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Study decks > Patho - Disorders of the Female Reproductive System > Flashcards

Patho - Disorders of the Female Reproductive System Flashcards

1
Q

what is amenorrhea? etiology?

A

Absence or suppression of menstruation.

Etiology: hormonal disturbances.
Stress & neoplasm’s interfere with normal hormonal secretion

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2
Q

what is metrorrhagia? etiology?

A

Bleeding between menstrual periods

Etiologies: Slight bleeding from endometrium during ovulation, uterine malignancy, cervical erosions, endometrial polyps, estrogen therapy

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3
Q

what is hypomenorrhea? etiology?

A

Deficient amount of menstrual flow; reduced flow

Etiologies: Endocrine or systemic disorders interfering with hormones, partial obstruction of menstrual flow

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4
Q

what is oligomenorrhea? etiology?

A

Infrequent menstruation

Etiology: Endocrine/systemic disorder causing failure to ovulate

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5
Q

what is polymenorrhea? etiology?

A

Increased frequency of menstruation

Etiology: Endocrine/systemic disorder causing ovulation

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6
Q

what is menorrhagia? etiology? treatment?

A

Increase in amount or duration of bleeding; prolonged and heavy bleeding

Etiology: Lesions of reproductive organs

Treatment: Surgery, oral contraceptives, and/or antiprostaglandins

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7
Q

what is dysfunctional uterine bleeding?

A

Abnormal endometrial bleeding
-Most common around menarche (immaturity in functioning of pituitary & ovaries) & menopause (d/t decrease in estrogen).

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8
Q

what is dysmenorrhea?

A

painful menstruation.
-Most common menstrual abnormality.
-Suprapubic cramping severe enough to limit activity, causes NVD

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9
Q

what is primary and secondary dysmenorrhea?

A

Primary—begins at onset of menses & is life long with unknown etiology—excessive prostaglandin production in the uterus which causes strong cxns, resulting in uterine ischemia & pain.

Secondary— occurs after having regular menses & usually d/t PID, endometriosis, STD, IUD, or fertility problems.
Often have scarring from the underlying cause.

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10
Q

uterine prolapse pathogenesis

A

Supporting pelvic structures relax & cervix (cx) sags downward into vagina.
-Can occur at any age

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11
Q

uterine prolapse etiology

A

Congenital defects, pregnancy & childbirth

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12
Q

uterine prolapse CM

A

-pelvic fullness
-vaginal discomfort
-difficulty urinating

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13
Q

what are the degrees of uterine prolapse?

A

1st degree: Uterus halfway between vaginal introitus & ischial spines

2nd degree: End of cx begins to protrude through introitus

3rd degree (complete prolapse): Body of uterus outside vaginal introitus

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14
Q

what is retrodisplacement of the uterus?

A

-Body of uterus is flexed into posterior pelvis
-Common: 20%-30% of women
-Associated with congenital defects, pregnancy & childbirth
-Pelvic pain, infertility, dysmenorrhea & dyspareunia
-5 positions: anteverted, midposition, anteflexed, retroflexed, retroverted

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15
Q

what is cystocele? etiology? CM?

A

Weakness in vaginal musculature allows bladder to protrude into anterior vagina.

Etiologies: Childbirth, surgery, aging, obesity, lifting.

Clinical Manifestations: back pain, incontinence, dysuria, pelvic pressure, dysmenorrhea & dyspareunia.

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16
Q

what is rectocele? etiology? CM?

A

Protrusion of anterior rectal wall into posterior vagina at a weakened part of vaginal musculature.

Etiologies: Childbirth injury, weakness with aging, multiparity, obesity.

Clinical Manifestations: Constipation, painful BM, painful intercourse

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17
Q

what is pelvic inflammatory disease?

A

Any acute, subacute, recurrent, or chronic infxn of oviducts, ovaries, & adjacent reproductive organs

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18
Q

cervicitis
endometritis
salpingitis
oophoritis

A

Cervicitis (cervix)
Endometritis (uterus)
Salpingitis (oviducts)
Oophoritis (ovaries)

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19
Q

pelvic inflammatory disease etiology

A

STI’s (Gonorrhea & Chlamydia), pelvic procedures,
IUD’s

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20
Q

pelvic inflammatory disease pathogenesis

A

Bacteria invade uterine & tubal tissues after migrating through cervix & scar tissue is formed

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21
Q

what is vulvovaginitis?

A

Inflammation of the vulva & vagina

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22
Q

vulvovaginitis etiology

A

Candida albicans (most common organism)

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23
Q

vulvovaginitis CM

A

-Thick, white, malodorous (odor), purulent discharge
-Red, edematous mucous membranes
-Intense itching
-Pain on urination and intercourse

24
Q

what is uterine leiomyomas?

A

-Most common uterine growths: AKA fibroids.
-20% women > 35yrs; more common in African-American women.
-Estrogen & GH influence development.
-Grow large & cause abd pain & pressure, DUB & vaginal d/c.

25
Q

what are ovarian cysts?

A

-Sacs on ovary that contain fluid.
-Develop anytime between puberty & menopause.
-Idiopathic.
-Usually asymptomatic & may change size with menstrual cycle.
-Rupture may result in severe abd pain & hemorrhage

26
Q

what is polycystic ovarian syndrome? etiology? symptoms? treatment?

A

Hormonal disorder that effects ovaries
-Common endocrine disorder (6-15% of females of reproductive age)
-Ovaries contain a large number of harmless follicular cysts.
-Frequent cause of anovulation (absence/irregularity)

-Etiology is unclear; probably multifactorial

-Symptoms include oligomenorrhea, signs of hyperandrogenism (acne, hirsuitism, elevated testosterone levels), polycystic ovaries, obesity, glucose intolerance

-Treatment may include clomifene in women who are trying to get pregnant, contraceptive pills to induce regular periods, and/or metformin to induce ovulation, control blood sugar, and reduce circulating androgen levels.

27
Q

what is endometriosis?

A

Growth of endometrium outside of uterus.
-Increased risk in nulliparous women >30 yrs of age.
-Benign dse, but tends to infiltrate & spread to adjacent tissues.
-Major complication of fertility.

28
Q

endometriosis etiology

A

Backflow of menstrual fluid through uterine tubes

29
Q

endometriosis pathogenesis

A

-Endometrial tissue outside uterus responds to hormones causing build up, scarring & further growth.
-Bleeding results in inflammation & pain in tissues, dysmenorrhea, dyspareunia.
-Repeated irritation causes formation of dense tissue adhesions

30
Q

cervix cancer etiology

A

-HPV (16,18)
-Herpesvirus type 2
-Other STI´s

31
Q

who is at risk for cervix cancer?

A

-Intercourse at young age
-Multiple sexual partners
-Multiple pregnancies

32
Q

how do you prevent cervix cancer?

A

HPV Vaccine
-11-12yrs (as young as 9)
-Recommended 13-26yrs females who have not received or completed vaccine series
-Ideally, vaccination before onset of sexual activity

33
Q

cervix cancer CM (pre-invasive & early invasive)

A

Pre
-Asymptomatic; changes in cells

Early
Abnormal vaginal bleeding & DC
Pain & bleeding after intercourse
-May spread to vaginal wall, pelvis, bladder, rectum & pelvic lymph nodes

-5yr survival rate stage 1-93%
-5yr survival rate stage 4-15%

34
Q

endometrial cancer diagnosis? treatment?

A

Diagnosis
No screening tests
Histologic tissue examination

Treatment
Radiation therapy
Total hysterectomy with removal of ovaries & oviducts
5yr survival rate with early diagnosis: 96%
5yr survival rate to 17% if CA

35
Q

what is ovarian cancer? CM?

A

Cancer on ovaries
-Leading cause of death from genital cancer
-Peak incidence 60-80yrs
-High mortality rate
-45% long-term survival rate

Clinical manifestations
-None until late in disease
-Increased abdominal girth
-Weight loss
-Abdominal pain
-Dysuria or urinary frequency
-Constipation

36
Q

what is vaginal cancer? CM?

A

-Most over 60 at time of Dx
-Women whose mothers took diethylstilbestrol (DES) during pregnancy
-Possible metastasis to bladder, rectum, vulva, pubic bone, other surrounding structures

Clinical manifestations
-Vaginal spotting & DC
-Pain, groin masses
-Changes in urinary pattern

37
Q

what is vulvar cancer? CM?

A

Cancer that occurs on the outside of genitalia

-5% all gynecologic malignancies
-Occurs any age, peak in mid-60s

Predisposing factors
-STDs
-Chronic vulvar pruritus with swelling & dryness
-Obesity, HTN, DM
-Never being pregnant

Clinical manifestations
-Leukoplakic changes (whitish plaque-like or ulcerated lesions) in vulva
-Abnormal urination & defecation

38
Q

what is pregnancy-induced hypertension?

A

-Also known as toxemia or preeclampsia.
-0.5-10% all pregnancies
Rapid rise in BP & proteinuria.
-Characterized by Na+ & water retention.
-Leading cause of pregnancy-related death

39
Q

pregnancy-induced hypertension etiology

A

Poor nutrition, teenager, multiple fetuses, pre-existing conditions

40
Q

pregnancy-induced hypertension CM

A

wt gain, edema, decreased GFR, HTN, seizures

41
Q

what is hyperemesis gravidarum?

A

-Excessive vomiting during pregnancy.
-Occurs in 1 in 1000 pregnancies
-Severe vomiting, dehydration & electrolyte imbalance.
-Cause is thought to be large amts of chorionic gonadotropin by the placenta.
-Treat with IV fluids, supportive care

42
Q

what is placenta previa?

A

-Placenta is implanted abnormally over internal os.
-More common in multiple pregnancies.
-Occurs in 1 in 200 deliveries.
-Idiopathic
-Interrupts fetal oxygen supply.
-Treatment—C-section

43
Q

what is abruptio placenta? etiology?

A

-Premature separation of placenta—1% of deliveries.
-Decreased fetal oxygen supply & causes maternal hemorrhage.
-Etiologies: trauma, short umbilical cord, PIH.

44
Q

what is miscarriage?

A

-Expulsion of products of conception from uterus before period of fetal viability
-10%-20% of all pregnancies

45
Q

miscarriage etiology? CM?

A

Etiologies: Fetal abnormalities, faulty implantation, infections & trauma

Clinical manifestations: vaginal bleeding, abdominal cramping

46
Q

what is mammary duct ectasia?

A

chronic inflammatory process (mastitis)

47
Q

what is breast abscess?

A

common in persons predisposed to infxns such as DM or on steroid therapy

48
Q

what is fat necrosis?

A

death of tissue after trauma or injury

49
Q

what is fibrocystic breast disease?

A

Benign breast lesions, common in women 20-50yrs

50
Q

fibrocystic breast disease etiology

A

Hormonal changes, aging, high caffeine intake

51
Q

fibrocystic breast disease pathogenesis

A

Mammary tissue retains fluid & forms cysts during later half of menstrual cycle & resolves with menses.
-Inflammation d/t repeated filling of cyst causes fibrosis & blocks drainage of fluid.
-Tender, firm, regular in shape, mobile on palpation
-Not at increased risk for breast CA

52
Q

what is carcinoma of the breast?

A

-Most common CA in women 25-75yrs, affects 1 in 8 women.
-10% linked to mutations of BRCA1 or BRCA2 gene.
-Hormone dependent; early menarche
-Invasive & noninvasive

53
Q

carcinoma of the breast pathogenesis?

A

-Arises in epithelium of glandular ducts of breast
-Malignant cells disseminate into lymph system of axilla
-Metastases to other sites: liver, lung, bone, brain, lymph nodes
-5-year survival rate 98% with no lymph involvement & 23% with metastasis
-More positive lymph nodes, less favorable the prognosis

54
Q

carcinoma of the breast CM

A

-Painless, hard, poorly mobile lump
-Dimpling of skin
-Nipple retraction
-Changes in breast contour
-Bloody d/c from nipple

55
Q

carcinoma of the breast treatment

A

Depends on extent of spread
-Lumpectomy: Removal of lump
-Mastectomy: Removal of breast
-Modified radical mastectomy: Removal of breast with portion of axillary lymphatic system dissected
-Radical mastectomy (rare): Removal of breast, lymphatic drainage, & pectoral muscles
-Chemotherapy
-Radiation therapy
-Supportive measures
Education
Follow-up care

Study decks (9 decks)

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