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Emily's IPE Revision > Repro > Flashcards

Repro Flashcards

1
Q

Hormonal changes in menopause

A

oestrogen drops dramatically so FSH and LH rise - FSH considerably.

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2
Q

When do testicular tumours present and what type of tumour are they usually?

A

Usually present in young men. majority are germ cell tumours

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3
Q

Where does BPH typically occur? How does it present?

A

Transitional zone of the prostate, urinary frequency, urgency and overflow incontinence

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4
Q

Where does prostatic adenocarcinoma typically occur? How does it present?

A

Peripheral zone of the prostate. Due to this symptoms don’t occur until later in the development of the disease. Urinary frequency, urgency and incontinence.

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5
Q

What are sertoli cells responsive to? what do they secrete?

A

FSH

Inhibin

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6
Q

What are sertoli cells responsive to? what do they secrete?

A

LH

Testosterone

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7
Q

What are theca cells responsive to? what do they secrete?

A

LH

produce androgens which are converted to oestrogen by granulosa cells

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8
Q

What are granulosa cells responsive to? what do they secrete?

A

FSH
modify androgens into oestrogen
secrete inhibin

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9
Q

Changes caused by oestrogen

A

Fimbrae become motile
endometrial thickening
growth and motility of the myometrium
thin, alkaline cervical fluid

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10
Q

Changes caused by progesterone

A

further thickening and sustaining of the endometrium
thickened myometrium
thick, acidic cervical mucus
increased temperature

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11
Q

How does progesterone only contraceptive pill work?

A

enhances the negative feedback of natural oestrogen preventing the positive feedback mechanism of oestrogen and therefore preventing ovulation.

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12
Q

Normal pubescent ages for males

A

1st change is increase in testicular size - from age 9 to 13. average starting age is 12 and a half years

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13
Q

Normal pubescent ages for girls

A

1st change is breast development, starting from age 8 to age 14. average starting age is 11 and a half years

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14
Q

What is precocious puberty?

A

puberty which starts before the age of 8 in girls or 9 in boys

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15
Q

Normal menopause

A

~49-50yrs with 12 months without menstruation

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16
Q

What is premenopause?

A

starts ~40yrs. follicular phase gets shorter, ovulation becomes early or absent, resulting in lower oestrogen and raised LH and FSH. reduced fertility.

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17
Q

Consequences of menopause

A 
hot flushes
bladder changes - urinary incontinence
mood changes
edometrial regression
myometrial thinning
cervical thinning
involution of breast tissue
skin changes
decreased bone mass
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18
Q

What is primary amenorrhoea?

A

absence of menses by the age of 14 without secondary sexual characteristic or by 16 with secondary sexual characteristics.

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19
Q

What is secondary amenorrhoea? Common causes?

A

established menstruation ceases for 3 months in a woman with regular periods or 9 months in a woman with irregular periods. PREGNANCY, menopause, PCOS

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20
Q

causes of menorrhagia

A

fibroids, coagulation problems, endometrial carcinoma, polyps, PID.

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21
Q

Causes of hyperprolactinaemia

A

phsyiological - levels rise during sleep, exercise, stress, pregnancy and whilst breast feeding
pharmacological - induced by dopamine inhibitors e.g. anaesthetics, opiates, H2 antagonists.
Pathological - pituitary adenoma, hypothyroidism.

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22
Q

Symptoms of hyperprolactinaemia

A

lactation, secondary amenorrhea, anovulation

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23
Q

Symptoms of PCOS

A

anovulatory secondary amenorrhea, acne, hirstutism

24
Q

What happens in PCOS

A

No dominant follicle is selected, so multiple continue to develop. excess androgens are converted to testosterone resulting in symptoms such as acne and hirstutism.

25
Q

What is hydrocoele?

A

Serous fluid in the tunica vaginalis. Sometimes associated with indirect inguinal hernias. Will transilluminate.

26
Q

What is a haematocoele?

A

Blood in the tunica vaginalis, can be due to testicular artery rupture or trauma. Does not transilluminate

27
Q

What is a varicocoele? Which side is more commonly affected?

A

Dilitation of the pampiniform plexus, resulting in varicosities. ‘bag of snakes’ More common on the left side.

28
Q

What is a spermatocoele?

A

retention cyst in the epididymal head.

29
Q

Where to testicular and scrotal cancers typically metastasise to?

A

testicular - preaortic and lumbar lymph nodes

scrotal - superficial inguinal nodes

30
Q

What is testicular torsion?

A

twisting of the spermatic cord and its vasculature. venous obstruction results in oedema and haemorrhage which will eventually result in testicular necrosis. medical emergency.

31
Q

Where to prostate tumours commonly metastasise to?

A

vertebrae, brain

32
Q

What is endometriosis?

A

Presence of endometrial glands and stroma outside the uterine cavity, resulting i chronic inflammation. The ectopic tissue commonly deposits in the peritoneum and the ovaries, and responds to hormonal changes of the menstrual cycle, including bleeding and pain. It presents with dysmenorrhoea, pelvic pain.,

33
Q

What is bartholinitis?

A

occlusion of bartholian (or greater vestibular) glands, resulting in infection.

34
Q

Consequences of pelvic floor damage

A

stress incontinence, vaginal prolapse, bladder prolapse

35
Q

What is acute pelvic inflammatory disease?

A

Ascending infection from the endocervix which is less than 6 months in duration. Endometriosis, salpingitis, oophonitis, pelvic peritonitis, and ovarian abscess formation can all occur.

36
Q

common causative organism of pelvic inflammatory disease

A 
N. gonorrhoea
Streptococci 
C. trachomatis
T. vaginalis 
H. influenzae
Cytomegalovirus
37
Q

Symptoms of PID

A

fever, cervical motion tenderness, purulent discharge, irregular menstruation

38
Q

Long term consequences of PID

A

increased risk of ectopic pregnancy, infertility, pain during sexual intercourse, pelvic adhesions

39
Q

Describe types of ‘natural’ contraception

A

abstinence, coitus interruptus, rhythm method.

40
Q

Describe types of permanent contraception

A

vasectomy, tubal ligation

41
Q

Barrier contraceptions

A

condoms, diaphragms and cervical caps. (only condoms protective against STIs

42
Q

How does the COCP work?

A

COCP - oestrogen and progesterone prevent follicular development and ovulation by preventing a rise in LH and FSH levels. Progesterone also causes thickened cervical mucus and uterine lining changes which also reduce pregnancy risk.

43
Q

Long acting reversible contraceptions

A

Implants and progesterone IM injections slowly release progesterone which acts in the same way as the POP. Hormonal IUDs also work this way. Copper IUD prevents the endometrial lining thickening

44
Q

Causes of infertility

A

sexual difficulties
anovulation - PCOS, ovarian falure, stress, low body weight, menopause
Tubal occlusion - PID, previous ectopic, endrometriosis
low sperm count

45
Q

What is placenta praevia?

A

Implantation in the lower uterine segment, increased risk of haemorrhage during pregnancy and requires C-section delivery.

46
Q

What is acute mastitis?

A

S. aureus infection of the breast which usually occurs when lactating. Results in nipple cracks and fissures, painful breast tissue and can result in breast abscesses.

47
Q

What is duct ectasia?

A

chronic duct dilatation and inflammation which can result in periareolar masses and nipple discharge. Commonly occurs perimenopause

48
Q

What is fat necrosis of the breast?

A

Presents as a mass, skin changes or an abnormality on mammography. Usually history of trauma or surgery. Presents similarly to breast cancer.

49
Q

What is fibrocycstic change of the breast?

A

Common, well-circumscribed, firm, freely moving mass or mammographic abnormality. Can be aspirated with a needle.

50
Q

What is epithelial hyperplasia of the breast?

A

proliferation of epithelial cells fill and distend the ducts and lobules. Is usually detected on mammography and whilst it is benign it is associated with a greater risk of carcinoma.

51
Q

What is Papilloma of the breast?

A

can be large and in the lactiferous duct near the nipple, or small and situated deep in the breast tissue. Present with nipple discharge, palpable mass, or on mammography.

52
Q

What is a stromal tumour of the breast?

A

a benign growth which cab become very large and can replace existing breast tissue. Well circumscribed, rubbery and grey or white in colour.

53
Q

What is a phyllodes tumour of the breast?

A

Stromal tumours that are commonly benign but can be premalignant. typically fast growing and present as a firm palpable mass. May reoccur after resection.

54
Q

What types of malignant breast cancer are there and how common are they?

A

95% are adenocarcinomas

  • ductal carcinomas in situ are adenocarcinomas which haven’t invaded through the ductal basement membrane
  • invasive carcinomas have invaded through the basement membrane
55
Q

Where do breast cancers usually metastasise?

A

Ipsilateral axillary lymph nodes, liver, brain, bone, lung

Emily's IPE Revision (5 decks)

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