Genital and Urinary System Disorders (FEMALE)- Notes from Slideshow (Quiz 4) PART 1 Flashcards
Normal menstrual cycle: phases
- mensuration phase
- follicular phase
- ovulation phase
- luteal phase
Normal menstrual cycle: Hormones
- LH
- FSH
- Estrogen
- Progesterone
Normal menstrual cycle: Hormone levels during menstruation phase
- LH: stable/normal
- FSH: stable/normal
- Estrogen: stable/normal
- Progesterone: stable/normal
Normal menstrual cycle: Hormone levels during follicular phase
- LH: spiked increase
- FSH: spiked increase
- Estrogen: spiked increase
- Progesterone: stable/normal
Normal menstrual cycle: Hormone levels during ovulation phase
- LH: decreases back to stable/normal
- FSH: decreases back to stable/normal
- Estrogen: begins to decrease
- Progesterone: stable/normal
Normal menstrual cycle: Hormone levels during luteal phase
- LH: stable/normal
- FSH: stable/normal
- Estrogen: dips low early in phase then elevates back to high level late in phase then lowers back to stable/normal by the end of phase
- Progesterone: Slowly increases reaches peak then decrease back to normal consistently over course of phase
Normal menstrual cycle: Uterus changes in each phase
- mensuration phase: Shedding lining
- follicular phase: growth of a thin to medium lining
- ovulation phase: -
- luteal phase: Thickening of lining
Normal menstrual cycle: Ovary changes in each phase
- mensuration phase: developing follicle
- follicular phase: mature follicle
- ovulation phase: release of egg
- luteal phase: early corpus luteum changes to regressing corpus luteum which changes to corpus albicans
- Dysfunctional uterine bleeding
- Menorrhagia
- Metrorrhagia
- Hypomenorrhea
- Amenorrhea
- PMS
Menstrual Cycle Abnormalities
Menstrual Cycle Abnormalities
- Dysfunctional uterine bleeding
- Menorrhagia
- Metrorrhagia
- Hypomenorrhea
- Amenorrhea
- PMS
Abnormal uterine bleeding in the absence of an organic uterine lesion
Dysfunctional uterine bleeding
Most common cause of Dysfunctional uterine bleeding
anovulation
Failure to ovulate
anovulation
Profuse or prolonged uterine bleeding
Menorrhagia
irregular uterine bleeding between periods
Metrorrhagia
A short or scanty menstruation
Hypomenorrhea
Absence of menstruation
Amenorrhea
Syndrome typically occurring in a predictable pattern before the onset of menstruation
Premenstrual syndrome (PMS)
A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
Polycystic ovary syndrome (PCOS)
Symptoms of PCOS
- infrequent, irregular or prolonged periods
- excess androgen levels
What is androgen?
male hormone
Result of PCOS
- ovaries develop small collections of fluid (called follicles)
- fail to regularly release eggs
A disorder in which tissue that normally lines the uterus grow on other pelvic organs.
Endometriosis
What other pelvic organs does uterine tissue grow on in Endometriosis?
- ovaries
- fallopian tubes
- pelvis lining
What can Endometriosis cause to happen?
Outside the uterus the abnormal endometrial tissue
- thickens
- bleeds
Normal female reproductive system anatomy- be able to identify and locate
- ovary
- fallopian tube
- uterus
- endometrium
- vulva
- vagina
- labia majora
- labia minora
- clitoris
Non Neoplastic Epithelial Disorders
- Lichen Sclerosus
- Lichen Simplex Chronicus
Uncommon condition that creates patchy, white skin that appears thinner than normal. Usually on the genital/anal areas.
Lichen Sclerosus
Smooth, white plaques in Lichen Sclerosus are called what?
leukoplakia
What occurs to the epithelium in Lichen Sclerosus ?
- superficial dermis: fibrosed
- deeper dermis: chronic inflammatory cells
Etiology of Lichen Sclerosus
Hypothesized to be autoimmune
Why is Lichen Sclerosus Hypothesized to be autoimmune?
- Activated T cells found in the subepithelial inflammatory infiltrate
- Increased frequency of autoimmune disorders in affected women
Localized, well-circumscribed area of thickened, skin.
Lichen Simplex Chronicus
Symptoms if Lichen Simplex Chronicus
- hyperkeratosis
- leukoplakia
- chronic irritation
- puritis
Thickening of the outer layer of the skin which contains a tough, protective protein called keratin in order to protect against irritation.
hyperkeratosis
What causes Lichen Simplex Chronicus?
An underlying inflammatory dermatosis
Important take away when considering a Lichen Sclerosus or Lichen Simplex Chronicus diagnosis.
- Leukoplakia can be seen in a variety of other benign conditions (Ex: psoriasis)
- Leukoplakia can also be seen in malignant lesions of the vulva (squamous cell carcinoma or invasive squamous cell carcinoma)
- Therefore, BIOPSY/micro exam are important to differentiate
What is seen on a micro exam of cells from a pt with and Lichen Simplex Chronicus?
- epidermal and epithelial hyperplasia
- hyperkeratosis
- fibrotic vertical streaks of collagen b/w hyperplastic rete
Inflammation of the vulva
Vulvitis
Inflammation of the vagina
Vaginitis
Most common causes of Vulvitis/Vaginitis.
Reactive inflammation in response to a stimulus
What are examples of stimuli that could cause Vulvitis/Vaginitis?
- irritant
- allergen
- infection
What are some infections that cause Vulvitis/Vaginitis?
- HPV
- HSV
- Gonorrhea
- Chlamydia
- Candida
- BV
Complication of vulvitis
- Obstruction of Bartholin glands
- Can cause Bartholin cyst and abscess formation
Two excretory, pea sized, compound, alveolar glands found slightly posterior and bilateral to the vaginal opening.
Bartholin glands
What do Bartholin glands excrete?
Mucus to lubricate the vagina
Bartholin’s glands are homologous to male anatomy?
bulbourethral glands
Main symptom of HPV
Warts
Main symptom of HSV
Cold sore
Rate of Gonorrhea in MA in 2018
118 per 100,000
Rate of Chlamydia in MA in 2018
444 per 100,000
State with highest rate of Gonorrhea in MA in 2018. How many?
- DC
- 611 per 100,000
State with lowest rate of Gonorrhea in MA in 2018. How many?
- Puerto Rico
- 17 per 100,000
State with highest rate of Chlamydia in MA in 2018. How many?
- DC
- 1,299 per 100,000
State with lowest rate of Chlamydia in MA in 2018. How many?
- American Samoa
- 107 per 100,000
Types of Vaginal Infections
- Vaginal Yeast Infection (candida)
- Bacterial Vaginosis (BV)
Vaginal Infections are typically related to what?
An imbalance normal vaginal flora
Vaginal Infections are typically NOT related to what?
STIs
Best way to determine etiology of Vaginal Infections
- pelvic exam
- wet mount slide-view micro
Candida vs BV: Micro findings
- Candida: fungal spores/budding yeast
- BV: blue cells
Candida vs BV: etiology
- Candida: candida/yeast overgrowth
- BV: bacteria overgrowth
Candida risk factors
- Antibiotic use
- Increased estrogen levels
- Uncontrolled diabetes
- Impaired immune system
BV risk factors
- Having multiple sex partners
- Having a new sex partner
- Douching
- Natural lack of lactobacilli bacteria
Candida vs BV: itch and irritation
- Candida: Yes
- BV: No
Candida vs BV: odor
- Candida: Unpleasant, fish-like
- BV: no
Candida vs BV: discharge consistency
- Candida: thin/watery
- BV: thick like cottage cheese
Candida vs BV: discharge color
- Candida: white/grey
- BV: white
Candida vs BV: soreness
- Candida: Yes
- BV: No
Bacterial infection of the female reproductive organs effecting the Pelvis
Pelvic Inflammatory Disease PID
What causes PID?
- Untreated bacterial infections
- Spread past the cervix to the pelvic organs/abdominal cavity
What bacteria left untreated is known to cause PID?
- chlamydia
- gonorrhea
- Acute abdominal/pelvic pain
- N&V
- Sometimes fever
- Purulent cervical discharge
- Cervical motion tenderness
Symptoms of PID
Symptoms of PID
- Acute abdominal/pelvic pain
- N&V
- Sometimes fever
- Purulent cervical discharge
- Cervical motion tenderness
Complication of untreated PID
- Permanent scarring of reproductive organs
- Can cause infertility
Is PID curable?
Yes if treated
A herniation of the bladder into the vagina
Cystocele
Cystocele is also known as?
Bladder:
- prolapse
- herniation
- dropped/fallen
Cause of Cystocele
- ligaments/muscles holding bladder up stretch/weaken
- causes bladder to sag into the vagina
Causes of weakening/stretching in Cystocele
- childbirth
- constipation
- violent coughing
- heavy lifting
Symptoms of Cystocele
- pressure in pelvis/vagina
- discomfort when straining
- feeling that bladder isn’t fully empty after urinating
Weakness of the rectovaginal septum causing herniation
Rectocele
Tissue between the rectum and the vagina
Rectovaginal septum
Cause of Rectocele
- process put pressure on wall
- cause wall to become thin/weak over time
Cause of weakening/stretching in Rectocele
- childbirth
- other pressures
Symptoms of Rectocele
- often no symptoms
- soft bulge in the vagina (may or may not protrude through the vaginal opening)
- difficult BMs
Descending of the small intestine into the lower pelvic cavity.
Enterocele
Symptoms of Enterocele
bulge at top of vagina
Complications of Enterocele
Pelvic organ prolapse
