Female Repro Supp Notes Flashcards
What is pelvic inflammatory disease?
An inflammatory response resulting in diffuse abdominal inflamation, scaring, and sequalae
Where can the inflammation/infection spread to in a person with PID
Ovaries, ligaments, peritoneal surfaces, and abdominal organs and even may spread to the liver
What is PID typically due to?
Infections and STIs such as gonorrhea and clamydia
In patients with PID the infection/inflammation ascends through…
The uterus and fallopian tubes
PID commonly occurs in what type of individuals?
- sexually active women
- younger women
- and women who never had a child
In rare cases PID is also associated with infections of these nearby organs?
- appendix
- colon
Why is inflammation in the fallopian tubes a concern?
- swelling can seal ends trapping the pus
- swelling can predispose them to abscess formation
What is a common sequelae of PID
Infertility ; due to the post inflammatory scaring
What is the treatment for PID
- laparoscopy
- antibiotics
- surgery to drain abscesses
Long term consequences (sequels): if scarring and formation of adhesions between the fallopian tubes, ovaries, and organs occur ….
- infertility
- interference with intestinal motility
- restriction of organ movement during body movement
- chronic abdo pain
- reoccurring fallopian tube infection
What is endometriosis
This is when tissue similar to the endometrium (uterine tissue) grows outside of the uterus
What is endometriosis commonly due to?
Endometrial fragments that are expelled through the fallopian tubes and reach the pelvic cavity where they become established
What is the common malignancy of the uterus?
Endometrial carcinoma
What does metastasizes mean?
When the cancer spreads from one area to another
What age does endometrial carcinoma often arise?
After menopause (55 - 65)
Exposure to high levels of estrogen can increase the risk of endometrial carcinoma. What conditions are associated with high levels of estrogen?
- DM
- Obesity
- HTN
- Delayed menopause
Early stage Manifestations of endometrial carcinoma
- abnormal painless bleeding
- in menstruating women, bleeding between periods.
Later stage manifestations of endometrial carcinoma
- cramping
- pelvic discomfort
- postcoital pain
- lower abdominal pressure
- enlarged lymph nodes
How is endometrial carcinoma diagnosed?
- biopsy, dilation, and curretage
Treatment for endometrium carcinoma?
- hysterectomy
- removal of adjacent pelvic organs
- radiation and hormone suppression therapy
What is the most common form of pelvic tumours?
Uterine fibroids
What are uterine fibroids?
Benign neoplasms (tumours) of the uterus. These are masses of muscle and connective tissue that are stimulated by estrogen
Uterine fibroids: intracavity
- inside the uterus cavity
- causes bleeding between periods (metorrrhagia)
- often causes severe cramping
Uterine fibroids: Intramural
- within the muscular wall of the uterus
- causes the uterus to bulge
Uterine fibroids: submucosal
- between the endometrium and uterine lining
- may lead to habitual abortion (infertility)
- heavy /prolonged bleeding w/ me striation
- often protrudes into the cavity
Uterine fibroids: Subserosal
- outermost uterine lay of the uterus
- projects inward into the abdominal cavity
- often asymptomatic
What is metrorrhagia?
Bleeding that occurs between period
What are ovarian cysts?
Fluid filled sacs (like blisters)
Ovarian cysts are common among which type of women?
Women during reproductive years ; most are harmless and go away without treatment
What is the cause/patho behind an ovarian cysts?
- during ovulation a follicle is formed inside the ovary
- the mature follicle ruptures when an egg is released during ovulatiion
- corpus luteum forms from the empty follicle and dissolves if fertilization does not occur
Most ovarian cysts form from which type of follicle?
Graafian follicles
What is the size of enlarged corpus luteum cysts?
1- 2 cm in diameter but can be as large as 8cm
What is poly cystic ovarian syndrome? (PCOS)
The presence of multiple cysts on both ovaries and occurs usually in younger women
Why might polycystic ovarian syndrome prevent ovulation and decrease fertility?
The buildup of follicular cysts causes ovaries to enlarge and create a thick outer covering
What is the diagnosis for ovarian cysts?
- pelvic exam
- ultrasound
- laparoscopy
What is the treatment for ovarian cysts?
- oral contraceptives
- surgery
What are the risk factors for breast cancer
- age over 50
- white and African Americans
- early first period
- late menopause
- no child bearing or late child making
- family hx or breast , ovarian, or brain
- obesity
- alcohol consumption
