Reproductive alterations

Question 1

Cryptorchidism

Answer 1

congenital/hereditary/hormone imbalance condition in which the male has an undescended testes. The condition may affect one or both testes, and there is a 35-50x greater risk for testicular cancer. If bilateral, the condition may result in sterility (b/c the temperature in the abdomen is too hot for sperm viability)

Question 2

Testicular cancer

Answer 2

Cancer of unknown etiology. It is the most common tumor in males and most common cause of testicular enlargement. Malignant cells mainly arise from germ cells (sperm-producing). Risk increases with cryptorchidism, genetic factors (brothers, relatives), testicular dysgenesis (abnormal dvlpmt) and those with history of trauma or infection. Metastatis initially involves lymph nodes and migration to cervical nodes, then lungs, liver, and CNS.

Question 3

Benign prostatic hypertrophy BPH

Answer 3

enlargement of the prostate that has an unknown etiology and may be a normal process of aging. Hypertrophy may relate to increased estrogen levels. Manifestations= compression of the urethra causing hesitancy, retention, dysuria, overflow dribbling, and frequency. Retention could lead to distention/hypertrophy of bladder, cystitis and renal infection.

Question 4

Prostatic carcinoma

Answer 4

Most common form of cancer/one of leading causes of death with unknown etiology. Probable factors include age, race, endocrine hormones, and environment. Manifestations= hesitancy, dysuria, frequency, hematuria, back pain (vertebral metastases), elevated serum acid phosphatase, metastasis to hypogastric lymph nodes, pelvic bones, lumber spine, lung and liver.

Question 5

Testicular torsion

Answer 5

testicle that has rotated on its vascular pedicle, often due to trauma or physical exertion,resulting in decreased blood supply. Manifestations= severe pain with scrotal swelling that isn’t relieved by rest or support. Surgery is required is not able to manually reduce.

Question 6

Pelvic inflammatory disease (PID)

Answer 6

inflammation of the vulva, its accessory glands, and then entire genital tract secondary to infection. Infection usually involves gonococcus (gonorrhea). Manifestations= pelvic and abd pain, dysmenorrhea, heavy, purulent and odorous discharge, dyspareunia (painful intercourse), pelvic adhesions, uterine and ovarian abscesses.

Question 7

What complications can arise secondary to PID?

Answer 7

peritonitis, intestinal obstruction due to adhesions, bacteremia, and infertility

Question 8

Cervical Carcinoma

Answer 8

Cancer of unknown etiology but female may have in situ lesions 10-12 years earlier. Manifestations= asymptomatic, back aches prior to long menstrual periods, constant watery discharge, spotting. With advanced= vaginal bleeding and yellow discharge, radiating back pain to hips/thighs, weight loss, anemia, rectal/urinary symptoms.

Question 9

The risk for cervical cancer increases for females that have:

Answer 9

early onset of sex activity
multiple sex partners
uncircumcised partners
HIV
early age for first pregnancy

Question 10

Endometriosis

Answer 10

condition in which endometrial glands/stroma are present outside of the uterus. This frequently occurs in ages 30-40. Manifestations= can be asymptomatic, severe dysmenorrhea and pelvic pain, intrapelvic bleeding, adhesions, dyspareunia, painful bowel movements, dysuria, menstrual irregularities, infertility

Question 11

Leiomyomas (Fibroids)

Answer 11

estrogen dependent condition which presents as benign tumors originating from smooth muscle. Grow increases during pregnancy (excess estrogen) but then shrinks and fibroses after menopause. manifestations= asymptomatic, profuse blood with menstruation, pain and pressure on bladder, impaired fertility, and large tumors will compress rectum and nerves.

Question 12

Leiomyomas (fibroids) will increase the risk of what complications for the pregnant woman?

Answer 12

spontaneous abortion, fetal mal-presentation, uterine inertia, and post-partum hemorrhaging.

Question 13

Endometrial cancer

Answer 13

Most common female reproductive cancer (usually in women>40 years) and commonly presents as an adenocarcinoma from the epithelial cells. Theory is that it is influenced by prolonged estrogen stimulation. Manifestations= asymptomatic, post menopausal bleeding, irregular vaginal bleeding with excessive leukorrhea, enlarged uterus, most have completely negative appearing cervix.

Question 14

The risk for endometrial cancer increases with all these conditions except:

a) obesity and high fat diets
b) diabetes
c) early menarche and late menopause
d) prolonged use of estrogen
e) early sex activity with multiple partners
f) infertility-nulliparous

Answer 14

e) early sex activity with multiple partners

Question 15

Polycystic ovarian disease

Answer 15

condition that occurs in young women (20-30) in which cysts are present in the ovary. The ovaries are enlarged, contain multiple cysts, and show a thick pearly white outer tunica. Cysts may be caused by abnormal stimulation of the ovaries by FSH and LH. Manifestations= abnormal bleeding or amenorrhea, virilism and hirsutism, and infertility

Question 16

virilism

Answer 16

development of male secondary sex characteristics- deepening of voice, facial hair growth, and clitoral enlargement in response to increased androgen levels.

Question 17

Ovarian Cancer

Answer 17

Malignant ovarian tumors that result in low abdominal pain and distention, GI symptoms, urinary frequency, dysuria, pelvic pressure, massive ascites if metastasis to abdominal cavity. Nulliparity (no pregnancies), family history, high fat diet, obesity, early menarche and late menopause are all risk factors.

Question 18

Benign breast disease

Answer 18

common breast disorder which manifests as multiple and bilaterally palpable breast lesions which can be tender or painful with pain increasing in premenstrual period. Disease is said to be caused by hormone imbalances (hyperestrinism).

Question 19

Breast cancer (manifestations)

Answer 19

Malignancy that commonly manifests as a solitary, painless, movable and delimited mass in the upper outer quadrant (most glandular tissue here). Other manifestations include retraction and dimpling of skin with orange-like appearance, retraction of the nipple, swelling, redness, tenderness, skin ulcerations, metastasis to lymph nodes, and then lungs, pleura, bone, liver and brain.

Question 20

Breast cancer statistics

Answer 20

Risk increases with age, leading cause of death in women aged 40-44. Other risk factors= genetic factors, hormones (use of birth control), environment, viral, reproductive factos. Also common in women who had their first child over age 30, and those who were never pregnant.

Question 21

Premenstrual Syndrome

Answer 21

cyclic recurrence of changes in the luteal phase of the menstrual cycle that results in painful and swollen breasts, bloating, abdomnial pain, food craving, headache, backache, depression, anxiety, irritability, fatigue and insomnia. Also, the worst time of the month for the male partner.

Question 22

Gonorrhea

Answer 22

infection caused by neisseria gonorrhea resulting in purulent discharge from the urethra and burning on urination. Infection can even lead to conjunctivitis or pharyngitis. Other persons may be asymptomatic

Question 23

Syphilis

Answer 23

infection of treponema pallidum that results (primarily) in a painless genital ulcer (chancre) that spontaneously regresses. Secondary syphilis=weeks-months later, with skin rash on palms and soles. Tertiary “= decades after initial infection, sensory loss, muscle weakness, and heart defects.

Question 24

Chlamydia

Answer 24

Do not have sex! If you have sex, you will get chlamydia and die. Chlamydia–“K-l-a…” Infection of chlamydia trachomatis that results in urethritis, cervicitis, discharge, itching, and burning on urination. May also see spotting in women after periods or sex.

Question 25

Trichomoniasis

Answer 25

infection of trichomonas vaginalis that presents with greenish discharge, itching, and pain with intercourse. Men are usually asymptomatic.