reproductive function 2

Question 1

congenital disorders (male)

Answer 1

epispadia/hypospadia
cryptochidism

Question 2

disorders of the testes and scrotum (male)

Answer 2

hydrocele, spermatocele, varicocele, torsion

Question 3

cancers (male)

Answer 3

penile, prostate, testicular

Question 4

sexually transmitted infections

Answer 4

chlamydia, gonorrhea, syphilis, herpes, trichomoniasis

Question 5

spermatogenesis & male genital anatomy

Answer 5

generates and transports sperm
produces sex hormones
aids in urination
includes penis, scrotum, testes, duct system, & accessory glands

Question 6

hypospadia (congenital penile variations)

Answer 6

-urethral meatus located on the ventral surface of the penis
-risk increases w maternal factors: age>35 yrs, obesity, use of fertility treatments, and hormone therapy
-most common penile variation

Question 7

epispadia (congenital penile variations)

Answer 7

-urethral meatus occurs on the dorsal surface of the penis and may extend the entire length of the penis
-can cause urination problems
-increased risk of urinary tract infections
-usually develops during the 1st month of gestation; urinary defects often also present

Question 8

cryptochidism (congenital penile variations)

Answer 8

-undescended testicle
-one or both testes do not descend from abdomen to scrotum;
-undescended testes usually remain along the path of descent

Question 9

hydrocele (disorders of the testes) causes & diagnosis

Answer 9

-fluid accumulation btwn the layers of the tunica vaginalis or along the spermatic cord
-can affect one or both testes
-causes: congenital defect, inflammation, infection, trauma, and tumors
-diagnosis: painless scrotal enlargement that transilluminates and scrotal heaviness

Question 10

varicocele (disorders of the testes)

Answer 10

-dilated vein in the spermatic cord
-results from valve issues that allow blood to pool in the veins
-most common cause for low sperm counts & decreased sperm quality bc of testicular ischemia
-more common in left testicle bc of anatomic factors

Question 11

varicocele (disorders of the testes) causes & manifestations

Answer 11

-causes: congenital defects and obstructions
-manifestations: “bag of worms” feeling to the scrotum and scrotal heaviness

Question 12

describe testicular torsion (disorders of the testes)

Answer 12

-abnorm rotation of the testes on the spermatic cord
-causes: trauma, but can also occur spontaneously
-manifestations: sudden scrotal edema & pain
-diagnosis: history, physical exam, & scrotal ultrasound
-treatment: manual manipulation & surgery

Question 13

describe penile cancer

Answer 13

-rare malignancy
-the exact cause unknown
-risk factors: smegma, being uncircumcised, poor hygiene, phimosis, & HPV infections
-appears as a thick, grey-white lesion (Bowen lesion) or a red, shiny lesion (erythroplasia of Queyrat)
-risk factors: being uncircumcised, poor hygiene, phimosis, & HPV infections
-prognosis is good w early diagnosis & early diagnosis & treatment
-treatment: penectomy, chemotherapy, radiation, & surgical excision

Question 14

describe testicular cancer

Answer 14

-uncommon but curable (even if metastatic) cancer most common in 15-35 year olds
-affecting one or both testicles
-risk factors: family history, infection, trauma, & cryptochidism
-manifestations: asymptomatic; a hard, painless, palpable mass that does not transilluminate; testicular discomfort or pain; enlargement of the testicle
-diagnosis: monthly self-testicular examinations
-treatment: orchiectomy, chemotherapy, & radiation

Question 15

prostate cancer

Answer 15

-most common cancer in men
-slow-growing tumor w an unknown cause; as it grows, it obstructs urethra
-second leading cause of cancer deaths
-risk factors: history of STIs, fam history, high-fat diets, & androgen hormone replacement
-manifestations: urinary difficulties, erectile dysfunctions, blood semen, & hematuria
-diagnosis: biopsy, the prostate-specific antigen test, & prostatic acid phosphatase test
-treatment: radical prostatectomy, radiation, orchiectomy, & antitestosterone drugs
-for cancers diagnosed in early stage, active surveillance is appropriate

Question 16

sexually transmitted infections

Answer 16

-infections that can be contracted through sexual contact
-more than 30 diff sexually transmissible bacteria, viruses, & parasites have been identified
-some can also be transmitted from mother to child during pregnancy & childbirth as well as through blood contact
-some of these are easily eradicated w appropriate treatment, whereas others remain for a lifetime
-3 are reportable to the Centers for Disease Control & Prevention – chlamydia, gonorrhea, & syphilis

Question 17

chlamydia

Answer 17

-chlamydia trachomatis: intracellular parasite that req a host cell to reproduce
-the most commonly reported STI in the US

Question 18

chlamydia complications & manifestations

Answer 18

complications: PID, epididymitis, prostatitis, infertility, & ectopic pregnancy, increases the risk for contracting other STIs
manifestations: if present, include dysuria; penile, vaginal, or rectal discharge; testicular tenderness or pain; rectal pain; & painful sexual intercourse

Question 19

gonorrhea

Answer 19

caused by Neisseria gonorrhoeae, an aerobic bacterium w many drug-resistant strains
-2nd most common STI

Question 20

gonorrhea complications & manifestations

Answer 20

complications: PID, epididymitis, prostatitis, infertility, ectopic pregnancy, arthritis, dermatitis, & endocarditis
manifestations: if present, include dysuria; penile, vaginal, or rectal discharge; redness/edema at urinary meatus (in men); testicular tenderness; rectal pain; painful intercourse; white blisters that darken & disappear

Question 21

syphilis

Answer 21

-ulcerative infection caused by Treponema pallidum, a spirochete that req a warm, moist environment to survive
-transmitted from skin or mucous membrane & from the mother to child through the placental barrier
-in utero, fetuses, are protected by Langhans layer for the first 4 months, so screening & treating the mother prior can decrease likelihood of fetus contracting the infection
-untreated may lead to fetal demise or defect affecting the bone, liver, lungs, & nerves

Question 22

Stage One: Primary Syphilis

Answer 22

-1+ painless chancres form at site 2-3 weeks after infection
-no other symptoms are present
-often go unnoticed & disappear abt 4-6 weeks later, even w out treatment
-bacteria become dormant
-contagious, but may not test pos, so testing should be repeated at a later date

Question 23

Stage 2: Secondary syphilis

Answer 23

-occurs abt 2-8 weeks after the 1st chancres form
-treatment in the primary stage can decrease the likelihood of developing this stage
-manifestations: generalized, brown-red rash; malaise; fever
-symptoms will go away without treatment, and again, the bacteria become dominant
-will test pos (if untreated) and is contagious, especially w direct contact w the rash

Question 24

Stage 3: Latent or tertiary syphilis

Answer 24

-begins when the secondary symptoms disappear and lasts 1-4 yrs
-can last for years; infection spreads to the brain, nervous system, heart, skin, and bones
-complications: blindness, paralysis, dementia, cardiovascular disease, and death
-will test pos (if untreated) & is only contagious during the early part of this stage

Question 25

Herpes simplex virus (HSV) (viral STI)

Answer 25

-recurrent episodes of lesions, sores
-transmitted through sexual, direct skin-to-skin contact, and from mother to fetus
-risk of transmission is the greatest when lesions are present
-the virus causes an initial infection at the entry site
-then the virus travels along the nerve root where it remains dormant until the next outbreak, which will occur at the same site

Question 26

HSV type 1

Answer 26

typically occurs above the waist and manifests as a cold sore

Question 27

HSV type 2

Answer 27

typically occurs below the waist

Question 28

genital herpes

Answer 28

outbreaks begin w a tingling or burning sensation at the site just before the lesion appears (prodrome)
-the lesions first appear as a vesicle surrounded by erythema
-vesicles rupture, leaving a painful ulcerative lesion with watery exudate
-crust forms over the ulcer, and it heals spontaneously 3-4 weeks

Question 29

genital herpes treatment

Answer 29

antiviral meds, avoiding reoccurrence triggers, proper hygiene, avoiding sexual act during outbreaks, and safe sex practices

Question 30

human papillomaviruses (HPVs)

Answer 30

-benign growths on external genitals, cervix and anus caused by a group of viruses
-incubation period can last up to 6 months; can lead to reproductive/anal cancer

Question 31

HPV manifestations

Answer 31

asymptomatic; growths that can be raised, flat, rough, smooth, flesh-colored, white, grey, pink, cauliflower-like, large, or barely visible, w abnorm bleeding, discharge, & itching

Question 32

HPVS diagnosis, prevention, & treatment

Answer 32

diagnosis: history, exam, Pap smear, biopsy, & PCR test
prevention: vaccine & safe sex prac
treatment: removal using chemicals, cryosurgery, electrocautery, laser therapy, or excision; treating sexual partners; & c section deliveries

Question 33

Trichomoniasis

Answer 33

-caused by Trichomonas vaginalis (a parasite), a one-celled anaerobic organism that can burrow under the mucosal lining
-in men, the organism primarily resides in the urethra & causes no symptoms
-in women, the organism resides in the vagina
-the organism cannot survive in the mouth or the rectum

Question 34

Trichomoniasis complications, manifestations, diagnosis, & treatment

Answer 34

-complications: cervical cancer
-manifestations: excessive odorous, frothy, white or yellow-green vaginal discharge; vagina & vulva irritation; itching painful intercourse; & dysuria
-diagnosis: history, physical exam, & pap smear
-treatment: antibiotic therapy, specifically metronidazole (flagyl), & screening & treating sexual partners

Question 35

fetal sex determination

Answer 35

-female gonad (ovary) is default
-male gonad (testis) only develops in the presence of SRY gene found on the ‘sex determining region’ of the Y chromosome

Question 36

The type of sex chromosome complex established at fertilization of the oocyte determines…

Answer 36

the type of gonad that differentiates from the indifferent gonad

Question 37

The type of gonad then determines the type of sexual differentiation that occurs….

Answer 37

in the genital ducts & external genitalia

Question 38

Androgen Insensitivity

Answer 38

XY chromosome complex, but tissues do not respond to testosterone, Testis develop but do not descend, external genitalia does not form