically resolve after menopause
34
Adenomyosis
Endometrial tissue found deeper in myometrium
35
Which population is Adenomyosis most common in?
More common in middle aged women
36
In Adenomyosis, there will be a relationship with repeated ____________
pregnancies
37
What are the symptoms of Adenomyosis?
heavy menses, dyspareunia May coexist with fibroids and uterine hyperplasia
38
Adenomyosis resolves with ____________________
menopause
39
_____________ is the Most common female reproductive tract cancer
Endometrial Cancer
40
What is the precursor to Endometrial Cancer?
endometrial hyperplasia
41
Endometrial Cancer occurs most often in __________ women, peaks at _____________
postmenopausal women, 55-65
42
Which two factors does endometrial cancer increase with?
obestiy and nulliparity (never had a baby)
43
What is the most common presenting symptoms in endometrial cancer?
is abnormal painless bleeding
44
Functional cysts
thin walled, typically holds fluid and found on surface of ovary
45
Follicular cysts
(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
Luteal cysts
(also very common) failure of corpus luteum to regress
47
S/S of ovarian cyts
asymptomatic, however may have dull ache > severe pain
48
What are the complications of ovarian cycsts?
ovarian torsion Rupture hemorrhage
49
Dermoid tumors
primordial germ cell tumors, may contain hair, sebum, teeth, etc
50
Granulosa tumors
excrete excess estrogen, cause increased bleeding
51
Sertoli-Leydig tumors
secrete androgen, cause hirsutism and virilism
52
What are the three types of ovarian cancers?
Epithelial (90%, most common) Germ cell Gonadal stromal
53
There is increased incidence with age _____________ with ovarian cancer
(40-65)
54
What are the risks for ovarian cancer?
Increased ovulatory age BRCA 1 or 2 + status (20-60% by age 70)
55
What are the symptoms of ovarian cancer?
vague, early asymptomatic, later see abdominal distention, early satiety, bloating, and pelvic pain
56
External genitalia infections
1. HPV- 2. HSV-
57
Internal lower genitalia infections
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
What is the most common sexually transmitted infection
HPV (Human Papillomavirus)
59
In HPV, Approximately ________of those who are sexually active will acquire a strain of HPV, usually within the first few years of sexual debut
75%
60
In HPV, Prevalence is greatest in ___________aged __________; in 2007 half of those newly infected will be from this age group
women, 15-24
61
HPV can be implicated in
genital warts, cervical cancer, as well as penile, anal, and head and neck cancers
62
Herpes Simplex Virus (HSV)
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
How is Herpes Simplex Virus (HSV) spread?
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
Most vulvar malignancies are ______________
squamous cell carcinomas (90%)
65
slide 28
66
Most often vulvar atypias present with:
pruritus/itching and/or an area of discoloration of skin an area of discoloration of skin
67
68
What is chlamydia?
Bacterial Infection due to Chlamydia trachomatis (CT) Sexually transmitted Steadily increasing over the years Usually asymptomatic **ASYMPTOMATIC**
69
CMT slid
wiggle finer, and woman wants to go off o go up to uterus and PID
70
Gonorrhea
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
Bacterial Vaginosis (BV)
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
Candidiasis
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
What is the classic symptom for candidiasis?
pruritus
74
Trichomonas Vaginalis
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
Endometritis is an infection of the ________, ____________ or both
endo/myometrium
76
Endometritis is seen after
Delivery Instrumentation Abortion
77
What are the s/s of upper pelvic infections
vaginal bleeding, uterine tenderness, fever, purulent discharge
78
What organisms can cause Pelvic Inflammatory Disease (PID)
PID polymicrobial, STIs, anaerobes, strep, H. flu, rarely TB, organisms that cause BV
79
In PID, infection ascends up the reproductive tract and an affect which structures?
uterus, fallopian tubes, and ovaries
80
Risk for developing PID in adolescents and young women and increases with _______ and in women who do not have __________
multiple sexual partners, children
81
Acute PID
the pt can die from it
82
Chronic PID
doesnt get beyond the pelivc sturctures
83
What are S/S of PID?
Lower abdominal pain, dyspareunia, vaginal/cervical discharge, cervical motion tenderness, and fever
84
What are complications with PID?
infertility, Fitz-Hugh-Curtis (liver involvement, RUQ Pain)

Patho (16 decks)

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