Reproductive Pathology Flashcards
Amenorrhea
absence of menstruation
- PRIMARY (menses has not started by age 15)
- SECONDARY (menstruation stops for three cycles or six months in women)
dysruption in the HPO axis…
(PCOS symptoms, hot flashes, and night sweats, glactorhea as seen in hyperprolactinemia)
Primary Amenorrhea
Turner syndrome
Androgen insensitivity syndrome
congenital absence of the uterus or vagina
Secondary Amenorrhea
pregnancy, actation
menopuase,
PCOS
hypothalamic amenorrhea
thyroid dysfunction
Anovulation
absence of ovulation
ovaries do not release oocyte during menstrual cycle
due to hormonal imbalances affecting the HPO axis… leading to insufficient stimulation of the ovaries
Dysfunctional Uterine Bleeding
Anovulation, leading to unopposed estrogen and lack of progesterone
Hormonal imbalance: PCOS, thyroid disorders and perimenopause
Medications like OCPs
Complications from perimenopause/menopause
Osteoporosis (decreased estrogen)
Cardivascular disease
Urogenital atrohpy
increased risk of cognitive decline and mood disorders
Ovarian insufficiency
POI / lose their normal function before the age of 40
decreased production of estrogen and irregular or absent menstrual periods
Ovarian Insufficiency symptoms
Irregular or absent menstrual periods
Symptoms or estrogen deficiency like hot flashes, night sweats, and vaginal dryness
Infertility
Mood changes and depression
Ovarian insufficiency / failure etiology…
Genetics (turner, fragile X syndrome)
Autoimmune disorders
Chemotherapy or radiation therapy
Idiopathic
Inflammatory diseases of reproductive tract
Balantitis
Cervicitis
Endometriosis
Endometritis
Orchitis
PID
Salpingitis
Vaginitis
Balanitis
inflammation of the glans penis
- infections, poor hygiene, irritants
PID
etiology: tendency towards anaerobes and gram negative rods
chlamydia trachomatis or Neisseria gonorrhoeae
Orchitis
inflammation of one or both testicals
Viral – mumps
Bacterial – e coli
OR STIS (G C)
trauma / injury
Autoimmune reactions
Salpingitis
Inflammation of fallopian tubes
(often from bacterial infections)
can lead to scarring and blockages of the tubes
Candidal Vaginitis
Yeast infections / overgrowth of candida species in the vaginal mucosa
often because of: antibiotic use, high estrogen states or a compromised immune system
Vaginitis / candida overgrowth sxs
intense itching / irritation of vulva
thick white / cottage cheese like vaginal discharge
redness and swelling of the vulva
pain during intercourse
burning sensation during urination
Crytorchidism
when one or both testes fail to descend from abdomen into scrotum during fetal development
Epispadias
congenital defect resulting form improper development of urethra and genital tubercle (abnormal opening of urethra on dorsal supper surface of penis)
- because of disruption in development of genital tubercle during embryonic period
IS THIS ENDODERM OR ECTODERM?
- 8-10 weeks in gestation
genital tubercle (ALL THREE LAYERS)
fragile X syndrome
expansion CGG trinucleotide repeate in the FMR1 gene on X chromosome
leads to decreased production of the fragile X mental retardation protein (FMRP)
genetic mutation inherited in an X linked dominant pattern
Hypospadias
incomplete fusion of urethral folds / urethral opening on ventral side of penis
REMEMBER THAT ANATOMICAL POSITION IS when penis is erect…
Imperforate Hymen
imperforate hymen results from incomplete degeneration of central portion of the hymen leading to a membrane covering the vaginal opening
Klenefelter syndrome
caused by the presence of an extra X chromosome
leads to androgen deficiency and hypogonadism
sxs: tall stature with long limbs, gynecomastia, small testes, reduced testosterone levels
Paraphimosis
when the foreskin is retracted behind the glans penis and cannot be returned to its normal position leading to construction and swelling
Phimosis
inability to retract the foreskin over the glans penis due to tightness
Septate vagina
incomplete resorption of the mullerian ducts during fetal development
leads to septum within the uterus or vagina
Turners Syndrome
complete or partial monosomy of the X chromosome which leads to developmental and physiological abnormalities
sxs
short stature
webbed neck
broad chest with widely spaced nipples
lymphedema or hands and feet in infancy
congenital heart defects
leads to
cvd abnormalities
kidney challenges
osteoporosis
increased risk of autoimmune disorders
Erectile Dysfunction
Often:
- vascular (athersclerosis, hypertension, diabetes)
- neurological (spinal cord injury… ms, neuropathy)
Hematocele
accumulation of blood within the tunica vaginalis (surrounding testicle)
*problem of hydrostatic pressure
Painful swelling of scrotum
Hydrocele
Accumulatio of serous fluids between layers of tunica vaginalis surrounding testicle
imbalance of fluid secretion and absorption
*transillumination of scrotum
*heaviness or discomfort in scrotum
Spermatocele
benign cystic accumulation of sperm in epididymis (painless fluid filled cyst in epididymis)
*** arises from blockages of efferent ducts
Varicocele
abnormal dilation of the pampiniform plexus of veins within the scrotum
***often defective venous valves leading to blood pooling
“bag of worms”
Fibrocystic breast disease
non-cancerous changes in the breast tissue, leading to the development of fibrous tissue and cysts
Galactocele
milk-filled cyst that occurs due to blockage of lactiferous duct in the breast shortly after lactation
BECAUSE of
obstruction of milk ducts during lactation
infrequent breastfeeding or weaning can contribute to duct blockage
Mammary duct ectasia
dilation and inflammation of the milk ducts beneath the nipple
typically occurs around menopause
**nipple discharge can be thick and greenish; nipple inversion and rectraction
Mastitis
infection of breast tissue, common during breastfeeding
inflammation, pain and infection due to bacterial entry through cracked nipples
BECAUSE: staphlococcus aureus
Truamatic fat nectosis
fatty breast tissue is damaged often due to injury or surgery leading to inflammation and necrosis of the adipose tissue
Paget **
malignant cells extending from the ducts to the skin of the nipple and areola
associated with underlying ductal carcinoma in situ
sxs: erythema and eczematous changes of the nipple and areola, nipple discharge, itching and burning sensation
Fibroadenoma
benign breast tumor composed of glandular and fibrous tissue
lobular carcinoma
arises from the lobules of the breast, where milk is produced
Ductal Carcinoma
originates in the milk ducts and can be in situ (DCIS) or invasive IDC
Dermoid cyst
Ovarian cyst
TERATOMA
Ovarian Cyst
fluid filled sacs that develop on or within an ovary
- functional cysts: follicular cysts, and corpus luteum cysts (from normal ovulation)
- Pathological cysts: include dermoid cysts (teratomas), cystademonas and endometriomas
Paraovarian Cysts
fluid filled sacs located in the broad ligament adjacent to but separate from the Ovary.
they arise from the remnants of the wolffian duct or paramesonephric duct
** developmental remnants of embryoloical structures
PCOS
chronic anovulation
hyperandrogenism
polycystic ovaries
Tubo-ovarian cysts
TOA (tubo ovarian cysts or abcessess) are complex infections involving the fallopian tube and ovary – leads to PID often
metabolic component
Choriocarcinoma
malignant tumor arising from trophoblastic tissue
abnormal proliferation of trophiblastic cells and lack of chorionic villi
*elevated levels of hCG, vaginal bleeding, sxs related to metastasis like cough, hemooptysis, headahce
Hydatidiform mole
gestational trophoblastic disease characterized by abnormal proliferation of trophoblastic tissue and dyropic degeneration of chorionic villi
aka…. fertilization of an egg with no genetic material by one or two sperm… resulting in 46 chromosomes entirely paternally derived
sxs:
- vaginal bleeding in first trimester
uterus larger than expected for gestational age
elevated hCG levels
Hyperemesis gravidarum
preEclampsia before 20 weeks gestation
snowstorm pattern on ultrasound
complete mole
fertilization of an egg with no genetic material by one or two sperm… resulting in 46 chromosomes entirely paternally derived
invasive mole
type of gestational trophoblastic disease where the molar tissue invades the myometrium
sometimes extends into adjacent structures and metastasizing
Preeclampsia
multisystem disorder of pregnancy characterized by hypertension and proteinuria after 20 weeks gestation
endothelial dysfunction, placental ischemia and an imbalance between proangiogenic and antiangiogenic factors
***involves abnormal placental and immune response
Clinical sxs: hypertension, proteinuria, edema, headache, visual disturbances, epigastric pain, HELLP syndrome
Bartholin cysts
result from the obstruction of the bartholin gland ducts, leads to the accumulation of mucous and the formation of a cyst
***blockage of the duct, due to infection, trauma or inflammation
Cystocele
ADD
Rectocele
ADD
Urethrocele
ADD
Cervical intracepithelial neoplasia (CIN)
CIN represents precancerous changes in the cerivcal epithelium (CIN1) CIN2, or CIN3 (mild to severe)
*** HPV 16, 18 increase risk for CIN
***this could lead to carcinoma in situ
Endometrial Hypertplasia
Endometrial hyperplasia involving the proliferation of endometrial glands due to prolonged estrogen stimulation without progesterone
BECAUSE: PCOS, estrogen secreting tumors, unopposed estrogen exposure, HRT
Fibroids / (Leiomyomas)
smooth muscle, MYOMETRIUM tissue
influenced by hormonal factors, specifically estrogen and progesterone
Invasive carcinoma of the cervix
develops from high grade CIN and involves the invasion of malignant cells beyond the basement membrane
*ALSO persistent infections with high risk HPV 16 and 18
Leiomyosarcomas
RARE MALIGNANT tumors of smooth muscle origin
*typically arises de novo rather than from pre-existiting leiomyomas
Clinical: rapidly enlarging pelvic masses
Prostate Carcinoma
originates from the glandular cells of the prostate (typically in the peripheral zone)
Clinical: urinary frequency, urgency, nocturia, weak stream… also bone pain, weight loss and anemia
Tumors of the Ovary
ovarian tumors can be benign or malignant, arises from epithelial cells, germ cells or stromal cells
*Braca1 and 2 increase risk
Squamous cell carcinoma of the penis
squamous cell carcinoma of the penis (arises from the epithelial cell of the penile skin OR mucosa)
