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PC705 Pathophysiology > Module 9 Male and Female Reproductive Disorders > Flashcards

Module 9 Male and Female Reproductive Disorders Flashcards

1
Q

Define hypospadias.

A

The urethral meatus is located on the ventral undersurface of the penis, between the glans and perineum.

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2
Q

Etiology of hypospadias.

A

Results from incomplete fusion of the urethral folds.

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3
Q

In the event of penoscrotal or perineal hypospadias, what other conditions should be considered?

A

Possible intersex due to insufficient masculinization.

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4
Q

With increasing severity of hypospadias, the meatus assumes a more poximal location and is more often associated with ____________.

A

chordee - a curvature of the penile shaft.

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5
Q

Define epispadias.

A

The urethra opens on the dorsal aspect of the penis, proximal to the glans.

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6
Q

Hypospadias & Epispadias

  1. Which is more disabling?
  2. Which is more common?
A
  1. Epispadias is more disabling.

2. Hypospadias is more common.

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7
Q

What other congenital condition is related to epispadias?

A

Exstrophy of the bladder.

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8
Q

Etiology of epispadias.

A

A mild degree of exstrophy with a deficiency of abdominal wall formation present inferiorly.

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9
Q

Is it more or less common to have incontinence with epispadias?

A

More common.

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10
Q

Define crytorchidism.

A

Undescended testis or “hidden testis”. Refers to any testis that occupies an extrascrotal position.

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11
Q

Etiology of crytorchidism.

A

Cause is uncertain, but may be related to an intrinsic testicular defect or subtle hormone deficiency.

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12
Q

What is orchiopexy?

A

Operative procedure to bring the testis into a normal scrotal position.

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13
Q

What are the complications of crytorchidism?

A

Fibrotic tubules, deficiency of spermatogenesis resulting in infertility.
Increased incidence of testicular malignancy.

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14
Q

Define priapism.

A

A painful, persistent erection, involving the corpus cavernosa, but not usually the corpus spongiosm or glans.

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15
Q

Etiology of priapism.

A

Multiple causes - most are idiopathic.
Other: sickle cell disease, anticoagulant therapy, DM, leukemia, and certain anti-depressants. On rare occasion oral erectile dysfunction meds.

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16
Q

Although multiple causes exist for priapism, what is the common abnormality?

A

Obstruction of venous drainage resulting in the buildup of viscous, poorly oxygenated blood in the corpora.

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17
Q

Define phimosis.

A

When uncircumcised foreskin cannot be retracted over the glans of the penis.

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18
Q

Etiology of phimosis.

A

Usually results from chronic inflammation and infection from poor hygiene.

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19
Q

Clinical manifestations and complications of phimosis.

A

Erythema (redness), tenderness, and discharge.

Increased incidence of calculi and squamous cell carcinoma.

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20
Q

Define paraphimosis.

A

Foreskin has been retracted over the glans and can not be replaced in its normal position.

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21
Q

Define Peyronie Disease.

A

Formation of palpable, fibrous plaque on the surface of the corpora cavernosa.

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22
Q

Clinical manifestations of peyronie disease.

A

Causes curvature of the penis with painful, incomplete erections.

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23
Q

Cause and risk factors for peyronie disease?

A

Usually result of smally blood vessels in the penis that rupture and cause scar tissue.
At risk: heredity, connective tissue disorder, smoking, aging

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24
Q

Define erectile dysfunction.

A

Inability to achieve or maintain an erection sufficient for satisfactory sexual performance.

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25
Q

Define primary impotence and list causes.

A

Inability to attain an erection throughout life.

Usually deep seated psychiatric problems or vascular trauma during childhood.

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26
Q

Define secondary impotence.

A

Normal erections in the past, but no longer able to achieve normal erections.

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27
Q

Etiology of secondary ED (impotence).

A

Many different causes- most relate to physiologic changes in the vasculature of the corporal bodies of the penis. Ex. peripheral vascular disease, medications, endocrine problems, trauma, hypertension.

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28
Q

Define hydrocele.

A

A fluid collection surrounding the testicle or spermatic cord and contained within the tunica or processus vaginalis. Congenital hydroceles caused by communication between abdominal cavity and scrotum through the processus vaginalis.

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29
Q

Clinical manifestations of hydrocele.

A

Scrotal swelling- usually painless.

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30
Q

Define spermatocele.

A

Painless, cystic masses containing sperm.

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31
Q

Define testicular torsion.

A

A twisting of the spermatic cord with subsequent compromise of the testicular vascular supply and testicular ischemia, followed by infarction.

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32
Q

In what age group does testicular torsion usually occur?

A

Prepubertal boys.

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33
Q

Clinical manifestations of testicular torsion.

A

Severe pain in one testis, followed by swelling of the scrotum. May also have low abd pain, N&V.

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34
Q

How is testicular torsion diagnosed?

A

Doppler ultrasound shows no blood flow or nuclear scanning.

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35
Q

An abnormal ____________________is present in almost all cases of male infertility.

A

Semen analysis.

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36
Q

Define epididymitis.

A

Inflammation of the testis.

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37
Q

Causes of epididymitis.

A

May occur as a result of trauma or reflux of urine up the vas deferens. Most are secondary to bacterial cause.

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38
Q

Clinical manifestations of epididymitis.

A

Scrotum enlarged, reddened, and tender. Pain may radiate into inguenal area. May also have fever, urethral discharge,cystitis, and cloudy urine.

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39
Q

What is the most common cause of acute scrotal pain in adult men?

A

Epididymitis

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40
Q

Define prostatitis.

A

Inflammation of the prostate.

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41
Q

What is the most common organism in bacterial prostatitis?

A

E coli

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42
Q

What are the routes of infection in prostatitis?

A

1) Ascending infection up the urethra (2) reflux of infected urine into the prostatic ducts (3) hematogenous infection (4) invasion of rectal bacteria by direct extension or lymphogenous spread.

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43
Q

Clinical manifestations of prostatitis.

A

Fever , chills, low back pain, and frequency, urgency, and dysuria.

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44
Q

What age group is most often affected by testicular cancer?

A

20-34

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45
Q

Histologically, what are the two groups in testicular cancer?

A

1) Non-germinal: originating from the Leydig cells or other stromal tissue cells of the testis
2) Germinal: from germinal cells of the testis

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46
Q

List two types of germinal testicular cancer and characteristics.

A

1) Seminomas: easily cured with radiation in early stages; most curable
2) Non-seminomas: usually managed with surgery in early stage.

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47
Q

What is the most common cancer in American men?

A

Prostate.

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48
Q

What age group is most often affected by prostate cancer?

A

Rarely occurs younger than 50 and incidence increases with age. Usually dx after age 65.

49
Q

What are the majority of prostate cancers?

A

Adenocarcinoma- dx by checking PSA level

50
Q

Who is at increased risk for prostate cancer?

A

Family history (father or brother doubles chance), genetics (HPC1, BRCA1, BRCA2), Black

51
Q

Define benign prostatic hyperplasia

A

Benign enlargement of the prostate.

52
Q

Etiology of BPH.

A

Exact cause unknown. Suggestive of aging male endocrine system (hormonal).

53
Q

Pathophysiology of BPH.

A

Hyperplasia of the glands surrounding the prostatic urethra increase the size of the prostate, which compresses the urethra and produces sx of bladder outlet obstruction.

54
Q

Clinical manifestations of BPH.

A

Decrease in the force of the urinary stream, hesitancy or difficulty initiating urination, interruption of the stream. May experience infection due to residual urine.

55
Q

Define primary amenorrhea.

A

Failure to begin menses by age 16 or 14 with no secondary sex characteristics

56
Q

Define secondary amenorrhea

A

The cessation of established, regular menstruation for 6 months or longer.

57
Q

Cause of primary amenorrhea?

A

HPO axis disturbance.

58
Q

Define abnormal uterine bleeding.

A

Irregular or excessive bleeding. Bleeding that varies from a woman’s normal pattern either in quantity or in frequency.

59
Q

Define metorrhagia.

A

Bleeding between periods.

60
Q

Define hypomenorrhea.

A

Deficient amount of flow.

61
Q

Define oligomenorrhea.

A

Infrequent menstruation. Usually reflects failure to ovulate.

62
Q

Define polymenorrhea.

A

Increased frequency in menstruation.

63
Q

Define menorrhagia.

A

Increase in the amount or duration of menstrual bleeding; often debilitating.

64
Q

Define dysfunctional uterine bleeding.

A

Abnormal endometrial bleeding not associated with tumor,inflammation, pregnancy, trauma, or hormonal effects. Occurs most often around menarche and menopause. Usually due to anovulation.

65
Q

Define dysmenorrhea.

A

Menstruation that is painful enough to limit normal activity.

66
Q

Characteristics of primary dysmenorrhea.

A

1) Not related to pathology
2) Usually develops 1-2 yrs after menarche
3) Cramps are suprapubic and sharp.
4) May have N&V, headache

67
Q

Characteristics of secondary dysmenorrhea.

A

1) Dull pain that may increase with age.

2) Associated with pelvic disorders (endometriosis, leiomyomas, pelvic adhesions)

68
Q

Define uterine prolapse.

A

Sinking of the uterus from it’s normal position.

69
Q

Cause of uterine prolapse.

A

When supporting structures (uterosacral ligaments and cardinal ligaments) relax and allow the relationship of the uterus to the vaginal axis to be altered. Permits cervix to sag downward into vagina. If support of the vaginal wall is also compromised, pressure of the abdominal organs on the uterus will force it downward through the vagina into the introitus.

70
Q

Differentiate between 1st, 2nd, & 3rd degree prolapse.

A

1st- uterus halfway between vaginal introitus and ischial spines
2nd- the end of the cervix protrudes through introitus
3rd- body of uterus is outside vaginal introitus

71
Q

Clinical manifestations of uterine prolapse.

A

Sensation of bearing down, and vaginal discomfort. May have difficulty urinating and more discomfort while walking/sitting with 2nd or 3rd. If protruding - bleeding / ulceration.

72
Q

Define cystocele.

A

A protrusion of a portion of the urinary bladder into the anterior of the vagina at a weakened part of the vaginal musculature.

73
Q

Define rectocele.

A

A protrusion of the anterior rectal wall into the posterior of the vagina at a weakened part of the vaginal musculature.

74
Q

Define pelvic inflammatory disease.

A

Any acute, subacute, recurrent, or chronic infection of the oviducts and ovaries with involvement of the adjacent reproductive organs

75
Q

Define vulvovaginitis.

A

Inflammation of the vulva and vagina.

76
Q

What is the most common causative agent for vulvovaginitis?

A

Candida albicans

77
Q

What are three causes of vulvovaginitis?

A

1) Yeast (candida)
2) Bacteria (multiple)
3) Protozoa (trich)

78
Q

Clinical manifestations of vulvovaginitis from

1) yeast
2) other infections

A

1) thick white discharge and red edematous mucous membranes. Intense itching. pH normal (<4.5). Fungal organisms seen on slide.
2) Malodorous, purulent discharge. Irritation and inflammation (red,swollen labia, pain on urination and intercourse, itching)

79
Q

Define bartholinitis.

A

Inflammation of the bartholin glands, which may form an abcess when bacteria are established.

80
Q

Clinical manifestations of bartholinitis.

A

Tenderness and swelling at the site (located on either side of the vaginal orifice). Pus may be observed exudating from the duct. Fever, malaise.

81
Q

Define uterine leiomyomas.

A

Fibroids, most common uterine growth in women. Benign tumors of the myometrium.

82
Q

Three types of leiomyomas.

A

Submucous, subserous, intramural

83
Q

Clinical manifestations of leiomyoma

A

Abdominal pain and pressure, abnormal vaginal bleeding and discharge, backache, constipation, urinary frequency or urgency.

84
Q

What women are usually affected by leiomyomas?

A

Black, reproductive ages.

85
Q

Define endometriosis.

A

Presence of endometrial tissue outside the lining of the uterine cavity.

86
Q

List sites for endometriosis.

A

Most common: ovary, peitoneum of the cul de sac or pouch of Douglas, uterosacral ligaments, round ligament, oviduct and the peritoneal surface of the uterus.

87
Q

Etioloty of endometriosis - 4 theories.

A
  1. Transportation: endometrial tissue flows backward through the oviducts during normal period. After this retrograde flow, fragments implant on the other surfaces.
  2. Metaplasia: inflammation or hormonal change triggers metaplasia (conversion of one kind of tissue to a form that is not normal for that tissue).
  3. Induction: combination of transportation and metaplasia.
  4. Immunology
88
Q

Define bartholinitis.

A

Inflammation of the bartholin glands, which may form an abcess when bacteria are established.

89
Q

Clinical manifestations of bartholinitis.

A

Tenderness and swelling at the site (located on either side of the vaginal orifice). Pus may be observed exudating from the duct. Fever, malaise.

90
Q

Define uterine leiomyomas.

A

Fibroids, most common uterine growth in women. Benign tumors of the myometrium.

91
Q

Three types of leiomyomas.

A

Submucous, subserous, intramural

92
Q

Clinical manifestations of leiomyoma

A

Abdominal pain and pressure, abnormal vaginal bleeding and discharge, backache, constipation, urinary frequency or urgency.

93
Q

What women are usually affected by leiomyomas?

A

Black, reproductive ages.

94
Q

Define endometriosis.

A

Presence of endometrial tissue outside the lining of the uterine cavity.

95
Q

List sites for endometriosis.

A

Most common: ovary, peitoneum of the cul de sac or pouch of Douglas, uterosacral ligaments, round ligament, oviduct and the peritoneal surface of the uterus.

96
Q

Etioloty of endometriosis - 4 theories.

A
  1. Transportation: endometrial tissue flows backward through the oviducts during normal period. After this retrograde flow, fragments implant on the other surfaces.
  2. Metaplasia: inflammation or hormonal change triggers metaplasia (conversion of one kind of tissue to a form that is not normal for that tissue).
  3. Induction: combination of transportation and metaplasia.
  4. Immunology
97
Q

Clinical manifestations of endometriosis.

A

Acquired dysmenorrhea. Pain in the lower part of the abdomen and in the vagina. Usually begins 5-7 days before the peak of menses and lasts 2-3 days.. May have excessive bleeding leading to anemia and fatigue.

98
Q

What is polycystic ovary syndrome?

A

One of the most common endocrine disorders affecting women of childbearing age.

99
Q

What disorder commonly causes infertility in women?

A

PCOS

100
Q

List the 4 key features of PCOS.

A
  1. Ovulatory and menstrual dysfunction
  2. Hyperandrogenemia
  3. Clinical features of hyperandrogenism
  4. Polycystic ovaries
101
Q

Most common cause of cervical cancer?

A

HPV 16 & 18

102
Q

Risk factors for cervical cancer.

A

sex at young age, multiple partners, multiple pregnancies, HSV 2, other STI

103
Q

Clinical manifestations of cervical cancer.

A

abnormal vaginal bleeding, persistent vaginal discharge, and pain and bleeding after intercourse (when sx appear it has usually progressed beyond early stages)

104
Q

Most common type of cervical cancer.

A

Squamous cell

105
Q

Risk factors for endometrial (uterine lining) cancer

A

Occurs less often in young women than cervical cancer, but both types occur with equal frequency in postmenopausal women.
Other: infertility, late menopause, obesity, diabetes, and hypertension. Also unopposed estrogen therapy.

106
Q

Clinical manifestations of endometrial cancer.

A

Bleeding between periods or postmenopausal bleeding..

107
Q

What is the leading cause of death from genital cancer?

A

Ovarian cancer. High mortality rate.

108
Q

Peak incidence for ovarian cancer?

A

Women 60-80

109
Q

Clinical manifestations of ovarian cancer.

A

Symptoms relate to abdominal metastasis.

Increasing abdominal girth, weight loss, abdominal pain, dysuria, or urinary frequency, and constipation.

110
Q

Define mammary duct ectasia

A

Chronic inflammatory process occurring in and around the terminal subareolar ducts of the breast.

111
Q

Pathogenesis of mammary duct ectasia

A

Ducts become distended with cellular debris and the irritating effect on the duct walls causes an inflammatory response. Granulation tissue is formed around a small cavity filled with thick yellowish/brownish material.

112
Q

Clinical manifestations of mammary duct ectasia

A

Palpable mass and dimpling or distortion of the breast or areola with persistent nipple discharge.

113
Q

What must be ruled out via biopsy in mammary duct ectasia

A

breast cancer

114
Q

Define fibrocystic breast disease.

A

Presence of palpable breast masses that fluctuate with menstrual cycles. not distinct disease

115
Q

What is the cause of fibrocystic breast disease and what age range is most often affected?

A

Hormonal imbalance in the reproductive years. Ages 30-50

116
Q

Clinical manifestations of fibrocystic breast disease.

A

kTenderness or pain in one or both breasts immediately before period. Cysts are firm, regular in shape, and mobile. Most often in upper outer quadrant.

117
Q

What is the most common form of cancer in women age 25-75?

A

Breast.

118
Q

Risk factors for breast cancer.

A

Hormonal factors (early menses and late menopause), reproductive factors (nullipara higher risk, ama as primip higher risk), dietary (fat), family hx (BRCA1, BRCA2), Age (increases as age progresses past age 25)

119
Q

Clinical manifestations of breast cancer.

A

Single lump- painless, hard and poorly movable. advanced signs-dimpling, nipple retraction,discharge

PC705 Pathophysiology (8 decks)

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