Repro Flashcards
1
Q
Male reproductive system embryo
A
mesoderm
2
Q
Female reproductive system embryo
A
mesoderm, week 7 and 8
3
Q
What structures develop from surface ectoderm?
A
epidermis, adenohypophysos, lens of eye, epithelial linings of oral cavity, sensory organs of ear, olfactory epithelium, anal canal below the pectinate line, parotid, sweat, mammary gland
4
Q
Breast embryo
A
first week of development from cytotrophoblast
5
Q
What structures develop from surface ectoderm?
A
epidermis, adenohypophysos, lens of eye, epithelial linings of oral cavity, sensory organs of ear, olfactory epithelium, anal canal below the pectinate line, parotid, sweat, mammary gland
6
Q
What structures develop from neural tube (ectoderm)?
A
brain, neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, ependymal cells, pineal gland, retina, spinal cord
7
Q
What structures develop from neural crest cells (ectoderm)?
A
ELMO PASSES
Enterochromaffin cells, leptomeninges (arachnoid, pia), melanocytes, odontoblasts, PNS ganglia (dorsal root, cranial, and autonomic), adrenal medulla, Schwann cells, Spiral membrane (aorticopulmonary septum), Endocardial cushions, Skull bone
8
Q
What structures develop from mesoderm?
A
muscle, bone, connective tissue, peritoneum, pericardium, pleura, spleen, cardiovascular structures, lymphatics, blood, wall of gut tube, proximal vagina, kidneys, adrenal cortex, dermis, testes, ovaries, microglia, dura mater, tracheal cartilage
9
Q
What structure develop from endoderm?
A
gut tube epithelium, most of urethra and distal vagina, lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular and parafollicular cells
10
Q
Male reproductive system gross anatomy
A
Internal: ductus deferens, seminal vesicle, ejaculatory duct, prostate
External: testes, glans penis,
11
Q
Female reproductive system gross anatomy
A
External: labia, clitoris, vaginal opening
Internal: ovaries, uterine tubes, uterus, broad ligament, and vagina
12
Q
Mammary gland structure
A
lobes (12-20) -> lobules -> alveoli -> mammary secretory epithelial cells
Lactiferous ducts: connect all lobes, open into areola to drain milk
Stroma: adipose + fibrous connective tissue (turns into suspensory ligaments of Cooper attach mammary glands to dermis) situated necks to lobes
13
Q
Breast Structure microanatomy
A
lobes (12-20) -> lobules -> alveoli -> mammary secretory epithelial cells
Lactiferous ducts: connect all lobes, open into areola to drain milk
Stroma: adipose + fibrous connective tissue (turns into suspensory ligaments of Cooper attach mammary glands to dermis) situated necks to lobes
14
Q
Areola structure
A
4th intercostal space lateral to midclavicular line
sebaceous glands
get bigger in pregnancy
secrete oily substances
15
Q
Nipple
A
conical in center or areola
no fat, hair, or sweat glands
lactiferous ducts open right into it
made up of circularly arranged smooth muscle fibers
16
Q
Breast blood supply and innervation
A
A: medial mammary branches, lateral thoracic, thoraocarmial, posterior intercostal
V: axillary and internal thoracic
N: anterior and lateral cutaneous branches of 4-6th intercostal
17
Q
Ovaries
A
lateral pelvic wall attached by mesovarium and suspensory ligament
produce oocytes, estrogen, and progesterone
Blood: ovarian and ascending branch of uterine
N: ovarian plexus and uterovaginal plexus
18
Q
Fallopian tube structure, blood, nerve
A
infundibulum -> ampulla -> isthmus
Blood: ovarian and ascending branch of uterine
N: ovarian plexus and uterovaginal plexus
19
Q
Uterus
A
body, cervix, external os, internal os, uterine cavity, cervical canal
bw bladder and rectum
B: Uterine arteries
N: Inferior hypogastric plexus
20
Q
Gametogenesis
A
- condensation of chromatin strand into visible pairs of chromosomes, cells are duplicated
- maternal and paternal copy of the same chromosome finds each other inside the nucleus
- attach to each other near the telomere region, cluster to one side of nucleus, genetic material is exchanged
- recombination of the four chromatids
- dissolution of the synaptonemal complexes
- remain dormant until puberty
- spindle microtubules attach to homologous pairs of chromosomes and align them along the equator of the spindles
- separated towards opposite poles
- Cytoplasmic division in females occurs asymmetrically and produces a small polar body and a much larger primary oocyte. In males, the cell division is incomplete and spermatocytes retain a cytoplasmic bridge.
- sister chromatids are aligned with the centromeres, they are separated along the spindle fibers to the opposite poles of the cell, four genetically unique haploid cells are produced
21
Q
Implantation
A
oocyte is fertilized by sperm, cells divide and turn into blastocyst -> travels down fallopian tube and floats around uterus -> implants
low ratio of estrogen to progesterone allow for this
22
Q
Embryogenesis
A
blastocyst get implanted day 5 -> divide into trophoblast and blastocyst -> trophoblast secrete hCG on day 8 which tells corpus luteum to continue to make estrogen and progesterone-> corpus leutm degrades at 13 weeks and syncytiotrophoblast make progesterone, estriol, human placental lactogen -> 2 weeks blastocyst start to organize into two-layered disc of embryonic cells (epiblast and hypoblast outer layer), amniotic cavity opens between it and trophoblast, hypoblast form yolk sac -> 3 weeks cells divide into 3 layers and become multipotent via gastrulation and forming an privative streak -> create endoderm, mesoderm, ectoderm
23
Q
testes
A
Lobules, septa, mediastinum of testis, seminiferous tubules (convoluted/straight), rete testis, efferent ductules.
tunica albuginea → lobes → seminiferous tubules and Leydig cells → germinal epithelium → Sertoli cells
Tunica vaginalis
N: Testicular plexus
B: Testicular artery
24
Q
prostate
A
true internal connective tissue capsule -> a false external capsule-> peripheral and anterior zone -> central zone -> transitional zone
B: internal pudendal artery, inferior vesical artery, middle rectal arteries.
N: pelvic splanchnic nerves
25
glans penis
Root (bulb of penis, crura, ischiocavernosus muscles, bulbospongiosus muscle)
Body (distal parts of corpora cavernosa and corpus spongiosum)
Glans (neck and corona of glans)
Tunica albuginea, deep fascia of penis (Buck’s fascia) and superficial fascia/subcutaneous tissue of penis (Colles’ fascia)
26
glans penis
Root (bulb of penis, crura, ischiocavernosus muscles, bulbospongiosus muscle)
Body (distal parts of corpora cavernosa and corpus spongiosum)
Glans (neck and corona of glans)
Tunica albuginea, deep fascia of penis (Buck’s fascia) and superficial fascia/subcutaneous tissue of penis (Colles’ fascia)
B: internal pudendal artery
N: cavernosal nerves
27
epididymis
Formed by efferent ductules from testis → join together in head and body → become single duct in tail → continues as ductus deferens
B: testicular arteries
N: testicular plexus
28
Ectocervix microanatomy
stratified squamous epithelium, non-keratinized
29
Transformation zone microanatomy
squamocolumnar junction
30
Endocervix microanatomy
simple columnar epithelium
31
Uterus cell layer type
simple columnar epithelium w/ long tubular glands in proliferative phase and coiled glands in secretory phase
32
Fallopian tube microanatomy
simple columnar epithelium, ciliated
33
Ovary outer surface microanatomy
simple cuboidal epithelium, germinal epithelium covering surface of ovary
34
What is the pathway of sperm during ejaculation?
```
SEVEn UP
seminiferous tubules
epididymis
vas deferens
ejaculatory ducts
```
urethra
penis
35
Ovary microanatomy
thin capsule of simple cuboidal epithelium
tunica albuginea dense layer of connective tissue
cortex: oocytes (round cell, large nucleus surrounded by zona pellucida (glycoprotein) and follicular cells) and ovarian follicles (single layer of cuboidal granulosa cells, theca cells), highly cellular connective tissue
medulla: losse fibroelastic connective tisse, blood vessels, lymphatic vessels
36
Leydig cells
interstitium, endocrine cells, seminiferous tubules
F: secrete testosterone in presence of LH, testosterone production unaffected by temp
37
Menstrual cycle
first 10 days theca cells bind LH and granulosa cells bind FSH → androstenedione and aromatase → aromatase converts androstenedione to 17beta-estradiol → day 10-14 granulosa cells develop LH receptors → follicles grow and ↑estrogen → negative feedback on anterior pituitary → some follicles will stop growing and die off → follicle w/ most FSH receptors becomes dominant → secretes estrogen → pituitary is more responsive to GnRH → ↑ estrogen leads to ↑↑↑FSH ↑↑↑LH → release of oocyte → endometrial lining is shed last for 5 days → ↑ estrogen during day 11-15 thickens endometrium, growth of endometrial glands, spiral arteries grow, and change cervical mucus to allow for sperm → corpus luteum is formed from dominant follicle → theca cell secrete androstenedione →granulosa cells convert it to estrogen, secrete P450scc due to ↓LH and inhibin → ↑ progesterone & inhibin → ↓LH ↓FSH ↓estrogen → endometrium receptive to implantation, spiral ateries longer, uterine gland more mucus → day 15 corpus luteum turn into corpus albicans → ↓estrogen & progesterone → spiral arteries collapse and functional layer sloughs off → mensuration
38
Spermiogenesis
seminiferous tubules
synthesis of BMP8B
spermatogonia (large round nuclei, round) →primary spermatocytes (large nuclei, big cytoplasm, clumps of chromatin) → secondary spermatocytes (divide quickly) → two haploid/early spermatids (small size, round nuclei)→ late spermatids z9small pointed nuclei) → spermatozoa
39
Oogenesis
outer layer of ovary
oogonium → mitosis → primary oocyte → at puberty LH/FSH cause development of a number of follicles → primary oocyte finishing first meiotic division → secondary oocyte → at ovulation it is released to uterus
40
Ovulation
14 days before the next mensural cycle
41
Physiological changes in cardio in pregnancy
↓SVR and ↑ blood volume → ↑SV→ ↑CO→↑ placental prefusion
| hemodilution → ↓oncotic pressure → peripheral edema
42
Estrogen composition
ovaries, adrenal cortex, placenta, and fat cells
43
Physiological changes in GI in pregnancy
↓GI motility, ↓ LES tone, gallbladder stasis, constipation, GERD, gallstones
44
Estrogen regulation
FSH/LH, GnRH
45
Physiological changes in Respiratory system in pregnancy
respiratory center stimulation → chronic hyperventilation → mild respiratory alkalosis
46
Estrogen composition
ovaries, adrenal cortex, placenta, and fat cells
cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 17-hydroxypregenolone → dehydroepiandrosterone → 3beta-hydroxysteroid dehydrogenase converts it into androstenedione → goes to theca cells → aromatase converts to 17beta-estradiol
47
Physiological changes in Renal in pregnancy
vasodilation → ↑renal plasma flow → ↑GFR→ ↓BUN and ↓creatinine
mild glucosuria, proteinuria, hydronephrosis, hydroureter, pyelonephritis
48
Progesterone composition/formation
cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone
49
Estrogen transport
sex-hormone binding globulin
50
Progesterone composition
cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone
cholesterol in granulosa cells → pregnenolone via P450scc → progesterone via 3beta-hydroxysteroid dehydrogenase
51
Progesterone transport
transcortin, albumin
52
Estrogen composition/synthesis
ovaries, adrenal cortex, placenta, and fat cells
cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 17-hydroxypregenolone → dehydroepiandrosterone → 3beta-hydroxysteroid dehydrogenase converts it into androstenedione → goes to theca cells → aromatase converts to 17beta-estradiol
53
Estrogen function/effect
make ovarian follicles develop and secrete hormones, thicken endometrium and sprout progesterone receptors,
maturation of fallopian tubes, uterus, cervix, vagina, breast, widening of hips, fat on buttocks, hips & thighs, makes blood vessel walls flexible, sustain bone density, lower LDL, ↑osteoblasts, ↑ clotting factors, ↑steroid-binging protein, ↑ acidification and provides food source for lactobacilli
54
Estrogen regulation
FSH/LH, GnRH
55
Progesterone function/effect
maturation of fallopian tubes, uterus, cervix, vagina; skin elasticity, bone strength
56
Progesterone composition/synthesis
cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone
cholesterol in granulosa cells → pregnenolone via P450scc → progesterone via 3beta-hydroxysteroid dehydrogenase
57
Progesterone transport
transcortin, albumin
58
Progesterone function/effect
maturation of fallopian tubes, uterus, cervix, vagina; skin elasticity, ↑lobular development ↓ milk production ↓endometrial growth, ↑endometrial secretion, mucosal secretion become thicken, ↑ total cholesterol, ↑LDL, ↑ Na excretion, ↑ internal temp, ↑ bone growth and strength
59
Progesterone regulation
FSH/LH, GnRH
60
Testosterone composition/synthesis
Leydig cells and some in adrenal cortex
cholesterol → dehydroepiandrosterone (DHEA) →androstenedione → testosterone via 17beta-hydroxysteroid dehydrogenase → dihydrotestosterone via 5 alpha-reductase has effects on cell
61
Testosterone function/effect
enlargement of penis & testes, increased libido, male pattern of hair growth, changes to larynx and vocal folds, growth spurt, closer of plate in puberty, broad shoulders, muscular arms and legs, erythropoiesis
62
Testosterone transport
Sex-hormone binding globulin, albumin
63
Testosterone regulation
GnRH, LH/FSH
64
Estrogen degradation
liver
estradiol → estrone → hydrocylation via CYP1A1 enzymes → 2-OHE2
CYP1B1→ 4-OHE2
CYP3A4→ 16a-OHE2
65
Progesterone degradation
liver
66
Testosterone degradation
metabolized to inactive metabolites in the liver, kidney, gut, muscle, and adipose tissue.
67
Amenorrhea def
absence of mentation in those w/ a uterus
primary: >15 hasn't had menarche and has secondary sexual characteristic or >13 w/ no menarche or secondary sexual characteristics
secondary: stop having regular cycles for 3 month or 6 mon in those w/ irregular periods
68
Amenorrhea cause
turner syndrome, Mullerian agenesis, imperforate hymen, pregnancy, mesopause, breastfeeding, functional hypothalamic amenorrhea, hyperprolactinemia, PCOS, premature ovarian failure, Cushing syndrome, Hypo or Hyperthyroid
69
Amenorrhea RF
FH, eating disorder, over-exercising, genetics, obesity
70
Amenorrhea comp
hip and wrist fractures, cardiovascular disease,
71
Amenorrhea clinical
loss of period
72
Anovulation comp
```
Endometrial hyperplasia
Insulin resistance or type 2 diabetes mellitus
Cardiovascular disease
Venous thromboembolism
Electrolyte derangements
Arrhythmias
```
73
Anovulation clinical
irregular periods, lack of periods, lighter or heavier mensural bleeding, infertility
74
Dysfunctional Uterine Bleeding def
uterine bleeding has changed w/ time and absent ovulation
75
Dysfunctional Uterine Bleeding cause
menopause, imbalance in the sex hormone
76
Dysfunctional Uterine Bleeding path
estrogen continually secreted→ never turns into follicle →progesterone isn't produced → uterine lining keep growing annd gets sloughed off at irregular intervals →
77
Dysfunctional Uterine Bleeding comp
endometrial hyperplasia and cancer
78
Dysfunctional Uterine Bleeding clinical
painless uterine bleeding, Menstrual bleeding lasting more than 7 days, Menstrual bleeding lasting less than 2 days, Heavy menstrual bleeding, Bleeding or spotting between periods
79
Menopause/
| Perimenopause def
entire year has passed since last menstrual period
80
Dysfunctional Uterine Bleeding path
estrogen continually secreted→ never turns into follicle →progesterone isn't produced → uterine lining keep growing annd gets sloughed off at irregular intervals →
81
Menopause/
| Perimenopause RF
female, old age,
82
Menopause/
| Perimenopause comp
fracture, cardiovascular disease,
83
Menopause/
| Perimenopause clinical
hot flashes, night sweats, trouble sleeping, vaginal dryness, dyspareunia, osteoporosis, high LDL
84
Ovarian Insufficiency/
| Failure def
ovaries stop functioning normally before 40
85
Ovarian Insufficiency/
| Failure cause
chromosomal abnormalities (Turner syndrome), BRCA1, fragile X syndrome, chemo/radiation, autoimmune
86
Ovarian Insufficiency/
| Failure path
few or no follicles → started out w/ few or degraded quickly → can't respond to LH/FSH
OR
dysfunctional follicles → can't generate gonadotropins, don't respond to LH/FSH, or can't make hormone → can't respond to LH/FSH
87
Ovarian Insufficiency/
| Failure RF
FH, 35-40, folx w/ uterus, genetics
88
Ovarian Insufficiency/
| Failure comp
cardiovascular disease, fractures
89
Ovarian Insufficiency/
| Failure clinical
missed/infrequent periods, infertility/difficulty, hot flashes, night sweats, vaginal dryness, dyspareunia, osteoporosis, spontaneous pregnancy due to intermittent ovarian function
90
Balanitis def
Inflammation of the glans penis
91
Ovarian Insufficiency/
| Failure path
few or no follicles → started out w/ few or degraded quickly → can't respond to LH/FSH
OR
dysfunctional follicles → can't generate gonadotropins, don't respond to LH/FSH, or can't make hormone → can't respond to LH/FSH
92
Balanitis comp
May cause Infection (STIs, fungal.candida, viral), trauma, irritants
93
Balanitis cause
inadequate personal hygiene, Candida albicans, Group B and group A beta-hemolytic streptococci, Neisseria gonorrhea, Chlamydia species, chemicals, tetracycline, sulfonamide
94
Balanitis path
oor hygiene, a tight foreskin, and a buildup of smegma serve as a nidus for bacterial and fungal overgrowth which can lead to irritation and inflammation
95
Balanitis RF
Uncircumcised males, obesity, diabetes, nursing home, condom catheters, CHF, nephrosis, reactive arthritis, STI
96
Balanitis comp
May cause Infection (STIs, fungal.candida, viral), trauma, irritants
97
Balanitis clinical
Inflammation, soreness, itchiness, or irritation of the glans, A thick cheesy white discharge under the foreskin (smegma), smell, Tight foreskin cannot retract, Painful urination, Swollen glands near the penis, Sores
98
Cervicitis def
swelling or inflamed tissue of the end of the uterus (cervix)
99
Cervicitis cause
Neisseria gonorrhea, Chlamydia trachomatis, mechanical, and chemical irritants
100
Cervicitis RF
sexually active, don't use condom
101
Cervicitis comp
pelvic inflammatory disease, abscess formation, chronic pain and infection, ectopic pregnancy, and infertility
102
Cervicitis clinical
purulent or mucopurulent vaginal discharge and intermenstrual or post-coital bleeding, dyspareunia
103
Cervicitis path
infectious or noninfectious agent sets up shop in the uterus → immune system recognize antigen → causes inflammation and destruction of the area
104
Endometriosis def
when endometrial cells grow outside of the uterus
105
Endometriosis path
endometrial cells travel to ovaries, fallopian tubes, uterine ligament via blood caring endometrial cells goes into fallopian tubes →implants or exist via opening in fallopian tube → immune system don't responds to endometrial implants
106
Endometriosis RF
FH, never been pregnant, early menarche, late menopause
107
Endometriosis comp
adhesions, rupture, ovarian carcinomas
108
Endometriosis cause
retrograde mensuration theory, dysfunction w/ immune system, metaplastic theory, benign metastases theory, extrauterine stem cell theory
109
Endometriosis path
endometrial cells travel to ovaries, fallopian tubes, uterine ligament via blood caring endometrial cells goes into fallopian tubes →implants or exist via opening in fallopian tube→ immune system don't responds to endometrial implants
110
Endometritis cause
Peptostreptococcus, Peptococcus, Bacteroides, Prevotella, Clostridium, groups A and B Streptococci, Enterococcus, Staphylococcus, Klebsiella pneumoniae, Proteus species, and Escherichia coli
111
Endometritis cause
Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, tuberculosis
112
Endometritis RF
pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,
113
Endometritis comp
endomyometritis, peritonitis, salpingitis, oophoritis, Asherman's syndrome (fibrous band, don't respond to hormone, infertility, recurring pregnancy loss)
114
Endometritis cause
Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, tuberculosis
115
Endometritis path
infectious cause get into the endometrium causing inflammation when they reach upper genital tract
childbirth mucus plug breaks allowing bacteria to enter
116
Endometritis RF
pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,
117
Orchitis cause
viral mumps infection, coxsackie B virus, E. coli
118
Orchitis path
mumps virus spreads to the testis → replicates and causes inflammation
119
Orchitis RF
Sexually active
120
Orchitis comp
atrophy, infertility, reactive hydrocele
121
Orchitis path
mumps virus spreads to the testis → replicates and causes inflammation
122
Pelvic Inflammatory Disease def
infection of upper female reproductive system
123
Pelvic Inflammatory Disease cause
Neisseria gonorrhoeae, Chlamydia trachomatis,
124
Pelvic Inflammatory Disease path
decreased mucus or inability to overcome bacteria w/ mucus, retrograde menstruation, sexual intercourse cause bacteria to get into upper tract → neutrophils, plasma cells, and lymphocytes → damage tubal epithelium → fill with pus → scar tissue is repaired and area w/ damage stick together forming pouches
125
Pelvic Inflammatory Disease comp
infertility, tubo-ovarian abscess, hydrosalpinx, ectopic pregnancy, chronic pelvic pain, Fitz-Hugh Curtis syndrome (inflammation expends into peritoneum and Glisson's capsule→ adhesions liver to peritoneum)
126
Pelvic Inflammatory Disease cause
Neisseria gonorrhoeae, Chlamydia trachomatis, 30% polymicrobial, vagina or cervix
127
Pelvic Inflammatory Disease RF
sexually active, multiple partners, don't use condoms
128
Pelvic Inflammatory Disease clinical
no symptoms or pelvic pain, tenderness around the ovaries & fallopian tubes, fever, abnormal vaginal discharge
129
Pelvic Inflammatory Disease comp
infertility, tubo-ovarian abscess, hydrosalpinx, ectopic pregnancy, chronic pelvic pain, Fitz-Hugh Curtis syndrome (inflammation expends into peritoneum and Glisson's capsule→ adhesions liver to peritoneum, RUQ tenderness)
130
Pelvic Inflammatory Disease clinical
no symptoms or pelvic pain, tenderness around the ovaries & fallopian tubes, fever, abnormal vaginal discharge, cervical motion tenderness
131
Salpingitis def
Inflammation of the fallopian tubes caused by bacterial infection
132
Salpingitis cause
Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae,
133
Salpingitis path
bacteria in the fallopian tube cause immune system to create damage and inflammation
134
Salpingitis RF
sexually active, multiple partners, no condoms, pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,
135
Salpingitis comp
tubal scarring, adhesions, blockages, ectopic pregnancy's, infertility
136
Salpingitis clinical
acute: unusual vaginal discharge, abdominal, pelvic, or low back pain, pain during menstruation, ovulation, or sex
chronic: mild or no symptoms
137
Vaginitis (candidal) def
inflammation or infection of the vagina
138
Vaginitis (candidal) cause
Candida albicans
139
Vaginitis (candidal) path
reduction or change of normal vaginal flora → candida can grow
140
Vaginitis (candidal) RF
DM, recent antibiotic use, immunosuppression, high estrogen levels
141
Vaginitis (candidal) comp
septic shock
142
Vaginitis (candidal) clinical
```
intense itching
thick white odorless vaginal discharge
vulvar burning
dyspareunia
dysuria
```
143
Bacterial vaginosis (BV) comp
salpingitis and/or endometritis, postsurgical infections, and adverse outcomes in pregnancy, mixed infection
144
Bacterial vaginosis (BV) clinical
discharge thin/homogenous/off white/foul smell,
145
Bacterial vaginosis (BV) path
number of lactobacilli decrease→ ↑pH→ bacterial vaginosis can can proliferate
146
Cryptorchidism def
incomplete/partial descent of testis into scrotal sac
147
Cryptorchidism path
mispositioned testis found in inguinal can
148
Cryptorchidism RF
prematurity, low birth weight, twining, 1st trimester maternal exposure to estrogen, FH, genetic syndromes, disorders of sexual development
149
Cryptorchidism comp
testicular atrophy, infertility, dysfunction, trauma, testicular torsion, germ-cell tumors,
150
Cryptorchidism clinical
asymptomatic, testes absent from scrotal sac
151
Epispadias def
dorsal urethral opening
152
Epispadias cause
hormones, genetics
153
Epispadias path
genital tubercle grows in posterior direction instead of cranial direction
154
Epispadias RF
FH, hormonal disturbances, low androgens, maternal age >35, maternal exposure to environmental toxins
155
Epispadias comp
urinary tract obstruction, UTI, infertility, psychosocial problems
156
Epispadias clinical
difficulty urinating/incontinence
157
Hypospadias def
ventral urethral opening
158
Hypospadias cause
hormones, genetics
159
Hypospadias path
urethral folds along penile urethra do not close properly -> abnormal opening along penile shafts ventral surface
160
Hypospadias RF
FH, hormonal disturbances, low androgens, maternal age >35, maternal exposure to environmental toxins
161
Hypospadias com
urinary tract obstruction, UTI, infertility, psychosocial problems
162
Hypospadias clinical
difficulty urinating/incontinence
163
Fragile X syndrome cause
X-linked Dominant, FMR1
164
Fragile X syndrome def
genetic condition due to changes to FMR1
165
Fragile X syndrome cause
X-linked Dominant, FMR1
166
Fragile X syndrome path
increased number of CGG repeats caused by slipped mispairing, promoter is locked into off
167
Fragile X syndrome RF
FH, genetics,
168
Fragile X syndrome clinical
intellectual disability, delayed speech, delayed motor development, autism, ADHD, seizures, long/narrow face, prominent jaw & forehead, large ears that stick out, males large testes
169
Imperforate Hymen def
the hymen remains intact during development
170
Imperforate Hymen path
hymen central epithelial cells fail to degenerate during fetal development→ during puberty menstrual blood accumulates
171
Imperforate Hymen comp
retrograde menstruation and endometriosis, and/or fertility complications
172
Imperforate Hymen clinical
bulging/bluish hymenal membrane, recurrent menstrual cramps and abdominal or pelvic pain
173
Klinefelter syndrome def
chromosomal male inherits one or more X chromosomes
174
Klinefelter syndrome cause
extra X chromosome
175
Klinefelter syndrome path
sperm or egg contains extra x chromosome → meiosis I or meiosis II they don't sperate→ 2 X in one gamete → ↓Sertoli and Leydig cell function→ ↓testosterone and inhibin→ ↓sperm production, testes maturation, secondary sex characteristics
176
Klinefelter syndrome RF
FH,
177
Klinefelter syndrome path
sperm or egg contains extra x chromosome → meiosis I or meiosis II they don't sperate→ 2 X in one gamete → ↓Sertoli and Leydig cell function→ ↓testosterone and inhibin→ ↓sperm production, testes maturation, secondary sex characteristics
178
Klinefelter syndrome clinical
hypogonadism, sterile, tall, long legs, short torso, broad hips, gynecomastia, less muscle mass, less facial & body hair, weaker bones, fatigue
179
Paraphimosis def
foreskin becomes trapped behind the corona and forms tight band of constricting tissue
180
Paraphimosis path
foreskin becomes trapped behind the corona and forms tight band of constricting tissue
181
Paraphimosis RF
uncircumcised males
182
Paraphimosis comp
pain, infection, and inflammation of the glans penis
183
Paraphimosis clinical
erythema, pain, and swelling of foreskin and glans
184
Phimosis def
inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis
185
Phimosis cause
Physiologic phimosis: born with tight foreskin at birth and loosens over time
scarring, infection or inflammation, balanitis xerotica obliterans
186
Phimosis path
prepuce fits tightly → oily secretion accumulate in preputial sac → build up and irritate skin
187
Phimosis RF
```
Being uncircumcised.
Diabetes.
Frequent diaper rash as an infant.
Poor hygiene.
Young age.
```
188
Phimosis path
prepuce fits tightly → oily secretion accumulate in preputial sac → build up and irritate skin
189
Phimosis clinical
erythema, itching, discharge, or pain with sexual intercourse.
190
Pseudohermaphroditism def
person whose gonads are consistent with the chromosomal sex but who has external genitalia of the opposite sex
191
Pseudohermaphroditism cause
Congenital adrenal hyperplasia, testosterone during pregnancy, mother ovarian tumors, Aromatase deficiency, gonadal dysgenesis, 5-alpha-reductase deficiency, androgen insensitivity syndrome,
192
Pseudohermaphroditism path
problems w/ testes, problems w/ hormone formation, problem using hormones,
193
Pseudohermaphroditism RF
exposure to hormones in utero, genetics, FH
194
Pseudohermaphroditism clinical
infertility, opposite genitalia
195
Septate Vagina and Uterus def
vagina and uterus are divided to create two of each
196
Septate Vagina and Uterus cause
genetics
197
Septate Vagina and Uterus path
problem in embryonic development
198
Septate Vagina and Uterus RF
premature birth, cesarean birth, fetal growth restriction, pre-labor rupture of membranes, placental abruption
199
Septate Vagina and Uterus comp
infection, obstruction
200
Septate Vagina and Uterus clinical
pain, abnormal vaginal bleeding
201
Turner syndrome def
chromosomal disorder affecting females where one X chromosome is completely or partially absence
202
Turner syndrome cause
45 X
203
Turner syndrome path
nondisjunction in sperm cells following meiosis I or II → egg combines w/ it
mosaicism → nondisjunction during mitosis → leading to mix of 45X and 46XX
→ ↓estrogen
204
Turner syndrome RF
genetic, random
205
Turner syndrome path
nondisjunction in sperm cells following meiosis I or II → egg combines w/ it
mosaicism → nondisjunction during mitosis → leading to mix of 45X and 46XX
→ ↓estrogen
206
Turner syndrome clinical
↑ loss of eggs, ovaries fail to form, preductal coarctation of aorta, bicuspid aortic valve, horseshoe kidney, lymphedema, neck webbing, cyanosis, and skeletal abnormalities, ↑ risk of DM II and hypothyroidism, low-set ears, broad chest, arms turn outward, widely spaced nipples, short stature, infertile, and amenorrhea
207
Erectile dysfunction def
inability to develop and maintain a full erection
208
Erectile dysfunction cause
stress, performance anxiety, depression, inadequate blood supply, HTN, atherosclerosis, DM, surgery, stoke, trauma, hypogonadism, meds (diuretics, antidepressants, methadone)
209
Erectile dysfunction path
low testosterone → low NO
210
Erectile dysfunction RF
mental health conditions, obesity, high fat diet, smoking, alcohol
211
Erectile dysfunction comp
psychosocial impacts
212
Erectile dysfunction clinical
not being able to maintain an erection
213
Hematocele def
hemorrhage into the tunica vaginalis space
214
Hematocele cause
traumatic or surgical injury or testis tumor
215
Hematocele RF
varicocele, Hydrocele
216
Hematocele comp
rupture
217
Hematocele clinical
a firm and painless scrotal mass
218
Hydrocele def
Accumulation of serous fluids between visceral and parietal layer of tunica vaginalis of testis
219
Hydrocele cause
Congenital:
Acquired: Orchitis, Wuchereia Bancrofti , trauma (hernia, torsion), tumor
220
Hydrocele path
processus vaginalis doesn't close
221
Hydrocele RF
premature babies, injury, STI
222
Hydrocele comp
May cause atrophy of testes due to compression, hematocele, calcification
223
Hydrocele clinical
Usually painless, may feel heaviness
May cause swelling of scrotum
soft, fluctuant, non-tender fullness in scrotum
224
Spermatocele def
cystic mass arising from a dilation of the epididymis, Rete testis, or efferent ductules
225
Spermatocele cause
trauma, infection, autoimmune
226
Spermatocele clinical
asymptomatic or pain
227
Varicocele def
abnormal enlargement of the pampiniform venous plexus in the scrotum
228
Varicocele cause
idiopathic, renal cell carcinoma
229
Varicocele path
impaired venous drainage → ↑venous pressure → vein dilation in left side → ↑flow of resistance from left testicular vein drainage into left renal vein
230
Varicocele comp
infertility, ↓sperm concnration, ↓sperm motility, other side can get affected
231
Varicocele path
impaired venous drainage → ↑venous pressure → vein dilation in left side → ↑flow of resistance from left testicular vein drainage into left renal vein
232
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) RF
20-40YO
233
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) clinical
Painful, changes with cycle
234
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) def
changes to breast tissue
235
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) path
acini, stomal fibrosis, calcifications
cells in terminal ductal/lobular epithelium, atypical cells
simple cysts, papillary apocrine changes or metaplasia, stromal fibrosis
236
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) comp
invasive carcinoma
237
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) comp
sclerosing adenosis inc risk of breast cancer
238
Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) clinical
bilateral breast pain, tenderness changes with cycle, multiple smooth well-defined mobile lumps usually upper outer quadrant
239
Galactocele path/cause
ecretory breast epithelium, prolactin stimulus, and ductal obstruction
Distal obstruction of the terminal duct lobular unit causes proximal focal ductal dilatation
240
Galactocele RF
Difficulty in breastfeeding, If breastfeeding is contraindicated and breastmilk is not emptied, oral-contraceptive pill
241
Galactocele comp
crystals
242
Galactocele sx
lump in her breast
solitary, non-tender, firm, discrete, and freely movable, may or may not be associated with a milky discharge from the nipple
243
Mammary Duct Ectasia def
benign (non-cancerous) breast condition that occurs when a milk duct in the breast widens and its walls thicken
244
Mammary Duct Ectasia path
inflammation & fibrosis cause blockage in subareloar ducts affected duct becomes dilated and tortuous, either due to breast involution or other factors, and accumulates granular debris with numerous lipid-laden macrophages.
245
Mammary Duct Ectasia RF
aging, nipple inversion, obesity, smoking
246
Mammary Duct Ectasia comp
obstruction, mastitis
247
Mammary Duct Ectasia sx
asymptomatic or nipple discharge ranging from thick to thin, serous, dirty white, yellow, or green and may fluctuate unilateral or palpable mass
248
Mastitis def
inflammation of breast tissue
249
Mastitis cause
Staphylococcus aureus, Streptococcus spp, milk stasis, vitamin A deficency
250
Mastitis path
bacteria from mouth of infant gains entry via cracks or fissure in the nipple -> inflammation and damage
251
Mastitis RF
cracked/damaged nipples, poor hygiene, ineffective breastfeeding technique, impaired immunity, diabetes, smoking
252
Mastitis comp
abscess formation
253
Mastitis sx
```
localized, firmness, redness, swelling, heat
palpable lump
breast pain
tender/enlarged axillary nodes
fever, malaise, myalgias
```
254
Traumatic Fat Necrosis def
inflammation of adipose tissue in breast leading to loss of oxygen supply
255
Traumatic Fat Necrosis cause
breast trauma, fine needle aspiration or biopsy, anticoagulation treatment, radiation, and breast infection
256
Traumatic Fat Necrosis path
area of fatty tissue gets damages → lipase releases fatty acids → form complex w/ calcium → saponification → more occurs → calcification →fibrosis via reactive inflammatory components
257
Traumatic Fat Necrosis RF
smoking, obesity, and older age, radiation, chemotherapy, and mastectomy
258
Traumatic Fat Necrosis comp
infection, need for multiple operations, and breast deformity, pain
259
Traumatic Fat Necrosis sx
feels like a firm, round lump or lumps, painless, fixed mass w/ possible skin or nipple retraction
260
Fibroadenoma def
benign tumors that arise from periductal stromal tissue
261
Fibroadenoma path
overgrowth of cellular & myxoid stroma surrounds & compresses epithelium-lined glandular & cystic spaces w/ age stroma become hyalinized, glandular epithelium atrophies
262
Fibroadenoma RF
premenopausal women
263
Fibroadenoma sx
asymptomatic
small, well-defined, spherical, painless, solitary, mobile breast mass
older women: mammographic density w/ possible calcification
can increase in size during luteal phase and lactation
264
Lobular Carcinoma def
a type of breast cancer that begins in the milk-producing glands (lobules) of the breast
265
Lobular Carcinoma cause
BRCA1 and BRCA2, genetic mutations occur in the DNA of breast duct cells
266
Lobular Carcinoma path
DNA damage and genetic mutations that can be influenced by exposure to estrogen
267
Lobular Carcinoma RF
advanced age, FH, ovarian cancer, estrogen exposure (mulliparity, late 1st pregnancy, early menarche, late menopause), alcohol, absence of breastfeeding, obesity, whites
268
Lobular Carcinoma comp
metastasis
269
Lobular Carcinoma sx
unilateral, firm, fibrous, rock-hard, palpable, sharp margins
advanced: skin dimpling, nipple retraction
270
Ductal Carcinoma def
invasive breast cancer arising terminal ductal lobular unit, most common type in males
271
Ductal Carcinoma cause
genetic mutations occur in the DNA of breast duct cells
272
Ductal Carcinoma path
DNA damage and genetic mutations that can be influenced by exposure to estrogen
273
Ductal Carcinoma RF
advanced age, FH, ovarian cancer, estrogen exposure (multiparty, late 1st pregnancy, early menarche, late menopause), alcohol, absence of breastfeeding, obesity, whites
274
Ductal Carcinoma comp
metastases to lymph nodes,
275
Ductal Carcinoma sx
bilateral w/ multiple lesions non-palpable
276
Paget disease of the breast def
ductal carcinoma extends into lactiferous ducts or nipple & areola
277
Paget disease of the breast sx
eczematous skin lesion or persistent dermatitis
278
Paget disease of the breast RF
female, 20-30, FH breast cancer,
279
Paget disease of the breast comp
breast cancer,
280
Paget disease of the breast sx
bloody/serous nipple discharge
breast feels full
eczematous skin lesion or persistent dermatitis
281
Benign Prostatic Hyperplasia def
increase in number of cells in the prostate gland
282
Benign Prostatic Hyperplasia cause
normal part of aging
283
Benign Prostatic Hyperplasia path
↑5 alpha-reductase w/ age → ↑dihydrotestosterone→ prostate cells live longer and multiple
284
Benign Prostatic Hyperplasia RF
males, older, >50
285
Benign Prostatic Hyperplasia comp
obstruction, bladder hypertrophy, bacterial infection, bladder stones, kidney damage, bladder damage
286
Benign Prostatic Hyperplasia sx
```
Urgency
Frequency
Nocturia
Involuntary urination
Urge incontinence
Urinary hesitancy
Weak stream
Straining
Leaking after end of urination
Dysuria possible
Hesitancy, weak stream, sensation of incomplete emptying, double voiding (within 2hrs), straining, post-void dribbling
DRE: Smooth (non-nodular), firm (rubbery), painless enlargement
```
287
Acute Bacterial Prostatitis def
inflammation of the prostate due to bacteria
288
Acute Bacterial Prostatitis cause
E. Coli, Klebsiella, proteus
289
Acute Bacterial Prostatitis path
infection causes prostate to enlarge and get damaged due to immune response
290
Acute Bacterial Prostatitis RF
Young men, BPH, epididymitis, orchitis, urethritis, sexually active, STI, immunocompromised, prostate manipulation, urethral stricture, phimosis
291
Acute Bacterial Prostatitis comp
Prostatic abscesses
292
Acute Bacterial Prostatitis sx
Sudden onset of fever, severe dysuria, myalgia, malaise
Irritative voiding sx or BOO (oliguria or anuria)
Hematuria, bacteriuria, pyuria
Acutely tender prostate on DRE
293
Chronic Bacterial Prostatitis def
Inflammation of the prostate gland that is caused by a bacterial infection and that continues or gets worse over a long period of time
294
Chronic Bacterial Prostatitis cause
Escherichia coli
295
Chronic Bacterial Prostatitis path
bacteria enters prostate causing infection
296
Chronic Bacterial Prostatitis RF
Intraprostatic ductal reflux and prostatic calculi
Other infections (eg, acute epididymitis, urinary tract infections)
Phimosis
Unprotected penetrative anal intercourse
Manipulation of the lower urinary tract
Secretory dysfunction of prostate gland
297
Chronic Bacterial Prostatitis comp
erectile dysfunction, prostate cancer
298
Chronic Bacterial Prostatitis sx
Fever, chills, pain, urgency, dysuria,
299
Ovarian Cysts def
fluid-filled growth that develops in/on ovary
300
Ovarian Cysts cause
functional: no LH surge, dysfunction in hypothalamic-pituitary-ovarian axis, corpus luteum doesn't dissolve, overstimulation of hCG
neoplastic:
301
Ovarian Cysts RF
early menarche, obesity, infertility, fertility treatments, PCOS, hypothyroidism, hyperandrogenism, tamoxifen use, smoking
302
Ovarian Cysts comp
rupture, hemorrhage, ovarian torsion
303
Ovarian Cysts sx
asymptomatic, pelvic pain/lower abdominal pressure sensation, dyspareunia,
304
Paraovarian Cysts def
fluid-filled sac found in the fallopian tubes near your ovaries.
305
Paraovarian Cysts path
remnants of paramesonephric (müllerian) or mesonephric (Wolffian) ducts that are present during urogenital embryologic development
306
Paraovarian Cysts comp
rupture, torsion, hemorrhage
307
Paraovarian Cysts sx
asymptomatic
| dull unilateral pelvic pain
308
Polycystic Ovary
| Syndrome (PCOS) def
a condition in which the ovaries produce an abnormal amount of androgens
309
Polycystic Ovary
| Syndrome (PCOS) cause
dysfunction in hypothalamic-pituitary-ovarian axis, insulin resistance,
310
Polycystic Ovary
| Syndrome (PCOS) path
insulin resistance → insulin causes theca cells to grow more LH receptors→ GnRH speeds up →anterior pituitary makes ↑LH → theca cells make ↑androstenedione → flows into blood → turned into estrone in adipose cells→ no LH surge to trigger dominant follicle to break free
311
Polycystic Ovary
| Syndrome (PCOS) RF
Oligoovulatory infertility, obesity, insulin resistance, DM, premature adrenarche, FH, anti-seizure meds,
312
Polycystic Ovary
| Syndrome (PCOS) comp
infertility, DM, metabolic syndrome, heart disease, and high blood pressure
313
Polycystic Ovary
| Syndrome (PCOS) sx
amenorrhea, acne, hirsutism, male-patterned baldness, oligomenorrhea, overweight, acanthosis nigricans
314
Tubo-Ovarian Cysts cause
pelvic inflammatory disease, Escherichia coli, Bacteroides fragilis, other Bacteroides species, Peptostreptococcus, Peptococcus, and aerobic streptococci
315
Tubo-Ovarian Cysts path
Bacteria from the lower genital tract ascend to create an inflammatory mass involving the fallopian tube, ovary, and potentially other adjacent pelvic organs
316
Tubo-Ovarian Cysts RF
multiple partners, sexually active, not using condoms, IUD insertion,
317
Tubo-Ovarian Cysts comp
rupture, sepsis,
318
Tubo-Ovarian Cysts sx
abdominal pain, pelvic mass on examination, fever, and leukocytosis, vaginal discharge, nausea, and abnormal vaginal bleeding
319
Choriocarcinoma def
Malignant, fast-growing tumor from trophoblastic cells
320
Choriocarcinoma def
Malignant, fast-growing tumor from trophoblastic cells from the placenta
321
Choriocarcinoma cause
miscarriage
ectopic pregnancy
abortion
322
Choriocarcinoma path
Overexpression of p53 and MDM2
| cytotrophoblastic cells function as stem cells and undergo malignant transformation (Placenta)
323
Choriocarcinoma Rf
maternal age extreme younger than 20 and older than 35, pervious, abortion or ectopic, molar pregnancy
324
Choriocarcinoma comp
profuse bleeding, hematogenous metastasis to lungs, brain, liver
325
Choriocarcinoma sx
abnormal uterine bleeding, unexplained amenorrhea, insomnia, anxiety, tachycardia, palpitations, theca lutein cyst, lower abdominal pain, high hCG
mets: coughing, dyspnea, hemoptysis, headache, dizziness, nausea, slurred speech, visual disturbances, neuropathy, hemiparesis
326
Hydatidiform Mole def
rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta
327
Hydatidiform Mole cause
an abnormally fertilized egg
328
Hydatidiform Mole path
error in normal fertilization
empty egg fuses w/ normal sperm
normal egg fuses w/ two sperm
329
Hydatidiform Mole RF
maternal age extreme younger than 20 and older than 35, previous molar pregnancy
330
Hydatidiform Mole comp
infection, shock, preeclampsia, sepsis
331
Hydatidiform Mole sx
complete: ↑hCG, missed periods, positive pregnancy test, vaginal bleeding, insomnia, anxiety, tachycardia, palpitations, N/V, dehydration, pain or pressure on affect side w/ theca lutein cyst, uterus larger than expected age
incomplete: uterus is not larger than expected, missed periods, vaginal bleeding
332
Invasive Mole def
penetration of molar tissue (complete or partial mole) into myometrium or uterine vasculature, Edematous villus and proliferative trophoblasts invade myometrium
333
Invasive Mole cause
evacuation of a molar pregnancy
334
Invasive Mole RF
complete mole pregnancy, prior molar pregnancy, advanced maternal age (>40 years), and Asian and American Indian ancestry
335
Preeclampsia def
develops after a molar pregnancy and is characterized by the presence of edematous chorionic villi with trophoblastic proliferation invading the myometrium
336
Invasive Mole sx
abnormal uterine bleeding, unexplained amenorrhea, insomnia, anxiety, tachycardia, palpitations, theca lutein cyst, lower abdominal pain, high hCG
337
Preeclampsia def
new onset of hypertension (>140/>90) after 20 weeks gestation-6 weeks after delivery
338
Preeclampsia path
abnormal placenta→ spiral arteries become fibrous →narrow → less blood → placenta releases pro-inflammatory proteins → cause endothelial cells that line blood vessels to become dysfunctional → vasoconstriction and retain Na → local vasospasm → decreased blood flow to organs
339
Preeclampsia Rf
first pregnancy, multiple gestations, mother >35, HTN, diabetes, obesity, FH
340
Preeclampsia comp
stroke, placental abruption, emboli, eclampsia
341
Preeclampsia sx
oliguria, proteinuria, blurred vision, flashings lights, scotoma, elevation in liver enzymes, RUQ pain, edema, cough, SOB, headaches, confusion, seizures
HELP (hemolysis, elevated liver enzymes, low platelets)
342
Bartholin Cysts def
a small fluid-filled sac just inside the opening of the Bartholin glands on vulva
343
Bartholin Cysts path/cause
Sometimes the openings of these glands become obstructed, causing fluid to back up into the gland
344
Bartholin Cysts RF
sexually active, 20-30, infection, injury or surgery, STI
345
Bartholin Cysts comp
infection, abscess
346
Bartholin Cysts sx
asymptomatic, soft, painless lump, pain if large
347
Cystocele vagina def
a condition in which supportive tissues around the bladder and vaginal wall weaken and stretch, allowing the bladder and vaginal wall to fall into the vaginal canal
348
Cystocele vagina cause
vaginal childbirth, contipation, obesity, heavy lifting, chronic cough, hysterectomy, pelvic prolapse repair, genetics, Ehlers-Danlos
349
Cystocele vagina path
muscles and tissues supporting the vagina weaken and stretch, allowing the bladder to move out of place
350
Cystocele vagina RF
older, giving birth vaginally, having a history of pelvic, surgery, overweight, FH
351
Cystocele vagina comp
urinary retention, kidney damage
352
Cystocele vagina sx
asymptomatic, a vaginal bulge, pressure in the vagina or pelvis, urinary incontinence, hesitancy, slow stream, frequency, urgency
353
Reectocele def
Posterior vaginal prolapse, causing the rectum to bulge into the vagina
354
Reectocele cause
vaginal childbirth and chronic increases in intra-abdominal pressure, Ehlers-Danlos
355
Reectocele path
occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen
356
Reectocele RF
age, vaginal birth, constipation
357
Reectocele comp
Pressure or discomfort in the pelvic area.
Constipation.
Leakage of bowel movements (incontinence)
Sexual dysfunction.
358
Reectocele sx
Pressure in the pelvic area
Constipation
Leakage of bowel movements (incontinence)
Sexual dysfunction
359
Urethrocele def
urethra moves from its normal position and presses against the front wall of the vagina
360
Urethrocele cause
pregnancy and childbirth, being overweight, or with frequent constipation
361
Urethrocele path
muscles and tissues that hold the urethra in place get weak or damaged
362
Urethrocele RF
age, pregnancy, obesity,
363
Urethrocele comp
urinary retention, kidney damage, recurrent UTI
364
Urethrocele sx
Abdominal pain
Back pain that may be only on one side
Severe side (flank) pain and spasms that may reach to the groin, genitals, and thigh
Blood in the urine
Burning pain while urinating (dysuria)
Fever
Difficulty starting urine flow or slowing of urine flow
365
Cervical Intraepithelial Neoplasia (CIN) def
```
dysplasia of basal layer of transformational zone
CIN 1 (1/3)→ CIN II (2/3)→ CIN III (3/3)→ CIS→ invasive
```
366
Cervical Intraepithelial Neoplasia (CIN) cause
HPV 16, 18, 31, 33 sexually transmitted
367
Cervical Intraepithelial Neoplasia (CIN) path
virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication
368
Cervical Intraepithelial Neoplasia (CIN) RF
multiple sexual partners, not using condoms, early age at 1st intercourse, smoking, immunosuppression, low SES
369
Cervical Intraepithelial Neoplasia (CIN) comp
squamous cell carcinoma or adenocarcinoma, vaginal cancer, bladder (hydronephrosis/renal failure), rectum, liver, lungs
370
Cervical Intraepithelial Neoplasia (CIN) sx
koilocytes
| postcoital bleeding, vaginal discomfort, foul-smelling vaginal discharge
371
Endometrial Hyperplasia def
increased growth of endometrium
372
Endometrial Hyperplasia cause
exposed to high levels of estrogen for long time, obesity, ganulosa cell tumor, PCOS, estrogen replacement therapy, tamixofen, mutation of PTEN
373
Endometrial Hyperplasia path
↑estrogen and low progesterone→ leads to ↑gland to low stroma ratio→
374
Endometrial Hyperplasia RF
early menarche, late menopause, never given birth,
375
Endometrial Hyperplasia comp
endometrial cancer (need nuclear atypia)
376
Endometrial Hyperplasia sx
menorrhagia, metrorrhagia, amenorrhea,
377
Fibroids (Leiomyoma) def
benign smooth muscle tumors of uterus, most common
378
Fibroids (Leiomyoma) cause
MED12 gene, estrogen and progesterone, hereditary leiomyomatosis and renal cell carcinoma syndrome
379
Fibroids (Leiomyoma) path
MED12 gene → regulates how transcription factors bind to RNA polymerase
fibroids ↑ receptors for estrogen and progesterone→ ↑fibroid growth
380
Fibroids (Leiomyoma) RF
African descent, premenopausal, never having a pregnancy, ↑ menstrual cycles, diethylstilbestrol
381
Fibroids (Leiomyoma) comp
infertility, miscarriage, fetal malpresentation, preterm labor, postpartum hemorrhage
382
Fibroids (Leiomyoma) sx and types
Types: intramural (most common), subserosal, submucosal, pedunculated, cervical
```
round, firm, grayish-white,
Asymptomatic or
Compressive sxs
Bleeding
abdominal pain
Urinary frequency
```
383
Invasive Carcinoma of the Cervix def
Cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body
384
Invasive Carcinoma of the Cervix cause
HPV 16, 18, 31, 33 from Cervical Intraepithelial Neoplasia sexually transmitted
385
Invasive Carcinoma of the Cervix path
virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication
386
Invasive Carcinoma of the Cervix RF
early onset of sexual activity, multiple sexual partners, not using condoms, PHM STI, immunosuppression, OCPs, low SES, smoking, genetics,
387
Invasive Carcinoma of the Cervix comp
vaginal cancer, bladder (hydronephrosis/renal failure), rectum, liver, lungs
388
Invasive Carcinoma of the Cervix sx
postcoital bleeding, vaginal discomfort, foul-smelling vaginal discharge
389
Leiomyosarcomas def
malignant tumor of smooth muscle from myometrium
390
Leiomyosarcomas path
mutations to oncogenes or tumor suppressors
391
Leiomyosarcomas RF
postmenopausal
392
Leiomyosarcomas comp
metastasis
393
Leiomyosarcomas sx
abdominal uterine bleeding, abdominal or pelvic pain or pressure
single lesion w/ necrosis and hemorrhage
394
Erection
physical stimulation or thoughts→ parasympathetic nerve fiber release Ach→ bind to muscarinic receptors on endothelial cells → activates nitric oxide synthase→ converts arginine to citrulline and NO → NO enters smooth muscle cells → activates guanylate cyclase → GTP to cGMP→ fall in intracellular Ca smooth muscle relax → cavernosal spaces expand and compress veins
395
Chancroid def
gram negative coccobacillus, non-motile, facultative anaerobic, oxidase +, catalase -, chocolate agar +
396
Chancroid cause
Haemophilus ducreyi
397
Chancroid path
enter cell through skin or mucosal breaks → attaches to cell via Flp1, Flp2, Flp3 → make its secrete IL-6 and IL-8 → CD4 T, neutrophils, macrophage → produce ROS → Haemophilus produces copper-zinc superoxide dismutase → produces HdCTD and cytotoxic hemolysin → cell death and lysis of foreskin epithelial cells, macrophage, T cell, and B cell → disorganization of epidermis →erythematous papules
398
Chancroid RF
multiple sex partners, unprotected sex,
399
Chancroid comp
HIV
400
Chancroid sx
erythematous papules→ pustules → soft canker gray/yellow purulent exudate, bleeds easily
men: corona, prepuce, glans
female: labia, vaginal introitus, perianal areas, dysuria, dyspareunia, abnormal vaginal discharge, rectal bleeding, painful defecation, unilateral lymphadenopathy
401
Herpes Simplex Virus (HSV) 1 def
enveloped, double strained DNA
402
Herpes Simplex Virus (HSV) 1 cause
Herpes Simplex Virus (HSV) 1 due to stress, skin damage, viral illness
403
Herpes Simplex Virus (HSV) 1 path
dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in trigeminal or sacral
404
Herpes Simplex Virus (HSV) 1 RF
young age, sharing thing w/ infected person,
405
Herpes Simplex Virus (HSV) 1 comp
encephalitis (brain infection) or keratitis (eye infection)
406
Herpes Simplex Virus (HSV) 1 sx
no symptoms,
lesions on gums, palate, tongue, lip, and facial area, fever and enlarged lymph nodes, pharyngitis (children)
cluster of small, painful, fluid-filled blisters that ooze and ulcerate
Reactivation: asx, vermillion border lesions on one side, smaller
407
HSV 2 path
dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in sacral or trigeminal
408
HSV 2 cause
HSV 2 due to stress, skin damage, viral illness
409
HSV 2 path
dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in sacral or trigeminal
410
HSV 2 RF
sexually active, not using condome, STI, HIV,
411
Human Papillomavirus (HPV) def
non-enveloped DNA virus
412
Syphilis cause
Treponema pallidum
413
Syphilis sx
Primary: Painless chancre
Secondary: Fever, lymphadenopathy, skin rashes, condylomata lata
Tertiary: Gummas, tabes dorsalis, general paresis, aortitis
414
Human Papillomavirus (HPV) cause
Human Papillomavirus 6, 11, 16, 18
415
Human Papillomavirus (HPV) path
virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication
416
Human Papillomavirus (HPV) RF
multiple sex partners, immunocompromised, smoking, radiation
417
Human Papillomavirus (HPV) comp
cervix, vagina, vulva, penis, anus cancer
418
Human Papillomavirus (HPV) sx
numerous warts, skin-collored, range in size, cauliflower look, painless, itching, burning, local pain or bleeding
419
Syphilis def
gram-negative, spirochete, obligate parasite, endoflagella,
420
Syphilis cause
Treponema pallidum
enter through body fluids via cuts or sexual contact or contaminated needles or direct contact w/ skin lesion or congenital
421
Syphilis path
1-3 week destroy skin where they enter body → 6-12 weeks enter blood → lymph node→ tissues → latent phase in capillaries of organs & tissues → tertiary type IV hypersentivity
422
Syphilis RF
sexual activity, no condom, IV drugs,
423
Syphilis comp
coagulative necrosis, damage to heart (endarteritis, aortic aneurysms), brain (loss of vibration and proprioception's, paralysis, memory loss, paresis), liver, joint, testes, Argyll Robertson pupil, stillborn
424
Syphilis sx
Primary: Painless chancre
Secondary (most infectious): Fever, lymphadenopathy, non-itchy maculopapular rash, pustular or papulosquamous condylomata lata (genital smooth small flat growth, grey)
Tertiary: Gummas (non-cancerous growth), tabes dorsalis (demyelination of dorsal column), general paresis, aortitis, fever, edema,
425
Toxic Shock Syndrome (TSS) def
gram +, facultative anaerobes, non-motile, no spores, catalase +, cocci, coagulase +
426
Toxic Shock Syndrome (TSS) path
mediated by toxic shock syndrome toxin-1 → growth of S. aureus in vagina/surgical sites → multiple organ dysfunction
427
Toxic Shock Syndrome (TSS) RF
immunosuppression, IV drugs, recent invasive procedure, foreign material in body, dialysis
428
Toxic Shock Syndrome (TSS) comp
sepsis, bacteremia, invasive infection
429
Toxic Shock Syndrome (TSS) sx
fever, hypotension, rash, coagulopathy, tissue necrosis
430
Trichomoniasis def
flagellated protozoan parasite
431
Trichomoniasis path
sexually transmitted→ infects squamous epithelium of lower genital tract → replicates by longitudinal binary fission → inflammatory response
432
Trichomoniasis RF
sexual activity, multiple sex partners, female
433
Trichomoniasis comp
HIV, premature birth, urethritis, cystitis
434
Trichomoniasis sx
asymptomatic, watery, foul-smelling vaginal discharge, burning, Vaginitis, strawberry cervix, motile in wet prep, pruritus, urethral discharge
