Reproductive System Flashcards
Chlamydia Risk factors Diagnostic factors Management Complications
Caused by chlamydia trachomatis -m.c STD in world -usually asymptomatic in both men and women Risk factors: -age 25 n under -frequent or recent change of sex partner -unprotected sex -Hx of prior STD -black race -low socioeconomic status
Diagnostic factors:
- asymotomatic
- dysuria (painful urination) and conjunctivitis
- penile and vaginal discharge
- lower abdominal/ pelvic pain
- intermenstrual bleeding
Complications:
- reactive arthritis
- pelvic inflammatory disease (PID)
- salpingitis (inflamation of fallopian tubes)
STIs- Herpes simplex
HSV-1 (oral) or HSV-2 (genital)
- Transmission: vaginal, anal, oro-genital or oro-anal
- virus remains latent in the body
- very common STI
Risk factorsL
- unprotected sex
- high risk sexual behaviour
- immunosuppression
- HIV infection
- young age
- female-female sex
- black race
Diagnostic factors
- fever, malaise, headache
- tingling/ itching
- painful genital/ oral ulcers
- inguinal lymphadenopathy
- dysuria
- meningitis/ encephalitis
Managment:
- antiviral therapy
- topical antivirals- if used at early stage
- reduce contact when lesions are present.
STI’s Gonorrhoea
- almost exclusively sexually transmitted
- can be found in genital tract, pharynx, conjunctiva and rectum
Diagnostic factors of:
- mostly asymptomatic in women (50%)
- urethral/ vaginal discharge
- urethral/ vaginal irritation
- dysuria
- epididmitis/ prostitis
- pelvic pain
- anal pruritus (itch around anus)
- positive culture/ microscopy
Risk factors:
- age 15-24
- black
- male-male sex
- hx of STD
- unprotected sex
- Hx of sexual or physical abuse
- substance use
Managment:
- Antibiotics
- sex partners from previous 60 days are evaluated and treated if needed
Complications (more serious in females)
- Epidiymo-orchitis, prostitis
- proctitis (inflammation of the anus and lining of rectum)
- PID & infertility (fmales)
- opthalmia neonatorum
STI’s - Anogenital warts -HPV
Genotypes: HPV-6, HPV-11, HPV-16, HPV-18
(Human papilloma virus)
- last 2 have strong assosiations with genital carcinomas
-skin to skin transmission
-lesion size ranges from few mm to several cm
-exophytic and single/ multiple and papular/flat
-the number and size increase during the pregnancy
Lesions typically appear within weeks to months after exposure
-rarely can be transmitted to mouth during oral sex
Diagnostic Factors:
- young age
- asymptomatic (except for warts)
- exophytic papilloma
- condyloma acuminata
- pruritus (itch)
- pain (anus)
Risk factors:
- start sex at an early age
- multiple sexual partners
- unprotected sex
- immunocompromised status
- not being vaccinated
Preventions:
Vaccines: Cervarix, Gardasil
Mal circumcision may protect against HPV infection
Management:
- no cure
- resolves spontaneously
- removal of visible warts (laser, cryo, creams or lotions)
Complications: Cervical, oral and anal cancer
BPH (benign prostatic hyperplasia)
-bening increase in the prostate
-what is it risk factors diagnostic factors tests management
BPH involves hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the transition zone of the prostate.[1] When sufficiently large, the nodules impinge on the urethra and increase resistance to flow of urine from the bladder.
Risk factors:
- age >50 stroong
weak: FHx, non asian race, smoking, male pattern baldness, metabolic syndrome
Diagnostic factors:
Common:
-storage symptoms (frequency, urgency, nocturia)
Voiding symptoms (weak, stream, hesitancy, emptying (retention), post void dribbling.
Uncommon: fever with dysuria
Tests:
-urinalysis- pyuria (urine containing pus)
-PSA- normal or slightly elevated
PSA = prostate specific antigen. 3 sources of damage- cancer, bacterial infection prostate infarction)
Diagnosis:
- clinical presentation
- PSA
- US
Management: -Mild to moderate symptoms -watchful waiting -medications Acute urinary retention -urgent catheterisation
Surgery:
Transurethral resection of prostate
-open prostatectomy
Prostatic carcinoma
-malignant changes common with age
Clinical features:
- asymotomatic
- symptoms of lower urinary tract obstruction
- symptoms of lower urinary tract obstruction
- Symptoms of metastatic spread (less common- back pain, weight loss or anaemia)
Invetigations:
- PSA/ DRE (digital rectal exam)
- US/ transrectal US
- Bx
Premenstrual Syndrome (PMS) what is it? physical symptoms psychological symptoms? sever form is called?
-symptoms appear during premenstrual phase and diminish or disappear when the period starts.
Physical symptoms:
-headache, fatigue, breast tenderness, abdominal distention and fluid retention.
Psychological symptoms:
-irritability, emotional lability or low mood and tension
The sever form of PMS is called PMDD
- premenstrual dysphoric disorder
- mood swings, irritability, depression and anxiety + Physical Px
Breast Cancer
Risk factors
- m.c cancer in australian women
- 1 in 8 women before 85
- early detection saves lives
Risk Factors:
- being female
- having a string history of breast cancer
- close relative diagnosed before age 50 (howevere majority of people diagnosed have no family history)
Inheriting a faulty gene
- mutation of BRCA 1 & 2 that increase risk
- having previously diagnosed with BC or ductal carcinoma in Situ
Other Risks that slightly increase:
- Starting menstruation at early age (before 12)
- starting menopause at late stage >55
- not having children or having first child after 30 yrs
- not breast feeding- more months spent BF, lower the risk
- taking HRT after menopause especially if taken for 5 yrs or longer
- drinking alcohol >2 a day
Breast cabcer ex findings
-lump, skin dimplining
-change in skin, colour, texture,
changes in how nipple looks, ie like pulling in of nipple
-clear or bloody fluid that leaks out of the nipple.
Endometriosis
What is it?
whos it most common in?
Results in what symptoms?
Endometriosis:
- presence of endomentrial glands and stroma outside the uterine cavity
- direct visualization confirmed by histological examination remains essential for diagnosis
Common in age 20-45
Symptoms:
Cyclical engorgement and inflammation results in:
-asymptomatic (infertile)
-pain (lower abdominal, pelvic pain, LBP)
-heavy or irregular bleeding
-dysmenorrhea
-dyspareunia
-intestinal adhesions or obstructions
-bloating, nausea and vomiting
-pain on micturution/ or urinary frequency
-pain during exercise
Endometriosis Risk factors
Risk factors
Managament
Risk factors:
- fx history of it
- short menstrual cycles (7d)
- heavy bleeding during menses
- delayed childbearing
- defects in the uterus or fallopian tubes
Management:
- Hormonal therapy
- progesterone, GnRH analogues,
PID (pelvic inflammatory disease)
What is it?
Whos the classic high risk patient?
Clinical Presnetation:
PID is an infectious and inflammatory disorder of the upper female genital tract, including the uterus, fallopian tube, and adjacent structures.
PID is initiated by infection that ascends from the vagina and cervix into the upper genital tract.
-Chlamydia is the predominant sexually transmitted organism ass with PID
Classic high-risk pt is a menstruating women younger than 25yrs who has multiple sex partners, doesnt use protection, and lives in an area with a high prevalence of STIs
Clinical presentation : Toxic symptoms: -fever, nausea, vomiting -severe pelvic pain -lower abdominal pain -abnormal vaginal discharge -unanticipated vaginal bleeding, often postcoital
Complications:
- infertility
- chronic pelvic pain
- ectopic pregnancy.
Cervical Cancer:
Risk factors
Clinical features
- Age >50
- HPV (human papillo virus) infection
- HIV
- early onset of sexual activity (<18)
- multiple sex partners
- smoking
- immunosupressed
Clinical features:
- Abnormal vaginal bleeding
- dysuria
- smelly vag
- Back pain, pelvic pain, cervical mass
- cervical bleeding
- bladder, renal or bowel obstruction
Look at the tables of vaginal discharge on slide
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